Attentional bias is a central feature of many cognitive theories of psychopathology. One of the most frequent methods of investigating such bias has been an emotional analog of the Stroop task. In this task, participants name the colors in which words are printed, and the words vary in their relevance to each theme of psychopathology. The authors review research showing that patients are often slower to name the color of a word associated with concerns relevant to their clinical condition. They address the causes and mechanisms underlying the phenomenon, focusing on J.D. Cohen, K. Dunbar, and J.L. McClelland's (1990) parallel distributed processing model.

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The Emotional Stroop Task and Psychopathology

OBJECTIVE: The clinical hallmark of schizophrenia is psychosis. The objective of this overview is to link the neurobiology (brain), the phenomenological experience (mind), and pharmacological aspects of psychosis-in-schizophrenia into a unitary framework. METHOD: Current ideas regarding the neurobiology and phenomenology of psychosis and schizophrenia, the role of dopamine, and the mechanism of action of antipsychotic medication were integrated to develop this framework. RESULTS: A central role of dopamine is to mediate the “salience” of environmental events and internal representations. It is proposed that a dysregulated, hyperdopaminergic state, at a “brain” level of description and analysis, leads to an aberrant assignment of salience to the elements of one’s experience, at a “mind” level. Delusions are a cognitive effort by the patient to make sense of these aberrantly salient experiences, whereas hallucinations reflect a direct experience of the aberrant salience of internal representations. Antipsyc...

Psychosis as a state of aberrant salience: A framework linking biology, phenomenology, and pharmacology in schizophrenia.

In the last 10 years a consensus has developed that the symptoms of psychosis may be better understood by linking the steps between the phenomenological experiences and social, psychological and neurobiological levels of explanation. Cognitive models of psychosis are an important link in this chain. They provide a psychological description of the phenomena from which hypotheses concerning causal processes can be derived and tested; social, individual, and neurobiological factors can then be integrated via their impact on these cognitive processes. In this paper, we set out the cognitive processes that we think lead to the formation and maintenance of the positive symptoms of psychosis and we attempt to integrate into our model research in social factors. If this model proves useful, a fuller integration with the findings of biological research will be required (Frith, 1992).

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A cognitive model of the positive symptoms of psychosis.

The authors review research showing that when recalling autobiographical events, many emotionally disturbed patients summarize categories of events rather than retrieving a single episode. The mechanisms underlying such overgeneral memory are examined, with a focus on M. A. Conway and C. W. Pleydell-Pearce's (2000) hierarchical search model of personal event retrieval. An elaboration of this model is proposed to account for overgeneral memory, focusing on how memory search can be affected by (a) capture and rumination processes, when mnemonic information used in retrieval activates ruminative thinking; (b) functional avoidance, when episodic material threatens to cause affective disturbance; and (c) impairment in executive capacity and control that limits an individual's ability to remain focused on retrieval in the face of distraction.

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Autobiographical memory specificity and emotional disorder.

Considerable knowledge has accumulated in recent decades concerning the significance of physical activity in the treatment of a number of diseases, including diseases that do not primarily manifest as disorders of the locomotive apparatus. In this review we present the evidence for prescribing exercise therapy in the treatment of metabolic syndrome-related disorders (insulin resistance, type 2 diabetes, dyslipidemia, hypertension, obesity), heart and pulmonary diseases (chronic obstructive pulmonary disease, coronary heart disease, chronic heart failure, intermittent claudication), muscle, bone and joint diseases (osteoarthritis, rheumatoid arthritis, osteoporosis, fibromyalgia, chronic fatigue syndrome) and cancer, depression, asthma and type 1 diabetes. For each disease, we review the effect of exercise therapy on disease pathogenesis, on symptoms specific to the diagnosis, on physical fitness or strength and on quality of life. The possible mechanisms of action are briefly examined and the principles for prescribing exercise therapy are discussed, focusing on the type and amount of exercise and possible contraindications.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1600-0838.2006.00520.x

Evidence for prescribing exercise as therapy in chronic disease.

The self, attributional processes and abnormal beliefs: towards a model of persecutory delusions.

Seventeen psychotic patients with persecutory delusions were matched against depressed and normal controls and assessed for magical ideation, locus of control and attributional style. The deluded and depressed patients were found to make global and stable attributions when compared to the normal subjects. However, the deluded patients, in contrast with both control groups, made excessively external attributions for negative events and internal attributions for positive events. Highly significant differences were observed between the deluded group and the two control groups on magical ideation and on the ‘powerful others’ subscale of the locus of control questionnaire. Both psychiatric groups differed from the normal control group on ‘chance’ locus of control and a significant difference was observed between the persecuted and normal subjects on the ‘internality’ subscale of the questionnaire. The implications of these findings for the understanding and treatment of paranoid delusions are discussed.

Persecutory delusions and attributional style

Attentional bias was investigated in patients suffering from persecutory delusions and matched psychiatric and normal controls, using the emotional Stroop task. Subjects were required to colour name words which were either meaningless strings of Os, neutral words, words indicating negative affect, or words judged to be of paranoid content. In comparison with the control subjects the deluded patients demonstrated a selective increase of response time for the paranoid words. A second analysis using indices of interference produced even more marked results. The relevance of these findings for the understanding of delusional thinking is discussed.

Content specific information processing and persecutory delusions: an investigation using the emotional Stroop test.

Abnormalities of 'social' reasoning were investigated in patients suffering from persecutory delusions and in matched depressed and normal controls using transparent (obvious) and opaque (unobvious) tests of attributional style. Whereas depressed and normal subjects yielded similar causal inferences for both attributional measures, the deluded subjects showed a marked shift in internality, attributing negative outcomes to external causes on the transparent Attributional Style Questionnaire but, on the more opaque Pragmatic Inference Task, attributing negative outcomes to internal causes and thus showing a cognitive style resembling that of the depressed group. This finding, interpreted in terms of explicit versus implicit judgements, supports the hypothesis that delusions function as a defence against underlying feelings of low self-esteem.

The defensive function of persecutory delusions. Evidence from attribution tasks.

The social reasoning of patients suffering from persecutory delusions and matched groups of depressed and normal controls was investigated using the framework of Kelley's (1967) theory of social attribution. Subjects were required to choose between person, circumstances and stimulus attributions for a series of social vignettes describing interactions between two persons. The vignettes varied in terms of the distinctiveness, consistency and consensus information supplied, as well as in respect of whether the actions described were positively or negatively valued. It was found that the deluded patients made excessive person attributions for negative events. It was also found that the deluded patients were excessively certain about their judgements compared to the depressed controls. Normal subjects tended to rate their certainty in their own judgements midway between the deluded and depressed patients.

Sue Kaney

Papers

The self, attributional processes and abnormal beliefs: towards a model of persecutory delusions.

Persecutory delusions and attributional style

Content specific information processing and persecutory delusions: an investigation using the emotional Stroop test.

The defensive function of persecutory delusions. Evidence from attribution tasks.

Paranoia and social reasoning: an attribution theory analysis.