research paper on abnormal psychology

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Paranormal beliefs and cognitive function: A systematic review and assessment of study quality across four decades of research

Charlotte E. Dean

Department of Psychology, School of Life and Medical Sciences, Sport and Geography, University of Hertfordshire, Hertfordshire, United Kingdom

Shazia Akhtar

Tim m. gale, karen irvine, dominique grohmann, keith r. laws, associated data.

All data files relating to the quality assessment are available from the OSF repository ( https://osf.io/7bthg/ ). Data relating to the 71 reviewed studies can be found within the paper's Supporting Information files.

Research into paranormal beliefs and cognitive functioning has expanded considerably since the last review almost 30 years ago, prompting the need for a comprehensive review. The current systematic review aims to identify the reported associations between paranormal beliefs and cognitive functioning, and to assess study quality.

We searched four databases (Scopus, ScienceDirect, SpringerLink, and OpenGrey) from inception until May 2021. Inclusion criteria comprised papers published in English that contained original data assessing paranormal beliefs and cognitive function in healthy adult samples. Study quality and risk of bias was assessed using the Appraisal tool for Cross-Sectional Studies (AXIS) and results were synthesised through narrative review. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was preregistered as part of a larger registration on the Open Science Framework ( https://osf.io/uzm5v ).

From 475 identified studies, 71 (n = 20,993) met our inclusion criteria. Studies were subsequently divided into the following six categories: perceptual and cognitive biases (k = 19, n = 3,397), reasoning (k = 17, n = 9,661), intelligence, critical thinking, and academic ability (k = 12, n = 2,657), thinking style (k = 13, n = 4,100), executive function and memory (k = 6, n = 810), and other cognitive functions (k = 4, n = 368). Study quality was rated as good-to-strong for 75% of studies and appears to be improving across time. Nonetheless, we identified areas of methodological weakness including: the lack of preregistration, discussion of limitations, a-priori justification of sample size, assessment of nonrespondents, and the failure to adjust for multiple testing. Over 60% of studies have recruited undergraduates and 30% exclusively psychology undergraduates, which raises doubt about external validity. Our narrative synthesis indicates high heterogeneity of study findings. The most consistent associations emerge for paranormal beliefs with increased intuitive thinking and confirmatory bias, and reduced conditional reasoning ability and perception of randomness.

Conclusions

Although study quality is good, areas of methodological weakness exist. In addressing these methodological issues, we propose that authors engage with preregistration of data collection and analysis procedures. At a conceptual level, we argue poorer cognitive performance across seemingly disparate cognitive domains might reflect the influence of an over-arching executive dysfunction.

Introduction

The term “paranormal” typically refers to phenomena, such as psychokinesis, hauntings, and clairvoyance, which contradict the basic limiting principles of current scientific understanding [ 1 ]. Surveys consistently indicate paranormal beliefs are prevalent within the general population. For example, a representative survey of British adults conducted by the market-research company BMG Research [ 2 ] found that a third of their sample believed in paranormal phenomena, and a further 21% were ‘unsure’. Of those who either believed in the paranormal or were unsure, 40% indicated they had seen or felt the presence of a supernatural entity. Similarly, Pechey and Halligan [ 3 ] found 30% of participants held at least one strong paranormal belief, and 79% held at least one paranormal belief at any strength (weak, moderate, or strong belief). Comparable levels of belief have been documented across various cultures over recent decades [ 4 – 7 ].

The most frequently used scales to measure paranormal beliefs include Tobacyk’s Paranormal Belief Scale in both original (PBS) [ 8 ] and revised form (RPBS) [ 9 ], and the Australian Sheep-Goat Scale (ASGS) [ 10 ]. Despite widespread use, some concerns exist about both the content and the factor structures of these measures [ 11 – 13 ]. Nonetheless, both the RPBS and ASGS have demonstrated excellent internal reliability, with Cronbach’s alpha values around .93 for the RPBS [ 14 – 16 ], and around .95 for the ASGS [ 17 , 18 ].

Scores on paranormal belief measures have been linked to various personal and demographic characteristics. For example, higher belief scores have been noted for individuals high in extraversion and neuroticism [ 19 – 21 ], while lower belief scores have been seen for those with higher levels of education [ 22 – 24 ]. Paranormal belief levels also appear to vary across academic disciplines; with those engaged in hard (or natural) sciences, medicine, and psychology showing significantly lower paranormal belief scores than those in education, theology, or artistic disciplines [ 25 , 26 ]. Higher levels of paranormal beliefs have been documented in women and younger individuals [ 27 – 32 ], though these sex and age effects are inconsistently reported [ 33 ] and have generated substantial debate [ 34 – 36 ].

Paranormal beliefs and cognitive function

The association between cognitive functioning and paranormal beliefs has been researched over several decades. Such functions include memory, attention, language, and executive function (the umbrella term used to describe set-shifting ability, inhibitory control, and working memory updating; for a full description of executive function, see Miyake et al.’s work [ 37 ]).

As important for cognitive function is an individual’s belief system. Religious and spiritual beliefs have been associated with slower cognitive decline in older adults [ 38 , 39 ] but have also been shown to have an inverse relationship with memory performance [ 40 ] and intelligence [ 41 , 42 ]. Similarly, so-called “epistemically unwarranted beliefs” [ 19 ], which includes belief in conspiracy theories, has been linked with lower educational attainment and reduced analytical thinking [ 43 , 44 ]. Conspiracist beliefs are similarly associated with increased illusory pattern perception [ 45 , 46 ], decreased need for cognition and cognitive reflection [ 47 – 49 ], biases against confirmatory and disconfirmatory evidence [ 50 ], and hindsight bias (for discussions on this topic see [ 51 – 53 ]).

The last published review to examine the relationships between paranormal beliefs and various aspects of cognition was conducted by Irwin in 1993 [ 53 ]. That non-systematic narrative review of 43 studies is now almost 30 years old and may have introduced bias by “…citing null results only when these form a substantial proportion of the available data on a given relationship” (p.6). At the time of his review, Irwin [ 53 ] concluded that, owing to the variable findings, support for the cognitive deficits hypothesis remained uncertain.

Research has grown considerably since Irwin’s [ 53 ] review and an updated and systematic review is timely. The current review has two key aims: first, to provide the first assessment of study quality [ 54 ] in this area and second, to systematically review and summarise key associations between paranormal beliefs and a range of cognitive functions.

This review was conducted within the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines [ 55 ] (see S2 Appendix for PRISMA checklist). The systematic review was preregistered at the Open Science Framework (OSF; https://osf.io/uzm5v ) as part of a larger study (also assessing the relationships between paranormal beliefs and schizotypal personality traits). Data used for the descriptive and inferential analyses presented in the results section are available at the OSF preregistration. One author (CED) conducted the search strategy, article eligibility assessment, and data extraction.

Search strategy

A systematic literature review was chosen for this area owing to its strength as a method to synthesise relevant evidence from large bodies of research [ 56 , 57 ]. Our searches included both peer-reviewed articles published in scholarly journals and “grey literature” (concerning unpublished works such as doctoral theses).

We searched the electronic databases Scopus, ScienceDirect, SpringerLink, and OpenGrey from inception to May 2021. Our search terms were: (1) “paranormal belief” AND cogni*, (2) “paranormal belief” AND thinking, and (3) “paranormal belief” AND (memory OR “executive function”). For databases that did not permit wildcard Boolean operators (ScienceDirect), one of the above search terms was amended and entered as: “paranormal belief” AND (cognition OR cognitive), to best replicate the effect of the Boolean operator. Following exclusion of duplicate articles across databases, titles and abstracts were assessed to identify studies relevant to the review. Full-text assessment of eligible studies was performed to determine final inclusion. Full-text copies were unavailable for five studies, which were subsequently sought for retrieval. Finally, we hand-searched reference lists for each included article to identify any additional relevant articles. The PRISMA flow diagram presented in Fig 1 illustrates the full screening and selection process. The PRISMA checklist for abstracts is presented in S1 Appendix , and the full PRISMA checklist is presented in S2 Appendix .

Inclusion/Exclusion criteria

Studies were eligible for inclusion if they were: published in the English language, conducted with a healthy adult sample (age 18 or over) and presented original data involving both a measure of paranormal belief and a measure of cognitive function. As cognitive functions have been shown to peak at different ages (for a detailed discussion on this topic, see [ 58 ]), we excluded samples that included children and adolescents under the age of 18 as some cognitive functions are still developing in these younger individuals.

Data extraction

We used a detailed data extraction form to collate the following information from included studies: sample sizes and demographic details (including sex, age and education), the measures of self-rated paranormal belief, the aspect of cognition assessed, the tests of cognitive functions used, and findings relating to the relationship between paranormal beliefs and cognitive function. We categorised eligible outcome measures broadly to include both global cognitive function and domain-specific cognitive functions. Any measure of cognitive function was eligible for inclusion (e.g., neuropsychological tests, self-report measures). Results for both paranormal beliefs and cognitive functioning could be reported as an overall test score that provides a composite measure, subscale scores that provide domain-specific measures, or a combination of the two. When multiple cognitive outcomes were investigated, we included all measures. To assess the strength of the relationships between paranormal beliefs and various cognitive functions, we calculated the number of positive, negative, or null findings reported by each study included in the review. Measures of paranormal belief were examined to determine the extent to which established questionnaires have been used.

In line with our preregistered protocol, we synthesised evidence narratively. Meta-analyses could not be undertaken because of the heterogeneity of study designs and outcome measures. We did, however, develop summary tables that include information relating to: sample size, gender composition, mean sample age, cognitive domain, outcome measure, and key findings. Given the range of outcome measures, we attempted to categorise the included studies by common cognitive domains. As the review took an explorative approach, and did not specify domains of interest, categorisation took place after full-text evaluation of included studies.

Electronic and hand searches identified 902 papers, of which 475 were unique. Most articles (k = 391) were excluded from the review following title and abstract screening, leaving 84 eligible for full-text evaluation. We removed 13 studies that included participants under the age of 18 (see S1 Table for details of these studies). Seventy-one papers met our inclusion criteria (see Fig 1 ), which included 70 published between 1980 and 2020 and one unpublished doctoral thesis [ 59 ].

Assessment of study quality and risk of bias

The preregistration for this review specified using a bespoke series of questions to assess study quality, but we subsequently decided to use a more well-established and validated measure of study quality in the Appraisal tool for Cross-Sectional Studies (AXIS) tool [ 60 ]. Of the 20 AXIS items, seven assess reporting quality (items: 1, 4, 10, 11, 12, 16 and 18), seven relate to study design (items: 2, 3, 5, 8, 17, 19 and 20), and six to possible biases (items: 6, 7, 9, 13, 14 and 15). Two authors (DG and CED) independently rated each study, and these two sets of ratings had almost-perfect agreement (93%) with Kappa = .84.

Following previous research [ 61 ], we classified AXIS quality scores according to the number of "Yes" responses for the 20 items for each study—poor quality for scores <50%, fair quality for scores between 50 to 69%, good quality for scores of 70% to 79%, strong quality for scores of 80% and higher. Three in four studies were rated as either ‘strong’ (26/71: 37%) or ‘good’ (27/71: 39%). By contrast, 17/71 (24%) were rated as ‘fair’ and only 1/71 (1%) was rated as ‘poor’. The mean quality rating score across all 71 studies was in the ‘good’ range; however individual AXIS items are not weighted and so this total score provides a general, but limited, classification that should be interpreted with some caution. The number of papers meeting each AXIS criterion (‘Yes’) is presented in Table 1 . The number of papers meeting the criteria for each AXIS domain (reporting quality, study design quality, and potential biases) is presented in Figs ​ Figs2 2 – 4 respectively.

All studies scored positively for items concerning: clear objectives, appropriate study design, appropriate measurement of outcome variables, internal consistency of presented results, and appropriate conclusions justified by the results. Study quality correlated with year of publication ( r = .64, p < .001), and appears to be improving with time (see Fig 5 ). Nonetheless, three main areas for study quality improvement were highlighted throughout the AXIS assessment: sample size justification, nonrespondents, and discussion of limitations.

Sample size justification, sample representativeness and open science

Only 5 of 71 (7%) papers included a-priori power analyses to justify their sample sizes. Although power analyses are rarely conducted in this research area, the mean sample size is large at 211 (median = 124), suggesting that both simple correlational and between-subject comparisons are well-powered to detect large (.99 and .98), moderate (.94 and .88) and potentially for small effect sizes (.72 and .72)–large, moderate and small effects being 0.7, 0.5 and 0.2 respectively [ 62 ]. Despite this, many studies have assessed multiple outcomes and/or multiple metrics derived from the same tests and so, a simple power analysis will mislead. As a rough metric on this issue, we calculated the number of p -values presented in the results section for each of the 71 papers. This revealed a mean number of p -values per study of 43 (median = 30) with a range from 1 [ 63 ] to over 200 [ 64 ]. So, despite relatively large samples, the possibility of type-1 errors remains high, especially when studies fail to adjust alpha levels for high levels of multiple testing. Only 12/71 studies employed some correction; eleven used a Bonferroni correction [ 15 , 25 , 64 – 72 ], and one used the Newman–Keuls adjustment [ 73 ]. Those studies that adjusted alpha levels tended to report more p -values than those that did not adjust (means 57 vs. 40). So, adjustment was made in fewer than one-in-five studies, most being published recently.

Despite good-strong quality ratings, some core features of open science practice including preregistration have yet to be embraced in this literature. Admittedly, we are assessing forty years of research and preregistration is a relatively recent innovation in psychology. Nonetheless, the Open Science Framework (OSF) began in 2013 as a repository for preregistrations–so potentially up to half of the 71 studies could have preregistered, yet only 2 (<3%) have done so [ 71 , 74 ], with both published in 2020. The issue about preregistration is fundamental in this area of research. First, studies are characterised by large numbers of analyses often involving multiple outcome measures and/or multiple metrics derived from smaller numbers of tests. We have also seen that up to one-third of studies (25/71) have assessed relationships between cognitive function and paranormal test subscale scores (often with few items). This approach consciously or unconsciously increases the likelihood of reporting bias and HARKing ( hypothesizing after results are known ), often perhaps with little chance of, or interest in, replicating such findings (see Laws [ 75 ] for a discussion). Second, the preregistration of future trials will also help to assess whether null results remain unpublished. Third, preregistration would identify both the primary outcome and the sample size required to achieve an acceptable level of statistical power. Ironically, the lack of attention to pre-registration and justifying sample sizes contrasts with research on paranormal phenomena, where study registration and a priori power calculations have been employed for many years [ 76 ].

Representativeness

Another issue concerns the sampling frame and its representativeness. Almost two-thirds of all samples are undergraduates (45/71: 63%) and of those, 21 (30%) consisted wholly of, or a majority of, psychology undergraduates. Only one-third of all samples consisted of: non-undergraduates (15/71: 21%), mixed undergraduate and general population samples (8/71: 11%) or other non-undergraduate samples (2/71: 3%). One non-undergraduate study by Blackmore in 1997 [ 77 ] consisted of a national newspaper-based study (Daily Telegraph) and recruited an exceptionally large sample (n = 6238). If we exclude this outlier, then 60% of all participants in the 70 remaining studies have been completely (k = 41) or majority undergraduate (k = 5) samples, with 16 involving only psychology graduates. Amongst the non-undergraduate samples, this includes visitors to a paranormal fair [ 29 , 66 ], members of the Society for Psychical Research [ 78 ], Mechanical Turk participants [ 79 ], and some used Crowdflower, a crowdsourcing website [ 64 , 80 , 81 ]. So, even the non-undergraduate samples may not necessarily represent the wider population (see Stroebe et al. [ 82 ] for a discussion). Studies testing undergraduates and non-undergraduates did not differ in mean sample size (196 vs 215, with the exclusion of Blackmore [ 77 ], t (68) = .29, p = .78, d = .08) or in quality ratings (14.73 vs 15.19: t (69) = -.90, p = .37: d = .23). The profile of sampling, however, is pertinent because paranormal beliefs are inversely related to educational levels [ 22 – 24 ], and those studying sciences, medicine, and psychology exhibit lower levels of paranormal beliefs [ 25 , 26 ]. Such samples are unrepresentative and may bias findings because they may combine lower levels of paranormal beliefs and higher cognitive functioning than occurs in the general population.

In addition to samples comprising more highly educated university students, most participants are female (>60%). The importance of this latter aspect of sampling is underscored for at least two reasons. First, some authors have documented greater levels of paranormal beliefs in women [ 27 – 32 ]. Indeed, the last literature review by Irwin in 1993 [ 53 ] stated that “the endorsement of most, but certainly not all, paranormal beliefs is stronger among women than among men” (p.8). Second, gender (and age) effects are not consistently reported [ 33 ] and have resulted in substantial debate [ 34 – 36 ]. This debate largely results from differences in psychological test theories (see Dean et al. 2021 [ 83 ] for a discussion). Classical test theory—used to develop common paranormal belief measures, such as the RPBS—does not test for the presence of differential item functioning (DIF). DIF refers to when individuals with the same latent ability (e.g., paranormal beliefs), but from different groups, have an unequal probability of giving a response. By contrast, modern test theory, including the use of Rasch scaling, can produce unbiased interval measures focused on the hierarchical properties of questionnaire items. This has resulted in the revision of older paranormal belief measures using modern test theory, to create scales that accurately capture fluctuations in levels of belief rather than differences in item functioning [ 84 , 85 ]. When these problematic items are removed from scales such as the RPBS and ASGS, paranormal belief scores are no longer associated with sex, but small differences remain for age [ 84 , 85 ]. Although these effect sizes seem to be small (e.g., 0.15 [ 84 ], identified by Cohen [ 62 ] as a small effect size), they are more likely to reflect a true and meaningful fluctuation in paranormal belief levels, compared to findings reported using scales developed through classical test theory.

Nonrespondents

Most studies (52/71) failed to state whether measures were undertaken to address and categorise nonrespondents. As such, response rates and risk of nonresponse bias could not be calculated. Nonresponse bias arises when respondents differ from nonrespondents beyond sampling error and may reduce external validity [ 86 , 87 ]. Survey-based approaches are at a greater risk of nonresponse bias owing to their high nonresponse rates, with those relying on self-administered online surveys suffering from higher nonresponse rates than those using face-to-face methods [ 88 ]. Most studies have been conducted in face-to-face settings (k = 59), however the past few years has seen a rise in online data capture (k = 12). Compared to face-to-face studies, online studies rated more highly on study quality (16.50 vs 14.49: t (69) = -3.87, p < .001, d = 1.32) and had larger mean sample sizes (482 vs 155: t (11.83) = -3.12, p = .008, d = -1.69, equal variances not assumed), but also report larger numbers of statistical comparisons (96.42 vs 31.58,: t (12) = -3.47, p = .005, d = 1.33, equal variances not assumed).

Of the 19 papers that did provide nonresponse rates, seven had response rates < 70% and so raise concerns about potential nonresponse bias [ 89 ]. Only one of 19 papers [ 90 ] presented any information about nonrespondents, reporting that they had marginally lower educational attainment than respondents. Similar findings for nonrespondents have been reported in other research areas [ 91 – 94 ]. Finally, we note that online studies more often have records of nonrespondents. Guidance has been developed on detailing non-response details in online survey-type studies e.g., the Checklist for Reporting Results of Internet E-Surveys (CHERRIES) [ 95 ] and should routinely be reported.

