Increased distractibility to own name in psychotic patients with ideas and delusions of reference

ABSTRACT

Introduction. This study examined the relationship between ideas and delusions of reference (I/DOR) and attentional shift to a self-referential stimulus (subject's own name, SON).

Methods. Psychotic patients with I/DOR (n = 20) and without I/DOR (n = 17) matched for age and education were tested for attentional shift to SON embedded in a background voice clip presented binaurally when engaging in an attention-demanding task (computerised Stroop task). Reaction time and accuracy in Stroop tasks with and without embedded SON were measured. I/DOR severity, other positive symptoms, negative symptoms and cognitive performance were assessed.

Results. There was significant interaction between conditions (Stroop tasks with and without SON) and groups (patients with and without I/DOR) on reaction time (F(1,32) = 4.22, p = .05). Simple main effects showed a significant mean difference in reaction time between conditions in patients with I/DOR (107.7 milliseconds, p = .001) but not in those without (5.8 milliseconds, p = .86). Within-subject difference in reaction time correlated with I/DOR severity scores (r = .33–.52, range; p < .05) and remained significant after controlling for other clinical and cognitive variables.

Conclusions. The significant interaction and simple main effect suggest that I/DOR are associated with a heightened attentional shift to SON. The SON paradigm can potentially be developed into a neurocognitive parameter of I/DOR. However, the lack of non-self stimuli in the SON paradigm limits the interpretation on whether I/DOR are associated with general or specific distractibility related to self-referential information and further studies are warranted.

KEYWORDS:

• Psychotic disorders
• delusions
• psychopathology
• neuropsychiatry
• attention

Acknowledgements

The authors would like to thank all the patients who participated in this study and Mr Kent Ka-lok Li for giving valuable comments on the manuscript. All authors contributed to and approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Funding

This work was supported by the departmental research fund from the Department of Psychiatry, University of Hong Kong, Hong Kong.

ORCID

Lawson S. C. Tang http://orcid.org/0000-0003-2320-6872