Internal , Personal And Situational Attributions Questionnaire Research Articles

Evaluation of social cognitive measures in an Asian schizophrenia sample

BackgroundConverging evidence has indicated that deficits in social cognition may manifest as poor functioning; therefore, social cognition has emerged as an important research area and treatment target. However, few studies have examined the psychometrics of multiple social cognition measures in an Asian population. This study aims to evaluate the psychometrics of measures indexing the four core social cognition domains. MethodsSchizophrenia outpatients (n = 116) and healthy controls (n = 73) completed a battery of nine social cognitive measures, twice, four weeks apart. Psychometric properties were examined via test-retest reliability, internal consistency, utility as a repeated measure, time administration, and tolerability. Logistic regression was performed to identify psychometrically sound tasks that best discriminated case-control status. PCA was conducted to explore social cognition dimensional structure. ResultsThe Bell Lysaker Emotion Recognition Task (BLERT), Penn Emotion Recognition Task (ER40), and The Awareness of Social Inference Test, branch III (TASIT-3) showed strongest psychometrics. The Ambiguous Intentions and Hostility Questionnaire, Hostility Bias subscale (AIHQ-HB) showed slightly weaker properties, requiring further evaluation. The Hinting task, Mini Profile of Nonverbal Sensitivity (MiniPONS), Relationships Across Domains (RAD), Internal Personal and Situational Attributions Questionnaire (IPSAQ), and Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) showed poorer psychometrics in our sample. PCA revealed a two-factor solution comprising social cognition skills and attributional style/bias. ConclusionHere, we examined the psychometric properties of a comprehensive social cognition battery based on the SCOPE study in an Asian schizophrenia population. Continued evaluation and standardization of social cognitive measures are needed to refine our understanding of this construct in schizophrenia.

F243. INFLUENCE OF METACOGNITION AND IRRATIONAL BELIEFS ON SOCIAL FUNCTIONING IN PSYCHOSIS OF RECENT ONSET

BackgroundSocial functioning is affected in early psychosis stages. This affection has multiple domains, such as vocational functioning or performance of independent living skills. These different domains are also linked; so elucidating differential or generalized determinants on specific areas and global outcomes is thus a critical step in case conceptualization and the development planning of effective early interventions. The aim of this study was to test the influence of specific domains of metacognition in different and global areas of social functioning.MethodsA cross-sectional study was performed based on baseline data from a main multicenter clinical trial. The sample was composed of 122 patients with psychosis of recent onset treated at one of the nine participating mental health centers from diverse regions of Spain. The order of assessment was a sociodemographic questionnaire, the Positive and Negative Syndrome Scale (PANSS), the Social Functioning Scale (SFS), the Hinting Task (Theory of Mind, ToM), the Beck Cognitive Insight Scale (BCIS), the Internal, Personal and Situational Attributions Questionnaire (IPSAQ), the Irrational Belief Test (TCI) and the Emotional Recognition Test Faces. Pearson correlations and multiple regression analysis were performed.ResultsIn the first models, results showed that social engagement/withdrawal was explained by Helplessness (9.2% of the variance). Interpersonal communication was explained by Emotional Irresponsibility, internal attribution of negative events, affective JTC and emotion recognition (17.5% of variance). Independence-competence was explained by Helplessness, Emotional Irresponsibility and ToM (16% of variance). Independence-performance was explained by Helplessness (8.2% of variance). Employment/occupation was explained Emotional Irresponsibility (12.4% of variance). Prosocial Activities was explained by Helplessness and Emotional Irresponsibility (14.4% of variance). Finally, the total score of the SFS was explained by Helplessness and self-reflectiveness (16% of variance). Subsequently, in a second analysis, negative symptoms emerged as a significant mediator for most domains of social functioning.DiscussionIn our results, two kind of irrational beliefs, one of the main axes of cognitive therapy, emerged as relevant for social functioning in psychosis of recent onset. However, classic social cognition and metacognition measures were less significant, only ToM and self-reflecteness influenced some aspects of social functioning. Further analysis of determinants of social functioning in psychosis should explore the role of irrational beliefs and consider them for treatment strategy, along social cognition and negative symptoms.