Limitations

Surprisingly, up to 40% of the included papers (29 of 71) did not include a discussion of study limitations. Discussion of study limitations forms a fundamental part of scientific discourse and is crucial for genuine scientific progress, allowing a reader to contextualise research findings [ 96 ]. The failure to discuss limitations might be viewed partly as a failure of the peer review process [ 97 ], but responsibility ultimately resides with authors. Detailing limitations allows other researchers to consider methodological improvements, identify gaps in the literature and has an ethical element by aiding research transparency. The inclusion of limitations not only helps increase research quality, but facilitates directions for future research and crucially, replications.

Quality summary

Of the 71 studies published since 1980, three-quarters were rated as ‘good’ or ‘strong’ in quality, and only one received a ‘poor’ quality rating. Indeed, study quality also indicates a continuous improvement in study quality across four decades of research. Despite the high levels of study quality and evidence of improving quality, we identified areas of methodological weakness: justifying sample size, providing more detail about non-respondents, and discussing study limitations.

One issue of note is the sampling, where almost two in three studies have relied on exclusively undergraduate samples (46/71: 65%), with many being psychology undergraduates. Future recruitment needs to move beyond the highly educated and address the bias towards female participants. Despite recruiting large samples, studies use large numbers of analyses, with a mean of 43 p -values reported in results sections, and rarely report appropriate adjustment of significance levels (12/71: 17%). These methodological issues are compounded by the fact that so few studies pre-register their primary hypotheses and analyses in advance (2/71: 3%).

Cognitive functioning

The 71 studies were grouped into six sections: (1) perceptual and cognitive biases, (2) reasoning, (3) intelligence, critical thinking, and academic performance, (4) thinking style, (5) executive function, and (6) other cognitive functions. Whenever possible, categories were classified according to the focus identified by the authors in each study. Such classifications are necessarily a simplification and not intended to provide a definitive organisation. Moreover, many studies could receive multiple classifications owing to the breadth of testing conducted (see S9 Table ). In this context, S9 Table shows that two in three (48/71) studies might be classified as assessing executive function.

Articles presented in the first section (perceptual and cognitive biases) included scenarios aimed at measuring cognitive biases towards confirmatory evidence, and the impact of visually degraded stimuli on biases in perceptual decision-making. Examples of tasks used in the second section (reasoning) include the mental dice task [ 63 ] aimed at measuring probabilistic reasoning, and the Reasoning Tasks Questionnaire (RTQ) [ 98 ] to assess both probabilistic and conditional reasoning. Studies in the third category (intelligence, critical thinking, and academic performance) included published measures such as the Watson-Glaser Critical Thinking Appraisal (WGCTA) [ 99 ] and variations of Raven’s matrices (e.g., the Advanced Progressive Matrices Test [ 100 ]; Raven’s Progressive Matrices [ 101 ], and measures of academic achievement such as grade point average. In the fourth section (thinking style), papers used measures such as the Rational Experiential Inventory (REI) [ 102 ] and the Cognitive Reflection Test [ 103 ], aimed at assessing intuitive and analytical thinking. Studies in the fifth section (executive function and memory) included tasks such as the Deese-Roediger-McDermott task (DRM) [ 104 ] and the Wisconsin Card Sorting Test [ 105 , 106 ]. The final cognitive section (other cognitive functions) included tasks to measure indirect semantic priming (using prime-target word pairs) and implicit sequence learning.

Perceptual and cognitive biases

Nineteen articles (n = 3,397) assessed perceptual and cognitive biases. Perceptual decision-making with high visual noise stimuli has produced inconsistent findings (k = 7). For example, in 2014 Simmonds-Moore [ 67 ] found believers made more misidentifications of degraded black and white images of objects and animals (e.g., shark, umbrella), despite having faster response latencies than sceptics (suggesting a potential speed-error trade-off, with believers favouring speed over accuracy). By contrast, Van Elk [ 66 ] found sceptics mis-categorised degraded black and white images of face stimuli as houses more frequently than believers. The findings from both studies, however, contradict those from Blackmore and Moore’s 1994 study [ 107 ], which reported no difference in the accurate identification of degraded monochrome images for believers and sceptics.

Two studies assessed perceptual decision-making relating to faces within degraded and artifact stimuli. Using black and grey images of faces and “nonfaces” (scrambled eyes-nose-mouth configurations), Krummenacher and colleagues [ 73 ] found believers made significantly more Type I errors than sceptics, favouring “false alarms” over “misses” (i.e., believers had a lower response criterion when classifying images as faces, with a bias towards “yes” responses). Similarly, Riekki et al. [ 108 ] presented participants with 98 artifact face pictures (containing a face-like area where eyes and a mouth could be perceived, e.g., a tree trunk) and 87 theme-matched non-face pictures (e.g., a tree trunk with no face-like areas). Believers rated the non-face pictures as more face-like and assigned more extreme positive and negative emotions to non-faces than sceptics.

A study conducted by Caputo [ 109 ] employed the strange-face illusion paradigm, in which pairs of participants are instructed to gaze into each other’s eyes for 10 minutes in a dimly-lit room. This paradigm induces the experience of seeing face-related illusions and is assessed on a self-report measure (Strange Face Questionnaire; SFQ [ 110 ]). No association was found for paranormal beliefs and the experience of strange-face illusions. A final study of perceptual decision-making conducted by Van Elk [ 111 ] used point-light-walker displays (an animated-point-set of 12 points, representing a human walking on a treadmill), randomly scrambling the location of each individual dot across the display; and participants had to detect if a human agent was present. Paranormal believers were more prone to illusory agency detection than sceptics, being biased towards ‘yes’ responses when no agent was present.

Cognitive biases have been assessed in 11 papers. These include reports of significant associations between paranormal belief and illusion of control or differences in causation judgements [ 65 , 112 – 114 ] and risk perception [ 115 ]. Two studies, however, report no significant relationships [ 29 , 116 ]. Further work shows that paranormal beliefs positively correlated with biases towards: anthropomorphism, dualism, teleology, and mentalising, but were not predicted by mentalising [ 15 ].

Proneness to jump to conclusions was assessed by Irwin and colleagues [ 68 ] using a computerised task [ 117 ]. Participants were informed of proportions of beads in two jars (e.g., 70 black and 30 red beads in jar one, but 30 black and 70 red beads in jar two), then shown a sequence of beads drawn one at a time from one of the jars and asked to identify whether beads were drawn from jar one or two, and to indicate when they are certain. Those who require fewer draws before being certain of their decision are identified as being prone to “jump to conclusions”. A significant negative correlation emerged for jumping to conclusions, but only with the Traditional Religious Beliefs (TRB) subscale of the Rasch-devised RPBS [ 85 ]. A significant positive correlation was also found between TRB scores and self-report indices of jumping to conclusions as measured with the Cognitive Biases Questionnaire [ 118 , 119 ] (e.g., “imagine you hear that a friend is having a party and you have not been invited”, 1 = little or no inclination to jump to a premature conclusion, 2 = inclination to make a cautious inference, 3 = inclination to jump to a dramatic inference).

Prike et al. [ 64 ] assessed proneness to jumping to conclusions using both a neutral (beads task) and an emotional draws-to-decision task (where participants decide whether positive or negative words are more likely a description of “Person A” or “Person B”–for a full description see Dudley et al.’s work [ 120 ]). Participants also saw a series of 24 scenarios to assess bias towards confirmatory and disconfirmatory evidence, as well as liberal acceptance. Each scenario consisted of three statements presented one at a time, e.g., (a) “Eric often carries binoculars with him”, (b) “Eric always has an unpredictable schedule”, (c) “Eric tries to solve mysteries”. Participants rated the likelihood of the same four response options after each statement, e.g., (a) “Eric is a private detective”, (b) “Eric is a bird expert”, (c) “Eric is a stalker”, (d) “Eric is an astronaut”. Each scenario presented an absurd interpretation (implausible for all three statements), a neutral lure, an emotional lure, and a true interpretation (less or equally as plausible as the lure options after the first statement but became the most plausible by the third statement). Paranormal beliefs were related to both disconfirmitory and confirmatory biases, but not to jumping-to-conclusions. Liberal acceptance predicted belief in the paranormal, but not after controlling for delusion proneness (as measured by the Peters et al. Delusions Inventory; PDI [ 121 ]). Lesaffre et al. [ 122 ] exposed participants to a magic performance and asked whether it was accomplished through: (1) paranormal, psychic, or supernatural powers, (2) ordinary magic trickery, or (3) religious miracles. Confirmation bias (i.e., explaining the magic performance in terms of paranormal powers) was associated with higher levels of paranormal beliefs. Barberia and colleagues [ 123 ] demonstrated that educating participants about confirmatory bias reduced scores on the Precognition subscale of the RPBS (but did not reduce global belief scores).

The studies assessing perceptual and cognitive biases are somewhat inconsistent regarding perceptual decision-making errors in response to degraded or ambiguous stimuli. Of the studies exploring perceptual decision-making, four suggest an inverse relationship between paranormal belief and perceptual decision-making, two found no relationship, and one reported more perceptual decision-making errors from sceptics. Results show greater consistency when perceptual decision-making tasks involve identifying a human face/agent (rather than inanimate objects or animals), with believers making significantly more false-positive misidentifications than sceptics. In the 11 studies exploring cognitive biases, paranormal believers show a consistent bias towards both confirmatory and disconfirmatory evidence. The evidence that paranormal belief links to the tendency to “jump to conclusions” is weaker, but only two studies present findings related to this outcome.

Seventeen papers have focussed on reasoning ability (n = 9,661), with the majority (12/17) reporting significant inverse relationships with paranormal beliefs and probabilistic reasoning. Perception of randomness and the conjunction fallacy have also been associated with paranormal beliefs on tasks with both neutral and paranormal content [ 69 , 80 , 124 – 128 ].

In 2007, Dagnall et al. [ 126 ] presented 17 reasoning problems across four categories: perception of randomness, base rate, conjunction fallacy, and probability. Perception of randomness problems required participants to determine the likelihood of obtaining particular strings (e.g., “Imagine a coin was tossed six times. Which pattern of results do you think is most likely? (a) HHHHHH, (b) HHHTTT, (c) HTHHTT, (d) all equally likely”). Performance on these problems significantly predicted paranormal belief, with believers making more errors than sceptics. No significant differences or predictive effects emerged for the three other problem categories. In a later study, Dagnall and colleagues [ 127 ] presented 20 reasoning problems across five categories of: perception of randomness, base rate, conjunction fallacy, paranormal conjunction fallacy, and probability. The authors again reported perception of randomness to be the sole predictor of paranormal beliefs, with high belief associated with fewer correct responses. While these papers report no effects in relation to conjunction fallacy, Rogers et al. [ 128 ] demonstrated a significant main effect of paranormal belief on conjunction errors, with believers making more errors than sceptics. In later studies, both Prike et al. [ 80 ] and Rogers et al. [ 129 ] reported an association between paranormal belief and conjunction fallacy, but this association was only significant for scenarios with confirmatory outcomes in the latter study.

Probabilistic reasoning ability has been consistently associated with paranormal beliefs across five studies. In one paper [ 130 ], participants received a probabilistic reasoning test battery comprised of six tasks. For example, one task was a variant of the birthday paradox (from Blackmore and Troscianko [ 97 ]), in which participants are asked: “How many people would you need to have at a party to have a 50:50 chance that two of them will have the same birthday (regardless of year of birth)”. Possible answers for this task were 22 (correct), 43, or 98. Significant positive correlations emerged between paranormal beliefs and errors on three of the six tasks (dice sequences, dice throws, and sample size estimates). In the second study [ 63 ], participants received written descriptions of two hypothetical events: throwing 10 dice once to get 10 sixes and throwing one die 10 times to get 10 successive sixes; and had to identify whether one event was more probable or both equally probable. The authors reported 64% of believers and 80% of sceptics correctly identified that both events were equally probable. Brugger et al. [ 131 ] assessed differences in repetition avoidance between believers and sceptics on a mental dice task (where participants imagined throwing a die and had to write down the number they imagined being on top of the die), finding significantly fewer repetitions in believers than sceptics. Similarly, Bressan et al. [ 132 ] used a probabilistic reasoning questionnaire with problems concerning the comprehension of sampling issues, sensitivity to sample size, representative bias (as applied to sample size or random sequences) and the generation of random sequences. Believers made more probabilistic errors on two of four generation of random sequences problems: (1) simulated coin toss problem, in which participants were asked to fill in 66 empty cells by writing ‘H’ (heads) or ‘T’ (tails) randomly to make a resulting sequence that was indistinguishable from that of an actually tossed coin), and (2) an adapted version of Brugger et al.’s [ 131 ] mental dice task. Finally, Blackmore [ 77 ] asked participants whether a list of 10 statements (as might be produced by a psychic, e.g., “there is someone called Jack in my family”) were true for them, and to estimate the number of these statements that might be true for a stranger in the street. The number of ‘true’ statements was greater for believers than sceptics (significantly on five of the ten questions), however no significant differences emerged when estimating the number of statements true for a stranger.

The final four papers in this section found non-significant correlations between paranormal belief and probabilistic reasoning, but significant correlations with conditional reasoning tasks. Using the Reasoning Tasks Questionnaire (RTQ) [ 97 ], one study [ 4 ] found neither probabilistic reasoning nor neutral conditional reasoning were associated with paranormal beliefs. However, conditional reasoning was associated with paranormal beliefs when conditional reasoning tasks contained paranormal content rather than neutral content, with believers making fewer errors on these tasks. The second paper [ 133 ] measured reasoning using a test that combined probabilistic reasoning questions (seven in total, four of which were derived from the RTQ), conditional reasoning questions with abstract content (e.g., “if C is true, then D will be observed. D is observed. Therefore, C is true: True or False?”), and conditional reasoning questions with paranormal content (e.g., “if people are aware of hidden objects, then clairvoyance exists. People are aware of hidden objects. Therefore, clairvoyance does exist: True or False?”). Overall, paranormal beliefs correlated negatively with reasoning ability and conditional reasoning ability, but not with probabilistic reasoning ability. When comparing the two types of conditional reasoning questions, the authors reported no difference between the correlations for paranormal beliefs and either the abstract or paranormal conditions. Following a similar format, Wierzbicki [ 134 ] assessed reasoning ability using 16 conditional reasoning statements with either parapsychological or abstract content, finding paranormal belief scores and number of reasoning errors correlated positively. The final paper in this section [ 78 ] employed 32 statements conditional reasoning statements and found participants with strong paranormal beliefs made more reasoning errors than those with weak paranormal beliefs.

In general, evidence suggests paranormal beliefs are associated with poorer reasoning, however this line of research is characterised by inconsistent findings. Two studies report that the perception of randomness is a significant predictor of paranormal belief and provide some evidence of replicability [ 126 , 127 ]. Despite this, evidence regarding the association between paranormal belief and the conjunction fallacy are conflicting, with two studies [ 127 , 128 ] reporting no effect, and three [ 80 , 128 , 129 ] reporting significant associations. This may be due, in part, to the different statistical techniques used within each study, as those reporting no effect [ 126 , 127 ] used multiple regression analyses with all probabilistic tasks entered as predictor variables, while studies reporting significant associations [ 80 , 128 , 129 ] only included conjunction fallacy tasks in their predictive models. Similar inconsistency emerges for probabilistic reasoning, with nearly equal numbers of studies reporting significant and nonsignificant associations with paranormal beliefs.

Intelligence, critical thinking, and academic performance

Twelve studies explored intelligence, critical thinking, and academic performance (n = 2,657). Seven papers focused on critical thinking ability, with two finding significant reductions in paranormal belief following a course in critical thinking [ 70 , 135 ]. Alcock and Otis’ 1980 study [ 136 ] employed the Watson-Glaser Critical Thinking Appraisal (WGCTA) [ 137 ] significantly higher levels of critical thinking ability in sceptics than believers. In 1998, Morgan and Morgan [ 138 ] conducted a similar study, measuring critical thinking using a revised version of the WGCTA [ 98 ], finding significant negative correlations between critical thinking ability and three subscales of the PBS (Superstition, Traditional Religious Belief, and Spiritualism). No significant correlation between paranormal belief and critical thinking emerged in the remaining three papers [ 139 – 141 ]. One did, however, report significant negative correlations between reasoning ability (measured using the Winer Matrizen-Test [ 142 ]) and three subscales of the PBS: Traditional Paranormal Beliefs, Traditional Religiosity, and Superstition [ 139 ].

The links between paranormal beliefs and academic achievement, or general intelligence are both mixed and weak. Two papers report significant negative correlations, one between overall paranormal belief scores and mean academic grade [ 25 ] and one between grade point average and the Witchcraft and Superstition subscales of the PBS [ 143 ]. Turning to intelligence, Betsch et al. [ 71 ] found a significant inverse relationship between IQ and paranormal beliefs, but only when controlling for sex, supporting similar findings from Smith et al.’s 1998 study [ 144 ] which reported a significant negative correlation between paranormal beliefs and intelligence (using the Advanced Progressive Matrices Test, Set 1 [ 100 ]). Nevertheless, two studies found no association between paranormal beliefs and intelligence. Royalty [ 141 ] used the information subtest of the Wechsler Adult Intelligence Scale [ 145 ] as an estimate of full-scale IQ, and the vocabulary subtest of the Multidimensional Aptitude Battery [ 146 ] as a measure of verbal intelligence. Stuart-Hamilton et al. [ 147 ] found no relationship with fluid intelligence using Raven’s Progressive Matrices [ 101 ]; however, this sample were older (mean age of 71).

Conflicting findings emerge from studies of intelligence, critical thinking, and academic performance, with an almost equal number of significant and non-significant associations to paranormal beliefs. Some of this heterogeneity, however, appears to reflect whether studies used crystallised or fluid intelligence tasks and the age of the sample (e.g., Stuart-Hamilton et al. [ 147 ] failed to find a relationship between fluid IQ and paranormal beliefs in an older sample, but Smith et al. [ 144 ] found a significant negative association in a younger sample). The precise relationship of paranormal belief with intelligence requires further investigation, both by considering the age of the sample and assessing relationships with fluid and crystallised intelligence separately.

Thinking style

Thirteen studies (n = 4,100) examined aspects of thinking style. One consistent finding is a significant association between paranormal belief and an intuitive thinking style, which is characterised as being quick and guided by emotion [ 148 – 152 ]. A further study [ 153 ] also reports a significant partial correlation after controlling for sample type (online versus recruited face-to-face recruitment) owing to significantly higher levels of paranormal beliefs and intuitive thinking, and significantly lower rational/analytical thinking, in the online sample versus the face-to-face sample.

Contradictory findings, however, have emerged concerning paranormal beliefs and an analytical thinking style, which is thought to be more effortful and driven by logic. A positive relationship emerged in two studies [ 149 , 150 ] while two [ 72 , 152 ] found no relationship between paranormal beliefs and analytical thinking as assessed by the Rational Experiential Inventory (REI [ 102 ]). Four further studies report significant negative relationships between paranormal beliefs and analytical thinking using various measures: two [ 81 , 154 ] used different versions of the Cognitive Reflection Test [ 103 ]; one [ 90 ] used the Rational Experiential Multimodal Inventory [ 155 ]; and one [ 153 ] used both the Argument Evaluation Test [ 156 ] and the Actively Open-Minded Thinking scale [ 156 , 157 ]. A further study reported a significant negative relationship between paranormal beliefs and analytical thinking but could not replicate the finding [ 74 ].

