Commentary : Does Cognitive Behavior Therapy for psychosis (CBTp) show a sustainable effect on delusions? A meta-analysis

Peer reviewedFinal Published versio

Are women better than men at multi-tasking?

Background: There seems to be a common belief that women are better in multi-tasking than men, but there is practically no scientific research on this topic. Here, we tested whether women have better multi-tasking skills than men.<p></p> Methods: In Experiment 1, we compared performance of 120 women and 120 men in a computer-based task-switching paradigm. In Experiment 2, we compared a different group of 47 women and 47 men on "paper-and-pencil" multi-tasking tests.<p></p> Results: In Experiment 1, both men and women performed more slowly when two tasks were rapidly interleaved than when the two tasks were performed separately. Importantly, this slow down was significantly larger in the male participants (Cohen’s d = 0.27). In an everyday multi-tasking scenario (Experiment 2), men and women did not differ significantly at solving simple arithmetic problems, searching for restaurants on a map, or answering general knowledge questions on the phone, but women were significantly better at devising strategies for locating a lost key (Cohen’s d = 0.49).<p></p> Conclusions: Women outperform men in these multi-tasking paradigms, but the near lack of empirical studies on gender differences in multitasking should caution against making strong generalisations. Instead, we hope that other researchers will aim to replicate and elaborate on our findings.<p></p&gt

Cognitive Behavioural Therapy for schizophrenia - outcomes for functioning, distress and quality of life : A meta-analysis

Background: The effect of cognitive behavioural therapy for psychosis (CBTp) on the core symptoms of schizophrenia has proven contentious, with current meta-analyses finding at most only small effects. However, it has been suggested that the effects of CBTp in areas other than psychotic symptoms are at least as important and potentially benefit from the intervention. Method: We meta-analysed RCTs investigating the effectiveness of CBTp for functioning, distress and quality of life in individuals diagnosed with schizophrenia and related disorders. Data from 36 randomised controlled trials (RCTs) met our inclusion criteria- 27 assessing functioning (1579 participants); 8 for distress (465 participants); and 10 for quality of life (592 participants). Results: The pooled effect size for functioning was small but significant for the end-of-trial (0.25: 95% CI: 0.14 to 0.33); however, this became non-significant at follow-up (0.10 [95%CI -0.07 to 0.26]). Although a small benefit of CBT was evident for reducing distress (0.37: 95%CI 0.05 to 0.69), this became nonsignificant when adjusted for possible publication bias (0.18: 95%CI -0.12 to 0.48). Finally, CBTp showed no benefit for improving quality of life (0.04: 95% CI: -0.12 to 0.19). Conclusions: CBTp has a small therapeutic effect on functioning at end-of-trial, although this benefit is not evident at follow-up. Although CBTp produced a small benefit on distress, this was subject to possible publication bias and became nonsignificant when adjusted. We found no evidence that CBTp increases quality of life post-intervention.Peer reviewedFinal Published versio

Cognitive dysfunction in body dysmorphic disorder: new implications for nosological systems and neurobiological models.

UNLABELLED: Introduction Body dysmorphic disorder (BDD) is a debilitating disorder, characterized by obsessions and compulsions relating specifically to perceived appearance, and which has been newly classified within the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Obsessive-Compulsive and Related Disorders grouping. Until now, little research has been conducted into the cognitive profile of this disorder. METHODS: Participants with BDD (n=12) and participants without BDD (n=16) were tested using a computerized neurocognitive battery investigating attentional set-shifting (Intra/Extra Dimensional Set Shift Task), decision-making (Cambridge Gamble Task), motor response-inhibition (Stop-Signal Reaction Time Task), and affective processing (Affective Go-No Go Task). The groups were matched for age, IQ, and education. RESULTS: In comparison to controls, patients with BDD showed significantly impaired attentional set-shifting, abnormal decision-making, impaired response inhibition, and greater omission and commission errors on the emotional processing task. CONCLUSION: Despite the modest sample size, our results showed that individuals with BDD performed poorly compared to healthy controls on tests of cognitive flexibility, reward and motor impulsivity, and affective processing. Results from separate studies in OCD patients suggest similar cognitive dysfunction. Therefore, these findings are consistent with the reclassification of BDD alongside OCD. These data also hint at additional areas of decision-making abnormalities that might contribute specifically to the psychopathology of BDD.Academy of Medical SciencesThis is the author accepted manuscript. The final version is available from Cambridge University Press via https://doi.org/10.1017/S109285291600046

Cognitive behavioural therapy for anxiety in children and young people on the autism spectrum: a systematic review and meta-analysis

