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Continuous Theta Burst Stimulation of the Posterior Medial Frontal Cortex to Experimentally Reduce Ideological Threat Responses

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Reducing Delusional Conviction through a Cognitive-Based Group Training Game: A Multicentre Randomized Controlled

Yasser Khazaal¹, Anne Chatton¹, Karen Dieben¹

¹Geneva University Hospitals, Geneva University , Geneva , Switzerland.

Frontiers in Psychiatry

|May 15, 2015

Summary

Michael's Game (MG) significantly reduced delusional conviction in adults with psychotic disorders. This card game showed sustained benefits in reducing conviction, distress, and preoccupation related to delusions.

Keywords:

cognitive therapy game hypothetical reasoning psychotherapy psychotic disorders randomized controlled study schizophrenia

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Area of Science:

Psychiatry
Cognitive Behavioral Therapy

Background:

Delusional conviction is a core symptom in psychotic disorders.
Generating alternative hypotheses is a key cognitive process to challenge delusions.

Purpose of the Study:

To evaluate the efficacy of "Michael's Game" (MG) in reducing delusional conviction.
To assess the impact of MG on related symptoms like distress and preoccupation, and on cognitive flexibility.

Main Methods:

A parallel, assessor-blinded, randomized controlled superiority trial was conducted.
Adult outpatients with psychotic disorders and persistent positive symptoms were randomized to "Michael's Game" plus treatment as usual (TAU) or TAU plus a waiting list.
Assessments were performed at baseline, 3 months (post-treatment), and 6 months (follow-up).

Main Results:

A significant reduction in delusional conviction (Peters Delusions Inventory-21 conviction subscale) was observed post-treatment (p=0.005) and sustained at follow-up (p=0.002).
Significant improvements were also noted at follow-up in delusion-related distress (p=0.002), preoccupation (p=0.001), and belief flexibility (Maudsley Assessment of Delusions Schedule, p=0.001).

Conclusions:

"Michael's Game" demonstrated significant beneficial effects in reducing delusional conviction.
The study suggests MG is an effective intervention for individuals experiencing persistent positive psychotic symptoms.