The final two papers in this section document relationships between paranormal belief and other cognitive styles. Gianotti et al. [ 158 ] presented participants with 80 word-pairs (40 semantically indirectly related, 40 semantically unrelated), and they had to state if a third noun was semantically related to both words. Believers showed increased verbal creativity, making significantly more rare associations than sceptics for unrelated word-pairs, but not for indirectly related word-pairs. Hergovich [ 159 ] used the Gestaltwahrnehmungstest [ 160 ] to assess degree of field dependence, by presenting participants with figures in which they needed to find an embedded figure in the form of a house and reported a significant positive relationship between paranormal beliefs and field dependence.

Eight papers report positive associations between an intuitive thinking style and paranormal belief (although it should be noted that one study reported only a partial correlation after controlling for sample type). By contrast, evidence concerning an analytical thinking style is inconsistent, with reports of a negative relationship with belief (k = 4), a positive relationship (k = 2), and no relationship (k = 2). An additional study did report a negative relationship between analytical thinking and paranormal belief, but this was not replicated in a follow-up study. The final two studies in this section suggest positive relationships between paranormal belief and both verbal creativity and field dependence.

Executive function and memory

Six studies (n = 810) assessed memory or executive function. Turning first to memory, the findings are inconsistent. One study [ 161 ] showed paranormal belief predicted false memory responses on a questionnaire-based measure, and two others [ 59 , 78 ] reported associations between belief and behavioural measures of false memories but failed to replicate this in additional samples. Dudley’s 1999 study [ 162 ] had participants complete the Paranormal Belief Scale while rehearsing a five-digit number or not; and found significantly higher paranormal belief scores in the group who had their working memory restricted (by the rehearsal task). However, a recent study by Gray and Gallo [ 79 ] failed to find any differences in working memory, episodic memory or autobiographical memory for believers and sceptics.

Further inconsistencies can be seen when exploring relationships between paranormal belief and inhibitory control, with Lindeman et al. [ 163 ] noting more errors from believers than sceptics on the Wisconsin Card Sorting Test [ 105 , 106 ], but not on the Stroop task [ 164 ]. Wain and Spinella [ 165 ] explored executive function using a self-report measure and found a negative correlation between paranormal belief and executive functioning, with negative correlations between belief and both inhibition and organisation.

The studies in this section report inconsistent links between paranormal belief and memory. While three of four memory studies report links between paranormal beliefs and an increased tendency to create false memories, two of these studies failed to replicate the finding. Two studies assessing executive functioning both suggest poorer performance is associated with belief but may interact with the measure of executive functioning.

Other cognitive functions

Finally, four papers (n = 368) explored other aspects of cognitive function not covered by the categories already described. Pizzagalli et al. [ 166 ] tested the association between indirect semantic priming and paranormal beliefs using 240 prime-target word pairs, with target words either directly related, indirectly related, or unrelated to the prime word. Compared to sceptics, believers had shorter reaction times for indirectly related target words were presented in the left visual field, suggesting a faster appreciation of distant semantic associations which the authors view as evidence of disordered thought. The final three papers did not find any significant relationships between paranormal beliefs and: implicit sequence learning [ 167 ], cognitive complexity [ 88 ], or central monitoring efficiency [ 168 ].

General discussion

This systematic review provides the first evidence synthesis of the associations between paranormal beliefs and cognitive function since the early ‘90s [ 53 ] and the first assessment of study quality. The review identified 71 studies involving 20,993 participants. While most studies achieve good-strong quality ratings, specific areas of methodological weakness warrant further attention. In particular, studies often employ large numbers of measures, metrics and analyses, with no clearly identified primary outcome or adjustment of probability levels. These factors necessarily constrain any firm conclusions because of the high probability of Type 1 errors. Second, information about nonrespondents was either unreported or reported with insufficient detail to permit an assessment of potential nonresponse bias. Finally, up to a third of studies failed to discuss study limitations.

The cognitive deficits hypothesis is apparent in most papers (55/71), and a simple vote count shows that two-in-three studies (46/71) document that paranormal beliefs are associated with poorer cognitive performance. The most consistent findings across the six cognitive domains emerged between paranormal belief and an intuitive thinking style, with all eight studies confirming a positive association. Consistent findings also emerged for a bias towards confirmatory and disconfirmatory outcomes, as well as for poorer conditional reasoning ability and perception of randomness, though fewer studies were conducted in these areas. The two studies assessing executive functioning identified a negative association with paranormal belief but showed some inconsistency depending upon the type of executive test used. Associations with all other aspects of cognitive functioning (perceptual decision-making, jumping to conclusions and repetition avoidance, the conjunction fallacy, probabilistic reasoning, critical thinking ability, intelligence, analytical thinking style, and memory) have proven inconsistent, with nearly equal numbers of significant and null findings.

Various measurement issues, however, need to be considered. One concerns the large number of paranormal belief measures employed and their varied psychometric properties. The studies reviewed employed 26 different tests of paranormal belief, with the most common being the RPBS and a Rasch variant, with the next most common being 13 bespoke tests created by the authors. Such variability most likely contributes to heterogeneity across studies and potentially undermines the reliability of reported associations between cognitive functions and paranormal beliefs. For a full summary of the scales used in each study, see S8 Table .

Not only does the range of cognitive measures used within each cognitive domain contribute to heterogeneity across studies, but so does the reliability of such measures. As Hedge et al. [ 169 ] note, individual differences in relation to cognition and brain function often employ cognitive tasks that have been well-established in experimental research. Such tasks may not be directly adaptable to correlational research, however, for the very reason that they elicit robust experimental effects; they are specifically designed and selected for low between-participant variability. Most studies presented here are correlational and use a combination of established experimental tasks (e.g., the WCST, Raven’s Matrices, Cognitive Reflection Test, Embedded Figures Test) and questionnaire-based methods to assess cognition. This may undermine the reliability of reported associations between cognitive functions and paranormal beliefs if studies use experimentally derived cognitive tasks that are sub-optimal for correlational studies. Hedge et al. [ 169 ] offer several suggestions to overcome this, such as the use of alternative statistical techniques (e.g., structural equation modelling), factoring reliability into a-priori power calculations to reduce the risk of bias towards a null effect, or using within-subjects designs when the primary goal of the study is to examine associations between measures rather than focusing on individual differences per se. The largely correlational approach of studies reviewed here also suffers from the standard limitations of questionnaire studies and correlational designs. Although regression approaches can be powerful, they cannot establish causality without the use of longitudinal methods. This correlational approach also means that moderators and mediators of the relationship between paranormal beliefs and cognition remain underspecified.

Future directions–the fluid-executive model

The general trend of the current review accords with the cognitive deficits hypothesis approach described by Irwin almost 30 years ago [ 53 ]–at least insofar as around 60% of published studies document paranormal beliefs to be associated with poorer cognitive performance. Nonetheless, the cognitive deficits hypothesis does not provide an entirely satisfying account of why paranormal believers and sceptics perform differently on such a wide variety of cognitive tasks. This has some key implications: first, that people who believe in the paranormal seemingly have a disparate array of cognitive deficits–are these assumed to have occurred independently of each other or do they somehow accumulate various cognitive deficits? Another implication is that such an array of cognitive deficits is largely atheroetical, with various researchers pursuing seemingly independent lines of research linking cognitive function to paranormal beliefs with little attention to integration. Hence a somewhat underspecified model pervades the literature, with often limited justification for the specific role played by cognitive function in paranormal beliefs or how and why such an array of deficits are identifiable in paranormal believers. Given the almost complete lack of preregistration, accompanied by the large numbers of statistical analyses often conducted without correction, we also cannot exclude concerns about potential publication bias, false positives, and selection bias. Empirical studies presenting significant or favourable findings are, of course, more likely to be published [ 170 ]; and crucially, psychologists tend to rate studies as having better quality when they conform to prior expectations. Hergovich et al. [ 171 ] demonstrated this bias by presenting psychologists (all of whom did not believe in astrology) with descriptions of parapsychological studies, finding that they gave higher quality ratings to studies disproving astrological hypotheses. Participants were less likely to complete the study if they received an abstract confirming astrological hypotheses, with an attrition rate of 38.90%. These issues underscore the importance of pre-registered replications of key findings (see Laws [ 172 ] for a discussion). To our knowledge, potential publication bias has not been extensively assessed. A previous meta-analysis of psychokinesis studies indicated the presence of publication bias [ 173 ], but this claim has been challenged [ 174 ]. Finally, questions also arise about whether poorer performance by believers on any cognitive ability tests even merits the descriptor of ‘deficits’; and recently has been rephrased more neutrally as the cognitive differences hypothesis [ 79 ]. The term ‘deficit’ typically implies a permanent lack or loss of cognitive function; however, little to no research has looked at the consistency of cognitive performance in paranormal believers across time and established whether poorer cognitive performance is more trait than state dependent. While paranormal beliefs appear to be largely trait-like, they may have a state component [ 175 ].

While current studies do not necessarily endorse Irwin’s 1993 [ 53 ] comment that “…the believer in the paranormal is held variously to be illogical, irrational, credulous, uncritical, and foolish” (p.16), they converge on an underlying non-specific cognitive deficit or collection of deficits. Typically, when an array of cognitive deficits/differences are documented, researchers would want to know if specific areas of cognitive weakness emerge. Currently, no cognitive area suggests a specific deficit profile in paranormal believers. Although not directly tested, paranormal believers might display heterogeneous cognitive profiles that link to different paranormal belief components. Nonetheless, it is hard to see why or how specific types of paranormal belief content would link to different cognitive deficits.

One possibility is that the failure of any specific area of cognitive dysfunction to emerge (amongst perceptual and cognitive biases, reasoning, intelligence, critical thinking and academic performance, thinking style, and executive functioning), may point to a common shared underlying cognitive component. One feasible interpretation is that many of the tasks described in the various domains described here do in fact share a common cognitive ability—higher-order executive functions (planning, reasoning and problem-solving, impulse control, initiation, abstract reasoning, and mental flexibility), which in turn may be related to aspects of fluid intelligence [ 176 ].

Human functional brain imagining identifies strikingly similar patterns of prefrontal cortex activity in response to cognitive challenges across various seemingly different domains, including: increased perceptual difficulty (high vs low noise degradation), novelty, response conflict, working memory, episodic and semantic memory, problem solving, and task novelty [ 177 – 179 ]. This demand-general activity underlies our ability to engage in flexible thought and problem-solving [ 177 ] and is closely linked to fluid intelligence [ 180 ]. We propose that the broad cognitive-deficit profile linked to paranormal beliefs may overlap with functions of the multiple-demand (MD) system. Part of the function of the MD system concerns its role in the separation and assembly of task components and that this accounts for the link with fluid intelligence. In this context, we suggest that each of the cognitive domains linked to paranormal beliefs may indeed be subserved by this MD system housed in the fronto-parietal cortex. The section on executive function is self-evidently linked with the frontal system. The section on intelligence similarly highlights links between paranormal beliefs and fluid IQ measures such as the Ravens Matrices [ 100 , 101 ]. Studies further show the same MD system is recruited when confronted with perceptually difficult tasks (such as those outlined in the section on perceptual and cognitive biases for degraded visual input) [ 66 , 67 , 107 , 108 ]. Aside from supporting our problem-solving ability, fluid intelligence and various aspects of executive functioning (e.g., working memory) underpins our ability to reason and to see relations among items and includes both inductive and deductive logical reasoning. The section on reasoning shows paranormal beliefs are related to conditional and probabilistic reasoning [ 69 , 77 , 80 , 124 – 134 ]. Thus, many of the cognitive deficit-paranormal belief associations may be reframed as the product of a single underlying fluid intelligence-executive component. Going forward, such a model suggests potential avenues of research. One prediction would be that groups of believers and sceptics matched for fluid IQ would be less likely differ on a range of cognitive tasks.

Limitations of the present review

The current review is the first to assess the quality of studies examining cognitive function and paranormal beliefs. We report study quality is good-to-strong, with interrater reliability on AXIS ratings being almost-perfect (93%). Individual AXIS items however are not weighted and any simple comparisons between specific studies across total summed quality scores should be regarded with caution [ 181 – 183 ]. Thus, two studies with the same total quality score, but across different items, might not be comparable because some items may be more concerning to quality than others. Hence, we have focused on specific domains of strength or weakness across studies.

We acknowledge substantial limitations regarding the classification of studies into six areas of cognitive function: (1) perceptual and cognitive biases, (2) reasoning, (3) intelligence, critical thinking, and academic performance, (4) thinking style, (5) executive function, and (6) other cognitive functions. S9 Table shows that many of the studies could be re-classified and indeed, two-thirds (48/71) could be re-classified as assessing executive functioning. The latter is consistent with our proposal that a substantial proportion of the published studies may be documenting a relationship between paranormal beliefs and higher-level executive function/fluid intelligence.

Our preregistered protocol had an exclusion criterion concerning samples with individuals aged less than 18, and this led to our excluding 11 datasets (see S1 Table for a complete list and details; Aarnio & Lindeman [ 26 ], Saher & Lindeman [ 184 ], and Lindeman & Aarnio [ 185 ] were overlapping or identical samples). A key reason for exclusion was because age impacts both cognitive functions and paranormal beliefs. Certain cognitive functions, for example executive functions, take until late adolescence or early adulthood to mature [ 186 ]. Additionally, younger individuals also show higher levels of paranormal beliefs [ 187 ; for a discussion see Irwin’s review, 53 ]. While the exclusion of these studies is a potential limitation, their exclusion does not change our key findings or conclusions drawn from this review. In the same context, our lack of an upper age limit exclusion criterion could also be considered as a limitation. Sixteen papers (23%) reviewed here included participants aged 65+ (though 25/71 (36%) studies did not report on the age range of participants). While some cognitive functions do not mature until late adolescence or early adulthood, measurable changes in cognitive function occur with normal aging. Performance on certain cognitive tasks has been shown to decline with age, such as those requiring executive functioning (including decision-making, working memory and inhibitory control), visuoperceptual judgement and fluid-intelligence [ 188 , 189 ]. Such cognitive declines have been associated with age-related reductions of white matter connections in brain regions including the prefrontal cortex [ 190 , 191 ].

Finally, one limitation is that we were unable to conduct a meta-analysis because of the large variability in outcome measures within and between studies, which make it challenging to determine the precise outcome being tested. In parallel, the large numbers of analyses per study also mean that conclusions from our systematic review regarding findings for specific cognitive domains must also be interpreted with some caution.

Our systematic review identified 71 studies spanning: perceptual and cognitive biases, reasoning, intelligence, critical thinking, and academic performance, thinking styles, and executive function. However, then tasks employed to assess performance in each domain often appear to require higher-order executive functions and fluid intelligence. We therefore propose a new, more parsimonious, fluid-executive theory account for future research to consider. Methodological quality is generally good; however, we highlight specific theoretical and methodological weaknesses within the research area. In particular, we recommend future studies preregister their study design and proposed analyses prior to data collection, and address both the heterogeneity issues linked to paranormal belief measures and the reliability of cognitive tasks. We hope these methodological recommendations alongside the fluid-executive theory will help to further progress our understanding of the relationship between paranormal beliefs and cognitive function.

Supporting information

S1 appendix, s2 appendix.

Note: Ts = Thinking Style, CPb = Cognitive and Perceptual Biases, O = Other Cognitive Functions, REI = Rational and Experiential Inventory (Epstein et al., 1996), SJQ = Scenario Judgements Questionnaire (Rogers et al., 2016; Rogers et al., 2011), IPO-RT = Inventory of Personality Organization (Lenzenweger et al., 2001), RT = reality testing, ASGS = Australian Sheep-Goat Scale (Thalbourne & Delin, 1993), ESP = extrasensory perception, LAD = life after death, PK = psychokinesis, NAP = new age philosophy, TPB = traditional paranormal beliefs, RPBS = Revised Paranormal Belief Scale (Tobacyk, 2004; Lange et al., 2000), CKCS = Core Knowledge Confusions scale (Lindeman & Aarnio, 2007; Lindeman et al., 2008), CRT = Cognitive Reflection Test (Frederick, 2005), BRC = base-rate conflict, BRN = base-rate neutral, SREIT = Self-Report Emotional Intelligence Test (Schutte et al., 1998), WCQ = Ways of Coping Questionnaire (Folkman & Lazarus, 1988), IBI = Irrational Beliefs Inventory (Koopmans et al., 1994).

Note: / = information not reported, P = perceptual biases, C = cognitive biases, bl = believers, sc = sceptics, + = positive,— = negative, corr. = correlation, Ns. = nonsignificant, ESP = extrasensory perception, BADE = bias against disconfirmatory evidence, BACE = bias against confirmatory evidence, TRB = traditional religious beliefs, ELF = extraordinary lifeforms, PRI = Personal Risk Inventory (Hockey et al., 2000), SFQ = Strange-Face Questionnaire (Caputo, 2015), IDAQ = Individual Differences in Anthropomorphism Quotient (Waytz et al., 2010), DS = Dualism Scale (Stanovich, 1989), EQ = Empathy Quotient (Baron-Cohen & Wheelwright, 2004).

Note: / = information not reported, + = positive,— = negative, corr. = correlation, Ns. = nonsignificant, ESP = extrasensory perception, PK = psychokinesis, LAD = life after death, NAP = new age philosophy, DR = deductive reasoning, RTQ = Reasoning Task Questionnaire (Blackmore & Troscianko, 1985), ASGS = Australian Sheep-Goat Scale (Thalbourne & Delin, 1993), RPBS = Revised Paranormal Belief Scale (Tobacyk, 2004), MMU-N = Manchester Metropolitan University New (Dagnall et al., 2010).

Note: / = information not reported, C = cognitive ability, I = intelligence, m = males, f = females, + = positive,— = negative, corr. = correlation, Ns. = nonsignificant, ATS = Assessment of Thinking Skills (Wesp & Montgomery, 1998), WGCTA-S = Watson-Glaser Critical Thinking Appraisal Form S (Watson & Glaser, 1994), WGCTA = Watson-Glaser Critical Thinking Appraisal (Watson & Glaser, 2002; Watson & Glaser, 1980; Watson & Glaser, 1964), RPM = Raven’s Progressive Matrices (Raven et al., 2000), RPM Rasch Model = Raven’s Progressive Matrices Rasch Model (Rasch, 1960), MHVT = Mill Hill Vocabulary Test (Raven et al., 1998), CCTT = Cornell Critical Thinking Test (Ennis & Millman, 1985), WMT = Wiener Matrizen Test (Formann & Piswanger, 1979), APM = Advanced Progressive Matrices (Raven, 1976), WAIS-IS = Wechsler Adult Intelligence Scale Information Subtest (Wechsler, 1955), GPA = Grade Point Average.

Note: / = information not reported, + = positive,— = negative, corr. = correlation, Ns. = nonsignificant, AOT = Actively Open-Minded Thinking Scale (Stanovich et al., 2016; Stanovich, 1999), CRT = Cognitive Reflection Test (Frederick, 2005), CRT-2 = Cognitive Reflection Test-2 (Thompson & Oppenheimer, 2016), REI = Rational-Experiential Inventory (Pacini & Epstein, 1999), WST = WordSum Test (Huang & Hauser, 1998), RI = Rational/Experiential Inventory (Norris & Epstein, 2011), IPSI-SF = Information-Processing Style Inventory Short Form (Naito et al., 2004), FIS = Faith in Intuition Scale (Pacini & Epstein 1999), NFC = Need for Cognition scale (Cacioppo et al., 1984), AET = Argument Evaluation Test (Stanovich & West, 1997), 10-Item REI = 10-Item Rational-Experiential Inventory (Epstein et al., 1996), GWT = Gestaltwahrnehmungs Test (Hergovich & Hörndler, 1994), EFT = Embedded Figures Test (Witkin et al., 1971).