This article is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.Abstract: Background: Anxiety is common in youth on the autism spectrum and cognitive behavioural therapy (CBT) has been adapted to address associated symptoms. The aim of the current systematic review and meta-analysis was to examine the efficacy of CBT for reducing anxiety in autistic youth. Method: Searches of PubMed and Scopus databases were undertaken from January 1990 until December 2020. Studies were included if they consisted of randomised controlled trials (RCTs) using CBT to reduce anxiety in autistic youth. Separate random effects meta-analyses assessed anxiety ratings according to informant (clinician; parent; child), both at end-of-trial and at follow-up. Results: A total of 19 RCTs met our inclusion criteria (833 participants: CBT N = 487; controls N = 346). Random effects meta-analyses revealed a large effect size for clinician rated symptoms (g = 0.88, 95% CI 0.55, 1.12, k = 11), while those for both parent (g = 0.40, 95% CI 0.24, 0.56; k = 18) and child-reported anxiety (g = 0.25, 95% CI 0.06, 0.43; k = 13) were smaller, but significant. These benefits were not however maintained at follow-up. Moderator analyses showed that CBT was more efficacious for younger children (for clinician and parent ratings) and when delivered as individual therapy (for clinician ratings). Using the Cochrane Risk of Bias 2 tool, we found concerns about reporting bias across most trials. Conclusions: The efficacy of CBT for anxiety in autistic youth was supported in the immediate intervention period. However, substantial inconsistency emerged in the magnitude of benefit depending upon who was rating symptoms (clinician, parent or child). Follow-up analyses failed to reveal sustained benefits, though few studies have included this data. It will be important for future trials to address robustness of treatment gains overtime and to further explore inconsistency in efficacy by informant. We also recommend pre-registration of methods by trialists to address concerns with reporting bias.Peer reviewe

Individual obsessive-compulsive traits are associated with poorer adjustment to the easing of COVID-19 restrictions.

BACKGROUND: As COVID-19 restrictions ease, the public are expected to relinquish previously enforced safety behaviors and resume a more normal lifestyle. Despite these aims, our recent survey of 438 adults from the general population, during a temporary release of lockdown in the United Kingdom (July-November 2020), showed that 25% of the public find re-adjustment problematic. This was especially the case in those with a history of mental disorder and obsessive-compulsive (OC) traits and symptoms, including rigidity as measured by a neurocognitive test of attentional flexibility. To aid in identifying those most at risk, we performed a secondary analysis on the data to determine which specific OC traits were related to specific aspects of behavioral adjustment. METHODS: Correlational and multiple regression analyses were performed to determine associations between the eight individual personality traits constituting DSM-5 Obsessive-Compulsive Personality Disorder (OCPD), as measured by the self-rated Compulsive Personality Assessment Scale (CPAS) and a range of self-rated Post-Pandemic Adjustment Questionnaire items. RESULTS: Three items on the Post-Pandemic Adjustment Questionnaire correlated with individual CPAS items: 'General difficulties adjusting' correlated with perfectionism, preoccupation with details, over-conscientiousness and need for control; 'social avoidance' correlated with perfectionism and preoccupation with details; and 'disinfecting behaviors' correlated with preoccupation with details and miserliness (Pearson's r - all p < .001). Intriguingly, none of the adjustment items correlated significantly with self-rated rigidity. CONCLUSIONS: Several OCPD traits predict post-pandemic adjustment difficulties, but perfectionism and preoccupation-with-details showed the most robust correlations. These traits constitute a platform for the development of new screening and interventional strategies aimed at restoring public mental health and wellbeing. Cognitive rigidity may be more reliably evaluated using an objective form of assessment

Childhood trauma and schizotypy in non-clinical samples: A systematic review and meta-analysis

© 2022 Toutountzidis et al. This is an open access article distributed under the Creative Commons Attribution License, to view a copy of the license, see: https://creativecommons.org/licenses/by/4.0/The association of early life adversities and psychosis symptoms is well documented in clinical populations; however, whether this relationship also extends into subclinical psychosis remains unclear. In particular, are early life adversities associated with increased levels of schizotypal personality traits in non-clinical samples? We conducted a systematic review and meta-analysis of associations between early life adversities and psychometrically defined schizotypal traits in non-clinical samples. The review followed PRISMA guidelines. The search using PubMed, Web of Science and EBSCO databases identified 1,609 articles in total. Twenty-five studies (N = 15,253 participants) met eligibility criteria for the review. An assessment of study quality showed that fewer than half of all studies were rated as methodologically robust. Meta-analyses showed that all forms of childhood abuse (emotional, physical and sexual) and neglect (emotional and physical) were significantly associated with psychometric schizotypy. The association of schizotypy traits with childhood emotional abuse (r = .33: 95%CI .30 to .37) was significantly larger than for all other form of abuse or neglect. Meta-regression analyses showed that the physical abuse-schizotypy relationship was stronger in samples with more women participants; and the sexual abuse-schizotypy relationship was stronger in younger samples. The current review identifies a dose-response relationship between all forms of abuse/neglect and schizotypy scores in non-clinical samples; however, a stronger association emerged for emotional abuse. More research is required to address the relationship of trauma types and specific symptom types. Future research should also address the under-representation of men.Peer reviewe

The use of social robots with children and young people on the autism spectrum: A systematic review and meta-analysis

© 2022 Kouroupa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, https://creativecommons.org/licenses/by/4.0/Background: Robot-mediated interventions show promise in supporting the development of children on the autism spectrum. Objectives: In this systematic review and meta-analysis, we summarize key features of available evidence on robot-interventions for children and young people on the autism spectrum aged up to 18 years old, as well as consider their efficacy for specific domains of learning. Data sources: PubMed, Scopus, EBSCOhost, Google Scholar, Cochrane Library, ACM Digital Library, and IEEE Xplore. Grey literature was also searched using PsycExtra, OpenGrey, British Library EThOS, and the British Library Catalogue. Databases were searched from inception until April (6th) 2021. Synthesis methods: Searches undertaken across seven databases yielded 2145 articles. Forty studies met our review inclusion criteria of which 17 were randomized control trials. The methodological quality of studies was conducted with the Quality Assessment Tool for Quantitative Studies. A narrative synthesis summarised the findings. A meta-analysis was conducted with 12 RCTs. Results: Most interventions used humanoid (67%) robotic platforms, were predominantly based in clinics (37%) followed home, schools and laboratory (17% respectively) environments and targeted at improving social and communication skills (77%). Focusing on the most common outcomes, a random effects meta-analysis of RCTs showed that robot-mediated interventions significantly improved social functioning (g = 0.35 [95%CI 0.09 to 0.61; k = 7). By contrast, robots did not improve emotional (g = 0.63 [95%CI -1.43 to 2.69]; k = 2) or motor outcomes (g = -0.10 [95%CI -1.08 to 0.89]; k = 3), but the numbers of trials were very small. Meta-regression revealed that age accounted for almost one-third of the variance in effect sizes, with greater benefits being found in younger children. Conclusions: Overall, our findings support the use of robot-mediated interventions for autistic children and youth, and we propose several recommendations for future research to aid learning and enhance implementation in everyday settings. PROSPERO registration: Our methods were preregistered in the PROSPERO database (CRD42019148981).Peer reviewe

Development of the Paranormal and Supernatural Beliefs Scale using classical and modern test theory

Background: This study describes the construction and validation of a new scale for measuring belief in paranormal phenomena. The work aims to address psychometric and conceptual shortcomings associated with existing measures of paranormal belief. The study also compares the use of classic test theory and modern test theory as methods for scale development. Method: We combined novel items and amended items taken from existing scales, to produce an initial corpus of 29 items. Two hundred and thirty-one adult participants rated their level of agreement with each item using a seven-point Likert scale. Results: Classical test theory methods (including exploratory factor analysis and principal components analysis) reduced the scale to 14 items and one overarching factor: Supernatural Beliefs. The factor demonstrated high internal reliability, with an excellent test–retest reliability for the total scale. Modern test theory methods (Rasch analysis using a rating scale model) reduced the scale to 13 items with a four-point response format. The Rasch scale was found to be most effective at differentiating between individuals with moderate-high levels of paranormal beliefs, and differential item functioning analysis indicated that the Rasch scale represents a valid measure of belief in paranormal phenomena. Conclusions: The scale developed using modern test theory is identified as the final scale as this model allowed for in-depth analyses and refinement of the scale that was not possible using classical test theory. Results support the psychometric reliability of this new scale for assessing belief in paranormal phenomena, particularly when differentiating between individuals with higher levels of belief.Peer reviewe

Meta-analysis of cognitive behaviour therapy and selective serotonin reuptake inhibitors for the treatment of hypochondriasis: Implications for trial design

Classification of hypochondriasis as an obsessive-compulsive and related disorder in the International Classification of Diseases 11th Revision (ICD-11) has generated new heuristics for treatment of this common, chronic and disabling disorder. Standard treatment involves cognitive behaviour therapy (CBT) or selective serotonin reuptake inhibitors (SSRIs), but no meta-analysis has so far considered hypochondriasis as a structured diagnosis or assessed the role of medication. A clearer understanding of the relative effectiveness of these interventions and identification of clinically relevant factors moderating the treatment response is needed for clinical guideline development