New approach to ‘thinking errors’

Promising results with a psychotherapy program for people with psychosis is leading researchers to look for ways to adapt it for other conditions such as eating disorders.

In new research published in Schizophrenia Bulletin,** the metacognitive training (or ‘MCT’) was found effective at reducing the conviction and distress caused by delusions, relative to a control condition.

The MCT intervention aims to help people to develop an awareness of the implausible content of their delusional beliefs while also targeting the cognitive biases, or ‘thinking errors,’ contributing to their condition.

National Schizophrenia Awareness Week, from Sunday 20-27 May 2019, is an opportunity to dispel myths and raise understanding of this distressing condition.

Up to 1 in 100 people can develop schizophrenia at some stage in their life, but the cause of schizophrenia is not fully understood.

Dr Ryan Balzan – a researcher and lecturer at Flinders University’s College of Education, Psychology and Social Work, says the MCT research complements new research into biological markers that help predict cognitive changes in people with schizophrenia, which may aid efforts to develop more effective drug treatments for schizophrenia.

The research, led by Neuroscience Research Australia, UNSW Sydney and Macquarie, included key data from South Australian patients.

“The study of this large cohort of critically ill patients has led to the discovery of an inflammatory mechanism or pathway that predicts brain volume loss and cognitive impairment associated with schizophrenia,” says Dr Balzan, who collaborated on the SA data collection in the comprehensive NeuRA study.

“It may represent a biomarker to help predict cognitive changes in people with schizophrenia and assist with more targeted cell therapies in the future.”

Dr Balzan’s latest research is focussing on adapting the MCT intervention to people with eating disorders.

“Eating disorders are serious mental illnesses that have a significantly harmful effect on psychological, physical and social wellbeing, with a high risk of mortality compared to other psychiatric disorders, particularly in teenagers,” says Dr Balzan, who is focusing on adolescents with anorexia nervosa in his latest study.

“The development of this new treatment approach has the potential to save lives.

“It will also contribute to our understanding of the cognitive biases that cause and maintain disordered eating beliefs and behaviours,” Dr Balzan says.

The study is supported by Statewide Eating Disorder Service research leader Flinders University Distinguished Professor Tracey Wade, Professor Steffen Moritz from the University Medical Center Hamburg Eppendorf, Germany and Professor Kate Tchanturia (Kings College London).

Funded by the Seven Children’s Research Foundation, about 40 adolescents with anorexia nervosa will be recruited for the MCT+ trial in Adelaide.

The latest biomarker article, ‘Dysregulation of kynurenine metabolism is related to proinflammatory cytokines, attention, and prefrontal cortex volume in schizophrenia, by J Kindler, CK Lim, CS Weickert, D Boerrigter, C Galletly, D Liu, KR Jacobs, R Balzan, J Bruggemann, M O’Donnell, R Lenroot, GJ Guillemin and TW Weickert (2019) has been published online in Molecular Psychiatry (Springer Nature).

**‘Individualized Metacognitive Training (MCT+) Reduces Delusional Symptoms in Psychosis: A Randomized Clinical Trial’ (2019), by Ryan P Balzan, Julie K Mattiske, Paul Delfabbro, Dennis Liu and Cherrie Galletly has been published in Schizophrenia Bulletin.

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College of Education, Psychology and Social Work