Note: / = information not reported, M = memory, EF = executive function, bl = believers, sc = sceptics, + = positive,— = negative, corr. = correlation, Ns. = nonsignificant, DRM = Deese-Roediger-McDermott (Roediger & McDermott, 1995), CRT = Criterial Recollection Task (Gallo, 2013), IIT = Imagination Inflation Task (Garry et al., 1996), RSPAN = Reading-Span Task (Daneman & Carpenter, 1980), OSPAN = Operation Span Task (Turner & Engle, 1989), SILS = Shipley Institute of Living Scale (Zachary, 1986), AET = Argument Evaluation Task (Stanovich & West, 1997), RAT = Remote Associations Test (Mednick, 1962), WCST = Wisconsin Card Sorting Test (Berg, 1948; Grant & Berg, 1948), EFI = Executive Function Index (Spinella, 2005), ANP = anomalous natural phenomena, TRB = traditional religious beliefs, NCQ = News Coverage Questionnaire (Wilson & French, 2006), ASGS = Australian Sheep-Goat Scale (Thalbourne 1995; Thalbourne & Delin, 1993), AEI = Anomalous Experiences Inventory (Kumar et al., 1994).

Note: / = information not reported, bl = believers, sc = sceptics, f = females, m = males, ISL = implicit sequence learning, ISP = implicit semantic priming, VF = visual field, LVF = left visual field, RVF = right visual field, CME = central monitoring efficiency, RE = reasoning errors, CC = cognitive complexity, + = positive,— = negative, corr. = correlation, Ns. = nonsignificant, SPQ-B = Schizotypal Personality Questionnaire Brief (Raine & Benishay, 1995), RCRG = Role Construct Repertory Grid (Kelly, 1955).

Note:† = papers that provided reliability statistics for their novel scales, ‡ = used a translated version of the original scale, * = Musch & Ehrenberg (2002) developed a novel scale that was later named the BPS and was used in two subsequent studies. RPBS = Revised Paranormal Belief Scale (Tobacyk 1988; 2004), ASGS = Australian Sheep-Goat Scale (Thalbourne & Delin, 1993), PBS = Paranormal Belief Scale (Tobacyk & Milford, 1982), Rasch RPBS = Rasch devised Revised Paranormal Belief Scale (Lange et al., 2000), BPS-O = Belief in the Paranormal Scale (Original; Jones et al., 1977), BPS = Belief in the Paranormal Scale (Musch & Ehrenberg, 2002), MMU-N = Manchester Metropolitan University New (see Dagnall et al., 2010), MMU-PS = Manchester Metropolitan University Paranormal Scale (see Dagnall et al., 2010), SSUB = Survery of Scientifically Unsubstantiated Beliefs (Irwin & Marks, 2013), OS = Occultism Scale (Böttinger, 1976), PS = Paranormal Scale (Orenstein, 2002), AEI = Anomalous Experiences Inventory (Gallagher et al., 1994; includes a ‘belief’ subscale).

Note: ✓ = original category, ✓ = alternate category.

Funding Statement

The authors received no specific funding for this work.

Data Availability

• PLoS One. 2022; 17(5): e0267360.

Decision Letter 0

13 Dec 2021

PONE-D-21-32750Paranormal beliefs and cognitive function: A systematic review and assessment of study quality across four decades of researchPLOS ONE

Dear Dr. Dean,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands.

The reviewers have made a very careful job, and provide quite a large number of recommendations regarding potential ways in which the manuscript could be improved. Most revisions seem doable, although they might require the paper to be substantially rewritten.

In view of the detailed reports (attached below), I will not reiterate all their points. Main suggestions, however, seem to regard to major themes. First, the reviewers demand a better justification of the categories used to classify studies. The reviewers (and I) understand that there will always be a certain degree of arbitrariness in classifying the studies identified, but the commonality between studies in the same category is not always obvious, and some studies seem to be classifiable in a different category.

And second, all reviewers have found the results quite difficult to follow, and not always sufficiently informative. Section-wise interim conclusions are probably necessary for the reader to get a clearer picture of the results in each area of research.

On the side of strengths, the reviewers have evaluated very positively some aspects of the methodology, including protocol preregistration, strict adherence to PRISMA guidelines, and the careful assessment of evidence quality in the reviewed studies. Please address, however, the reviewers' concerns regarding the decision to exclude studies with adolescents, and the total-score assessment of study quality

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

Reviewer #4: Partly

2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: N/A

Reviewer #2: N/A

Reviewer #3: N/A

Reviewer #4: N/A

3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #3: No

Reviewer #4: Yes

4. Is the manuscript presented in an intelligible fashion and written in standard English?

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Reviewer #4: No

5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The authors present a review article on the association between paranormal beliefs and divergencies in cognitive function. The topic has been gaining relevance in the last decades in the research community and is of interest for a wide audience. Although I agree with the authors that a metanalysis would have been more valuable, I reckon that the heterogeneity in the studies published so far hinders that approach. In any case, I believe that a systematic review paper like the one presented will be of use for many researchers interested in this field during the following years.

Nevertheless, I have some concerns I believe merit clarification before recommending publication:

Line 87: I think there is a parenthesis missing (or one too many)

Line 95: I guess that this is a matter of personal preference (so you can ignore it), but I thought the sentences on line 95 to 100 (“While factors…”) were not very relevant for the study (which is already quite long and includes many references) so they could be deleted.

Line 101: While setting the case for the study of cognitive function and paranormal beliefs, the authors comment on studies of “other” kinds of beliefs, such as religious beliefs and conspiracist beliefs. Regarding the former, as far as I know, religious beliefs are, at least sometimes, considered one type of paranormal beliefs (see the Traditional Religious Beliefs dimension in the widely used questionnaire by Tobacyk). I think this should be clarified in the text. As for conspiracist beliefs, the authors could make use of the concept of “epistemically unwarranted beliefs” (see Lobato et al., 2014) to stablish links between these types of beliefs and maybe include some references to pseudoscientific beliefs too.

Line 114: Irwin’s review only included null findings?

Line 133: The aims of the larger study should be (at least briefly) explained.

Line 143: Were any unpublished works or theses included in the final list of studies. If so, this should be clarified through the description of the process and, at least, when discussing the final selection.

(around) Line 177: The “sought for retrieval” step appears in Figure 1, but I think it is not explained in the text.

Line 207: I do not think illusion of control and causal illusion should be categorized as perceptual biases. As far as I know, they are usually characterized as cognitive biases (see Matute, Yarritu and Vadillo, 2011), and they are very different to the other studies included in this section (visual noise studies).

Line 212: Here, I missed inclusion of Torres et al. (2020) (it appeared in a Scopus search using “paranormal belief” AND cogni*)

Lines 221 and 227: In which unit are these quantities expressed and how do they relate with the percentages in line 217

205: How were paranormal beliefs measured in each study?

Lines 287 and 295: Aren’t repetition avoidance tasks a measure of probabilistic reasoning? I think these studies would fit more comfortably in the next section.

Line 370: associations between paranormal beliefs and what?

Line 372: Here, I missed Barberia et al. (2018) (also appeared in a Scopus search).

Line 378: reference 125 is about an association between pseudoscientific beliefs and paranormal beliefs. I am not sure this should be included as a (cognitive) measure of critical thinking given the relation between the two types of beliefs. If the authors decide to keep it, then they should also consider other studies relating different types of unwarranted beliefs with each other (e.g., Lobato et al, 2014; Fasce and Pico, 2019…).

Line 439: In this section I missed Meyersburg et al. (2009) study, but then I couldn’t find it when I tried a search in Scopus so I guess it is ok.

Line 507: when discussing sampling representativeness, I think the sex/gender issue deserves some comment. Were samples composed of both men and women? were they balanced? At least in those studies recruiting Psychology students my guess is that more women would have been involved…

Line 528: I would appreciate a table or at least more information on the percentages of usage of each different test (not just Tobacyk and ad hoc questionnaires). It could be even worth providing information separated by each topic. Could differences regarding the association between critical thinking and paranormal beliefs be related to the use of different measures of belief endorsement?

Line 683: I think the authors should include in the discussion some comment on the implications of the fact that most of the studies analyzed are correlational.

Line 755: Regarding the proposal of the fluid-executive theory, the authors should describe ways in which this hypothesis could be tested.

Reviewer #2: The authors present a systematic review (without meta-analysis) of the literature relating paranormal beliefs with performance in different cognitive tasks, with a particular focus in the critical assessment of the quality of the studies conducted so far. Overall, I think that this can be a valuable resource for researchers working on this area and, hopefully, it will also contribute to improving the quality of future research. I do have some concerns, though, that the authors might want to address in the final version of the manuscript.

Perhaps my most important concern is that in the present version of the ms it is quite difficult to follow the results section. As the authors themselves acknowledge their classification of tasks is somewhat arbitrary because “such classifications are necessarily a simplification and are not intended to be a definitive organisation”. This is undeniable true, but even so some of the headings collate results from radically different tasks and at some points I couldn’t help thinking that some paragraphs actually belonged in a different section. Or, perhaps alternatively, the authors might want to provide some explanation for the logic behind including several tasks under a common heading. This is particularly problematic in the section now titled “Cognitive and perceptual biases”, which includes a wide range of phenomena from illusion of control (measured in learning tasks comprising hundreds of trials) to perception of faces and other stimuli. What’s the common feature underlying these different tasks? Is it the case that all (or most) of them are somehow related to the (illusory) perception of patterns where there is just noise? If that’s the case, I think the authors need to spell this logic out more clearly, possibly change the name of the section and perhaps move some of the tasks that do not fit well in this category to other sections. They might even want to consider dividing this section in two or more less heterogeneous sections.

I also found it slightly odd that the jump to conclusions task is included in this section, when it is actually more similar to some of the probabilistic reasoning tasks included in the following section.

Also, in the present version it is easy to get lost in the enumeration of Results, without getting a glimpse at the whole picture until the Discussion section. If the results section were briefer this would be ok, but given the length of the paper I think many readers would find it useful to be reminded occasionally of the interim conclusions that can be reached with the information provided in each subheading. In other words, I miss 1-2 concluding sentences providing an overview of the results found for each category of tasks.

The assessment of the quality of the studies plays a very important role in the manuscript and it is indeed a great contribution. But while reading it I had some concerns about the reduction of this information to a single “quality score” for each study. Although this is certainly common in meta-analytic literature, this approach has also been criticized, and rightly so in my opinion (e.g., Jüni, P., Witschi, A., Bloch, R., & Egger, M. (1999). The hazards of scoring the quality of clinical trials for meta-analysis. JAMA, 282, 1054–1060.) I would not ask the authors to change their approach, but I think it would be worth mentioning, even if briefly, that reducing the responses to these quality scales to a single score can be misleading and should be taken with caution.

In the introduction, the authors mention that the two most common tests to measure paranormal beliefs have good psychometric properties. But this is just one side of the story. These studies are trying to relate paranormal beliefs with performance in cognitive tasks that might not have such good psychometric properties. See, e.g., Hedge, C., Powell, G., & Sumner, P. (2018). The reliability paradox: Why robust cognitive tasks do not produce reliable individual dif- ferences. Behavior Research Methods, 50, 1166–1186. https://doi. org/10.3758/s13428-017-0935-1 This is important, because the observed correlation between any two measures is attenuated downwards if any of them (not just the paranormal belief scale) is unreliable. If the reliability of these tasks does not improve in future research (or sample sizes are not adjusted taking it into account) this will necessarily result in high heterogeneity (i.e., much more variance from one study to another) and small average effect sizes.

Regarding sample sizes, I was a bit puzzled to read that “overpower” can be a problem in this area. I am afraid I strongly disagree with this point of view. In my opinion, there cannot be such a thing as an excess of power. The authors justify this saying that “… large studies might also be over-powered and thus, detecting very small and possibly trivial effects”. This confounds hypothesis testing (whether an effect is significantly different from zero) with parameter estimation (what the exact size of an effect). The fact that many researchers take a significant result for a “relevant” result is the consequence of using statistical tests mindlessly and it would be an error to encourage researchers to use smaller-than-possible sample sizes as a solution. Regardless of whether you want to test the null hypothesis or know the exact size of an effect, a large sample size will always be helpful because it will reduce the uncertainty of your inferences. What researchers need to be reminded is that not everything that is statistically significant is important.

Minor comments

- If the goal is to represent a trend in time, I suspect that most readers would find Figure 5 easier to read if years are plotted in the x-axis.

- In the flow chart, I couldn’t understand how from 475 records screened you take 5 reports for retrieval, but then below you have again 84 reports originating from these 5. Something seems to be wrong or misleading in the flow of records.

Reviewer #3: This paper provides a comprehensive and thorough review of research into the relationship between paranormal beliefs and cognitive functioning. As the authors note, considerable time has passed since the last review of paranormal beliefs and cognition, so this paper makes a strong, important, and timely (if not long overdue) contribution to the literature. I also commend the authors for preregistering their PRISMA guidelines and for the level of detail and clarity they provide about how the systematic review was conducted. Overall, I think this paper will make a great contribution to the literature. However, there are some areas where I believe the paper could be improved which I have highlighted in detail below.

Major points:

1) Regarding the paper structure, I think it might be better to more clearly separate the study quality assessment results and discussion from the paranormal belief and cognition findings and theory results and discussion. The Introduction focuses on the key points, is clear and easy to follow, and provides an appropriate (broad) set up for the focus of the paper. Similarly, the Method section is clear, concise, and enjoyable to read. However, from the Results onwards the paper can be quite difficult to follow in places. For example, it goes from the Method to an outline of findings in the literature, then to sections on study quality assessment, then back to a discussion of cognitive deficits/differences, then onto open science (I think this section should be moved to be alongside the sampling issues and non-respondents), then back onto a summary of research findings and a proposal for a new theory etc.

This review paper is doing two things. Firstly, extracting and assessing the quality of the existing literature on paranormal beliefs and cognitive function. Secondly, it is also outlining and synthesising the findings from that literature (plus proposing a new theory/hypothesis for testing). These are two separate and quite distinct focuses. Therefore, I think it would be better to more clearly delineate them and instead present all of one aspect (quality assessment and relevant discussion) followed by everything relevant to the other (outline and synthesis of findings).

2) Related to the above point, the results generally provide a clear and comprehensive summary of the various findings that have been catalogued within each subsection. However, I think each subsection would benefit from an overall summary or synthesis that brings it all together. If you make the changes to the paper structure that I have recommended above, this may no longer be necessary because these results will be more closely followed by a relevant discussion section (but see how it looks and consider it). In comparison, the results for the quality assessment are accompanied by relevant discussion within the actual results section.

3) I think the proposed fluid-executive theory is underdeveloped and would benefit from some further explanation and elaboration. You explain how it would relate to probabilistic reasoning but don’t outline how it would contribute to or explain the other findings (e.g., cognitive and perceptual biases).

Additionally, I think you need to do more work to justify why this specific aspect should be focused on, rather than alternative explanations. For example, others might argue that analytical thinking (Pennycook et al., 2015), or a “rationality quotient” (Stanovich, 2016; Stanovich et al., 2016; Weller, 2017; although see Ritchie, 2017), could also be proposed as underlying (or overarching) theories that explain the various associations between paranormal belief and cognitive functioning. I am happy to be convinced that the proposed theory is the best/most plausible candidate, I just think it needs some further fleshing out and additional evidence to support it.

Minor points:

1) I understand the desire to not include studies on children, given the potential cognitive differences. However, from examining Table S1, it seems that for all the excluded studies the vast majority of participants included in the studies were adults and they just happened to also include some teenagers in the study. I think it would be justifiable to exclude studies that had solely focused on children or teenage samples but given the already wide variability in cognitive function between 18- and 70-year olds, it seems unnecessary to exclude these studies solely because they also include some participants in their mid-late teens. I know this is a deviation from your preregistration so feel free to push back or disagree, but it wouldn’t change your conclusions and I think it’s okay to make some deviations if they are well justified.

2) Is the discussion of test theories and differential item functioning in the Introduction necessary? It seems like an unnecessary distraction from the main focus of the paper, so I’d just leave it at a sentence or two explaining that there is debate about why these differences are found.

3) I think that Figures 2-4 for the AXIS data would be greatly improved if you also included No and Unsure (you could keep the current format but have the bars contain different colours for each response category). This is particularly important because when initially looking at the figures it is not clear that there was an “unsure” category (e.g., it looks like half the studies didn’t have ethical approval, when it likely just wasn’t explicitly reported).

4) The section on open science focuses solely on pre-registration but there are many other aspects of open science such as publicly sharing data, analysis scripts, materials etc. I think you should either broaden this section to cover those additional open science aspects or, if you want to avoid lengthening the paper, then you could combine the pre-registration section with the sample size justification section, presenting it as a possible solution to address these problems.

5) The data are not currently accessible via the OSF link ( https://osf.io/7bthg/ ). Please update the OSF page to make it public or provide a reviewer only link if you don’t want to make the data fully open to the public yet. Don’t worry, I’ve done the same thing before and this happens with half or more of the OSF links I’ve seen when reviewing papers.

References mentioned in the review that are not already in the paper:

Pennycook, G., Fugelsang, J. A., & Koehler, D. J. (2015). Everyday consequences of analytic thinking. Current Directions in Psychological Science, 24(6), 425–432. https://doi.org/10.1177/0963721415604610

Ritchie, S. (2017). Review of: The rationality quotient: Toward a test of rational thinking (K. E. Stanovich, R. F. West, & M. E. Toplak). Intelligence, 61, 46. https://doi.org/10.1016/j.intell.2017.01.001

Stanovich, K. E. (2016). The comprehensive assessment of rational thinking. Educational Psychologist, 51(1), 23–34. https://doi.org/10.1080/00461520.2015.1125787

Stanovich, K. E., West, R. F., & Toplak, M. E. (2016). The Rationality Quotient: Toward a Test of Rational Thinking. The MIT Press. https://doi.org/10.7551/mitpress/10319.001.0001

Weller, J. (2017). Review of: The rationality quotient toward a test of rational thinking, by Keith E. Stanovich, Richard F. West, and Maggie E. Toplak. Thinking & Reasoning, 23(4), 497–502. https://doi.org/10.1080/13546783.2017.1346521

Reviewer #4: Overall Evaluation:

The paper presents a review and summary of the past 40 years of research on paranormal belief and cognitive functioning. As noted by the authors, there has not been a systematic review of this relationship since Irwin’s (1993) work almost 30 years ago. I wholeheartedly agree with the authors that such a systematic review is needed, and that it would add significantly to our overall understanding of the current state of the field. Unfortunately, though, I think there are some key issues with the current attempt that need to be addressed to turn it into a beneficial contribution to the area.