Monocausal attribution and its relationship with reasoning biases in schizophrenia

BackgroundAberrant attributional styles are counted to a set of circumscribed cognitive biases that are implicated in the pathogenesis of (paranoid) psychosis. However, evidence for a specific profile (e.g., an exaggerated self-serving bias, other-blaming bias) has become equivocal over the years. More recently, one-sided (monocausal) attributions have been reported in patients with psychosis. MethodsWe compared a large sample of patients with diagnosed schizophrenia (n=145) to nonclinical controls (n=30) on a revised version of the Internal, Personal and Situational Attributions Questionnaire (IPSAQ-R). In this task, participants have to assign probability estimates to each of three potential causes (i.e., myself, others, circumstances) for a specific (negative or positive) event. ResultsParticipants with schizophrenia displayed an abolished self-serving bias and showed a significant preference for one-sided/monocausal attributions, which was neither correlated with jumping to conclusions nor overconfidence in errors. School education correlated with less monocausal attributions. We did not find any congruence between attributional styles with core delusional ideas.Conclusions: Our study corroborates earlier investigations showing that monocausal attributions may play a role in the pathogenesis of psychosis; this bias unlikely represents an epiphenomenon of established biases. Unexpectedly, attributional styles (e.g., external-blaming) did not shape delusional contents. The true prevalence of monocausal attributions in psychosis is perhaps underestimated in the study, as groups were equated on school education, which was correlated with monocausal attributions.

An investigation of attributional style, theory of mind and executive functioning in acute paranoia and remission

This study assessed associations between attributional style and ToM measures in patients with paranoid symptoms and non-clinical controls, as well associations between these aspects of social cognition and executive skills. Using a longitudinal design, we further assessed performance on measures following the remission of paranoid symptoms. Patients and controls completed the Internal Personal and Situational Attributions Questionnaire (IPSAQ), ToM tasks, the Stroop, the modified Wisconsin Card Sorting Test (WCST) and a measure of premorbid IQ at time one. Following the remission of paranoid symptoms, the patient group repeated the assessment process. Patients had a higher personalising bias for negative events and impairments in second order false belief and executive skills compared to control participants. Personalising bias for negative events was associated with poorer IQ, a tendency to make perseverative errors, a poorer performance on the second order false belief task and more severe symptoms. Personalising bias for negative events, performance on the second order false belief task or the tendency to make perseverative errors did not significantly change following symptom remission. The findings increase understanding of the mechanisms that potentially underpin the development and maintenance of paranoia. Specifically targeting personalising attributions for negative events in remitted patients may be an important goal of psychological therapy.

Why do bad things happen to me? Attributional style, depressed mood, and persecutory delusions in patients with schizophrenia.

Theoretical models postulate an important role of attributional style (AS) in the formation and maintenance of persecutory delusions and other positive symptoms of schizophrenia. However, current research has gathered conflicting findings. In a cross-sectional design, patients with persistent positive symptoms of schizophrenia (n = 258) and healthy controls (n = 51) completed a revised version of the Internal, Personal and Situational Attributions Questionnaire (IPSAQ-R) and assessments of psychopathology. In comparison to controls, neither patients with schizophrenia in general nor patients with persecutory delusions (n = 142) in particular presented an externalizing and personalizing AS. Rather, both groups showed a "self-blaming" AS and attributed negative events more toward themselves. Persecutory delusions were independently predicted by a personalizing bias for negative events (beta = 0.197, P = .001) and by depression (beta = 0.152, P = .013), but only 5% of the variance in persecutory delusions could be explained. Cluster analysis of IPSAQ-R scores identified a "personalizing" (n = 70) and a "self-blaming" subgroup (n = 188), with the former showing slightly more pronounced persecutory delusions (P = .021). Results indicate that patients with schizophrenia and patients with persecutory delusions both mostly blamed themselves for negative events. Nevertheless, still a subgroup of patients could be identified who presented a more pronounced personalizing bias and more severe persecutory delusions. Thus, AS in patients with schizophrenia might be less stable but more determined by individual and situational characteristics that need further elucidation.

Symptom-specific self-referential cognitive processes in bipolar disorder: a longitudinal analysis

Although depression and mania are often assumed to be polar opposites, studies have shown that, in patients with bipolar disorder, they are weakly positively correlated and vary somewhat independently over time. Thus, when investigating relationships between specific psychological processes and specific symptoms (mania and depression), co-morbidity between the symptoms and changes over time must be taken into account. Method A total of 253 bipolar disorder patients were assessed every 24 weeks for 18 months using the Hamilton Rating Scale for Depression (HAMD), the Bech-Rafaelsen Mania Assessment Scale (MAS), the Rosenberg Self-Esteem Questionnaire (RSEQ), the Dysfunctional Attitudes Scale (DAS), the Internal, Personal and Situational Attributions Questionnaire (IPSAQ) and the Personal Qualities Questionnaire (PQQ). We calculated multilevel models using the xtreg module of Stata 9.1, with psychological and clinical measures nested within each participant. Mania and depression were weakly, yet significantly, associated; each was related to distinct psychological processes. Cross-sectionally, self-esteem showed the most robust associations with depression and mania: depression was associated with low positive and high negative self-esteem, and mania with high positive self-esteem. Depression was significantly associated with most of the other self-referential measures, whereas mania was weakly associated only with the externalizing bias of the IPSAQ and the achievement scale of the DAS. Prospectively, low self-esteem predicted future depression. The associations between different self-referential thinking processes and different phases of bipolar disorder, and the presence of the negative self-concept in both depression and mania, have implications for therapeutic management, and also for future directions of research.

Validation of Social Cognition Rating Tools in Indian Setting (SOCRATIS): A new test-battery to assess social cognition

Social cognition is a cognitive domain that is under substantial cultural influence. There are no culturally appropriate standardized tools in India to comprehensively test social cognition. This study describes validation of tools for three social cognition constructs: theory of mind, social perception and attributional bias. Theory of mind tests included adaptations of, (a) two first order tasks [Sally–Anne and Smarties task], (b) two second order tasks [Ice cream van and Missing cookies story], (c) two metaphor-irony tasks and (d) the faux pas recognition test. Internal, Personal, and Situational Attributions Questionnaire (IPSAQ) and Social Cue Recognition Test were adapted to assess attributional bias and social perception, respectively. These tests were first modified to suit the Indian cultural context without changing the constructs to be tested. A panel of experts then rated the tests on likert scales as to (1) whether the modified tasks tested the same construct as in the original and (2) whether they were culturally appropriate. The modified tests were then administered to groups of actively symptomatic and remitted schizophrenia patients as well as healthy comparison subjects. All tests of the Social Cognition Rating Tools in Indian Setting had good content validity and known groups validity. In addition, the social cure recognition test in Indian setting had good internal consistency and concurrent validity.

Psychotic-like cognitive biases in borderline personality disorder

Whereas a large body of research has linked borderline personality disorder (BPD) with affective rather than psychotic disorders, BPD patients frequently display psychotic and psychosis-prone symptoms, respectively. The present study investigated whether cognitive biases implicated in the pathogenesis of psychotic symptoms, especially delusions, are also evident in BPD. A total of 20 patients diagnosed with BPD and 20 healthy controls were administered tasks measuring neuropsychological deficits (psychomotor speed, executive functioning) and cognitive biases (e.g., one-sided reasoning, jumping to conclusions, problems with intentionalizing). Whereas BPD patients performed similar to controls on standard neuropsychological tests, they showed markedly increased scores on four out of five subscales of the Cognitive Biases Questionnaire for Psychosis (CBQp) and displayed a one-sided attributional style on the revised Internal, Personal and Situational Attributions Questionnaire (IPSAQ-R) with a marked tendency to attribute events to themselves. The study awaits replication with larger samples, but we tentatively suggest that the investigation of psychosis-related cognitive biases may prove useful for the understanding and treatment of BPD.

Attributional biases in paranoid schizophrenia: Further evidence for a decreased sense of self‐causation in paranoia

Attributional biases are assumed to be part of the pathogenesis of persecutory delusions. The aim of the present study was to explore whether such biases are confined to current paranoid delusions or related to other positive symptoms as well. Another goal was to investigate whether current paranoid schizophrenia patients only show an exaggerated personalizing bias for negative events (i.e. personalizing blame) or also tend to externalize responsibility for positive events (i.e. decreased sense of self‐causation). The Internal, Personal and Situational Attributions Questionnaire (IPSAQ) was administered to 29 schizophrenia patients (10 with current paranoia), 26 psychiatric patients (OCD) and 33 healthy controls. Acutely paranoid patients made fewer internal attributions for positive and negative events, thus replicating a previously reported decreased sense of self‐causation. This kind of attributional style was related to acute positive symptomatology, but not to persecutory beliefs in particular. No evidence was found for a relationship between personalizing blame and the severity of current persecutory beliefs. An analysis of the narrative causal statements of the IPSAQ revealed that paranoid patients more often made external‐situational attributions particularly for positive events. Both psychiatric groups gave significantly more mono‐causal explanations for events than healthy controls.

