Inflexibility in Reasoning: Comparisons of Cognitive Flexibility, Explanatory Flexibility, and Belief Flexibility Between Schizophrenia and Major Depressive Disorder

Abstract

Introduction: Inflexibility in reasoning has been suggested to contribute to psychiatric disorders, such as explanatory flexibility in depression and belief flexibility in schizophrenia. However, studies tended to examine only one of the flexibility constructs, which could be related to each other, within a single group of patients. As enhancing flexibility in thinking has become one of the psychological treatment goals across disorders, this study aimed to examine three constructs of flexibility (cognitive flexibility, explanatory flexibility, and belief flexibility) in two psychiatric groups.Methods: We compared three groups of participants: (i) 56 outpatients with a schizophrenia-spectrum disorder and active delusions, (ii) 57 outpatients with major depressive disorder and at least a moderate level of depression, and (iii) 30 healthy controls. Participants were assessed on symptom severity and flexibility, using the Trail-Making Task, the Attributional Style Questionnaire, the Maudsley Assessment of Delusions Scale (MADS) and the Bias Against Disconfirmatory Evidence (BADE) Task.Results: Cognitive flexibility was reduced in the two clinical groups compared to controls. Explanatory flexibility was comparable across groups. The three groups differed in belief flexibility measured by MADS but not by the BADE task. Response to hypothetical contradiction was reduced in the delusion group than the other two groups, and the ability to generate alternative explanations was reduced in the delusion group than healthy controls.Discussion: We found an effect of diagnosis on cognitive flexibility, which might be confounded by differences in intellectual functioning. Reduced belief flexibility tended to be specific to delusions.

Developing a novel assessment of interpretation flexibility: Reliability, validity and clinical implications

“…This concept refers to the ability to integrate new attributes of unfolding situations and update interpretations within changing circumstances (Everaert et al, 2018). Research indicates that interpretation inflexibility is associated with affective (Zhu, Kwok, Chan, Chan, & So, 2020) and psychotic symptoms across the severity continuum (Colbert, Peters, & Garety, 2010;Serrano-Guerrero, Ruiz-Veguilla, Martin-Rodriguez, & Rodriguez-Testal, 2020;So et al, 2012). Further, modifying rigid thinking and revising biases in interpretation are well-established treatment goals for depression (Yasinski et al, 2020) and paranoid thinking (Geraets et al, 2020).…”

Consistency within change: Evaluating the psychometric properties of a widely-used predictive-inference task

“…Tracking participants' actions on each trial therefore allowed researchers to characterise learning 1,3,4,12,15,20 , arousal 2,6 , and neural mechanisms 7,8,11,19,21 in relation to these environmental changes. This cognitive flexibility is particularly relevant to psychiatric research, as cognitive inflexibility has been associated with several psychiatric disorders 13,18,[22][23][24][25][26][27][28][29][30][31][32] . For example, a study using this predictive-inference task showed that schizophrenic patients were prone to extreme forms of learning (i.e., little behavioural adaptation to new evidence and complete adaptation to it) 18 while patients with obsessive-compulsive disorder (OCD) have been seen to primarily over-emphasise new information at the cost of rashly discarding previously encountered evidence 13 .…”

The co-occurrence of multidimensional loneliness with depression, social anxiety and paranoia in non-clinical young adults: A latent profile analysis

“…In addition, the current study only considered core schemas as predictors of profiles. There may be other etiological processes, such as biases in reasoning and social cognition [e.g., (80)(81)(82)], that contribute to the classification of profiles. Lastly, the cross-sectional design of the study did not allow us to infer any directional relationships between loneliness and co-occurring symptoms, or to test the causal role of core schemas in the development of these profiles.…”