Group-Based Worry Intervention for Persecutory Delusions: an Initial Feasibility Study.

BACKGROUND: A one-to-one cognitive behavioural therapy intervention targeting worry significantly reduces both worry and persecutory delusions (Freeman et al., 2015). AIM: To adapt this intervention for group delivery and conduct a feasibility trial within routine clinical practice. METHOD: Thirteen participants were randomized to a weekly 8-session worry intervention group (n = 7) or wait-list control (n = 6). RESULTS: All but one participant completed measures at all time points. Participants attended an average of six therapy sessions. CONCLUSIONS: Recruitment, retention and therapy uptake were feasible. Observed treatment effects were in the expected direction, but may be diluted compared with one-to-one interventions.

Jumping to perceptions and to conclusions: specificity to hallucinations and delusions.

BACKGROUND: There is evidence that people with psychosis display a "jump-to-conclusions" (JTC) reasoning style, and that this bias may be specific to delusions. A "jump-to-perceptions" (JTP) cognitive bias has also been found and is typically linked to hallucinations. However, there is some evidence for an association between JTP and delusions, and its specificity to hallucinations remains unclear. It has been suggested that these biases are related and products of shared cognitive processes. METHODS: This study examined the symptom specificity of JTC and JTP, and the relationship between them, in a sample of 98 individuals with delusions divided into 'hallucinators' (n=51) and 'non-hallucinators' (n=47). Biases were assessed using the beads task and visual and auditory perceptual tasks. RESULTS: As predicted, both groups demonstrated a JTC bias, but the 'hallucinators' showed a more pronounced JTP style in both modalities. The presence of JTC and JTP biases did not co-occur: making a decision on the beads task after two or fewer draws was not related to visual JTP, and was associated with a less marked JTP bias in the auditory perceptual task. No differences were found in JTP or JTC between participants with and without a schizophrenia diagnosis. JTP, but not JTC, was associated with the presence of hallucinations. CONCLUSIONS: These findings suggest that the JTC and JTP biases show specificity to delusions and hallucinations, respectively, and not to diagnosis. There was no evidence that they are the product of shared cognitive processes, further supporting their specificity.

Cognitive predictors of social functioning improvements following cognitive remediation for schizophrenia.

A greater understanding of the links between cognitive and social functioning changes is needed to refine cognitive treatments for schizophrenia. To date, studies have been cross-sectional, and few have investigated the impact of cognitive change. This single-blind randomized controlled trial explored the links between changes in executive/memory functions and social behavior, as well as the moderating effect of cognitive remediation therapy (CRT). A total of 85 participants with schizophrenia received 40 sessions of CRT (an individual psychological therapy aiming to improve attention, memory, and problem solving) or treatment-as-usual. At baseline, social functioning was significantly associated with "verbal working memory," "response inhibition," "verbal long-term memory," and "visuo-spatial long-term memory," but not "schema generation," factors. However, only improvement in "schema generation" predicted improved social functioning. This was true whether or not participants had received CRT. These results suggest that cross-sectional associations between cognitive functions and social functioning may not offer the best means for identifying good targets for intervention. Improvement in the ability to generate new schemas has a beneficial impact on social functioning.