Abstract

This study compared delusional dimensions and attribution biases along the continuum of psychosis. Participants completed questionnaires on delusion-like beliefs and attributions. Although patients with first-episode psychosis (N = 70) endorsed fewer delusion-like beliefs than non-clinical individuals with psychotic-like experiences (N = 12), they scored highest on delusional conviction, distress and preoccupation, followed by non-clinical individuals with psychotic-like experiences, and then healthy controls (N = 642). Self-serving bias was found in patients and non-clinical individuals with psychotic-like experiences, but not in healthy controls. Personalizing bias for negative events was not significantly different across the three groups. When compared with healthy controls, non-clinical individuals with psychotic-like experiences had an exaggerated self-serving bias, but were not more marked in personalizing bias. Self-serving bias and personalizing bias were both associated with delusional dimensions. However, the association between self-serving bias and number of delusion-like beliefs was stronger among patients than non-clinical participants. Future research could investigate the extent to which self-serving bias, in combination with an appraisal of delusional ideation as convincing, distress, and preoccupying, contributes to the development of clinical delusions.

Highlights

  • The view of psychosis as a continuum has been supported by two main lines of research—that psychotic symptoms are reported across clinical and non-clinical populations, and that psychosocial factors that predict the development of psychotic symptoms in patients exert similar impacts in non-clinical individuals [1–8]

  • Chinese outpatients with a case note diagnosis of schizophrenia spectrum disorder according to the Diagnostic and Statistical Manual of Mental Disorders [22] were recruited from a service for first episode psychosis (FEP) in Hong Kong

  • This study compared delusional dimensions and attributional biases between clinical patients with first-episode psychosis and non-clinical individuals, who were subdivided according to a self-report screening tool

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Summary

Introduction

Studies assessing delusions multi-dimensionally found that dimensions/ aspects of delusional experience, especially distress and preoccupation, are more important than number of delusions in distinguishing patients from community samples [9–11]. These studies did not distinguish, within their community samples, those who met the criteria for psychosis from those who did not have psychotic experiences. We would expect that clinical patients with psychosis will score higher on delusional dimensions (conviction, distress and preoccupation) than individuals in the community who may have a high risk of psychosis, but are not seeking treatment

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