Samson Crystal, Livet Audrey, Gilker Andy, Potvin Stephane, Sicard Veronik, Lecomte Tania
Département de Psychologie, Université de Montréal, Montréal, Québec, Canada.
Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal (CR-IUSMM), Montréal, Québec, Canada.
PLoS One. 2024 Dec 27;19(12):e0314965. doi: 10.1371/journal.pone.0314965. eCollection 2024.
Cognitive biases have been studied in relation to schizophrenia and psychosis for over 50 years. Yet, the quality of the evidence linking cognitive biases and psychosis is not entirely clear. This umbrella-review examines the quality of the evidence and summarizes the effect sizes of the reasoning and interpretation cognitive biases studied in relation to psychotic characteristics (psychotic disorders, psychotic symptoms, psychotic-like experiences or psychosis risk). It also examines the evidence and the effects of psychological interventions for psychosis on cognitive biases. A systematic review of the literature was performed using the PRISMA guidelines and the GRADE system for 128 analyses extracted from 16 meta-analyses. Moderate to high-quality evidence with medium to large effect sizes were found for the following interpretation biases: externalization of cognitive events and self-serving bias, when people with psychotic symptoms were compared to control conditions. Regarding reasoning biases, moderate to high quality evidence with medium to large effect sizes were found for belief inflexibility when linked to delusion conviction and global severity in people with active delusions, although measures from the MADS, overlapping with symptoms, may have inflated effect sizes. Moderate quality evidence with medium to large effect sizes were found for jumping to conclusion biases when clinical samples with psychosis were compared to controls, when using data-gathering tasks. Other cognitive biases are not supported by quality evidence (e.g., personalizing bias, belief about disconfirmatory evidence), and certain measures (i.e., IPSAQ and ASQ) systematically found no effect or small effects. Psychological interventions (e.g., MCT) showed small effect sizes on cognitive biases, with moderate-high-quality evidence. This umbrella review brings a critical regard on the reasoning and interpretation biases and psychotic symptoms literature-although most biases linked to psychotic symptoms are supported by meta-analyses in some way, some have only demonstrated support with a specific population group (e.g., aberrant salience and hostility attribution in healthy individuals with psychotic-like experiences), whereas other biases are currently insufficiently supported by quality evidence. Future quality studies, particularly with clinical populations with psychotic symptoms, are still warranted to ascertain the psychosis-cognitive bias link for specific biases.
认知偏差与精神分裂症和精神病的关系已被研究了50多年。然而，将认知偏差与精神病联系起来的证据质量并不完全清楚。本综述性研究考察了证据质量，并总结了与精神病特征（精神障碍、精神病症状、类精神病体验或精神病风险）相关的推理和解释性认知偏差的效应大小。它还考察了针对精神病的心理干预对认知偏差的证据和影响。使用PRISMA指南和GRADE系统对从16项荟萃分析中提取的128项分析进行了文献系统综述。当将有精神病症状的人与对照条件进行比较时，发现以下解释偏差存在中等至高质量的证据且效应大小为中等至大：认知事件的外化和自利偏差。关于推理偏差，当与有活跃妄想的人的妄想信念和总体严重程度相关时，发现信念僵化存在中等至高质量的证据且效应大小为中等至大，尽管MADS的测量与症状重叠，可能夸大了效应大小。当使用数据收集任务将患有精神病的临床样本与对照进行比较时，发现有中等至高质量的证据且效应大小为中等至大的急于下结论偏差。其他认知偏差没有得到高质量证据的支持（例如，个性化偏差、关于反证的信念），并且某些测量方法（即IPSAQ和ASQ）系统地未发现有影响或影响较小。心理干预（例如，MCT）对认知偏差的效应大小较小，证据质量为中等至高。本综述性研究对推理和解释偏差以及精神病症状文献进行了批判性审视——尽管大多数与精神病症状相关的偏差在某种程度上得到了荟萃分析的支持，但有些仅在特定人群组中得到了支持（例如，有类精神病体验的健康个体中的异常显著性和敌意归因），而其他偏差目前没有得到高质量证据的充分支持。未来仍需要进行高质量的研究，特别是针对有精神病症状的临床人群，以确定特定偏差的精神病-认知偏差联系。
