title: Bias against disconfirmatory evidence in the 'at-risk mental state' and during psychosis.
abstract: Prior studies have confirmed a bias against disconfirmatory evidence (BADE) in schizophrenia which has been associated with delusions. However, its role in the pathogenesis of psychosis is yet unclear. The objective was to investigate BADE for the first time in subjects with an at-risk-mental-state for psychosis (ARMS), patients with a first episode of psychosis without antipsychotic treatment (FEP) and healthy controls (HC). A standard BADE test presenting written scenarios was employed. In addition, psychometric rating scales and a neuropsychological test battery were applied. A three-staged image was revealed. FEP-patients showed a significant BADE compared to the other groups. The performance of ARMS-patients lay in between HC and FEP-patients. A trend towards significance became evident for a bias against confirmatory evidence (BACE) in FEP-patients. Results were not attributable to antipsychotic or other medication or depressive symptoms. Correlations with delusions reached medium effect sizes but failed significance after Bonferroni-corrections. These results provide evidence for aberrations in evidence integration in the pathogenesis of psychosis and contribute to our knowledge of metacognitive functioning which can be used for (meta-)cognitive intervention in psychosis.
authors.affiliation: Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, J5, 68159 Mannheim, Germany. Electronic address: sarah.eisenacher@zi-mannheim.de.
authors.forename: Sarah
authors.initials: S
authors.lastname: Eisenacher
authors.affiliation: Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, J5, 68159 Mannheim, Germany.
authors.forename: Franziska
authors.initials: F
authors.lastname: Rausch
authors.affiliation: Department of Clinical Psychology, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, J5, 68159 Mannheim, Germany.
authors.forename: Daniela
authors.initials: D
authors.lastname: Mier
authors.affiliation: Department of Clinical Psychology, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, J5, 68159 Mannheim, Germany.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Fenske
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical center Hamburg-Eppendorf, 20246 Hamburg, Germany.
authors.forename: Ruth
authors.initials: R
authors.lastname: Veckenstedt
authors.affiliation: Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, J5, 68159 Mannheim, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Englisch
authors.affiliation: Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, J5, 68159 Mannheim, Germany.
authors.forename: Anna
authors.initials: A
authors.lastname: Becker
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical center Hamburg-Eppendorf, 20246 Hamburg, Germany.
authors.forename: Christina
authors.initials: C
authors.lastname: Andreou
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical center Hamburg-Eppendorf, 20246 Hamburg, Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Moritz
authors.affiliation: Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, J5, 68159 Mannheim, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Meyer-Lindenberg
authors.affiliation: Department of Clinical Psychology, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, J5, 68159 Mannheim, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Kirsch
authors.affiliation: Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, J5, 68159 Mannheim, Germany.
authors.forename: Mathias
authors.initials: M
authors.lastname: Zink
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D015982:Bias; D003072:Cognition Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D003863:Depression / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011594:Psychometrics; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D012307:Risk Factors; D012559:Schizophrenia / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents