Researchers have suggested the presence of a self-serving attributional bias, with people making more internal, stable, and global attributions for positive events than for negative events. This study examined the magnitude, ubiquity, and adaptiveness of this bias. The authors conducted a meta-analysis of 266 studies, yielding 503 independent effect sizes. The average d was 0.96, indicating a large bias. The bias was present in nearly all samples. There were significant age differences, with children and older adults displaying the largest biases. Asian samples displayed significantly smaller biases (d = 0.30) than U.S. (d = 1.05) or Western (d = 0.70) samples. Psychopathology was associated with a significantly attenuated bias (d = 0.48) compared with samples without psychopathology (d = 1.28) and community samples (d = 1.08). The bias was smallest for samples with depression (0.21), anxiety (0.46), and attention-deficit/hyperactivity disorder (0.55). Findings confirm that the self-serving attributional bias is pervasive in the general population but demonstrates significant variability across age, culture, and psychopathology.

Is There a Universal Positivity Bias in Attributions? A Meta-Analytic Review of Individual, Developmental, and Cultural Differences in the Self-Serving Attributional Bias.

Cognitive Behavioural Therapy (CBT) has established itself as one of the most effective therapies for treating a wide range of psychological disorders. However, research and treatment in this field typically adopts a DSM driven 'disorder-focused' approach - researchers and clinicians target a specific disorder, try to understand its aetiology and maintenance, and try to develop more effective strategies to treat the disorder. This book proposes an insightful and original approach to understanding these disorders, one that focuses on what they have in common. Instead of examining in isolation, for example, obsessive compulsive disorders, insomnia, schizophrenia, it asks - what do patients with these disorders have in common? It takes each cognitive and behavioural process - attention, memory, reasoning, thought, behaviour, and examines whether it is a transdiagnostic process - i.e., serves to maintain a broad range of psychological disorders. Having shown how these disorders share several important processes, it then describes the practical implications of such an approach to diagnosis and treatment. Importantly it explores why the different psychological disorders can present so differently, despite being maintained by the same cognitive and behavioural processes. It also provides an account of the high rates of comorbidity observed among the different disorders. This book provides a novel review and integration of the empirical literature and gives clinicians and researchers a valuable new theoretical base for assessing and treating psychological disorders. Cognitive Behavioural Therapy (CBT) has established itself as one of the most effective therapies for treating a wide range of psychological disorders. However, research and treatment in this field typically adopts a DSM driven 'disorder-focused' approach - researchers and clinicians target a specific disorder, try to understand its aetiology and maintenance, and try to develop more effective strategies to treat the disorder. This book proposes an insightful and original approach to understanding these disorders, one that focuses on what they have in common. Instead of examining in isolation, for example, obsessive compulsive disorders, insomnia, schizophrenia, it asks - what do patients with these disorders have in common? It takes each cognitive and behavioural process - attention, memory, reasoning, thought, behaviour, and examines whether it is a transdiagnostic process - i.e., serves to maintain a broad range of psychological disorders. Having shown how these disorders share several important processes, it then describes the practical implications of such an approach to diagnosis and treatment. Importantly it explores why the different psychological disorders can present so differently, despite being maintained by the same cognitive and behavioural processes. It also provides an account of the high rates of comorbidity observed among the different disorders. This book provides a novel review and integration of the empirical literature and gives clinicians and researchers a valuable new theoretical base for assessing and treating psychological disorders.

Cognitive Behavioural Processes across Psychological Disorders: A Transdiagnostic Approach to Research and Treatment

Anxiety Disorders and Phobias: A Cognitive Perspective

Persecutory delusions: a review and theoretical integration.

Since publication of the original Schizophrenia Patient Outcomes Research Team (PORT) treatment recommendations in 1998, considerable scientific advances have occurred in our knowledge about how to help persons with schizophrenia. Today an even stronger body of research supports the scientific basis of treatment. This evidence, taken in its entirety, points to the value of treatment approaches combining medications with psychosocial treatments, including psychological interventions, family interventions, supported employment, assertive community treatment, and skills training. The most significant advances lie in the increased options for pharmacotherapy, with the introduction of second generation antipsychotic medications, and greater confidence and specificity in the application of psychosocial interventions. Currently available treatment technologies, when appropriately applied and accessible, should provide most patients with significant relief from psychotic symptoms and improved opportunities to lead more fulfilling lives in the community. Nonetheless, major challenges remain, including the need for (1) better knowledge about the underlying etiologies of the neurocognitive impairments and deficit symptoms that account for much of the disability still associated with schizophrenia; (2) treatments that more directly address functional impairments and that promote recovery; and (3) approaches that facilitate access to scientifically based treatments for patients, the vast majority of whom currently do not have such access.

The Schizophrenia Patient Outcomes Research Team (PORT): Updated Treatment Recommendations 2003

Background Early identification and specialised treatment of individuals with enduring positive symptoms may assist in alleviating symptoms and has the potential to change the course of illness. Method Prevalence and descriptive data on enduring positive symptoms in two first-episode samples are outlined. Attempts to incorporate the focus of early intervention for persisting psychosis into routine clinical care of individuals with first-episode psychosis are described. Results Of the 227 individuals with first-episode psychosis who were assessed using the Brief Psychiatric Rating Scale at 3/6 months and 12 months following initial stabilisation (from a total sample of 347), 6.6% experienced enduring positive symptoms at all three time points. When the analysis was restricted to schizophrenia, schizophreniform and schizoaffective disorders (n = 158) the percentage increased to 8.9%. These patients had significantly longer mean duration of untreated psychosis prior to initiation of treatment and, at 12-month follow-up, significantly higher depression and poorer psychosocial functioning. Conclusions The association of untreated psychosis with treatment resistance supports the argument for early intervention as soon as possible following the onset of psychotic symptoms.

Prolonged recovery in first-episode psychosis

Background The present study describes the results of the pilottesting of a therapy we have developed for people with first-episode psychosis. Cognitively-oriented psychotherapy for early psychosis (COPE) is aimed at facilitating the adjustment of the person, and at preventing or alleviating secondary morbidity in the wake of the first psychotic episode. Method Eighty people formed three groups: those who were offered and accepted COPE (COPE subjects); those who refused COPE (refusal subjects); and those who were offered neither COPE nor any other continuing treatment from our service (control subjects). The individuals were assessed prior to, and at the end of, COPE treatment (a 12-month period) on the Integration/Sealing Over, Explanatory Model, Scale for the Assessment of Negative Symptoms, Brief Psychiatric Rating Scale, Quality of Life, SCL–90–R, and Beck Depression Inventory measures. Results People who received COPE obtained significantly superior scores (P < 0.05) to the control group on four of the seven measures but only significantly out-performed the refusal group on one of the seven measures (P<0.05). The COPE group performed significantly worse on the BDI than the refusal group (P < 0.05). Effect sizes are also provided for each measure. Conclusions There seems to be a place for psychological therapy in this group of people butour results need to be replicated in a more definitive randomised controlled trial and such a study is now in progress.

Cognitively-oriented psychotherapy for early psychosis (COPE). Preliminary results.

Objectives. Cognitively oriented psychotherapy for early psychosis (COPE) is aimed at facilitating the adjustment of the person, and at preventing or alleviating secondary morbidity in the wake of the first psychotic episode.



Design. A total of 80 people participated in the initial trial and completed assessments on a range of outcome measures. Post-treatment assessment results from a non-randomized controlled trial of COPE have been previously reported. The present paper describes the results obtained from 51 patients who attended a follow-up assessment 1 year subsequent to the end-of-treatment assessment.



Method. The 51 patients formed three groups: (1) those who were offered and accepted COPE; (2) those who were offered COPE but refused it, and continued to receive other services from the Early Psychosis Prevention and Intervention Centre (EPPIC) (refusal subjects); and (3) those who were offered neither COPE nor any other continuing treatment from EPPIC (control subjects).



Results. At 1-year follow-up, there was only one significant difference and this was between the COPE and refusal groups on the Integration/Sealing Over (I/SO) measure (p = .008). End-of-treatment differences were mostly sustained over the 1-year follow-up period. When the complete sample of 80 was considered, there were no differences between the three groups in terms of hospital admissions, community episodes, or time taken to first in-patient re-admission.



Conclusions. The study was weakened by the poor follow-up rates in the two control groups. This reduced power to detect differences between groups on the seven major measures. However, the relapse data gathered on the complete set of 80 patients were discouraging and suggest that the present formulation of COPE does not confer any advantage to those patients receiving the therapy over those not receiving the therapy.

/pdf/cognitively-oriented-psychotherapy-for-early-psychosis-cope-zw72gdq72w.pdf

Cognitively oriented psychotherapy for early psychosis (COPE): A 1‐year follow‐up

Objective. The present study investigated covert and overt attributional styles in individuals experiencing a first episode of psychosis. It was hypothesized that those individuals experiencing paranoia, as operationalized by higher scores on the suspiciousness item of the Brief Psychiatric Rating Scale (BPRS) would perform differently on both covert and overt measures of attributional style when compared to those individuals who scored lower on the BPRS suspiciousness item.



Design and Methods. A cross-sectional design was used. The sample consisted of 62 participants (50 males and 12 females) from the Early Psychosis Prevention and Intervention Centre. The Pragmatic Inference Task (PIT) was used to measure covert attributional style, whereas the Attributional Style Questionnaire (parallel form; ASQpf) measured overt attributional style. The Rosenberg Self-Esteem Questionnaire measured global self-esteem. Participants positive, negative, and depressive symptoms were assessed by means of the BPRS, the Scale for the Assessment of Negative Symptoms, and the Beck Depression Inventory, respectively.



Results. Regression analyses found that less suspiciousness (p=.02) and more depression (p=.02) predicted higher internal attributions for negative events scores on the ASQpf. There was a trend (p=.07) for more suspicious individuals to endorse the self-serving bias (SSB) on the PIT, even despite the SSB not being large enough to be considered defensive. Verbal IQ emerged as a significant predictor of covert attributional style (p=.04).



Conclusions. The findings suggest that increasing suspiciousness does predict attributional style in the early stages of psychosis, although the relationship appears weaker than in reports with more chronic psychotic patient samples. Longitudinal research is needed to ascertain whether attributional style is a stable characteristic in psychosis, or whether it fluctuates between periods of remission and active psychosis.

An investigation of attributional style in first-episode psychosis.

Objectives. Cognitively oriented psychotherapy for early psychosis (COPE) is aimed at facilitating the adjustment of the person, and preventing or alleviating secondary morbidity in the wake of the first psychotic episode. The present study reports on the outcomes of a controlled trial comparing two conditions: COPE versus No-COPE. Method. Ninety-one people participated in the trial which was analysed by intention-to-treat, including 12 people who were assigned to COPE but refused to participate. Assessments were conducted at pre-treatment, mid-treatment and post-treatment. Hospital readmission data were obtained through a Psychiatric Case Register. The study was conducted in a front-line public mental health service, the Early Psychosis Prevention and Intervention Centre (EPPIC). Clients in both COPE and No-COPE were provided with full access to the complete range of EPPIC services. Results. There were no significant differences between the two conditions on the nine primary outcome variables. Hospital readmissions were assessed for each client at yearly intervals up to 4 years following the completion of treatment and again there were no significant between-group differences. Conclusions. The study indicated that there was no significant advantage to COPE over and above routine care at EPPIC.

https://www.cambridge.org/core/services/aop-cambridge-core/content/view/S0033291705004927

Dana Maude

Papers

Prolonged recovery in first-episode psychosis

Cognitively-oriented psychotherapy for early psychosis (COPE). Preliminary results.

Cognitively oriented psychotherapy for early psychosis (COPE): A 1‐year follow‐up

An investigation of attributional style in first-episode psychosis.

A controlled trial of cognitively oriented psychotherapy for early psychosis (COPE) with four-year follow-up readmission data