Biased and Inattentive Responding Drive Apparent Metacognitive Biases in Mental Health

Large-scale online studies with healthy adults have documented consistent associations between transdiagnostic psychiatric traits and metacognitive biases. Here, analysis of existing and new large-scale datasets reveals that such correlations are largely driven by surface-level dimensions of questionnaire-filling behaviour: systematic rating biases and inattentive responding. Specifically, a bias to report positive or negative values in self-report scales generalizes to confidence ratings, producing spurious correlations between the two. Additionally, systematic over-confidence among inattentive responders produces spurious positive correlations between confidence and the endorsement of rare symptoms. We show that previously identified transdiagnostic dimensions of “anxiety-depression” and “compulsivity and intrusive thought,” both shown to correlate with decision confidence, map neatly onto these two biases of questionnaire-filling behaviour. In a pre-registered experiment, we further show that decision confidence and self-reported obsessive-compulsive tendencies are correlated with independent measures of inattentive and biased responding. Taken together, we find an alarming degree of influence of inattentive and biased responding over both self-report psychiatric measures and confidence ratings. When not accounted for, these factors produce a mirage of apparent metacognitive alterations in mental health. We discuss concrete precautionary measures that are needed to control for these biases.