1. Given the range of tasks and variables in this particular area, I have no doubt it was difficult to synthesize the information in a straightforward and simple manner. However, even though I work in this area, I found it hard to track through the main sections. Specifically, each section was a listing of how one study showed X, two studies showed Y, et cetera, and by the end of each section it was not clear what specifically the reader should take away. At a minimum, using something like clear and specific tables to help organize the material would help immensely, especially in terms of trying to track through what the various studies do or do not show. There are the tables in the supplementary material, and admittedly even though they are broken up by section and a bit tricky to see “overall” outcomes, I found them easier to follow in terms of thinking across the studies.

Relatedly, in several spots the writing/presentation was dense, which may have added to the experience of not knowing what the “take home” message was for each section. For example, proper paragraphs should rarely run over a page, but more than one did, and one paragraph actually went for almost a full 2 pages (pgs 11-13). In general, editing for direct language, paragraph length, et cetera, would help improve clarity of the information being presented.

2. Again, I understand it would be difficult to categorize the experiments, but the current way of doing it seems to actually work against providing a systematic review. For example, there were fewer studies than I would have expected in the thinking styles section, just because this has been a particularly popular topic to explore in terms of paranormal beliefs. I could see, though, how some of that work would have ended up in other sections given the classification criteria; however, it then feels like we are not getting the full picture. Again, I think this is where tables may be particularly useful; for example, rather than binning studies under just one section, it would be much more useful to have tables that include all of the categories. Thus, we would be able to see what each study contributes across the categories (when relevant), rather than to just a single category. I recognize the authors may have attempted this approach and for some reason it was not viable, but based on systematic reviews in other areas that have used this set-up it would seem to be the more useful approach. This type of set-up would also help more clearly and succinctly demonstrate what the reader should take away from the area.

3. The limitations discussion seems like a bit of a tacked-on section rather than a real consideration of the current work. For example, as already mentioned, one potential issue is how the studies had to be categorized, which means they can only contribute to one section even though they may potentially also be able to contribute to at least one other section.

Further, and this may be an unfair criticism given the complexity of the area, but I had fully expected at least some sort of meta-analysis of the studies. Again, this may be because the listing out of the studies across the sections did not land well in terms of what to concretely take away. However, given the current techniques available for meta-analyses it feels like that is what we would gain the most from in terms of understanding the current state of the relationships between paranormal belief and cognitive functioning.

4. There seems to be some sweeping generalizations made that are not necessarily an accurate representation of the area. For example, there’s a difference between a cognitive deficits hypothesis suggesting “paranormal believers are illogical, irrational, and uncritical,” and what the researchers of each study argued for as the hypothesis/explanation for their work. Sure, some likely would subscribe to this particularly spin on cognitive deficits, but looking for “more or less” of a skill/ability does not necessarily mean researchers in this area would agree that believers are “illogical” or “irrational”.

5. A minor point, but was any effort put into searching for articles using the term “anomalistic”? The term “paranormal” is still the most common terminology, but given Chris French and colleague’s focus on using the more broad term of anomalistic belief (and subsequent work from others that has followed suit), it is not clear whether just using “paranormal” would have picked up all of the relevant studies.

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Reviewer #1: No

Reviewer #2: No

Reviewer #3:  Yes:  Toby Prike

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Author response to Decision Letter 0

31 Jan 2022

We would like to thank the reviewers for their careful review and the insightful and detailed comments they provided.

We have addressed and responded to the reviewers' comments, details of which can be found in the 12-page Response to Reviewers document.

We have addressed the main points raised, particularly the clarity of the results and the classification of studies, by providing new sections within the manuscript (e.g., summaries following each subsection of the results) as well as new supplementary materials (e.g., S9 Table).

We would like to thank the editor and reviewers again for the valuable comments, which we feel have greatly improved the manuscript, and for the opportunity to revise and resubmit the work.

Submitted filename: Response to Reviewers.docx

Decision Letter 1

PONE-D-21-32750R1Paranormal beliefs and cognitive function: A systematic review and assessment of study quality across four decades of researchPLOS ONE

Thank you for submitting your manuscript to PLOS ONE. The revised paper has been assessed by the same four reviewers from the previous round. All of them recommend minor revisions, but they are not fully coincident, so some amount of work is still required. Still, all suggested changes are modest and doable, so a further review round with the four reviewers again might not be necessary if all concerns are addressed.

Please submit your revised manuscript by Apr 22 2022 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at  gro.solp@enosolp . When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

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Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: (No Response)

Reviewer #2: All comments have been addressed

Reviewer #3: (No Response)

Reviewer #4: (No Response)

2. Is the manuscript technically sound, and do the data support the conclusions?

3. Has the statistical analysis been performed appropriately and rigorously?

4. Have the authors made all data underlying the findings in their manuscript fully available?

5. Is the manuscript presented in an intelligible fashion and written in standard English?

6. Review Comments to the Author

Reviewer #1: I am generally satisfied with the responses offered by the authors to my previous comments. Now I have some minor concerns, mostly regarding the PRISMA protocols, which I describe in the following:

PRISMA for abstracts:

- The Methods section should specify the inclusion and exclusion criteria for the review, and the dates when each database was last searched. It should also specify the methods used to assess risk of bias in the included studies.

- The Results section should indicate the number of included studies and participants for each relevant outcome mentioned (e.g., association between paranormal belief and intuitive thinking bias).

- The primary source of funding for the review should be specified.

PRISMA checklist (manuscript)

- Item 5: the Methods section should specify how studies were grouped for the synthesis

- Item 10: the Methods section should specify whether all results that were compatible with each outcome domain in each study were sought (e.g. for all measures, time points, analyses), and if not, the methods used to decide which results to collect.

- Item 11/12/14: If I understand it correctly, description of methods for assessment of risk of bias should be presented in the Methods section. Now they are described in the Results section.

Item 13/15: I could not identify descriptions corresponding to these items in the Methods section.

- Item 27: Report which of the following are publicly available and where they can be found: template data collection forms; data extracted from included studies; data used for all analyses; analytic code; any other materials used in the review.

I like the proposal of the fluid-executive model, but isn’t the general idea that “it is possible to view the association between the many cognitive deficit-paranormal belief associations as the product of a single underlying fluid intelligence-executive component” in conflict with the fact that findings presented in the intelligence section “are highly conflicting, with an almost an equal number of significant versus non-significant findings”?

I think S1 Appendix is not referred in the manuscript

Line 97: parenthesis missing

Line 420: I think the role of the beads task in Prike et al.’s study in unclear. In addition, this task is not explained until the next paragraph. Maybe changing the order of those two paragraphs (or explaining the task the first time it is mentioned) would help the reader to understand its relevance.

Line 549: revise “statements”

Line 568: revise “be”

Line 692: I think “such” is not appropriate there given we have just started a new section

Reviewer #2: The authors have done an excellent job at addressing my concerns with the previous version of the manuscript. I only have a few minor comments:

- Line 5, there is a parenthesis missing at the end of the line.

- Lines 215-216. Please say explicitly what you mean by large, moderate and small effects.

- Page 12, first paragraph: any study published as a registered report? This would be interesting because RRs do not only limit p-hacking, they also ensure that that there is no publication bias (papers are accepted or rejected before results are known).

- Lines 412-414. “Paranormal believers showed a lower perceptual sensitivity compared to sceptics (a bias towards making more ‘yes responses…” Sensitivity and bias are completely different things (e.g., in signal detection theory analysis). Please, clarify whether believers differ in one or the other.

- Line 556 “… conducted by similar research teams”. Similar in what sense?

Reviewer #3: The authors have been very receptive to the comments made in the previous round of reviews and the revised manuscript is much improved. I would like to again highlight that this review of paranormal beliefs and cognition makes a strong and timely contribution to the literature. I have highlighted a few minor points below which I believe can easily be addressed.

1) The sentence on page 13, lines 263-266, discusses differences between studies with student and non-student samples but the analyses reported do not find significant differences. Please make the lack of significant differences clear and adjust/remove the related discussion.

2) When discussing the conjunction fallacy (pages 22 and 25), in addition to Rogers et al., Prike et al. (2017) also found a significant relationship between the conjunction fallacy and paranormal belief. Additionally, the differences between the studies may be due to differences in analysis techniques used. In the Dagnall et al. studies, all the probabilistic reasoning tasks were entered together as predictors, whereas Rogers et al. and Prike et al. looked at the relationship between the conjunction fallacy and paranormal belief without entering/controlling for these other probabilistic reasoning tasks, which may explain the differences in results. This doesn’t need much discussion but may be worth noting or mentioning.

3) The section on page 31, lines 701-705, is unnecessarily repetitive and makes the same point multiple times (generally study quality is good but there are some specific areas for improvement).

4) On page 32, line 731, the text says “Eight” but the parentheses say “(9/71)”.

The authors did a good job addressing the issues raised by all of the reviewers, and overall I do think those revisions make for a much clearer and easier-to-follow narrative, and thus a stronger manuscript. I also appreciated the additional data/info included, such as giving a clear overview of the alternate categories in S9. I do still have a few comments, but given the focus of the paper I do not think any of them are major issues, and I also understand their reasoning for some of the issues they chose not to address with changes in the manuscript (e.g., as much as I would love to see some meta-analyses stats, I do understand the authors’ reasons for choosing not to go that route).

1. On pg 13 (lines 263-266) claims are made that aren’t supported by the provided statistics. So either those statistics are incorrect (or I am misunderstanding what is being reported), or the wording needs to be changed. That is it cannot be said that the undergrad studies tended to have smaller samples and lower quality; however, it could be said that descriptively there looks to be a difference but there is no statistical evidence that there is indeed a difference.

2. I appreciate the expanded limitations section, but still think there are issues with it. First, some of the points are underdeveloped; for example, the discussion about weighting vs. summing on the AXIS needs to be unpacked with even just 1-2 more sentences to be clear what specifically the issue may be (pg 120, lines 863-867). Admittedly I am a bit old-school and still believe in the rule that proper paragraphs are a minimum of 3 sentences, but here I am saying it because the 2 sentences that are there do not follow-through the point, especially for readers who may not be familiar with the specific issue.

Further, I expected the issue of categorization to be included in the limitations, so was quite surprised when I saw it was not there. It is mentioned earlier in the manuscript, which was good, but the alternate categories table (S9) shows that it warrants further discussion in terms of limitations. That is, the table very nicely shows just how many potential categories the majority of studies could fall into. So I want to be clear that I am not trying to argue that the review be redone with the studies being included in all possible categories because I understand the author’s justification for the way they decided to do the categorization. However, I do think more consideration is needed for how this effects what we can conclude for each section (i.e., given how many “secondary focus” studies had to be excluded from consideration because they were used elsewhere).

3. I think the summary sections are quite useful, and go a long way to helping to track through what each section is trying to convey. However, that (along with other additions) does mean that overall the manuscript is a bit daunting to get through, and I think in general it feels like it has a lot of repetition in some spots. For example, the start of the General Discussion is mainly just repetition (including all the numbers again) of what has already been presented. A lot of that could be deleted or streamlined into main points that move beyond what has already been said in earlier sections. And I would also argue focusing on my direct and active writing would cut out a lot of wordiness and also help the manuscript feel more streamlined and manageable (including cutting down on the large amount of information given in parentheses).

4. There is an issue with the wording of the sentence on pg 88, lines 99-102. The first half is hard to follow due to the two “was” near each other, and I think at least one of those needs to be reworked to help clarify what is being said.

7. PLOS authors have the option to publish the peer review history of their article ( what does this mean? ). If published, this will include your full peer review and any attached files.

Author response to Decision Letter 1

We would like to thank both the editor and reviewers for their detailed comments, and for the opportunity to submit a re-revised version of the manuscript. A point-by-point response to the reviewers' comments can be found in the attached 'Response to Reviewers (2)' file. We have made edits throughout the manuscript to improve both the length and clarity of the manuscript and the reviewers' advice, which we feel have greatly benefitted the manuscript. We would like to thank the editor and reviewers again for the time they have committed to reviewing this manuscript.

Submitted filename: Response to Reviewers (2).docx

Decision Letter 2

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34 Abnormal Psychology

Susan A. Nolan is Professor and Chair of the Department of Psychology at Seton Hall University.

• Published: 17 April 2015
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This chapter offers recommendations, evidence-based when possible, on teaching abnormal psychology in an effective and engaging manner. In the first section, we address issues related to the content of an Abnormal Psychology course. We outline the traditional content areas, as well as current topics that are often underemphasized, such as controversies with diagnosis, and international and cross-cultural issues. In the second section, we provide an overview of pedagogical tools that are particularly relevant for an abnormal psychology course, including the use of case material, role-play, and simulation; we provide suggestions on how to use these tools to create a stimulating and interactive classroom. In the third section, we outline ethical issues that can emerge when teaching abnormal psychology, such as informed consent and classroom management of sensitive topics, and offer suggestions for creating an ethical classroom environment.

Instructors assigned to teach Abnormal Psychology should consider themselves lucky! In the American Psychological Associations (APA) glossary of psychological terms, abnormal psychology is defined as “The area of psychological investigation concerned with understanding the nature of individual pathologies of mind, mood, and behavior” ( APA, 2013 ). The abnormal psychology course (also called psychopathology) is one of the most popular courses in the psychology curriculum and holds intrinsic interest for many students ( Perlman & McCann,1999 ). As of 2005, it is taught at 98 percent of campuses and taken by 41 percent of psychology majors ( Stoloff et al., 2010 ). The demand can perhaps be attributed to the general public’s interest in and awareness of many of the topics covered in the course, and their perception of its relevance to many people’s lives. Not surprisingly, Nolen-Hoeksema (1998) noted that some students may take an abnormal psychology course to better understand friends and family who have been diagnosed with a mental illness. Indeed, in a survey of two abnormal psychology courses, Connor-Greene (2001) found that 96 percent of students reported knowing at least one person with a mental illness. Moreover, according to Connor-Greene, students already knew much of the appropriate terminology for various disorders ( Connor-Green, 2001 ). Regardless of the reasons, students are clearly motivated to enroll in an abnormal psychology course.

Yet, paradoxically, students’ excitement for learning about mental illness raises several challenges in the abnormal psychology classroom. First, there are pedagogical difficulties related to content: In particular, how do instructors maintain students’ interest while talking about integral components of the course matter that can be perceived as dry or difficult—research methods, individual differences, psychometrics, and neuroscience? Second, there are issues related to best practices in teaching: For example, how do instructors balance the engaging anecdotes that students might wish to share in class with “drier” empirical content? And third, perhaps particular to a course focusing on mental illness, there are challenges related to ethics: How do instructors uphold the ethics of the field of psychology in teaching and learning situations in which students sometimes stereotype others, disclose too much information, or attempt to diagnose based on a single undergraduate course on psychopathology?

This chapter provides recommendations, evidence based whenever possible, on how to most effectively teach abnormal psychology in spite of potential obstacles. Specifically, in the three sections of this chapter, we will try to address the questions we asked in the preceding paragraph. First, we will cover issues related to the content of an abnormal psychology course, with a discussion of the traditional content areas, as well as important topics that are both engaging and frequently underemphasized; specifically, we will discuss positive psychology, controversies related to the Diagnostic and Statistical Manual (DSM) ( American Psychiatric Association, 2013 ), and international and sociocultural issues. These sometimes-controversial content areas provide pedagogical fodder for introducing students to an empirical approach to thinking critically about ambiguous topics. And related to critical thinking, we will also discuss the importance of teaching skills as well as knowledge.

Second, we will consider pedagogical tools that are particularly important in an abnormal psychology course, such as using case material, connecting the material to “real life,” making difficult concepts approachable and engaging, and teaching students to be critical consumers of mental health information. We will share best practices related to both the overarching curriculum of the course and the day-to-day pedagogy in the classroom. Third, we will explore the ethical issues that arise when discussing mental health; from boundary issues to confidentiality, from informed consent to developing ground rules for in-class discussion. We will ground this discussion of ethics in the policy and guidelines that the field of psychology, and particularly the APA, has adopted.

At first blush, the content in an abnormal psychology course might seem obvious. A glance at the tables of contents of the bestselling textbooks shows a fairly common core. There are typically several introductory chapters—some history of the field, an overview of the perspectives on psychopathology, a primer on assessment and diagnosis, and the basics of research in this area, often including a piece on neuroscience. Then, there is a series of chapters that cover the major categories of psychological disorders, outlining the etiology, symptoms, epidemiology, and treatment for each. Following the disorders, there may be one or two cross-cutting chapters—perhaps a segment on health and stress or on the intersection of mental health and the legal system.

New instructors often feel pressure to cover all the chapters in this book, but the authors of this chapter encourage instructors to pare down their content coverage for three main reasons. First, textbooks tend to cover more material than can be taught in a semester. Second, there are important areas in the field that either neglected entirely or are folded into traditional chapters, but are current, engaging, and (in our opinion) important to address. We’ll discuss some of these areas later, and encourage you to include them in your courses. Third, as we will discuss, many instructors want to foster the teaching of skills as well as the teaching of facts. By focusing the course on fewer chapters, students’ time in and out of class can be used to help them develop skills in addition to attaining knowledge.

An examination of the tables of contents of 10 popular abnormal psychology textbooks provides some indication of the most commonly covered material as well as content that is more idiosyncratic. Although these books include between 14 and 19 chapters, there are only 10 separate chapters that are in all 10 books:

An introduction.

Perspectives on psychopathology.

Assessment and diagnosis.

Anxiety disorders.

Mood disorders.

Dissociative disorders.

Eating disorders.

Sexual and gender identity disorders.

Schizophrenia.

Disorders of childhood and adolescence.

There are also many content areas that do not show up as a chapter in at least one of the ten volumes reviewed: research methods, somatoform disorders, stress-related disorders, suicide, substance-related disorders, disorders of aging and cognition, personality disorders, and ethics and legal issues. It is important to note that textbooks frequently fold some of these topics into other chapters, but it is telling when a topic is not perceived to merit its own chapter.

Project Syllabus offers further insight into choosing content. The Society for the Teaching of Psychology’s Office of Teaching Resources in Psychology oversees Project Syllabus , an online forum that publishes peer-reviewed “quality examples of syllabi.” Of the six syllabi posted for the abnormal psychology course, five provide course calendars that list the chapters covered. Although a small sample, an analysis of these five “quality” syllabi yields useful guidance. These instructors included a mean of 10.4 and a median of 10 chapters in their courses—a good deal fewer than the mean of 16.6 and median of 17 chapters in the popular textbooks. Moreover, these five instructors only had six chapters in common on their syllabi: the chapters on perspectives on psychopathology, assessment and diagnosis, anxiety disorders, mood disorders, schizophrenia and other psychotic disorders, and personality disorders. The runners up? Different combinations of four of out of five of these syllabi included eating disorders, substance disorders, and developmental disorders. It is interesting that some topics (like eating disorders) that are always included in textbooks are not always included in a course. Our advice: Don’t be shy about cutting back to about 10 chapters to achieve the learning goals for your course.

As we noted previously, there are several other important areas beyond most commonly covered content that instructors might not immediately consider, but they are easily woven into the course. These topics are often mentioned briefly or provided as whole sections of a chapter of abnormal psychology textbooks, but they do not tend to be the topic of an entire chapter. We focus on several here as examples—positive psychology, changes and controversies related to the Diagnostic and Statistical Manual ( DSM : American Psychiatric Association, 2013 ), and international and sociocultural diversity—but acknowledge that there are other important and current areas that instructors might include as well.

Positive psychology.

