Evidence map›Paper›PMID 40774027›Full record

Trial reportSchizophrenia research2025

Therapy process factors in early psychosis: The effect of working alliance on clinical symptoms and cognitive biases in Ultra High Risk young people.

Paulina Bagrowska, Cassandra Wannan, Andrea Polari, Hok Pan Yuen, Paul Amminger, Melissa Kerr, Jessica Spark, Nicky Wallis, Martha Shumway, Cameron Carter and 5 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Schizophrenia research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Paulina BagrowskaExperimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland. Electronic address: pbagrowska@psych.pan.pl.
Cassandra WannanOrygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.
Andrea PolariOrygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; Orygen Specialist Program, Melbourne, Victoria, Australia.
Hok Pan YuenOrygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.
Paul AmmingerOrygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.
Melissa KerrOrygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.
Jessica SparkOrygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.
Nicky WallisOrygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.
Martha ShumwayDepartment of Psychiatry and Behavioral Sciences, University of California, San Francisco, United States of America.
Cameron CarterDepartment of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, United States of America.
Lisa DixonDepartment of Psychiatry, Columbia University, New York, New York, United States of America.
Tara A NiendamDepartment of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, United States of America.
Rachel LoewyDepartment of Psychiatry and Behavioral Sciences, University of California, San Francisco, United States of America.
Patrick McGorryOrygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.
Barnaby NelsonOrygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.

Funding

Building the Evidence Base for Adaptive Treatment Sequences in Clinical High RiskU01MH105258 · NIMH · ORYGEN YOUTH HEALTH RESEARCH CENTRE · PI MCGORRY, PATRICK · 2015 to 2019
$6.0M
NIMH NIH HHS U01 MH105258Wellcome Trust
6 · The paper itself

Abstract

Approximately 25 % of individuals at Ultra High Risk (UHR) transition to a full psychotic disorder. Cognitive biases are thought to play a role in this risk, and improvements in cognitive biases have been associated with better clinical outcomes. Early intervention is crucial, yet no therapeutic approach has proven superior, and treatment adherence remains a challenge. Therapeutic alliance, shown to enhance adherence and clinical outcomes, might also influence depression and cognitive biases, but its role in these domains among UHR patients remains unclear. A total of 202 UHR participants (59.4 % females, mean age 17.4), taking part in the sequential multiple-assignment randomized trial (SMART), completed questionnaires assessing cognitive biases, attenuated psychotic symptoms, quality of life, general and social functioning, depression, and overall psychopathology at baseline, and at 6- and 12-month follow-ups. Additionally, both patients and their corresponding therapists rated working alliance following the 6- and 12-month treatment periods. The results revealed that patient-rated therapeutic alliance significantly predicted improvements in attenuated psychotic symptoms, cognitive biases, general psychopathology, social functioning, and quality of life, with the strongest effects observed when measured 6 months into treatment. The relationship between working alliance and decreases in attenuated psychotic symptoms, as well as between working alliance and reduction in general psychopathology, turned out to be mediated by improvements in cognitive biases. Therapist-rated working alliance did not significantly predict clinical improvements, showing only a minor association with quality of life. Strengthening the therapeutic alliance and prioritizing cognitive bias modification early in interventions for UHR patients may improve treatment outcomes. Further research is needed to validate these findings.

Indexed as

Outcome Assessment, Health CarePsychotic DisordersTherapeutic AllianceAdolescentFemaleFollow-Up StudiesHumansMaleProdromal SymptomsQuality of LifeRiskYoung AdultCognitive biasesPsychosisPsychotic disordersTherapeutic allianceUHRUltra-High-RiskWorking alliance

Identifiers

PMID40774027
PMCPMC13456984

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.