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How do confidence and self-beliefs relate in psychopathology: a transdiagnostic approach

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Abstract

Confidence is suggested to be a key component in psychiatry and manifests at various hierarchical levels, from confidence in a decision (local confidence), to confidence about performance (global confidence), to higher-order traits such as self-beliefs. Most research focuses on local confidence, but global levels may relate more closely to symptoms. Here, using a transdiagnostic framework, we tested the relationships between self-reported psychopathology, local and global confidence, and higher-order self-beliefs in a general population sample (N = 489). We show contrasting relationships between confidence and psychopathology dimensions. An anxious-depression dimension related to local and global underconfidence. By contrast, a compulsive-intrusive-thoughts dimension related to increased overconfidence at both levels, and showed a decoupling between (1) higher-order self-beliefs and (2) local and global task confidence. The strongest predictor of mental health was a self-beliefs dimension. This study examines higher-order confidence in relation to psychiatric symptoms fluctuating in the general population. Critically, psychopathological symptoms show distinct associations with confidence.

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Fig. 1: Experimental task design.
Fig. 2: Behavioral results of transdiagnostic dimensions and self-beliefs.
Fig. 3: Relationships between hierarchical levels of metacognition and transdiagnostic symptom dimensions.

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Data availability

Fully anonymized task and questionnaire data are available on https://osf.io/ncg4s/.

Code availability

The R analysis script is available on https://osf.io/ncg4s/.

References

  1. Boldt, A., Blundell, C. & De Martino, B. Confidence modulates exploration and exploitation in value-based learning. Neurosci. Conscious. 5, niz004 (2019).

    Article  Google Scholar 

  2. Vinckier, F. et al. Confidence and psychosis: a neuro-computational account of contingency learning disruption by NMDA blockade. Mol. Psychiatry 21, 946–955 (2016).

    Article  PubMed  Google Scholar 

  3. Heilbron, M. & Meyniel, F. Confidence resets reveal hierarchical adaptive learning in humans. PLoS Comput. Biol. 15, e1006972 (2019).

    Article  PubMed  PubMed Central  Google Scholar 

  4. Lee, D. & Daunizeau, J. Trading mental effort for confidence in the metacognitive control of value-based decision-making. eLife 10, e63282 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  5. Fleming, S. M., Dolan, R. J. & Frith, C. D. Metacognition: computation, biology and function. Philos. Trans. R. Soc. B 367, 1280–1286 (2012).

    Article  Google Scholar 

  6. Pouget, A., Drugowitsch, J. & Kepecs, A. Confidence and certainty: distinct probabilistic quantities for different goals. Nat. Neurosci. 19, 366–374 (2016).

    Article  PubMed  PubMed Central  Google Scholar 

  7. Folke, T., Jacobsen, C., Fleming, S. M. & De Martino, B. Explicit representation of confidence informs future value-based decisions. Nat. Hum. Behav. 1, 0002 (2017).

  8. Hoven, M. et al. Abnormalities of confidence in psychiatry: an overview and future perspectives. Transl. Psychiatry 9, 268 (2019).

    Article  PubMed  PubMed Central  Google Scholar 

  9. Seow, T. X. F., Rouault, M., Gillan, C. M. & Fleming, S. M. How local and global metacognition shape mental health. Biol. Psychiatry 90, 436–446 (2021).

    Article  PubMed  Google Scholar 

  10. Quiles, C., Prouteau, A. & Verdoux, H. Associations between self-esteem, anxiety and depression and metacognitive awareness or metacognitive knowledge. Psychiatry Res. 230, 738–741 (2015).

    Article  PubMed  Google Scholar 

  11. Bandura, A. Self-efficacy: toward a unifying theory of behavioral change. Psychol. Rev. 84, 191–215 (1977).

    Article  PubMed  Google Scholar 

  12. Bergamin, J., Luigjes, J., Kiverstein, J., Bockting, C. L. & Denys, D. Defining autonomy in psychiatry. Front. Psychiatry 13, 801415 (2022).

    Article  PubMed  PubMed Central  Google Scholar 

  13. O’Kearney, E. L. et al. Mastery is associated with greater physical and mental health-related quality of life in two international cohorts of people with multiple sclerosis. Mult. Scler. Relat. Disord. 38, 101481 (2020).

    Article  PubMed  Google Scholar 

  14. Eklund, M., Bäckström, M. & Hansson, L. Personality and self-variables: important determinants of subjective quality of life in schizophrenia out-patients. Acta Psychiatr. Scand. 108, 134–143 (2003).

    Article  PubMed  Google Scholar 

  15. Moroz, M. & Dunkley, D. M. Self-critical perfectionism and depressive symptoms: low self-esteem and experiential avoidance as mediators. Pers. Individ. Dif. 87, 174–179 (2015).

    Article  Google Scholar 

  16. Korn, C. W., Sharot, T., Walter, H., Heekeren, H. R. & Dolan, R. J. Depression is related to an absence of optimistically biased belief updating about future life events. Psychol. Med. 44, 579–592 (2014).

    Article  PubMed  Google Scholar 

  17. Beck, A. in Clinical Advances in Cognitive Psychotherapy: Theory and Application (eds. Leahy, R. L. & Dowd, E. T.) 29–61 (Springer, 2002).

  18. Rouault, M., Dayan, P. & Fleming, S. M. Forming global estimates of self-performance from local confidence. Nat. Commun. 10, 1141 (2019).

    Article  PubMed  PubMed Central  Google Scholar 

  19. Insel, T. et al. Research domain criteria (RDoC): toward a new classification framework for research on mental disorders. Am. J. Psychiatry 167, 748–751 (2010).

    Article  PubMed  Google Scholar 

  20. Gillan, C. M., Kosinski, M., Whelan, R., Phelps, E. A. & Daw, N. D. Characterizing a psychiatric symptom dimension related to deficits in goaldirected control. eLife 5, e11305 (2016).

    Article  PubMed  PubMed Central  Google Scholar 

  21. Rouault, M., Seow, T., Gillan, C. M. & Fleming, S. M. Psychiatric symptom dimensions are associated with dissociable shifts in metacognition but not task performance. Biol. Psychiatry 84, 443–451 (2018).

    Article  PubMed  PubMed Central  Google Scholar 

  22. Seow, T. X. F. & Gillan, C. M. Transdiagnostic phenotyping reveals a host of metacognitive deficits implicated in compulsivity. Sci. Rep. 10, 2883 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  23. Fleming, S. M. HMeta-d: hierarchical Bayesian estimation of metacognitive efficiency from confidence ratings. Neurosci. Conscious. 2017, 1–14 (2017).

    Article  Google Scholar 

  24. Maniscalco, B. & Lau, H. A signal detection theoretic approach for estimating metacognitive sensitivity from confidence ratings. Conscious. Cogn. 21, 422–430 (2012).

    Article  PubMed  Google Scholar 

  25. Silverstone, P. H. & Salsali, M. Low self-esteem and psychiatric patients: part I - the relationship between low self-esteem an psychiatric diagnosis. Ann. Gen. Hosp. Psychiatry 2, 2 (2003).

    Article  PubMed  PubMed Central  Google Scholar 

  26. Kleitman, S. & Gibson, J. Metacognitive beliefs, self-confidence and primary learning environment of sixth grade students. Learn. Individ. Differ. 21, 728–735 (2011).

    Article  Google Scholar 

  27. Kleitman, S. & Stankov, L. Self-confidence and metacognitive processes. Learn. Individ. Differ. 17, 161–173 (2007).

    Article  Google Scholar 

  28. Moses-Payne, M. E., Rollwage, M., Fleming, S. M. & Roiser, J. P. Postdecision evidence integration and depressive symptoms. Front. Psychiatry 10, 639 (2019).

    Article  PubMed  PubMed Central  Google Scholar 

  29. Rouault, M., Will, G. J., Fleming, S. M. & Dolan, R. J. Low self-esteem and the formation of global self-performance estimates in emerging adulthood. Transl. Psychiatry 12, 1–10 (2022).

    Article  Google Scholar 

  30. Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2013).

  31. Bekker, M. H. J. & Croon, M. A. The roles of autonomy-connectedness and attachment styles in depression and anxiety. J. Soc. Pers. Relat. 27, 908–923 (2010).

    Article  Google Scholar 

  32. Bekker, M. H. J. & Belt, U. The role of autonomy–connectedness in depression and anxiety. Depress. Anxiety 23, 274–280 (2006).

    Article  PubMed  Google Scholar 

  33. Bachrach, N., Bekker, M. H. J. & Croon, M. A. Autonomy-connectedness and internalizing-externalizing personality psychopathology, among outpatients. J. Clin. Psychol. 69, 718–726 (2013).

    Article  PubMed  Google Scholar 

  34. Sowislo, J. F. & Orth, U. Does low self-esteem predict depression and anxiety? A meta-analysis of longitudinal studies. Psychol. Bull. 139, 213–240 (2013).

    Article  PubMed  Google Scholar 

  35. Muris, P. Relationships between self-efficacy and symptoms of anxiety disorders and depression in a normal adolescent sample. Pers. Individ. Dif. 32, 337–348 (2002).

    Article  Google Scholar 

  36. Henriksen, M. G. & Parnas, J. Self-disorders and schizophrenia: a phenomenological reappraisal of poor insight and noncompliance. Schizophr. Bull. 40, 542–547 (2014).

    Article  PubMed  Google Scholar 

  37. Strayhorn, J. M. Self-control: theory and research. J. Am. Acad. Child Adolesc. Psychiatry 41, 7–16 (2002).

    Article  PubMed  Google Scholar 

  38. Rouault, M., McWilliams, A., Allen, M. G. & Fleming, S. M. Human metacognition across domains: insights from individual differences and neuroimaging. Personal. Neurosci. 1, 1–13 (2018).

    Article  Google Scholar 

  39. De Ruiter, N. M. P., Van Geert, P. L. C. & Kunnen, E. S. Explaining the ‘how’ of self-esteem development: the self-organizing self-esteem model. Rev. Gen. Psychol. 21, 49–68 (2017).

    Article  Google Scholar 

  40. Rouy, M. et al. Systematic review and meta-analysis of metacognitive abilities in individuals with schizophrenia spectrum disorders. Neurosci. Biobehav. Rev. 126, 329–337 (2021).

    Article  PubMed  Google Scholar 

  41. Guggenmos, M. Measuring metacognitive performance: type 1 performance dependence and test-retest reliability. Neurosci. Conscious 2021, 1–14 (2021).

    Article  Google Scholar 

  42. Lee, J. K., Rouault, M. & Wyart, V. Compulsivity is linked to maladaptive choice variability but unaltered reinforcement learning under uncertainty. Preprint at bioRxiv https://doi.org/10.1101/2023.01.05.522867 (2023).

  43. Orth, U., Robins, R. W. & Roberts, B. W. Low self-esteem prospectively predicts depression in adolescence and young adulthood. J. Pers. Soc. Psychol. 95, 695–708 (2008).

    Article  PubMed  Google Scholar 

  44. Rieger, S., Göllner, R., Trautwein, U. & Roberts, B. W. Low self-esteem prospectively predicts depression in the transition to young adulthood: a replication of Orth, Robins, and Roberts (2008). J. Pers. Soc. Psychol. 110, e16–e22 (2016).

    Article  PubMed  Google Scholar 

  45. Gillan, C. M. et al. Disruption in the balance between goal-directed behavior and habit learning in obsessive-compulsive disorder. Am. J. Psychiatry 168, 718–726 (2011).

    Article  PubMed  PubMed Central  Google Scholar 

  46. Vaghi, M. M. et al. Compulsivity reveals a novel dissociation between action and confidence. Neuron 96, 348–354 (2017).

    Article  PubMed  PubMed Central  Google Scholar 

  47. Snorrason, I., Lee, H. J., de Wit, S. & Woods, D. W. Are nonclinical obsessive-compulsive symptoms associated with bias toward habits? Psychiatry Res. 241, 221–223 (2016).

    Article  PubMed  Google Scholar 

  48. Hoven, M., Rouault, M., van Holst, R. & Luigjes, J. Differences in metacognitive functioning between obsessive- compulsive disorder patients and highly compulsive individuals from the general population. Preprint at PsyArXiv https://doi.org/10.31234/osf.io/fb32r (2022).

  49. Benwell, C. S. Y., Mohr, G., Wallberg, J., Kouadio, A. & Ince, R. A. A. Psychiatrically relevant signatures of domain-general decision-making and metacognition in the general population. npj Ment. Heal. Res. 1, 10 (2022).

    Article  Google Scholar 

  50. Katyal, S. & Fleming, S. M. Construct validity in metacognition research: balancing the tightrope between rigor of measurement and breadth of construct. Preprint at PsyArXiv https://doi.org/10.31234/osf.io/etjqh (2023).

  51. Wells, A. Breaking the cybernetic code: understanding and treating the human metacognitive control system to enhance mental health. Front. Psychol. 10, 2621 (2019).

    Article  PubMed  PubMed Central  Google Scholar 

  52. Anwyl-Irvine, A. L., Massonnié, J., Flitton, A., Kirkham, N. & Evershed, J. K. Gorilla in our midst: an online behavioral experiment builder. Behav. Res. Methods 52, 388–407 (2020).

    Article  PubMed  Google Scholar 

  53. Condon, D. M. & Revelle, W. The international cognitive ability resource: development and initial validation of a public-domain measure. Intelligence 43, 52–64 (2014).

    Article  Google Scholar 

  54. Zorowitz, S., Niv, Y. & Bennett, D. Inattentive responding can induce spurious associations between task behavior and symptom measures. Preprint at PsyArXiv https://doi.org/10.31234/osf.io/rynhk (2021).

  55. Faul, F., Erdfelder, E., Lang, A.-G. & Buchner, A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav. Res. Methods 39, 175–191 (2007).

    Article  PubMed  Google Scholar 

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Acknowledgements

M.R. is the beneficiary of a postdoctoral fellowship from the AXA Research Fund, and is also supported by the Fondation des Treilles, and by a department-wide grant from the Agence Nationale de la Recherche (ANR-17-EURE-0017, EUR FrontCog) and receives support under the programme “Investissements d’Avenir” launched by the French government and implemented by ANR (ANR-10-IDEX-0001-02 PSL). J.L. and this work is supported by an NWO VENI fellowship grant (916-18-119). R.J.v.H. is supported by an NWO aspasia grant (2019/SGW/00764779).

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Authors and Affiliations

  1. Amsterdam UMC location University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands

    Monja Hoven, Judy Luigjes, Damiaan Denys & Ruth J. van Holst

  2. Institut du Cerveau et de la Moelle Épinière, Centre National de la Recherche Scientifique, Hôpital Pitié Salpêtrière, Paris, France

    Marion Rouault

  3. Département d’Études Cognitives, École Normale Supérieure, Université Paris Sciences et Lettres, Paris, France

    Marion Rouault

  4. Centre for Urban Mental Health, University of Amsterdam, Amsterdam, The Netherlands

    Ruth J. van Holst

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  1. Monja Hoven
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  2. Judy Luigjes
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  3. Damiaan Denys
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  4. Marion Rouault
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  5. Ruth J. van Holst
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Contributions

J.L. and R.J.v.H. conceptualized the study. M.R. designed the task. M.H. performed data collection and data analyses and wrote a first draft, and subsequent editing. J.L., R.J.v.H. and M.R. supervised data collection and analyses. J.L., R.J.v.H., M.R. and D.D. reviewed and edited the manuscript.

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Correspondence to Monja Hoven.

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Nature Mental Health thanks Christopher S. Y. Benwell and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.

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Supplementary methods, discussion, Figs. 1–10 and Tables 1–5.

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Hoven, M., Luigjes, J., Denys, D. et al. How do confidence and self-beliefs relate in psychopathology: a transdiagnostic approach. Nat. Mental Health 1, 337–345 (2023). https://doi.org/10.1038/s44220-023-00062-8

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