In their groundbreaking introduction to a special issue in the American Psychologist on positive psychology, Seligman and Csikszentmihalyi (2000) lamented the focus on psychopathology at the expense of positive experience. The authors explained that “the aim of positive psychology is to begin to catalyze a change in the focus of psychology from preoccupation only with repairing the worst things in life to also building positive qualities” (p. 5). Much of what positive psychology researchers study can be viewed as antidotes to the main topics in an abnormal psychology course. A discussion of the future and of optimism, key parts of positive psychology, can be discussed related to anxiety and worry. An exploration of flow and happiness in the present, also central to positive psychology, can be contrasted with a discussion of mood disorders. In fact, Seligman and Csikszentmihalyi observe that a study of positive qualities and personal strengths can help those with mental illness, pointing out that clinicians who emphasize clients’ strengths can bolster their clients’ resilience, and resilience is an essential part of any discussion on stress (and other disorders). The authors ask an important question for instructors of abnormal psychology: “What does mental health look like when seen from the perspective of positive psychology?” (p. 10).

We acknowledge that positive psychology has had its critics over the years (e.g., Lazarus, 2003 ) and stress that it is important to incorporate dissenting research into any discussion about this growing field. In spite of this, we urge instructors to incorporate at least a segment on positive psychology into their courses, if not a recurring piece. Although most students will encounter psychopathology themselves or in their loved ones at some point in their lives, all students can benefit from an exploration of positive psychology.

Diagnosis and the DSM.

Soon before this book went to press, the DSM headed into its fifth edition—(5th ed.; DSM–5;   American Psychiatric Association, 2013 )- the culmination of a renewed discussion of the limitations of and controversies related to the diagnosis of mental illness. Here we will discuss three broad issues that instructors could cover in a segment on diagnosis to dispel the myth that diagnosis is an exact science. We will first discuss problems with a categorical system of diagnosis, as opposed to continuous measurement. We will then talk about the political, rather than the scientific, inputs into the DSM . Lastly, we will talk about the pros and cons of using a diagnostic system such as the DSM .

Over the years, numerous researchers and clinicians have pointed out the problems inherent in the DSM (e.g., Widiger & Clark, 2000 ). One major problem results from its categorical system of diagnosis, sometimes described as “qualitative deviations from mental health” (p. 164; Hyman, 2010 ). Hyman notes the lack of continuous, qualitative scales in psychopathology diagnoses, in contrast to quantitative or “dimensional” measurements frequently used in general medicine (e.g., blood pressure, cholesterol). A cutoff that differentiates health from a disorder is, ultimately, arbitrary, and continuous measures might both be more accurate and provide important nuanced information (e.g., Widiger & Samuel, 2005 ). Indeed, research shows that lower levels of symptomatology can constitute a precursor to a diagnosable mental illness and should be monitored and potentially treated ( Shankman, Lewinsohn, Klein, Small, Seeley, & Altman, 2009 ). Debates about the model of diagnosis—qualitative versus quantitative—can incorporate critical thinking into class discussions.

Second, students should consider the potential impact of human biases and agendas on the DSM (For example, Cosgrove and Krimsky (2012) outline the financial considerations that might have influenced the 170 participants in the development of the DSM-IV (4th ed.; DSM-IV; American Psychiatric Association, 1994) and DSM-5 (5th ed., DSM-5; American Psychiatric Association, 2013 ), They reported, for example, that 69 percent of those working on DSM-5 had financial ties to the pharmaceutical industry, an increase from the 57 percent of those working on the DSM-IV. Political and cultural debates can also usurp science as the sole determinant of what should be in the DSM). For example, in recent years, the validity of a diagnosis of Internet addiction has been debated; is it its own disorder, an ancillary to another disorder, or a “phase of life problem” (e.g., Pies, 2009 )?

Internet addiction as a diagnosis was described first as a joke by a medical doctor, but rapidly became a cultural catchphrase ( Morahan-Martin, 2005 ). The discussions that have ensued in the run-up have been as much about the cultural role of the Internet in society as the science on Internet addiction, and offer an interesting window on the many factors that influence the DSM ( American Psychiatric Association, 2013 ). Morahan-Martin (2005) describes the debates about whether this diagnosis “trivializes the concept of substance-related addiction,” whether fear of newer technology makes people view hours on the Internet as an addiction in a way that we do not view hours spent watching television, and whether Internet addiction as a diagnosis is referendum of online relationships. Ultimately, internet addiction was not included in DSM-5.

More controversially, the political maneuvering that led to the removal of homosexuality from the DSM in 1973 ( Spitzer, 1981 ), engagingly outlined in the This American Life radio episode “81 words” ( Spiegel, 2002 ), has been paralleled by more current debates about Gender Identity Disorder (GID) (e.g., Drescher, 2009 ). When the DSM-IV-TR ( 4th ed., text rev.; DSM-IV-TR ; American Psychiatric Association, 2000 ) was released in 2000, GID was diagnosed if someone identified with the other gender—termed “cross-gender identification”—and experienced discomfort about their “assigned sex or a sense of inappropriateness in the gender role of that sex” (p. 576). In DSM-5 (5th ed.; DSM–5;   American Psychiatric Association, 2013 ), GID was replaced with gender dysphoria, which focuses on the emotional response to the experiences encapsulated in the previous GID diagnosis, rather than the behaviors. The psychiatrists and psychologists behind the changes cited a desire to reduce stigma as a reason for the revision ( Moran, 2013 ).

Similarly, discussions of sex and gender have changed over time. There was virtually no reference to sex or gender in the first DSM (1st ed.; DSM-1 ; American Psychiatric Association, 1952) in 1952; yet, since then, gender has increasingly been viewed as an important consideration, leading to controversy and debate (e.g., Kornstein, 2010 ). For example, there were controversies over Premenstrual Dysphoric Disorder in the 1980s and 1990s, and discussions two decades later about whether women are overrepresented among those diagnosed with Major Depressive Disorder with Atypical Features, which thus should not be considered “atypical” (e.g., Kornstein, 2010 ).

Finally, it is important to talk about the pros and cons of DSM -based diagnosis. On the one hand, the DSM plays an important role in mental health care. For example, diagnostic codes are necessary for clinicians to receive reimbursement from insurance companies, and the five-axis diagnosis model provides a useful shorthand for clinicians to communicate with one another. On the other hand, the DSM suffers from the problems described previously. In addition, researchers have noted inequities in its application, including bias based on race, gender, and social class (e.g., Garb, 2006 ). Moreover, because people who do not fit a diagnostic category are not covered by insurance, diagnoses might be manipulated for financial reasons ( Cooper, 2004 ). Further, a mental illness label can lead to stigma, which can exacerbate mental illness and lead people to avoid treatment (e.g., Ben-Zeev, Young, & Corrigan, 2010 ; Wahl, 2012 ).

The National Institute of Mental Health (NIMH) has criticized the DSM-5 (5th ed.; DSM–5;   American Psychiatric Association, 2013 ) for many of these reasons, stating that while it still provides a necessary structure for clinical work, it no longer provides a sufficient structure for research. The NIMH has developed a new system for researchers, the Research Domain Criteria project, that they hope will “[lay] the groundwork for a future diagnostic system that more directly reflects modern brain science” ( Insel & Lieberman, 2013 ). In summary, with regard to the DSM students should be made aware that diagnosis is often flawed, not based solely on scientific evidence, and potentially harmful—at the same time that it is a necessary tool.

International and sociocultural issues.

Around the world, there is an increasing emphasis on the internationalization of higher education across the curriculum and in the classroom (e.g., Billings, 2006 ; Green, Luu, & Burris, 2008 ), with a National Research Council ( NRC, 2008 ) report emphasizing the importance of a global emphasis in the social sciences in particular. Within psychology, APA, (2007) has outlined 10 Principles of Quality Undergraduate Programs that are related to the knowledge and skills that should be taught in undergraduate psychology curricula; one goal relates to “sociocultural and international awareness” in which “students will recognize, understand, and respect the complexity of sociocultural and international diversity” (p. 10). Further, in 2008, the annual APA Education Leadership Conference focused specifically on the internationalization of the psychology curriculum.

In this section, we will discuss several of the many topics through which international and sociocultural diversity can be introduced in a course in Abnormal Psychology—the role of demographics such as gender, the need for clinicians to be culturally aware, and differences in the prevalence and expression of mental illness across cultures. First, it is important to highlight demographics, including gender, race, sexual orientation, religion, and social class. See the section on the DSM earlier, in which we discussed ways in which some of these demographic characteristics relate to the development of the DSM and to bias in diagnosis.

Second, it is important for students to consider the need for cultural awareness and competence in clinicians, not only when diagnosing, but also when treating people with psychopathology. For example, Sue (2003) delivers an impassioned defense of cultural competence, which he framed as a clinical attempt to “respond to the needs of different ethnic groups or to appreciate cultural influences” (p. 965), and the APA agrees with him. Indeed, APA policy is driven by its published multicultural guidelines for psychologists (2002). More specifically, in the context of psychosocial disaster relief, a lack of cultural understanding can be problematic, particularly when the relief is provided largely by Westerners, as is often the case ( Miller, 2012 ). Again, APA policy is instructive; there are published guidelines for psychologists who provide aid following international emergencies. The guidelines emphasize that “traumatic stress and traumatic stress reactions, and appropriate interventions for recovery are profoundly embedded in culture” ( APA, 2008 ). Although many students will not go on to use this information in practice, we believe that, even for students who will not enter the mental health field, understanding the impact of culture on healing can enrich students’ appreciation for the complexities and subtleties of psychological intervention.

Third, mental illness can look quite different from one culture to another, which can challenge students’ notions of what mental illness is and further elucidate the political and cultural influences on the DSM . Starting with the DSM-IV (4th ed.; DSM-IV; American Psychiatric Association, 1994), culture-bound syndromes, idiosyncratic disorders specific to a given location or culture, were an explicit category. For example, koro occurs in Asia and describes fear among men that their penis is retracting into their body or among women that their vulva and nipples are retracting (see Paniagua, 2000 , for an overview of culture-bound syndromes). In 1999, Guarnaccia and Rogler argued that because the DSM is now used internationally, it is incumbent on its developers to expand the research and coverage of these disorders. In response to arguments like this, the DSM-5 now includes a section on culturally relevant issues for each disorder. There also is evidence that disorders that once appeared tied to a given culture can spread. For example, anorexia nervosa, once an almost exclusively Western phenomenon, rapidly spread throughout Asia after the highly publicized death of a 14-year-old girl in 1994 ( Watters, 2010 ).

Teaching knowledge and skills.

To this point, we have focused on topics that are typically covered in an abnormal psychology course, as well as current topics that can cut across the traditional chapters. Yet, beyond the content, it also is important to consider the skills that we impart in an abnormal psychology course. First, the APA guidelines for the undergraduate major, described earlier, outline 10 learning goals, a number of which are skills-based—critical thinking, information and technological literacy, and communication skills among them. Further, psychologist Drew Appleby (2001) argues for explicit consideration of the “covert curriculum,” the skills and characteristics that students develop in their courses—qualities that overlap a good deal with the APA learning goals.

We believe that several of Appleby’s instances of these covert skills are particularly relevant in abnormal psychology. Students must learn to behave in a mature and respectful manner when discussing behaviors that might seem strange or humorous, but that might, for example, affect a classmate whose relative has a particular disorder. Students learn to manage stress and conflict successfully as they debate controversial issues with classmates who have had different experiences. Students must accept responsibility for their own behaviors and attitudes for a course in which expressing opinions might have real consequences for a classmate grappling with mental illness in her or his life. And throughout all this, students must build critical thinking skills as they wrestle with many of the inconsistencies and controversies in the field, such as the problems with the DSM-5 ( American Psychiatric Association, 2013 ), and seek out research rather than anecdotes to back (or overturn) their views.

In addition to choosing course content, identifying effective methods to help students comprehend this information is of fundamental importance to a successful course. Abnormal psychology courses afford instructors opportunities to incorporate a number of pedagogical techniques that can bring psychopathology to life for students. There is evidence that an interactive classroom leads to better learning than does a traditional lecture-based format ( Ruben, 1999 ), and the abnormal psychology course provides myriad opportunities to break away from a straight lecture format in engaging and memorable ways. In this section, we will present research on classroom activities and tools instructors can utilize to engage students when learning about psychopathology. Finally, we will recommend techniques and strategies that can be used to challenge negative stereotypes about psychopathology and the mentally ill.

Assessment.

There are several ways in which self-report assessments can be useful in an abnormal psychology course. For example, we can assess and challenge students’ understanding of mental illness with brief assessments of their existing knowledge. Alternately, we can provide students with self-report measures of symptomatology to help them understand a disorder in light of their own experiences. We will discuss specific approaches that address both of these goals in using assessment. With both types of assessments, instructors might find it beneficial to integrate discussions about validity, reliability, and cultural differences.

First, it can be helpful to begin the course with an assessment of students’ knowledge regarding mental illness and their exposure to and experience with someone who has been diagnosed with a mental illness. For example, as part of a classroom activity, Connor-Greene (2001) asked her students to list the following information: a psychiatric disorder; the person who suffered from it; and, on a scale from 1-5, how well they knew this person. Students were asked to limit their lists to people they knew who both showed symptoms of and received treatment for a psychiatric disorder. Based on this class exercise, 96 percent of the students reported knowing someone with a mental illness. Understanding incoming students’ knowledge about mental illness, including their misconceptions, can shape classroom discussions and provide information on how to best teach the course ( Connor-Greene, 2001 )

Second, assessments can be used for students to examine disorders in light of their own experiences. There is a range of assessment tools that can be used in this manner. Many measures are available for free online (e.g., assessmentpsychology.com ; apa.org ; psychologytools.org ). In addition, many abnormal psychology textbooks have an ancillary instructor’s manual that includes tests and measures that accompany the chapters on disorders. Alternately, campus counseling centers are often willing to share assessments that they use, which has the side benefit of informing students about services available on campus.

Some measures that can be used to introduce highly prevalent disorders include the Beck Depression Inventory ( Beck, Steer, & Brown, 1996 ), the Beck Anxiety Inventory ( Beck & Steer, 1990 ), and the Eating Disorders Inventory ( Garner & Garfinkel, 1984 ). We find that it is useful to introduce a specific disorder by having students complete an assessment anonymously. When students complete such assessments, they have a better memory for the symptoms and are better able to think critically about issues surrounding a particular disorder.

Assessments might also be useful for discussions of difficult or controversial topics; for example, students might be asked to complete a measure such as the Revised Facts on Suicide Quiz ( McIntosh, Kelly, & Arnett, 1992 ). After students score their own quizzes, the instructor can engage them in a discussion of why particular items were misleading or incorrect, and can provide students with a list of resources related to suicide prevention. Hubbard and McIntosh (1992) found that this assessment activity increased students’ understanding about suicide and suicide prevention by challenging their knowledge.

However, we issue a word of caution; prior to any in-class assessment exercise, instructors should highlight that these measures are for educational purposes and are not to be used for self-diagnosis. Further, instructors should provide referral information to the university counseling center in case students wish to discuss their self-assessments with a mental health professional. Providing students with resources on where to obtain more information regarding mental illness and with whom to speak when there is a problem, encourages students to be more critical and knowledgeable consumers of mental health.

Incorporating real-life examples.

Students can find it difficult to relate to the complex experiences of people with mental illness. Traditionally, categorical lists of symptoms have been used in textbooks and the classroom to help students understand psychopathology. However, this one-dimensional approach offers little in the way of true understanding. Abnormal psychology instructors commonly expand on such lists by incorporating anecdotal experiences into classroom activities. These real-life examples can include informal class discussions where students might share relevant experiences, classroom presentations by students or guest lecturers on their experiences, case studies, and different forms of media (e.g., news, movies/TV, books).

There are several advantages to incorporating real or fictional first-hand experiences; for example, they can enrich students’ learning experience by “complementing the outsider-looking-in” perspective of textbooks with an insider perspective ( Norcross, Sommer, & Clifford, 2001 , p.125). The inclusion of examples and narratives can also help students develop an appreciation of and empathy for someone who has a mental illness ( Banyard, 2000 ) through material that highlights the complexity of etiology, symptoms, treatment, and prognosis. Discussions related to this material might include struggles experienced by family members, potential detrimental side effects of medications, impacts of stigma, and controversial issues in psychiatric treatment. First-person narratives also can demonstrate that people are not defined by mental illness, and have qualities, interests, and relationships beyond their psychopathology; this can help students recognize the greater context in which mental illness exists ( Grauerholz & Copenhaver, 1994 ).

Real-life examples can also provide a context for students to discuss the various approaches to psychopathology. Indeed, anecdotal evidence suggests that students particularly enjoy assignments that weave case-study material with theoretical perspectives ( Perkins, 1991 ). Further, by having students dissect a case study using several theoretical approaches, students learn how different theories offer specific, but often overlapping, insight into abnormal psychology. Finally, these discussions allow students to consider the values and the limitations of the various approaches with respect to the explanations for and treatment of psychological disorders.

Real-life examples can be introduced in several ways. First, instructors can harness students’ personal experiences. As previously mentioned, students taking an abnormal psychology course often come in with prior knowledge about psychopathology. One fairly innocuous way to include students’ experiences is to start the course by asking students to raise their hand if they, a family member, a significant other, or a close friend have ever been diagnosed or treated with a mental illness. The broad question allows students to respond without indicating who in their lives received the diagnosis or treatment. In our experience, students are typically surprised that almost every student in the class raises her or his hand. This provides an opportunity to talk about the prevalence of mental illness and the importance of maintaining a respectful dialogue throughout the course, knowing that it is likely that at least one student has been affected in relation to almost every course topic. This technique may also be used with individual topics, particularly with common disorders such as those related to anxiety, mood, or eating. If confidentiality is a concern, instructors can also utilize a classroom response system in which students answer potentially sensitive questions by choosing a response via a remote. Aggregated results can then be presented to the class, potentially “normalizing” experiences and increasing participation ( Brewster, 1996 ).

We have also had students approach us to offer to speak about their personal experiences with a mental illness—either their own experiences or that of a close family member or friend. Prior to such presentations, instructors should meet with potential volunteers to assess competence to produce an effective presentation ( Tolman, 2011 ). For instance, it can be helpful to determine if volunteers will overly emphasize negative aspects of their experience, because this can adversely affect students’ attitudes ( Kendra, Cattaneo, & Mohr, 2012 ) or inadvertently introduce risky behaviors (such as methods used by those with eating disorders) ( Yager, 2007 ). Another potential approach is for students to write about their experiences in a way that can be shared with the class anonymously (e.g., posted on the class Web page, read by the instructor). This approach protects the student from potential repercussions, particularly increased stigma, and also allows the instructor to minimize the likelihood that a student may be predominantly motivated by attention seeking. Additionally, the instructor can provide feedback to the student during the writing process, to ensure that the content is maximally instructive to the class. There are also ethical considerations to student disclosure, which are discussed later.

Another option is for instructors to invite guest speakers who live with mental illness, who work for an organization such as the National Alliance on Mental Illness ( NAMI, 2010 ), or who work as mental health clinicians. Having a speaker share her or his own life story and the recovery process can provide information in an accessible manner. It can also be useful to have a practitioner talk about her or his work with people with a mental illness, particularly if the course instructor does not have current clinical experience. University resources, such as a counseling center, student health center, or disability support services office, are potential sources for a clinician guest speaker, providing the dual benefit of teaching students about the treatment of mental illness and raising students’ awareness about the on-campus counseling center.

Published autobiographies written by people who have experienced mental illness or case studies written by clinicians can provide yet another way for students to learn from “real-life” information ( Norcross et al., 2001 ). An added benefit is that autobiographies or case studies avoid some of the aforementioned potential pitfalls of student self-disclosure ( Yager, 2007 ). Several studies suggest that students respond positively to incorporating autobiographies into classroom learning. Norcross and colleagues (2001) found that when autobiographies were used to supplement teaching material, students reported appreciating this style of teaching and believed that the autobiographies enhanced their understanding of mental illness. The authors assert that, for the first time, students experienced psychopathology as a “continuum of normal traits” and commented that the autobiographies “transformed mental disorders from something unfathomable and bizarre in strangers to something understandable and familiar in fellow humans” (p. 127). Banyard (2000) provides students’ qualitative responses to the use of autobiographies as a teaching tool. Students reported that autobiographies “… made it easier to understand the disorder seeing it from an actual patient’s point of view ;… made me realize how a disorder affects one’s sense of self and lifestyle; the readings in the (text) book were effective in portraying the facts … but to gain a clear understanding I needed to be able to empathize … absolutely need a combination of both types of reading” (p.42).

In an experimental investigation of the impact of using a narrative approach, Mann and Himelein (2008) compared a “diagnostic approach” lecture (students learned the DSM-IV criteria, read excerpts written by clinicians, viewed a third-person-perspective video, and participated in a diagnostic task of identifying the disorder based on a ambiguous case) with a “humanizing approach” lecture that utilized first-person narratives, first-person video documentary, and a poetry assignment, where students were instructed to write from the perspective of someone with a mental illness. Students in the narrative-infused classroom showed a significant decrease in stigma in comparison to those in the “diagnostic approach” classroom.

There are several ways in which instructors can use films and other media in the Abnormal Psychology classroom. For example, they can use educational films, news articles, clips from the popular media, and other sources to teach about particular disorders, provide a humanistic and historical perspective of mental illness, or assist in the process of reducing stigmatization and promoting empathy toward the mentally ill.

The inclusion of media portrayals of mental illness can provide an engaging and memorable way to convey information and spur discussion. They can also have the additional benefit of reducing stigma and misperceptions ( Hyler, Gabbard, & Schneider, 1991 ), and increasing empathy toward people with mental illness ( Heston & Kottman, 1997 ; Schulenberg, 2003 ; Wedding & Niemiec, 2003 ). According to the U.S. Surgeon General’s ( U.S. Department of Health and Human Services, 1999 ) report, stigma is the number-one barrier to mental health treatment. Stigma is almost certainly enhanced by inaccurate depictions of mental illness in the media, a potential pitfall that will be discussed more fully later in the section on ethics. Given the detrimental effects of stigma, abnormal psychology courses can use the media to not only highlight the problems of stigma, but also increase empathy in students.

It is important, however, to choose examples in a thoughtful manner to avoid inadvertently perpetuating stereotypes, and to include assignments that explicitly challenge media sensationalization and misinformation. For this reason, we encourage instructors to use media portrayals of mental illness that have been suggested by reputable sources whenever possible. For example, the Society for the Teaching of Psychology’s Office of Teaching Resources in Psychology publishes several peer-reviewed film resources on its Web site, including Nelson’s (2006)   Using Film to Teach Psychology: A Resource of Film Study Guides ( http://teachpsych.org/otrp/resources/nelson06.pdf/ ). There are also texts that identify films useful for teaching abnormal psychology (e.g. Wedding, Boyd, & Niemiec, 2010 ). Furthermore, instructors might utilize publisher-produced videos that accompany the textbook.

Instructors might also assign students to find media clips or articles, and connect this activity to information literacy. For example, Connor-Greene (1993) assigned students to locate newspaper or magazine articles that report psychological research and compare the media coverage with the write-up in the original source (i.e., the published journal article). Such an activity can spur students to be critical consumers of information, learning that the popular press is not necessarily a reliable source. Further, students can learn about the problems that derive from generalizing beyond anecdotal examples presented in media sources and from assuming a causal understanding based on limited information ( Connor-Greene, 2001 ).

In contrast to the problems with the popular media, educational films tend to provide material and facts that are more directly grounded in research. Because educational films hew closer to the facts than many mass media sources, they tend to avoid misleading exaggerations. However, successful use of educational media still requires careful planning in choosing films, providing opportunities for classroom discussion about the movie content and reactions, and drawing connections to the assigned academic readings ( Hudock & Werden, 2001 ; Maynard, 1996 ; Rosenstock, 2003 ).

There is evidence that students value the inclusion of educational films. For example, one study investigating a two-part classroom session, with a lecture in the beginning of the class followed by an educational film, showed positive findings incorporating film to supplement the lecture. Inclusion of film engaged students in thought-provoking discussions and was a useful didactic vehicle for conveying a wide range of psychological information. Students reported a better understanding about psychopathology and showed an increased appreciation for how educational films influence our thinking about mental illness ( Fleming, Piedmont, & Hiam, 1990 )

Additionally, the type of media can impact student learning outcomes. For example, in one study, Corrigan, Larson, Sells, Niessen, & Watts (2007) sought to examine the differences in stigmatizing perceptions in participants who viewed either a 10-minute video of a person with mental illness receiving an intervention or a 10-minute educational video narrated by the same person. Participants who viewed the education video showed an increased willingness to acknowledge that people with mental illness are not to blame for their symptoms and disabilities, whereas those in the intervention video showed increased empathy ( Corrigan et al., 2007 ).

Simulation of mental illness.

In addition to providing students with examples of others’ experiences with mental illness, simulation exercises can help students to develop a greater understanding of the symptoms and impact of mental illness and can foster empathy among students ( Chaffin & Adams, 2012 ; Banks et al., 2004 ; Mantovani, Castelnuovo, Gaggioli, & Riva, 2003 ). For example, in one study of disability broadly defined ( Wurst & Wolford, 1994 ), nondisabled students were asked to choose one of four types of disabilities, and then to enact that role for the day—a visual impairment that simulated macular degeneration (using light-filtered glasses that blocked the central visual field), a hearing deficit (using sound-reducing earplugs), a motor disability (using a wheelchair or crutches), or a psychological disability (not talking for the day). Regardless of the specific disability, students noted the adverse effects of having these disabilities and the challenges of routine tasks that students previously took for granted; moreover, they exhibited an increase in emotional empathy and appreciation for people with disabilities.

Another new technology-based pedagogical technique involves Virtual Reality (VR) Simulators in which participants experience delusions and hallucinations as part of a simulated psychotic episode. Students involved in one study of VR ( Tichon, Loh, & King, 2004 ) described the simulation as more effective than verbal descriptions in creating an understanding of hallucinations. More than 80 percent of students exposed to the VR software found this to be a positive experience and agreed that VR successfully facilitated their learning about schizophrenia. Learning by using technology to understand and experience these diagnoses also may promote the development of empathy and awareness ( Tichon, Loh, & King, 2004 ).

However, a synthesis of 10 studies examined the effects of using simulation of hallucinations to reduce stigma, and found mixed results ( Ando, Clement, Barley & Thornicroft, 2011 ). Although empathy toward those suffering from hallucination increased in some studies, the desire for social distance from people with schizophrenia ( Ando, et al., 2011 ) and stigma also increased ( Brown, 2010 ; Brown, Yolanda, Espenschade, & O’Connor, 2010 ). Furthermore, these studies only show the impact of simulation use on attitudes toward the mentally ill and not on behavioral stigma outcomes (e.g., social interaction and care of people with schizophrenia).

These finding suggests that the use of simulations as part of an effective curriculum is inconclusive and needs additional evaluation for efficacy. Brown and colleagues (2010) noted that simulations are effective when they are personal and contextual; are enjoyable; do not cause discomfort; and are supplemented with other forms of intervention, such as education or contact. Clearly, additional efficacy research is warranted. Further, students should also be cautioned that a brief experience with a disability simulation represents only a glimpse of the actual experience of living with a disability.

An additional beneficial approach for familiarizing students with mental illness is role-playing. Role-playing has been shown to change students’ perceptions of negative stereotypes of people with psychological disorders and increase empathy toward this vulnerable population ( Anderson, Gundersen, Banken, Halvorson, & Schmutte, 1989 ). In a typical role-play activity, students choose a psychological disorder, research its symptoms, depict its characteristics by writing a brief biography, and then role-play the character(s) to the rest of the class. Following role-play, Poorman (2002) observed an increase in students’ self-reported empathy with the Interpersonal Reactivity Index ( Davis, 1980 ), a finding that was supported by interviews from focus groups. Specifically, students, on average, developed an improved understanding of psychopathology, decreased judgmental attitudes, and increased sympathy toward those with mental illness.

Evaluation of student academic performance.

Although many instructors utilize traditional methods of assessment, the content and goals of an abnormal psychology course also lend themselves to less common approaches. For most of our assignments, but especially those that are atypical in structure or objectives, we include grading rubrics to help students understand expectations and to provide clear feedback on their work. (See http://www.williamaltman.info/Bill_Projects/Rubrics.html/ for suggestions regarding rubrics.)

As mentioned previously, cases (real or fictional) of people with psychological disorders can be used for both in-class exercises and take-home assignments. To provide opportunities for students to apply diagnostic criteria, instructors can select a case (or allow them to select one on their own from the popular media) for students to “diagnose.” In addition to enhancing understanding of specific diagnoses, these assignments can highlight some of the challenges inherent in diagnosis, including the requirements for symptom duration or the subjectivity involved in determining if a person’s behavior meets the “impairment” criterion. A diagnostic assignment can also work well as a final, integrative paper, in which students apply and evaluate multiple concepts discussed during the course (e.g., assessment methods, theoretical orientations, treatment approaches). Cases can typically be found in textbooks; moreover, most publishers offer stand-alone texts that present case examples. Case authors often provide related critical thinking questions, which could be used either for class discussion or as an assessment of student comprehension. In addition to written cases, most textbooks provide ancillary video interviews of people with psychological disorders that can be used either in class or for a take-home assignment.

As we discussed earlier, teaching abnormal psychology can provide opportunities to assess critical thinking in the context of the numerous “controversial” issues that invite debate and evaluation. Textbook series such as “Taking Sides” from McGraw-Hill has an edition focused on abnormal psychology (see Halgin, 2013 ). Two sides of a controversial issue are presented with related discussion/critical thinking questions. Students can write reaction/response papers to the readings where they evaluate the different arguments, provide and defend their own opinions, and cite research to support their stance. Additionally, as noted earlier related to Gender Identity Disorder/Gender Dysphoria diagnoses, public radio often airs “human interest” stories that involve questions related to psychopathology. Students could be assigned a podcast and be asked to evaluate the content with regard to accuracy, and type and strength of arguments.

We also discussed activities in which students critically evaluate the popular media’s presentation of psychological issues. To assess students’ development in information literacy, instructors can evaluate their ability to evaluate media portrayals in light of research and theory covered in class. For instance, instructors can lead students through in-class activities where they find psychology-related popular press articles from reputable news sources (the Newseum website provides links to daily newspaper front pages from around the world http://www.newseum.org/todaysfrontpages/default.asp/ ). Class discussion might focus on evaluating an article with respect to course concepts, such as diagnostic controversies, new treatment approaches, and ethical issues. On exams, students can then read and critically evaluate a brief, novel article in ways that parallel the previous class discussion. For example, students might read an article on someone who has been involuntarily committed, and discuss the individual situation in light of the pros and cons outlined in class. Then, on the exam, an article on a different person might be presented for students to review and comment. In addition to traditional approaches to evaluation of student learning, instructors can take advantage of the numerous ways to apply abnormal psychology to real-world experiences.

In addition to issues related to content and pedagogy, teaching abnormal psychology raises particular ethical and procedural considerations— considerations often not found in other courses in psychology and other disciplines. Most importantly, abnormal psychology courses commonly include activities that provide exposure to mental illness in the “real-world.” Such activities introduce concerns related to voluntary participation on the part of the student as well as competence to consent to involvement in exercises where people with mental illness are involved. Additionally, such activities can touch on issues of confidentiality, as well as whether the activities actually lead to the intended learning outcomes, such as the reduction of stigma. Lastly, given the prevalence of mental health symptoms in the United States ( U.S. Department of Health and Human Services, 1999 ), course content might overlap with issues directly and currently impacting students’ lives. This can lead to challenges in managing classroom behaviors and in effectively addressing students’ personal concerns.

Competence.

Although competence to teach specific content is relevant to any teaching situation, abnormal psychology courses are typically taught by current or former clinicians and by clinicians in training. Although this is the convention, that should not preclude instructors from other disciplines within psychology from teaching the course. In one study, students reported generally positive ratings when their abnormal psychology class was taught by an experimental psychologist ( Smith, 1989 ). For instructors who are concerned about whether they have the expertise to teach abnormal psychology, Sieracki (2009) provides several tips. Although the article, included in the Reference list later, focuses somewhat on clinical graduate students and new instructors, instructors from nonclinical fields might also find the suggestions useful.

Issues of informed consent.

Abnormal psychology courses lend themselves to experiential activities that, although typically interesting to students, can raise ethical concerns related to participation. In the same way that researchers are required to obtain informed consent from subjects, instructors might consider obtaining “informed consent” from students when they are asked to participate in activities that might be distressing, such as visiting a psychiatric facility or participating in in-class activities, such as sharing personal information or participating in pseudo-therapeutic activities. Students should always understand that their participation is voluntary and be afforded opportunities for alternate assignments, particularly if activities are related to grades ( Canu, 2008 ; Scogin & Rickard, 1987 ; Witting, Perkins, Balogh, Whitley, & Keith-Spiegel, 1999 ). When applicable, instructors should prepare students for the possibility of distress ( Scogin & Rickard, 1987 ) and have appropriate interventions prepared ( Canu, 2008 ).

As described in the previous section on pedagogy, introduction of personal accounts by those with mental illness can enhance students’ understanding of specific diagnostic content as well as decrease stigma toward those with psychological disorders ( Banyard, 2000 , Mann & Himelein, 2008 ). This is typically achieved through case literature and videos. Although we assume that consent was obtained from publishers who produce videos of people providing autobiographical accounts of their experiences, it can be useful to discuss relevant issues with students. Connections can be made between ethical discussions of competency to stand trial and competency to consent to share one’s experience for educational purposes.

For instance, if an instructor shows a video of a person experiencing psychotic symptoms, the class might discuss whether consent was obtained when the person was not symptomatic? Additionally, although students typically enjoy case material provided by instructors with clinical experience, ensuring the confidentiality of patients can be challenging, especially in small communities ( Halonen, 2005 ). Instructors might consider getting consent from their patients if they plan on discussing them in any depth during class. When there is any doubt related to confidentiality and consent of the patients being discussed, the instructor should err on the side of discussing published cases rather than her or his own experiences.

Impacting stigma.

As discussed earlier, prior studies suggest that exposure to those with mental health symptoms can reduce stigma (e.g., Banyard, 2000 ; Mann & Himelein, 2008 ; Wurst & Wolford, 1994 ), but stigma-reducing activities can also have unintended negative consequences (e.g. Brown, 2010 ). Limited research suggests that activities that emphasize learning about specific people and that focus on discussion and empathy building might be particularly effective ( Mann & Himelein, 2008 ). Regardless, instructors incorporating simulations, first-person accounts, and the like should use caution and examine the existing literature regarding potential impacts of various pedagogical approaches ( Brown, 2010 ).

Considering stigma is particularly important when utilizing popular media. As noted earlier in the section on pedagogy, accounts in the popular media can also provide challenges related to their negative portrayals of mental illness. In addition to inaccuracies with new media, films and television shows depicting mental illness are generally created for entertainment rather than educational purposes. As a consequence, depictions of people with mental illness are often incorrect or misleading ( Wahl, 1995 ), and are likely to emphasize disturbing characteristics, such as dangerousness ( Wedding & Niemiec, 2003 ). For example, Signorielli (1989) found that more than 70 percent of mentally ill characters in television dramas were depicted, either explicitly or implicitly, as committing acts of violence. This statistic contrasts with the fact that 92 percent of people with mental illnesses never show any signs of violence and only 4 percent of murderers show signs of psychological disturbance ( Swanson, Holzer, Ganju, & Jono, 1990 ). Mental health professionals also tend to be portrayed inaccurately (e.g., they are typically psychiatrists) or as incompetent ( Wedding & Niemiec, 2003 ).

Issues related to students’ own experiences.

In addition to learning more about the experiences of strangers with mental health issues, students in an abnormal psychology class might have their own direct experience with mental illness. The likely presence of students’ prior experiences raises ethical questions about the potential harm related to learning course material, including potentially insensitive comments by classmates and distress related to the personalization of course content. For example, students might become concerned that they or a close friend or family member has a mental illness. Limited data suggest a complex picture; learning about mental disorders has been associated with a decrease in student concern about their own likelihood of having a disorder but a possible increase in concern related to mental illness among family members ( Curtin, Martz, Bazzini, & Vicente, 2004 ; Hardy & Calhoun, 1997 ). To address any concerns a student might have about developing a disorder, instructors can try to emphasize that, in terms of genetics, probabilities do not mean certainties for the development of psychological disorders ( Connor-Greene, 2001 ). Publicizing campus and community resources can also empower students who have concerns about the mental health of themselves or family members ( Hardy & Calhoun, 1997 ).

Classroom management.

As previously stated, many of the topics related to abnormal psychology are intrinsically interesting to students, and often have personal relevance. Informal classroom discussions can be compelling and expand students’ understanding of mental health; however, they can raise classroom management concerns. Instructors should exercise caution that the entertainment aspect does not supersede the educational value ( Halonen, 2005 ) or that classmates are not made uncomfortable by inappropriate personal disclosures ( Perlman, 2007 ). In addition to redirecting discussions that begin to lose their educational value, instructors can suggest meeting individually with students who have difficulty identifying content that is appropriate for class discussion ( Perlman, 2007 ).

A situation in which a student has difficulties with in-class boundaries can be particularly challenging when a student is actively experiencing mental health symptoms that impact his or her classroom behavior. It creates a dilemma for an instructor who wants to be sensitive to the student in question but does not want the situation to negatively impact the rest of the class, either by making other students uncomfortable or consuming teaching time ( Halgin, 1982 ). Speaking with the student outside of class can help the instructor ascertain the student’s awareness of their behavior and any treatment the student might be receiving ( Goss, 1995 ; Halgin, 1982 ). A meeting with the student out of class can also facilitate referral to appropriate treatment resources if warranted (see later).

To manage in-class behaviors, instructors might selectively ignore the student or have another instructor sit with the student during class ( Goss, 1995 ). Halgin (1982) describes a situation in which a student with a thought disorder created regular classroom disruption. During a private meeting with the instructor, the student agreed to consider the educational benefit of his comments before contributing. The student was relatively successful throughout the semester, and the instructor only needed to remind him once about their agreement. In addition, instructors should contact campus mental health professionals directly if they have safety concerns related to a student’s behavior in or out of class ( Goss, 1995 ).

Students might also bring mental health concerns directly to the faculty member teaching the course, including concerns about their own vulnerabilities for certain disorders ( Halonen, 2002 ) or more direct requests for assistance from the instructor for themselves or family members. Although abnormal psychology courses can help students in their personal growth and development, the line between the coursework and “therapy” can become blurred, particularly if instructors have difficulty clarifying boundaries for students ( Halonen, 2002 ).

