Comparing non-clinical dissociative and psychotic-like experiences: reality monitoring and ‘fast thinking’ bias as possible cognitive correlates

Background and Hypothesis: Dissociative and psychotic experiences are closely linked, with particularly high co-occurrence at non-clinical levels. This suggests the possibility of shared mechanisms between psychotic-like experiences (PLEs) and dissociation. This study investigates the meta-memory function reality monitoring (RM) and cognitive bias ‘fast thinking’ as potential shared processes. It compares these functions across dissociation and PLEs to identify potential mechanistic overlap at these early stages and thus guide clinical priorities for patients presenting with this initial state.Study Design: Dissociation, PLEs (paranoia and unusual sensory experiences), and fast thinking were measured via self-report questionnaire in 162 general population participants. RM was measured with an auditory word-generation task and memory test and modelled using hierarchical Bayesian signal detection. Bayesian network models of the cognitive factors were compared across dissociation and PLEs. Study Results:Dissociation and PLEs were highly intercorrelated. RM was weakly positively correlated with unusual sensory experiences only, and there were no significant differences between the RM-mental health correlations. The network models revealed that fast thinking was positively related to paranoia and dissociation, but not to unusual sensory experiences. Paranoia showed the strongest association with fast thinking.Conclusions: Non-clinical dissociation was strongly related to PLEs. Dissociation and paranoia both related to fast thinking, whereas unusual sensory experiences did not show this trend. This illustrates heterogeneity within potential cognitive mechanisms PLEs and demonstrates that the dissociation-PLEs relationship is equally nuanced. The current study indicates mechanisms may overlap between dissociation and PLEs but that further work investigating other cognitive processes is needed.