Investigating the Role of Cognitive Biases and Cognitive Insight in Paranoia in Youth at Risk for Psychosis

Poster B69, Tuesday, October 9, 11:30 am - 1:00 pm, Essex Ballroom

Shaynna Herrera1,2, Katarzyna Wyka3, Carrie Swiderski1, Rachel Jespersen1, Alexander Robateau1, Yulia Landa1,2,4; 1Icahn School of Medicine at Mount Sinai, New York, NY, 2James J. Peters VA Medical Center, Bronx, NY, 3City University of New York Graduate School of Public Health and Health Policy, New York, NY, USA, 4Weill Cornell Medical College New York, NY, USA

Youth at risk for psychosis often experience anxiety and suspiciousness without having fully formed paranoid delusions. Research suggests that cognitive biases and poor insight play a role in the formation and maintenance of paranoia. In order to better understand the cognitive factors that contribute to suspiciousness in youth at risk for psychosis, this study investigated the association between anxiety and paranoia through cognitive insight and cognitive biases. Participants were 20 youth (50% female) ages 14-25 (M = 17.85, SD = 3.24) who met CAARMS criteria for At-Risk Mental State (ARMS) and were entering a Group and Family-Based Cognitive Behavioral Therapy Program (GF-CBT). We examined the potential mediating effects of cognitive biases (DACOBS) and cognitive insight (BCIS) on the association between Anxiety (STAI) and Paranoia (PANSS P6 Suspiciousness/Persecution). Mediation analysis was performed using SPSS Process Macro with bias-corrected bootstrapping method based on 10,000 bootstrap samples. Results showed that cognitive biases mediate the association between anxiety and paranoia (indirect effect β = 0.03, 95% CI = 0.01-0.08). Further analysis of cognitive bias subscales showed significant indirect effects for the selective attention to threat bias (β = 0.06, 95% CI =0.02-0.12) and self as target bias (β = 0.04, 95% CI = 0.01-0.08). The indirect effect of cognitive insight was in the expected direction but not statistically significant. Targeting cognitive biases during psychosocial treatment for ARMS youth may prevent or mitigate transition to full-blown paranoid delusions. CBT is an appropriate treatment to address cognitive biases and may facilitate recovery from ARMS.

Topic Area: Ultra High Risk / Prodromal Research

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