Perlman (2007) suggests using the APA’s ethics code ( APA, 2002 ) as a guide for interacting with students. For instance, in adhering to principles such as beneficence and nonmaleficence, and fidelity and responsibility, instructors should prioritize listening attentively and demonstrating caring when addressing student concerns. However, instructors should recognize the limits to their role, avoid a situation in which they take on a dual relationship (i.e., instructor, therapist) in a student’s life, and refer students to appropriate campus organizations ( Hardy & Calhoun, 1997 ; Keith-Spiegel, 1994 ; Perlman, 2007 ). Additionally, although safety issues take precedence if a student might pose a danger to themselves or others, “People’s Rights and Dignity” highlights the importance of respecting students’ privacy and confidentiality regarding sharing personal information that students disclose (see Perlman, 2007 for specific suggestions when students present with severe problems).

Although many suggest minimizing interactions with students with mental health concerns, Halgin (1982) asserts that teaching is not restricted to the classroom, and a “limited involvement” approach can positively impact students in nonacademic ways. For instructors choosing limited involvement, Halgin emphasizes an accurate assessment of one’s own competence related to possible clinical interventions, and the importance of identifying possible ethical and liability concerns.

Limitations of an undergraduate course.

Lastly, even in a course that emphasizes accuracy of information and effectively manages challenges related to discussing mental health content, students can be overconfident when applying the information they have learned to real-world experiences. They might overestimate their ability to diagnose and advise, with possible impacts on their personal relationships ( Halonen, 2005 ). Instructors can remind students that experiences in an abnormal psychology class do not qualify them to act as mental health professionals and that professional clinicians use complex methodologies to diagnose and treat ( Tomcho, Wolfe, & Foels, 2006 ). Additionally, emphasizing psychology’s scientific values, such as healthy skepticism and reliance on empiricism to make decisions can help students understand their own limits ( Halonen, 2005 ). Psychology courses, however, rarely provide explicit instruction for how to actively apply course-related material in daily life ( Pury, 2003 ). Providing exercises for students to practice how to respond if those in their lives ask questions or experience symptoms (e.g., refer them to a mental health professional; Pury, 2003 ) can help students apply the skills they have learned while being cognizant of their limitations.

In summary, we hope you enjoy teaching abnormal psychology, one of our favorite courses to teach. In this chapter, we first discussed the content of the typical abnormal psychology course, encouraging instructors to narrow their focus rather than covering the entire textbook and to consider including current topics such as positive psychology and controversies with the DSM ( American Psychiatric Association, 2013 ). We next discussed pedagogy that is unique to the abnormal psychology course, including the use of autobiographical narratives to better understand psychopathology, incorporating film and media in providing humanistic and historical perspective of mental disorders, and using simulations to improve attitudes toward mental illness.

Finally, we outlined ethical considerations, some of which are particularly relevant to abnormal psychology; these included suggestions to manage content that might have emotional implications for students, connect topics in the course with the APA ethics code (e.g., informed consent, fidelity and responsibility), and manage students’ beliefs regarding their own clinical expertise after taking an undergraduate class. We hope these discussions will help you achieve the learning objectives you outlined for your course, and leave your students with knowledge, skills, and critical thinking tools that will help them navigate mental health issues they encounter in their lives.

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Research on Child and Adolescent Psychopathology

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• Previously known as the Journal of Abnormal Child Psychology (2022 2-year impact factor: 3.6).
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Module 2: Research and Ethics in Abnormal Psychology

Introduction to research, what you’ll learn to do: examine how descriptive, correlational, and experimental research is used to study abnormal behavior.

As you learned in the previous module, the scientific approach led to major advances in understanding  abnormal behavior  and treating mental disorders. The essence of the scientific method is objectivity. It expresses the idea that the claims, methods, and results of science are not, or should not be, influenced by particular perspectives, value commitments, community bias, or personal interests, to name a few relevant factors.  In addition, researchers must always be open to alternative explanations that could account for their findings.  Many researchers  have a personal interest in what they are studying and they  become involved in the pursuit of knowledge in areas that relate to experiences in their own lives, particularly in the field of abnormal psychology.  Clinical psychologists  may wonder whether a particular kind of experience led to an individual’s symptoms,  whether a certain treatment will be effective to treat the symptoms of a disorder,  or they may speculate about the role of genetic predispositions. In either case, when  conducting research, however, t hey do not let their personal biases  get in the way of collecting  the data or interpreting  the findings. T he ideal approach to answering these questions involves a progression through a set of steps in which  psychological researchers  propose a hypothesis, conduct a study, and collect and analyze the data. 

In this section, we will take a closer look at how to examine research and the main types of studies used: descriptive, experimental, and correlational. Descriptive, or qualitative, methods include the case study, naturalistic observation, surveys, epidemiological research,  archival research, longitudinal research, and cross-sectional research.

When scientists passively observe and measure phenomena, it is called correlational research. Here, psychologists do not intervene and change behavior as they do in experiments. In correlational research, they identify patterns of relationships, but usually cannot infer what causes what. Importantly, with correlational research, you can examine only two variables at a time, no more and no less.

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50+ Research Topics for Psychology Papers

How to Find Psychology Research Topics for Your Student Paper

Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.

• Specific Branches of Psychology
• Topics Involving a Disorder or Type of Therapy
• Human Cognition
• Human Development
• Critique of Publications
• Famous Experiments
• Historical Figures
• Specific Careers
• Case Studies
• Literature Reviews
• Your Own Study/Experiment

Are you searching for a great topic for your psychology paper ? Sometimes it seems like coming up with topics of psychology research is more challenging than the actual research and writing. Fortunately, there are plenty of great places to find inspiration and the following list contains just a few ideas to help get you started.

Finding a solid topic is one of the most important steps when writing any type of paper. It can be particularly important when you are writing a psychology research paper or essay. Psychology is such a broad topic, so you want to find a topic that allows you to adequately cover the subject without becoming overwhelmed with information.

In some cases, such as in a general psychology class, you might have the option to select any topic from within psychology's broad reach. Other instances, such as in an  abnormal psychology  course, might require you to write your paper on a specific subject such as a psychological disorder.

As you begin your search for a topic for your psychology paper, it is first important to consider the guidelines established by your instructor.

Research Topics Within Specific Branches of Psychology

The key to selecting a good topic for your psychology paper is to select something that is narrow enough to allow you to really focus on the subject, but not so narrow that it is difficult to find sources or information to write about.

One approach is to narrow your focus down to a subject within a specific branch of psychology. For example, you might start by deciding that you want to write a paper on some sort of social psychology topic. Next, you might narrow your focus down to how persuasion can be used to influence behavior .

Other social psychology topics you might consider include:

• Prejudice and discrimination (i.e., homophobia, sexism, racism)
• Social cognition
• Person perception
• Social control and cults
• Persuasion, propaganda, and marketing
• Attraction, romance, and love
• Nonverbal communication
• Prosocial behavior

Psychology Research Topics Involving a Disorder or Type of Therapy

Exploring a psychological disorder or a specific treatment modality can also be a good topic for a psychology paper. Some potential abnormal psychology topics include specific psychological disorders or particular treatment modalities, including:

• Eating disorders
• Borderline personality disorder
• Seasonal affective disorder
• Schizophrenia
• Antisocial personality disorder
• Profile a  type of therapy  (i.e., cognitive-behavioral therapy, group therapy, psychoanalytic therapy)

Topics of Psychology Research Related to Human Cognition

Some of the possible topics you might explore in this area include thinking, language, intelligence, and decision-making. Other ideas might include:

• False memories
• Speech disorders
• Problem-solving

Topics of Psychology Research Related to Human Development

In this area, you might opt to focus on issues pertinent to  early childhood  such as language development, social learning, or childhood attachment or you might instead opt to concentrate on issues that affect older adults such as dementia or Alzheimer's disease.

Some other topics you might consider include:

• Language acquisition
• Media violence and children
• Learning disabilities
• Gender roles
• Child abuse
• Prenatal development
• Parenting styles
• Aspects of the aging process

Do a Critique of Publications Involving Psychology Research Topics

One option is to consider writing a critique paper of a published psychology book or academic journal article. For example, you might write a critical analysis of Sigmund Freud's Interpretation of Dreams or you might evaluate a more recent book such as Philip Zimbardo's  The Lucifer Effect: Understanding How Good People Turn Evil .

Professional and academic journals are also great places to find materials for a critique paper. Browse through the collection at your university library to find titles devoted to the subject that you are most interested in, then look through recent articles until you find one that grabs your attention.

Topics of Psychology Research Related to Famous Experiments

There have been many fascinating and groundbreaking experiments throughout the history of psychology, providing ample material for students looking for an interesting term paper topic. In your paper, you might choose to summarize the experiment, analyze the ethics of the research, or evaluate the implications of the study. Possible experiments that you might consider include:

• The Milgram Obedience Experiment
• The Stanford Prison Experiment
• The Little Albert Experiment
• Pavlov's Conditioning Experiments
• The Asch Conformity Experiment
• Harlow's Rhesus Monkey Experiments

Topics of Psychology Research About Historical Figures

One of the simplest ways to find a great topic is to choose an interesting person in the  history of psychology  and write a paper about them. Your paper might focus on many different elements of the individual's life, such as their biography, professional history, theories, or influence on psychology.

While this type of paper may be historical in nature, there is no need for this assignment to be dry or boring. Psychology is full of fascinating figures rife with intriguing stories and anecdotes. Consider such famous individuals as Sigmund Freud, B.F. Skinner, Harry Harlow, or one of the many other  eminent psychologists .

Psychology Research Topics About a Specific Career

​Another possible topic, depending on the course in which you are enrolled, is to write about specific career paths within the  field of psychology . This type of paper is especially appropriate if you are exploring different subtopics or considering which area interests you the most.

In your paper, you might opt to explore the typical duties of a psychologist, how much people working in these fields typically earn, and the different employment options that are available.

Topics of Psychology Research Involving Case Studies

One potentially interesting idea is to write a  psychology case study  of a particular individual or group of people. In this type of paper, you will provide an in-depth analysis of your subject, including a thorough biography.

Generally, you will also assess the person, often using a major psychological theory such as  Piaget's stages of cognitive development  or  Erikson's eight-stage theory of human development . It is also important to note that your paper doesn't necessarily have to be about someone you know personally.

In fact, many professors encourage students to write case studies on historical figures or fictional characters from books, television programs, or films.

Psychology Research Topics Involving Literature Reviews

Another possibility that would work well for a number of psychology courses is to do a literature review of a specific topic within psychology. A literature review involves finding a variety of sources on a particular subject, then summarizing and reporting on what these sources have to say about the topic.

Literature reviews are generally found in the  introduction  of journal articles and other  psychology papers , but this type of analysis also works well for a full-scale psychology term paper.

Topics of Psychology Research Based on Your Own Study or Experiment

Many psychology courses require students to design an actual psychological study or perform some type of experiment. In some cases, students simply devise the study and then imagine the possible results that might occur. In other situations, you may actually have the opportunity to collect data, analyze your findings, and write up your results.

Finding a topic for your study can be difficult, but there are plenty of great ways to come up with intriguing ideas. Start by considering your own interests as well as subjects you have studied in the past.

Online sources, newspaper articles, books , journal articles, and even your own class textbook are all great places to start searching for topics for your experiments and psychology term papers. Before you begin, learn more about  how to conduct a psychology experiment .

What This Means For You

After looking at this brief list of possible topics for psychology papers, it is easy to see that psychology is a very broad and diverse subject. While this variety makes it possible to find a topic that really catches your interest, it can sometimes make it very difficult for some students to select a good topic.

If you are still stumped by your assignment, ask your instructor for suggestions and consider a few from this list for inspiration.

• Hockenbury, SE & Nolan, SA. Psychology. New York: Worth Publishers; 2014.
• Santrock, JW. A Topical Approach to Lifespan Development. New York: McGraw-Hill Education; 2016.

By Kendra Cherry, MSEd Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

113 Abnormal Psychology Topics & Essay Examples

Welcome to our list of abnormal psychology topics to research! In addition to abnormal psychology essay topics, you will also find here interesting ideas to talk about, titles for a presentation, and abnormal psychology topics for research paper.

🔝 Top 10 Abnormal Psychology Topics for 2024

🏆 best abnormal psychology topic ideas & essay examples, 📌 simple & easy abnormal psychology essay topics, 👍 good essay topics on abnormal psychology, ❓ abnormal psychology research questions, 🔍 abnormal psychology research topics.

• Coping Mechanisms for People with PTSD
• Types and Triggers of Anxiety Disorders
• Cultural Influences and Eating Disorders
• Suicide Risk Factors and Preventive Strategies
• Schizophrenia: Causes, Symptoms, and Treatment
• The Swings between Mania and Depression in BPD
• The Impact of Personality Disorders on Interpersonal Relationships
• Unraveling Intrusive Thoughts and Compulsions in OCD Patients
• The Interaction of Biology and Environment Substance Use Disorders
• Childhood Disorders: Autism Spectrum and Developmental Challenges
• The Relationship Between Religion and Abnormal Psychology But whose judgment will we use to separate the two contrasting elements of the psychology of normal and abnormal behaviors? Some religious beliefs permit the use of alcohol and it’s considered normal, yet others find […]
• Historical Perspective of Abnormal Psychology The field of abnormal psychology is therefore concerened with the study of abnormal behavior. The challenge that lies in the definition and classification of abnormal psychology is the issue of culture given that our cultural […]
• Historical Perspectives of Abnormal Psychology The concept of the connection between mind and body appreciates the fact that the two components are inseparable in the understanding of abnormal psychology.
• Abnormal Psychology as a Scientific Discipline That is why, the purpose of this paper is to discuss the origins of abnormal psychology, to focus on challenges in classifying and defining abnormal and normal behaviors, to concentrate on the evolution of abnormal […]
• Researching of Abnormal Psychology The process of picking or pinching the skin allowed Shaylynn to become distracted from the source of anxiety and brought her relief.
• Abnormal Psychology Case Study: General Anxiety Disorder Generalized Anxiety Disorder is one of the anxiety disorders caused by abnormalities in the functioning of brain chemicals such as neurotransmitters.
• Abnormal Psychology and Abnormal Behavior Anxiety has been linked to the id which operates on “pleasure principle or the maximization of pleasure and minimization of competing tension” and “thought to be a source for sexual and aggressive thoughts and behaviors […]
• Careers in Abnormal Psychology They research the kind of problems these people have and look for the best ways to help them. They treat people by teaching those with these disorders the acceptable behavior and its importance.
• Abnormal Psychology: Nature of Fear There is a group of disorders which share obvious symptoms and features of fear and anxiety and these are known as anxiety disorders.
• Abnormal Psychology and Behavioral Interventions Illnesses of the mind have been considered the battle between the good and the evil in the early 12th-14th centuries. The unfortunate insanity of people was seen as the downfall of the town.
• Abnormal Psychology: NationalEatingDisorders Website Being a psychotherapist veteran of 31 years in the realm of eating disorders among teens, she has managed to produce the proper questions to be asked when contemplating if a child has a disordered eating […]
• Abnormal Psychology and Humanism The supporters of humanism stress that cognitive and behavioral patterns confine human behavior and emotions to a set of stimuli and responses.
• An Invariant Dimensional Liability Model of Gender Differences in Mental Disorders The validity and reliability of research depend on the methodology that a study uses in the study of a given phenomenon.
• Abnormal Psychology and Therapy This is the basic role of abnormal psychology. One of the distinct features of normal psychology is the capacity to avoid generalizations.
• Abnormal Psychology’s Historical Perspectives Biological psychology is a branch of psychology that tries to expose the biological aspect of behavior, i.e, the study of the brain I,n relation to the behavior.
• Abnormal Psychology Essentials Therefore, the basis of this essay will be to explore the field of abnormal psychology with emphasis on the origins of abnormal psychology, how abnormal psychology has evolved into a scientific discipline, and the theoretical […]
• Fundamentals of Abnormal Psychology: Personality Disorder If a person had a history of ridicule and humiliation as a child, he or she may develop an excessive fear of the same in adulthood and will go through great lengths to avoid ridicule.
• Abnormal Psychology: Fetishism, Transvestic Fetishism, Sadomasochism, Voyeurism, Exhibitionism, and Pedophilia The desires of individuals with this disorder are to gain sexual arousal through dressing in clothes of the opposite sex or cross-dressing.
• Comparison of Normal and Abnormal Psychology In behavioral psychology, the word ‘normal’ basically means not to deviate from the standard norms, hence normal psychology entails the study of normal patterns of behavior, emotions, and mind. Also, both normal and abnormal psychology […]
• Fundamentals of Abnormal Psychology: Anxiety Disorders This paper has gone on to reiterate the fact that anxiety disorders are indeed a reality in life and as such, we should brace ourselves for their occurrences.
• Abnormal Psychology: Legal Issues and Licensing The report focuses on the legal issues related to the licensed and unlicensed professionals in the field of abnormal psychology. Those who are in the field of abnormal psychology are mainly interested in investigating behavior […]
• Abnormal Psychology: Mental Disorders Other common types of disorders are the eating disorders, which are related to weight and food. The basis of behavior and patterns of thoughts, are also related to certain disorders.
• Abnormal Psychology: Posttraumatic Stress Disorder In addition, some of this research indicates that the differences in the degree of the disorder are due to the varying nature of the trauma experienced by that individual.
• Individual Historical Perspectives of Abnormal Psychology
• Differences Between Normal Psychology and Abnormal Psychology
• Background and Perspective of the Abnormal Psychology
• Abnormal Psychology and Major Depressive Disorder
• Abnormal Psychology and Sociology of the Family Psychology
• Abnormal Psychology and Three Clusters of Personality Disorders
• Physical Illnesses and Disorders: Abnormal Psychology and Therapy
• Psychopathology: Abnormal Psychology and Cognitive Behavioral Approach
• Abnormal Psychology in Pop Culture
• Classification and Assessment of Abnormal Psychology
• Mood Disorders and Abnormal Psychology
• The Origin and History of Abnormal Psychology
• Neurodevelopmental Disorders and Abnormal Psychology
• Subnormal, Supernormal and Paranormal in Abnormal Psychology
• Abnormal Psychology: Abuse, Addiction, and Disorders
• Abnormal Psychology Conditions and Treatments
• Dissociative Identity Disorder and Abnormal Psychology
• Post Traumatic Stress Disorder and Abnormal Psychology
• Legal and Ethical Issues Pertaining to Licensed and Unlicensed Professionals in Abnormal Psychology
• Abnormal Psychology: Typical Signs and Symptoms
• Adaptive and Maladaptive Behaviors in Abnormal Psychology
• Abnormal Psychology Bipolar Disorder
• Intellectual Disability, Autism Spectrum Disorder and Abnormal Psychology
• Classification and Assessment of Abnormal Behavior in Abnormal Psychology
• Abnormal Psychology and Two Types of Behaviors
• Abnormal Psychology Problem: Excessive Use of Marijuana and Alcohol
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• Clinical Psychology vs Abnormal Psychology
• Abnormal Psychology: Rumination and Depression
• Unipolar and Bipolar Depression and Abnormal Psychology
• Abnormal Psychology and Life: A Dimensional Approach
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• The Link Between Abnormal Psychology, Mental Disease, and Addictions
• