Corrigendum: Thinking preferences and conspiracy belief: intuitive thinking and the jumping to conclusions-bias as a basis for the belief in conspiracy theories.

[This corrects the article DOI: 10.3389/fpsyt.2020.568942.].

Teaching Cognitive Behavior Therapy to Postgraduate Health Care Professionals in Times of COVID 19 - An Asynchronous Blended Learning Environment Proved to Be Non-inferior to In-Person Training.

Training of postgraduate health professionals on their way to becoming licensed therapists for Cognitive Behavior Therapy (CBT) came to a halt in Germany in March 2020 when social distancing regulations came into effect. Since the German healthcare system almost exclusively relies on this profession when it comes to the implementation of CBT and 80% of those therapists active in 2010 will have retired at the end of 2030, it is critical to assess whether online CBT training is as satisfactory as classroom on-site CBT training. An asynchronous, blended, inverted-classroom online learning environment for CBT training (CBT for psychosis) was developed as an emergency solution. It consisted of pre-recorded CBT video lectures, exercises to train interventions in online role-plays, and regular web conferences. Training was provided at five different training institutes in Germany (duration 8-16 h). Postgraduate health care professionals (psychiatrists and psychologists) (n = 43) who received the online CBT training filled out standard self-report evaluations that assessed satisfaction and didactic quality. These evaluations were compared to those evaluations of students (n = 142) who had received in-person CBT training with identical content offered by the same CBT trainer at the same training institutes before the COVID-19 crisis. Both groups were comparable with respect to interest in the subject and prior knowledge. We tested non-inferiority hypotheses using Wilcoxon-Mann-Whitney ROC-curve analyses with an equivalence margin corresponding to a small-to-medium effect size (d = 0.35). The online training evaluations were non-inferior concerning information content, conception of content, didactic presentation, assessment of the trainer as a suitable role-model, working atmosphere, own commitment, and practical relevance. In contrast, we could not exclude a small effect in favor of in-person training in professional benefit and room for active participation. Our results suggest that delivering substantial CBT knowledge online to postgraduate health-professionals is sufficient, and at most incurs minimal loss to the learning experience. These encouraging findings indicate that integrating online elements in CBT teaching is an acceptable option even beyond social distancing requirements.

Corrigendum: Thinking Preferences and Conspiracy Belief: Intuitive Thinking and the Jumping to Conclusions-Bias as a Basis for the Belief in Conspiracy Theories.

[This corrects the article DOI: 10.3389/fpsyt.2020.568942.].

Problems in measuring the JTC-bias in patients with psychotic disorders with the fish task: a secondary analysis of a baseline assessment of a randomized controlled trial.

BACKGROUND: The jumping to conclusions bias (JTC) is considered to be an important causal factor in theoretical models for the formation and maintenance of delusions. However, recent meta-analytic findings show a rather equivocal pattern of results regarding associations between JTC and delusions. Thus, the present study aims to investigate in a large sample whether the JTC-bias is more pronounced in patients with psychotic disorders in comparison to controls and whether the JTC bias is associated with a more severe delusional conviction, persecutory delusions, and positive symptoms in general. METHODS: Patients with psychotic disorders (n = 300) enrolled in a therapy trial and healthy controls (n = 51) conducted a variant of the beads task (fish task) as a measure for the JTC-bias at the start of the trial. Further, clinical interviews were used to assess patients' delusional severity and delusional conviction. RESULTS: There were no statistically significant differences between patients with psychotic disorders (with 53% displaying the JTC-bias) and controls (41%). Furthermore, there were no statistically significant correlations between JTC measures and persecutory delusions, delusional conviction, and positive symptoms. CONCLUSIONS: We found no differences in JTC between patients with psychotic disorders and healthy controls, which is in part in line with meta-analytic findings using a wide range of JTC task variants. Interestingly, patients with psychotic disorders displayed JTC rates commonly found in the literature, while healthy control subjects showed an unexpectedly high level of JTC. The task variant we used in the present study (fish task) is discussed as a potential reason for our results, as it may induce a more deliberative reasoning style in controls as compared to the traditional beads task. Furthermore, possible implications for the measurement of the JTC-bias, in general, are discussed. TRIAL REGISTRATION: ISRCTN29242879 ( isrctn.com ), date of registration: April 12th 2006, retrospectively registered.

