The effect of reducing the 'jumping to conclusions' bias on treatment decision-making capacity in psychosis: A randomised controlled trial with mediation analysis

Turner, David T; MacBeth, Angus; Larkin, Amanda; Moritz, Steffen; Livingstone, Karen; Campbell, Alison; Hutton, Paul

Abstract

Background
Evidence-based psychological interventions to support treatment decision-making capacity (‘capacity’) in psychosis do not currently exist. This study sought to establish whether reducing the extent to which this group form conclusions based on limited evidence, also
known as the ‘jumping to conclusions’ (JTC) bias, could improve capacity.
Methods
In a randomised-controlled open trial, 37 patients aged 16-65 years diagnosed with schizophrenia-spectrum disorders were randomly assigned (1:1) to receive a single-session intervention designed to reduce the JTC bias (MCT-JTC; adapted from Metacognitive
Training) or an attention control (AC) condition designed to control for therapist attention, duration, modality and face validity. Primary outcomes were treatment decision-making capacity measured by the MacArthur Competency Assessment Tool for Treatment (MacCATT)
and the jumping-to-conclusions reasoning bias measured by draws to decision on the Beads task, each of which were administered by the psychologist delivering the intervention.
Results
Those receiving MCT-JTC had large improvements in overall capacity (d=0.96, p

Citation

Turner, D. T., MacBeth, A., Larkin, A., Moritz, S., Livingstone, K., Campbell, A., & Hutton, P. (2019). The effect of reducing the 'jumping to conclusions' bias on treatment decision-making capacity in psychosis: A randomised controlled trial with mediation analysis. Schizophrenia Bulletin, 45(4), 784-793. https://doi.org/10.1093/schbul/sby136

• Journal Article Type: Article
• Acceptance Date: Sep 3, 2018
• Online Publication Date: Sep 26, 2018
• Publication Date: 2019-07
• Deposit Date: Sep 3, 2018
• Publicly Available Date: Sep 26, 2018
• Journal: Schizophrenia Bulletin
• Print ISSN: 0586-7614
• Electronic ISSN: 1745-1701
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 45
• Issue: 4
• Pages: 784-793
• DOI: https://doi.org/10.1093/schbul/sby136
• Keywords: capacity, psychosis, RCT, jumping-to-conclusions, meta-cognitive therapy
• Public URL: http://researchrepository.napier.ac.uk/Output/1290620
• Contract Date: Sep 3, 2018