Jumping To Conclusions Research Articles

Information gathered through draws-to-decision, social functioning, and personal recovery among patients with schizophrenia in Japan

ABSTRACT Introduction In schizophrenia, social functioning and personal recovery are pivotal outcomes potentially influenced by cognitive biases such as Jumping to Conclusions (JTC). Despite their significance, the relationship between JTC, social functioning, and personal recovery remains unclear. This study aims to investigate this relationship to inform tailored interventions for schizophrenia management. Methods Data were collected from 94 schizophrenia patients using standardised measures. The Beads Task assessed JTC, whereas the Brief PANSS, TMT-J, SLOF-J, and RAS-J evaluated psychiatric symptoms, neurocognitive functioning, social functioning, and personal recovery, respectively. Statistical analyses included correlation and hierarchical regression. Results Correlation analyses revealed a significant negative correlation between JTC and personal recovery (r = −0.27, p < 0.05). Hierarchical regression indicated JTC as a significant negative predictor of personal recovery (β = −0.33, p = 0.01). No significant correlation was found between JTC and social functioning. Discussion Increased JTC was associated with lower levels of personal recovery in schizophrenia patients, independent of demographic and clinical factors. In the case of individuals with schizophrenia who demonstrate JTC, there is a potential to suggest the paradox of insight or apparent personal recovery scores.

Associations of conservatism and jumping to conclusions biases with aberrant salience and default mode network.

While conservatism bias refers to the human need for more evidence for decision-making than rational thinking expects, the jumping to conclusions (JTC) bias refers to the need for less evidence among individuals with schizophrenia/delusion compared to healthy people. Although the hippocampus-midbrain-striatal aberrant salience system and the salience, default mode (DMN), and frontoparietal networks ("triple networks") are implicated in delusion/schizophrenia pathophysiology, the associations between conservatism/JTC and these systems/networks are unclear. Thirty-seven patients with schizophrenia and 33 healthy controls performed the beads task, with large and small numbers of bead draws to decision (DTD) indicating conservatism and JTC, respectively. We performed independent component analysis (ICA) of resting functional magnetic resonance imaging (fMRI) data. For systems/networks above, we investigated interactions between diagnosis and DTD, and main effects of DTD. We similarly applied ICA to structural and diffusion MRI to explore the associations between DTD and gray/white matter. We identified a significant main effect of DTD with functional connectivity between the striatum and DMN, which was negatively correlated with delusion severity in patients, indicating that the greater the anti-correlation between these networks, the stronger the JTC and delusion. We further observed the main effects of DTD on a gray matter network resembling the DMN, and a white matter network connecting the functional and gray matter networks (all P < 0.05, family-wise error [FWE] correction). Function and gray/white matter showed no significant interactions. Our results support the novel association of conservatism and JTC biases with aberrant salience and default brain mode.

Examining the influence of self-referential thinking on aberrant salience and jumping to conclusions bias in individuals with schizophrenia-spectrum disorders

Background and objectivesCognitive processes such as aberrant salience and the jumping to conclusions (JTC) bias are implicated in the development of delusions. Self-referential thinking is implicated in this process; however, it is unknown how it may interact with aberrant salience and JTC bias in individuals with schizophrenia-spectrum disorders (SSDs). This study examined associations of self-referential thinking with aberrant salience, JTC bias, and delusion severity, and whether self-referential stimuli led to an increase in aberrant salience and JTC bias in SSDs (n = 20) relative to psychiatrically healthy controls (n = 20). MethodsTo assess aberrant salience and JTC bias, participants were asked to complete both self-referential and neutral versions of the Salience Attribution Test (SAT) and the Beads Task, as well as self-report measures of aberrant salience and JTC bias. ResultsSelf-referential task condition interacted with clinical group to predict JTC beads task scores, such that participants with SSDs exhibited greater levels of JTC bias than psychiatrically healthy controls during the neutral task condition, when controlling for levels of motivation, cognitive insight, and functioning. Self-referential thinking was significantly associated with aberrant salience, JTC bias, and delusion severity. LimitationsThis experiment examined trait-level relationships between variables, so does not provide information about state-level interrelationships and would benefit from replication using more dynamic methods such as ecological momentary assessment. ConclusionsThese findings highlight the interrelationships between self-referential thinking, JTC bias, aberrant salience, and delusion severity, in individuals with SSDs, and support the interactive role of self-referential thinking in predicting JTC bias.

Hasty decision making and belief inflexibility in the more delusion prone? A modified disambiguating-scenarios paradigm assessing cognitive biases implicated in delusions.

Contemporary models of psychosis imply that cognitive biases such as the jumping to conclusions (JTC), the bias against disconfirmatory evidence (BADE), and the liberal acceptance (LA) bias play a role in the pathogenesis of delusions. Most of the studies investigating the role of cognitive biases, however, have been conducted with socially neutral or abstract stimuli and have assessed patients with established psychoses. For the present study, we aimed to concurrently investigate multiple biases (i.e., the JTC, BADE, and LA biases) in a community sample with a new paradigm using more socially engaging stimuli. A large sample of participants (N=874) recruited via Amazon Mechanical Turk was subdivided into two groups based on the frequency of their psychotic-like experiences (PLEs) according to the positive subscale score of the Community Assessment of Psychic Experiences (CAPE) and matched based on major demographics variables, resulting in two equally sized groups called High-PLE (at least 2 SD above the mean) and Low-PLE (maximum 0.5 above the mean; n=46 for each group). Using a modified version of the written-scenarios BADE task, which emphasized social interactions between agents embedded in the scenario, participants rated the plausibility of response options in the face of new information. In line with previous findings, the High-PLE group demonstrated the JTC, BADE, and LA biases. That is, the members of this group made more decisions after the initial piece of information, were less likely to revise their beliefs in light of new information, and provided higher plausibility ratings for implausible response options compared to the Low-PLE group. Results corroborate prior findings suggesting that the JTC, BADE, and LA biases may be contributing factors in delusional ideation and that metacognitive biases extend to social situations.

Cognitive biases are associated with aberrant salience experience in schizophrenia spectrum disorders

IntroductionCognitive models suggest the co-occurrence of cognitive biases and aberrant salience is unique to psychosis, but their interaction is not yet fully understood. Therefore, we aimed to elucidate the relationship between subjective cognitive biases and aberrant salience in individuals with schizophrenia spectrum disorders (SSDs) in this study. MethodsA sample of 92 subjects with SSDs underwent an assessment using Davos Assessment Cognitive Biases (DACOBS) and the Aberrant Salience Inventory (ASI) in a cross-sectional design. We evaluated psychopathological differences based on ASI scores and conducted a linear regression analysis to examine the variables associated with aberrant salience. ResultsSubjects with an ASI score ≥14 demonstrated significantly higher scores across all subscales and total score of ASI and DACOBS (p<0.001). ASI subscales were significantly positive correlated with all DACOBS subscales, ranging from 0.250 for Increased Significance and Safety Behavior to 0.679 for Heightened Emotionality and Social cognition problems. The linear regression analysis revealed a positive association between aberrant salience and the DACOBS subscales jumping to conclusions (JTC) (β=0.220), social cognition problems (β=0.442), subjective cognitive problems (β=0.405), and a negative association with the subscale belief inflexibility (β=−0.350). ConclusionsOur findings suggest that JTC, social cognition problems and subjective cognitive problems may play a central role in the experience of aberrant salience in individuals with SSDs. This work informs about the need of developing prevention and intervention strategies that specifically target cognitive biases and aberrant salience in the treatment of psychosis.

Jumping to conclusions bias, psychosis and impulsivity in early stages of Parkinson’s disease

ObjectivesThe aim was to explore the correlations between Jumping to Conclusions (JtC) tendency and neuropsychiatric features in patients with early Parkinson’s disease (PD).BackgroundAccording to few reports, PD patients with impulsive–compulsive behaviors (ICBs) are prone to working memory difficulties including JtC bias. The correlation of psychotic features and JtC tendency remains still unclear.MethodsHealthy controls and patients within 3 years of PD onset were recruited. Participants were examined for psychotic symptoms using a 10 question PD-specific psychosis severity scale. JtC was measured by a probalistic reasoning scenario (beads task). In PD group, medication use, motor and non-motor symptoms were documented. Impulsivity was evaluated using the Questionnaire for Impulsive–Compulsive Disorders in PD (QUIP).ResultsThe prevalence of JtC bias was 9% (6/70) in healthy individuals, compared to 32% (22/68) of PD group [p = 0.001]. No association was detected between the presence of JtC tendency and PD-associated psychosis (p = 0.216). Patients with JtC had shorter duration of PD, more tremor-dominant PD subtype and higher QUIP scores, regardless of the dopaminergic therapy (p = 0.043, p = 0.015, p = 0.007, respectively). A trend towards attention and inhibition control deficit was noticed in JtC patients.ConclusionsWe found a high prevalence of JtC bias in early, cognitively intact PD population and a potential link between subthreshold ICBs and poor performance on beads task. Additional studies are needed to confirm our results and elaborate on the mechanisms that correlate impulsivity with JtC tendency, which are likely to be different from those mediating psychotic features in early PD.

Relationships between cognitive biases, decision-making, and delusions

Multiple measures of decision-making under uncertainty (e.g. jumping to conclusions (JTC), bias against disconfirmatory evidence (BADE), win-switch behavior, random exploration) have been associated with delusional thinking in independent studies. Yet, it is unknown whether these variables explain shared or unique variance in delusional thinking, and whether these relationships are specific to paranoia or delusional ideation more broadly. Additionally, the underlying computational mechanisms require further investigation. To investigate these questions, task and self-report data were collected in 88 individuals (46 healthy controls, 42 schizophrenia-spectrum) and included measures of cognitive biases and behavior on probabilistic reversal learning and explore/exploit tasks. Of those, only win-switch rate significantly differed between groups. In regression, reversal learning performance, random exploration, and poor evidence integration during BADE showed significant, independent associations with paranoia. Only self-reported JTC was associated with delusional ideation, controlling for paranoia. Computational parameters increased the proportion of variance explained in paranoia. Overall, decision-making influenced by strong volatility and variability is specifically associated with paranoia, whereas self-reported hasty decision-making is specifically associated with other themes of delusional ideation. These aspects of decision-making under uncertainty may therefore represent distinct cognitive processes that, together, have the potential to worsen delusional thinking across the psychosis spectrum.

Examining the relationship between cognitive factors and insight in panic disorder before and during treatment

ABSTRACT Individuals with Panic Disorder (PD) often have impaired insight, which can impede their willingness to seek treatment. Cognitive processes, including metacognitive beliefs, cognitive flexibility, and jumping to conclusions (JTC) may influence the degree of insight. By understanding the relationship between insight and these cognitive factors in PD, we can better identify individuals with such vulnerabilities to improve their insight. The aim of this study is to examine the relationships between metacognition, cognitive flexibility, and JTC with clinical and cognitive insight at pretreatment. We investigate the association among those factors’ changes and changes in insight over treatment. Eighty-three patients diagnosed with PD received internet-based cognitive behavior therapy. Analyses revealed that metacognition was related to both clinical and cognitive insight, and cognitive flexibility was related to clinical insight at pre-treatment. Greater changes in metacognition were correlated with greater changes in clinical insight. Also, greater changes in cognitive flexibility were related to greater changes in cognitive insight. The current study extends previous studies suggesting potential relationships among insight, metacognition, and cognitive flexibility in PD. Determining the role of cognitive concepts in relation to insight may lead to new avenues for improving insight and can have implications for engagement and treatment-seeking behaviors.

A pilot 1-year follow-up randomised controlled trial comparing metacognitive training to psychoeducation in schizophrenia: effects on insight

Poor insight in schizophrenia spectrum disorders (SSD) is linked with negative outcomes. This single-centre, assessor-blind, parallel-group 1-year follow-up randomised controlled trial (RCT) tested whether metacognitive training (MCT) (compared to psychoeducation) may improve insight and outcomes in outpatients with SSD assessed: at baseline (T0); after treatment (T1) and at 1-year follow-up (T2). Insight (primary outcome) was measured with (i) the Schedule for Assessment of Insight-Expanded version- (SAI-E), including illness recognition (IR), symptom relabelling (SR), treatment compliance (TC) and total insight scores (TIS); and (ii) the Beck Cognitive Insight Scale (BCIS). Between-group comparisons were nonsignificant, while within the MCT group (but not within controls) there was a significant medium effect size for improved TIS at T2 (d = 0.67, P = 0.02). Secondary outcomes included cognitive measures: Jumping to Conclusions (JTC), Theory of Mind (ToM), plus symptom severity and functioning. Compared to psychoeducation, MCT improved the PANSS excitement (d = 1.21, P = 0.01) and depressed (d = 0.76, P = 0.05) factors at T2; and a JTC task both at T1 (P = 0.016) and at T2 (P = 0.031). Participants in this RCT receiving MCT showed improved insight at 1-year follow-up, which was associated with better mood and reduced JTC cognitive bias. In this pilot study, no significant benefits on insight of MCT over psychoeducation were detected, which may have been due to insufficient power.

Effects of group therapy on jumping to conclusion bias in adolescents with autism spectrum disorder : An exploratory study

Jumping to conclusion (JTC)-a cognitive bias in thinking processes-leads to drawing conclusions based on little information, and could be related to psychosis and paranoia. While it has recently been pointed out that it could accompany the autism spectrum disorder (ASD), no interventions targeting this bias in adolescents with ASD have been reported. Therefore, this exploratory study investigated the effects of a group social cognition program on JTC bias in adolescents with ASD.Group rehabilitation using social cognition and interaction training (SCIT) was conducted for 12- to 18-year-old adolescents with ASD. An SCIT program comprehensively targets social cognitive functions, including interventions for JTC bias, and examines changes before and after the SCIT intervention, social cognitive functioning tasks, and subjective quality of life (QOL).Thirteen adolescents with ASD participated in this program ; 10 (76.9%) stayed through it. The proportion of participants with JTC bias decreased significantly before and after SCIT (before : 7/10 ; after : 1/10 ; p = 0.041), and subjective QOL increased significantly (p=0.014).The results show that a group social cognition program with a JTC bias approach improves the JTC bias and increases subjective QOL in adolescents with ASD. J. Med. Invest. 70 : 115-122, February, 2023.

Whodunit – A novel video-based task for the measurement of jumping to conclusions in the schizophrenia spectrum

Jumping to conclusions (JTC) is implicated in the formation and maintenance of the positive symptoms of psychosis and over the years has become a prominent treatment target. Yet, measures designed to detect JTC are compromised by a number of limitations. We aimed to address some of these shortcomings with a new video-based "Whodunit task" among participants scoring high and low on the Community Assessment of Psychic Experiences (CAPE).We recruited a large sample (N = 979) from the general population who were divided into subgroups high vs. low on psychotic-like experiences (PLE), matched for depression and background characteristics. In the Whodunit task, participants were asked to rate the likelihood that one out of six suspects was the perpetrator of a crime (deliberately ambiguous with no clear clues until the end). The primary measure was the number of sequences-to-decision (STD).In line with the hypothesis, participants scoring high on the CAPE positive subscale displayed significantly lower STD and a higher rate of JTC. Response confidence in the assessments was elevated in the PLE-High group. The number of overall decisions was also significantly elevated for the PLE-High group. No group differences were found when comparing those scoring high versus low on depression. The STD index correlated significantly with a corresponding index from another JTC task.The study presents a new paradigm for the measurement of data gathering in the schizophrenia spectrum. Speaking to its validity, the Whodunit task was correlated with another JTC measure. Future research should test abbreviated versions of the paradigm, preferably using multiple trials with differing topics/emotional themes.

Jumping to Conclusions and Its Associations With Psychotic Experiences in Preadolescent Children at Familial High Risk of Schizophrenia or Bipolar Disorder-The Danish High Risk and Resilience Study, VIA 11.

The jumping to conclusions (JTC) bias, ie, making decisions based on inadequate evidence, is associated with psychosis in adults and is believed to underlie the formation of delusions. Knowledge on the early manifestations of JTC and its associations with psychotic experiences (PE) in children and adolescents is lacking. Preadolescent children (mean age 11.9 y, SD 0.2) at familial high risk of schizophrenia (FHR-SZ, n = 169) or bipolar disorder (FHR-BP, n = 101), and controls (n = 173) were assessed with the Beads Task to examine JTC. The number of beads drawn before making a decision, "draws to decision" (DTD) was used as a primary outcome. PE were ascertained in face-to-face interviews. General intelligence was measured with Reynolds Intellectual Screening Test. Children at FHR-SZ took fewer DTD than controls (4.9 vs 5.9, Cohen's d = 0.31, P = .004). Differences were attenuated when adjusting for IQ (Cohen's d = 0.24, P = .02). Higher IQ was associated with a higher number of DTD (B = 0.073, P < .001). Current subclinical delusions compared with no PE were associated with fewer DTD in children at FHR-SZ (P = .04) and controls (P < .05). Associations between delusions and DTD were nullified when accounting for IQ. JTC marks familial risk of psychosis in preadolescence, not reducible to general intelligence. JTC is associated with subclinical delusions, but this may be an expression of intellectual impairment. Future studies should establish temporality between JTC and delusion formation and examine JTC as a target for early intervention.

Cognitive biases in first psychotic episode with Attention deficit and hyperactivity disorder: a controlled study

IntroductionCognitive biases are a core feature of psychotic disorders. Moreover, people with first episode of psychosis (FEP) have more difficulties in social cognition, in particular in theory of mind. On the other hand, deficits in processing speed and distractibility appear to be core features of attention deficit hyperactivity disorder (ADHD) and impairment in these basic processes can lead to deficits in more complex functions, that could induced to cognitive biases.ObjectivesTo evaluate whether FEP with and without ADHD differ in the rate and type of cognitive biases.MethodsParticipants 121 FEP treated at the Early Intervention Service of Reus and aged between 14 and 28 years. Instruments : The Diagnostic Interview for ADHD (DIVA) and the Cognitive Biases Questionnaire for Psychosis (CBQp) measuring 2 themes : anomalous perception (AP) and threatening events (TE) and 5 cognitive biases: Intentionalising (Int) , Catastrophising (Cat), Dichotomous thinking (DT), Jumping to conclusions (JTC) and Emotional reasoning (ER)Results31 out 121 (25.6%) met criteria for childhood ADHD. Compared with FEP ADHD- , FEP-ADHD+ presented significant higher scores in the CBQp total score (U= 2.538 ; p=0.001), the AP theme (U=2.262; p=0.02) , the TE theme (U= 2.242 ; p=0.02) and DT bias ((U= 2.188 ; p=0.03)ConclusionsOur findings support the fact that subjects with FEP-ADHD+ presented more cognitive biases than those ADHD-. So, FEP-ADHD+ subjects could represent a clinical subgroup with a worse prognosis than FEP-ADHD - subjects, presenting more delusions, distress and a worse cognitive insight.DisclosureNo significant relationships.

Jumping to conclusions correlates with negative symptoms, poor response inhibition, and impaired functioning in individuals diagnosed with schizophrenia.

The jumping to conclusions (JTC) bias is the tendency to make immediate decisions based on little information. There are few studies that have investigated the relationship between JTC and frontal lobe function. We examined the association between JTC and the Brief Psychiatric Rating Scale (BPRS), Frontal Assessment Battery (FAB), and Global Assessment of Functioning (GAF) scale in individuals with schizophrenia. In total, 50 individuals diagnosed with schizophrenia and 50 healthy control individuals were administered the beads task. Individuals diagnosed with schizophrenia were assessed using the FAB, BPRS, and GAF. There was a significant negative correlation between JTC and the negative symptoms of the BPRS (rs=-.368, p=.008). There was a significant positive correlation between JTC and the Go/No-Go task of the FAB (rs=.319, p=.026), and the GAF (rs=.433, p=.002). JTC in individuals with schizophrenia may be categorized according to several causes, including negative symptoms and poor response inhibition.

The relationship between jumping to conclusions and social cognition in first-episode psychosis

Jumping to conclusions (JTC) and impaired social cognition (SC) affect the decoding, processing, and use of social information by people with psychosis. However, the relationship between them had not been deeply explored within psychosis in general, and in first-episode psychosis (FEP) in particular. Our aim was to study the relationship between JTC and SC in a sample with FEP. We conducted a cross-sectional study with 121 patients with FEP, with measures to assess JTC (easy, hard, and salient probability tasks) and SC (emotional recognition, attributional style, and theory of mind). We performed Student’s t-test and logistic regression in order to analyse these associations.We found a statistically significant and consistent relationship of small-moderate effect size between JTC (all three tasks) and impaired emotional recognition. Also, our results suggest a relationship between JTC and internal attributions for negative events. Relationships between JTC and theory of mind were not found. These results highlight the importance of psychological treatments oriented to work on a hasty reasoning style and on improving processing of social information linked to emotional recognition and single-cause attributions.

People with jumping to conclusions bias tend to make context-independent decisions rather than context-dependent decisions

Beads task (BT) uses a probabilistic reasoning paradigm and reveals jumping to conclusions (JTC) bias, the tendency to make premature judgments based on insufficient information (i.e., making fewer draws to decision-DTD). In this study, healthy participants (N = 207) were tested on the 80:20 and 60:40 color ratio versions of BT. We investigated associations of JTC bias with a set of cognitive bias problems and Cognitive Bias Task (CBT), a non-veridical (agent-centered) decision-making task that determines context-dependent and context-independent decision-making bias.Results showed that the converted CBT scores were negatively, and cognitive bias scores were positively correlated with JTC bias (DTD ≤ 2) on both versions of the BT. The CBT demonstrated to have satisfactory convergent and predictive validity for JTC bias. The findings suggest that people with JTC bias fail to solve cognitive bias problems and are more likely to make context-independent response selections than context-dependent response selections.

Is intuition allied with jumping to conclusions in decision-making? An intensive longitudinal study in patients with delusions and in non-clinical individuals.

Research suggests that a jumping-to-conclusions (JTC) bias, excessive intuition, and reduced analysis in information processing may favor suboptimal decision-making, both in non-clinical and mentally disordered individuals. The temporal relationship between processing modes and JTC bias, however, remains unexplored. Therefore, using an experience sampling methodology (ESM) approach, this study examines the temporal associations between intuitive/analytical information processing, JTC bias, and delusions in non-clinical individuals and patients with schizophrenia. Specifically, we examine whether a high use of intuitive and/or a low use of analytical processing predicts subsequent JTC bias and paranoid conviction. In a smartphone-based ESM study, participants will be prompted four times per day over three consecutive days to answer questionnaires designed to measure JTC bias, paranoid conviction, and preceding everyday-life intuition/analysis. Our hierarchical data will be analyzed using multilevel modelling for hypothesis testing. Results will further elucidate the role of aberrant human reasoning, particularly intuition, in (non-)clinical delusions and delusion-like experiences, and also inform general information processing models.

The relationship between early symptom severity, improvement and remission in first episode psychosis with jumping to conclusions

It is suggested that Jumping To Conclusions (JTC) reasoning bias might contribute to the distortion of external reality. However, the association between psychotic manifestations and JTC is obscure, especially if general intelligence is considered as a mediator. The aim of this study is to investigate the relation between severity, early clinical improvement and remission of symptoms in First Episode Psychosis (FEP) with JTC as an explanatory factor. One hundred seventy-one FEP individuals were evaluated with the Positive and Negative Syndrome Scale (PANSS) at baseline and one month after treatment initiation. Clinical improvement was ascribed as symptom change one-month post-baseline measurements. Symptomatic remission was assessed with the Andreasen severity criteria and JTC with the Beads Task, operationalized through Draws To Decision (DTD) (the lower the number of DTD, the higher the JTC bias). Regarding symptoms severity, total psychotic, total positive psychotic, and hallucinations-item PANSS scores showed a negative association with JTC after controlling for IQ. Regarding early clinical improvement, the association with JTC was non-significant. No significant association was detected between one month remission status of FEP and JTC. Our findings indicate that severity of positive symptoms is not associated with hastiness in decision-making, but rather with a heightened conservatism in terms of increased data gathering. Further research is required to replicate the results and clarify the cognitive processes involved.

Hasty decision-making in individuals at higher risk of developing an eating disorder

Background and objectivesThe Jumping to Conclusions (JTC) bias is the tendency to make hasty decisions based on limited evidence and may contribute to the formation of over-valued beliefs about the importance of weight, shape and eating. Previous research investigating the JTC bias in clinical eating disorder samples, as assessed by the beads task, is inconclusive. The current study investigated the JTC bias in a non-clinical sample of undergraduate students identified as being lower or higher risk of developing an eating disorder. The study used a more reliable ‘distractor’ beads task that also incentivised hastier decisions by elevating the pressure of the task. MethodsFemale undergraduate students (N = 156, 48%, classified as higher risk) completed a pressure and non-pressure distractor beads task, along with measures of weight concern and body-image flexibility. ResultsHigher risk participants displayed a hastier decision-making style than lower risk participants. Task pressure elicited a hastier decision-making style across the whole sample, however, was unable to distinguish between higher and lower eating disorder risk status. LimitationsInterpretation of findings are limited to non-clinical samples and may not generalise to clinical eating disorder populations. ConclusionsFindings suggest the need for replication in a clinical eating disorder sample using the distractor beads task. Future research should investigate whether eating disorder salient stimuli elicits a stronger bias.

Identifying and changing cognitive vulnerability in the classroom: preliminary evaluation of CUES-Ed, a school-based universal cognitive behavioural early intervention service for 7-10 year olds.

School-based early intervention may alleviate current emotional and behavioural problems, and, by targeting underlying vulnerability, safeguard children's future mental health. Improving on mixed outcomes to date is an international public health priority. CUES-Ed is a classroom-based, clinician-led, universal cognitive behavioural programme for primary school children, designed to promote emotional literacy and regulation. Additionally, CUES-Ed targets cognitive mechanisms implicated in the future development of mental disorder: stigmatising appraisals of emotional expression and of unusual perceptual experiences, and the tendency to jump-to-conclusions (JTC). We report here on fitness for purpose of our in-service assessment of cognitive vulnerability, and change in cognitive vulnerability following CUES-Ed and compared with a naturalistic waitlist. From 05/2017-11/2017, 960 children participated (900 CUES-Ed; 60 naturalistic waitlist). Assessments were completed in whole classes; 732 children provided pre-post data on all measures; 227 were missing data through absence or poor completion (n = 1 declined assessment). Relationships between baseline cognitive vulnerability measures and their components were consistent with reliable and valid assessment. Cognitive vulnerability reduced from before to after CUES-Ed and compared with the naturalistic waitlist, for JTC (large effects) and stigmatising appraisals (small-medium effects), for all children (ESs pre-post: 0.2-1.0; between-group: 0.1-1.0) and vulnerable subgroups (ESs pre-post: 0.5-1.7; between-group: 0.2-2.0). Targeted cognitive vulnerability mechanisms change following CUES-Ed. As stigmatising appraisals and JTC may increase vulnerability to future mental illness, findings suggest a promise in reducing future risk. A formally controlled research study, with longer-term follow-up, is required to test this. Limitations and implications for future evaluation are discussed.