Liberal Acceptance Bias, Momentary Aberrant Salience, and Psychosis: An Experimental Experience Sampling Study

Ulrich Reininghaus*, Margaret Oorschot, Steffen Moritz, Charlotte Gayer-Anderson, Matthew J. Kempton, Lucia Valmaggia, Philip McGuire, Robin Murray, Philippa Garety, Til Wykes, Craig Morgan, Inez Myin-Germeys

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

11 Citations (Web of Science)

Abstract

Cognitive models of psychosis posit that reasoning biases are an important mechanism contributing to the formation of psychotic symptoms, in part through transforming anomalous experiences of aberrant salience into frank psychotic symptoms. This study aimed to investigate the interplay of liberal acceptance (LA) bias, which is a specific type of reasoning bias, and momentary aberrant salience in the development of paranoid and psychotic experiences in daily life in first-episode psychosis patients (FEP), at-risk mental state participants (ARMS), and controls. We used a novel experimental Experience Sampling Methodology (eESM) task for measuring LA bias (ie, decisions based on low probability estimates) and ESM measures of momentary aberrant salience and paranoid and psychotic experiences in 51 FEP, 46 ARMS, and 53 controls. We found evidence that LA bias was more likely to occur in FEP than in controls. Further, LA bias was associated with psychotic and paranoid experiences (all P <.007) and modified the association between momentary aberrant salience and psychotic experiences (chi(2)(df) = 7.4(2), P = .025) in A RMS, such that momentary salience was associated with more intense psychotic experiences in the presence of LA bias in ARMS, but not in FEP and controls. Our findings suggest that LA bias may be central for anomalous experiences such as momentary aberrant salience to increase intensity of psychotic experiences in at-risk individuals. Further, LA bias appears to be more likely to be present, but not directly linked to current intensity of psychotic experiences, in treated FEP. Novel eESM tasks open new avenues for targeting psychological processes under real-world conditions.

Original languageEnglish
Pages (from-to)871-882
Number of pages12
JournalSchizophrenia Bulletin
Volume45
Issue number4
DOIs
Publication statusPublished - Jul 2019

Keywords

  • reasoning bias
  • aberrant salience
  • experimental experience sampling methodology
  • prodrome
  • first-episode psychosis
  • DAILY-LIFE STRESS
  • POSITIVE SYMPTOMS
  • CONCLUSIONS BIAS
  • COGNITIVE MODEL
  • LINKING BIOLOGY
  • HIGH-RISK
  • SCHIZOPHRENIA
  • INDIVIDUALS
  • DELUSIONS
  • PREDICTION

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