Attribution style as a factor in psychosis and symptom resolution

IntroductionAttribution (AT) style theory provides a framework for understanding the causal explanations that individuals give for their own behaviour and the behaviour of others. It has been suggested that patients with persecutory delusions excessively attribute hypothetical positive events to internal causes (self) and hypothetical negative events to external personal causes. Despite this, how AT associates with psychotic symptoms (not only persecutory delusions) and how it changes with the resolution of psychosis has never been investigated. We conducted a cross-sectional study to investigate how AT is associated with psychopathology and a longitudinal study to examine the change of AT during the first 6 weeks of antipsychotic treatment and the relationship with psychopathology improvement. Methods86 patients meeting DSM-IV criteria for schizophrenia and related psychotic disorders were included in the cross-sectional study, and 17 patients in the longitudinal study. The longitudinal group were free of antipsychotic drugs at baseline and followed for 6 weeks after being started on antipsychotic medication by their psychiatrist. We used the Internal, Personal and Situational Attributions Questionnaire (IPSAQ) as a measure of AT. ResultsPatients that tend to internalize (i.e. less self-serving bias), showed greater overall psychopathology, as measured by PANSS-Total (F(2,83)=6.59, p=0.002), with a trend toward significance for PANSS-Positive (F(2,83)=2.62 p=0.07). Longitudinally, having a low self-serving bias was associated with poorer response to antipsychotic treatment. Further, externalizing bias seems to change early on in treatment (F=9.65 df=1,15 p=0.007) and reach ceiling effects thereafter. ConclusionsAT is related to overall symptom severity, with internalizing style linked to higher global psychopathology. Antipsychotic treatment has little effect on AT, at least within 6 weeks of antipsychotic exposure, and only a modest effect is on EB which plateaus within 2 weeks. Finally, internalizing style appears associated with poorer response to antipsychotic treatment.

Personalizing and externalizing biases in deluded and depressed patients: Are attributional biases a stable and specific characteristic of delusions?

The purpose of this study was to explore whether explicit and implicit attributional styles of delusional patients were associated to their clinical state, and whether attributions biases are specific to delusional psychopathology or also appear in other disorders (i.e. depression). A cross-sectional design was used. The sample consisted of 136 participants (40 acute deluded participants, 25 remitted deluded participants, 35 depressed patients and 36 normal controls). The Internal, Personal and Situational Attributions Questionnaire (IPSAQ) and the Pragmatic Inferential Test (PIT) were used to assess explicit and implicit attributional style, respectively. All participants, with the exception of the depressed patients group, showed an externalizing bias (EB) for negative events. Although both acute and remitted deluded patients showed a similar overall pattern of explicit attributions, the personalizing bias (PB) was significantly greater in the acute group. The magnitude of this bias, which was also found in the depressed patients, was significantly related to the patient's degree of severity, as assessed by the total BPRS score (r=.45, p<.001). The results on the implicit attributions were more equivocal, perhaps due the low reliability of the PIT. Attributional biases seem to be a stable characteristic of delusions. Yet, the PB might be a rather unspecific characteristic that varies with the degree of the severity of psychopathology. The implications of these findings for understanding the role of attributional biases in depression and delusion formation are discussed.

Theory‐of‐mind deficits and causal attributions

The ability to understand and conceptualize the mental processes of other people is considered to play a vital role in social interactions. Deficits in this area, sometimes known as theory‐of‐mind (ToM) deficits, have been identified as playing a possible causal role in autism, Asperger's syndrome and schizophrenic disorders, particularly paranoia. Paranoia has also been associated with an abnormal attributional style, an observation that suggests that ToM and attributional processes may be related phenomena. This paper describes a study examining the relationship between attributional processes and ToM deficits. Seventy‐seven undergraduate participants completed a ToM task and forty‐six also completed the Internal, Personal and Situational Attributions Questionnaire (IPSAQ). ToM deficits were associated with an increased tendency to identify other individuals as responsible for negative social situations. The implications of the observed relationship between attributions and ToM deficits are discussed.

A new measure of causal locus: the internal, personal and situational attributions questionnaire

Abstract Attributional style is commonly assessed using Peterson, Semmel, Von Baeyer, Abramson, Metalsky and Seligman's ( Cognitive Therapy and Research , 1982) Attributional Style Questionnaire (ASQ). The ASQ has been criticized for its low internal reliability, particularly with regard to the internality subscales. However, recent research has indicated that judgements of causal locus may be implicated in severe psychiatric disorders, particularly paranoia, and has pointed to the potential utility of taxonomies of causal locus not included in the ASQ. This report describes the development of a new method of assessing causal locus, the Internal, Personal and Situational Attributions Questionnaire (IPSAQ). For positive and negative events two measures of internality are derived from responses on the questionnaire, a measure of self-blame and a measure of the extent to which external attributions implicate other persons as opposed to situations. In a group of normal subjects the IPSAQ subscales were found to be adequately reliable. Self-blame was significantly associated with ASQ internality scores and with depressed mood. Scores representing the proportion of personal as opposed to situational external attributions were significantly associated with an analogue measure of paranoia.