Thinking Preferences and Conspiracy Belief: Intuitive Thinking and the Jumping to Conclusions-Bias as a Basis for the Belief in Conspiracy Theories.

BACKGROUND: The belief in conspiracy theories and paranoid ideation are often treated as almost synonymous. However, there is to date no research concerning shared underlying cognitive underpinnings of belief in conspiracy theories and paranoid ideation. One potential underlying factor could be the well-known jumping to conclusion (JTC) bias, the tendency of persons with delusions to perform hasty decisions that are sometimes based on little evidence. Furthermore, a preference for a more intuitive general thinking style, as opposed to an analytical thinking style, could be an additional underlying cognitive factor of both conspiracy theories and paranoia. Thus, the aim of the present study is to investigate in a large sample of non-clinical individuals whether the JTC-bias is more pronounced in individuals who display a stronger belief in conspiracy theories and whether both are related to a more intuitive thinking preference. METHODS: We assessed the data of 519 non-clinical individuals regarding their respective approval of 20 specific conspiracy theories in an online study. Further, we assessed the JTC-bias by using a computerized variant of the beads task (fish task). Thinking preferences were measured with the Rational-Experiential Interview. RESULTS: Subjects who displayed the JTC-bias presented a more pronounced belief in conspiracy theories. In addition, gathering little information in the fish task before performing a decision (less draws to decision) was related to a stronger endorsement of conspiracy theories and a more intuitive thinking style (and a less analytic thinking style). Finally, a preference for intuitive thinking predicted a stronger belief in conspiracy theories in a multiple regression analysis. CONCLUSIONS: Our results demonstrate the implication of a preference for an intuitive thinking style accompanied by a propensity to faster decision-making (JTC-bias) as possible cognitive underpinnings of beliefs in conspiracy theories. Furthermore, our study is the first to confirm the notion of the JTC-bias as a reflection of the use of an intuitive thinking style.

Theory of mind, emotion recognition, delusions and the quality of the therapeutic relationship in patients with psychosis - a secondary analysis of a randomized-controlled therapy trial.

BACKGROUND: Cognitive models of psychosis postulate an important role of Theory of mind (ToM) in the formation and maintenance of delusions, but research on this plausible conjecture has gathered conflicting findings. In addition, it is still an open question whether problems in emotion recognition (ER) are associated with delusions. We examined the association of problems in ToM and ER with different aspects of delusions in a large sample of patients with psychosis enrolled in a therapy trial. This also enabled us to explore the possible impact of ToM and ER on one part of patients' social life: the quality of their therapeutic relationship. METHODS: Patients with psychotic disorders and delusions and/or hallucinations (n = 185) and healthy controls (n = 48) completed a ToM picture sequencing task and an ER task. Subsequently, patients were enrolled in a randomized-controlled Cognitive Behavior Therapy (CBT) trial (ISRCTN29242879). Patients and therapists rated the quality of the therapeutic relationship during the first five sessions of therapy. RESULTS: In comparison to controls, patients were impaired in both ToM and ER. Patients with deficits in ER experienced more severe delusional distress, whereas ToM problems were not related to delusions. In addition, deficits in ER predicted a less favorable therapeutic relationship and interactional problems viewed by the therapist. Impaired ER also moderated (increased) the negative influence of delusions on the therapeutic relationship and interactional difficulties viewed by the therapist. CONCLUSIONS: Cognitive models on the formation and maintenance of delusions should consider ER as a potential candidate that might be related to the formation and maintenance of delusional distress, whereas problems in ToM might not be directly related to delusions and secondary dimensions of delusions. In addition, problems in ER in patients with psychosis might have an impact on the quality of the therapeutic relationship and patients with problems in ER are more likely to be viewed as problematic by their therapists. Nevertheless, training ER might be a way to improve the quality of the therapeutic relationship and potentially the effectiveness of CBT or other interventions for patients with psychosis.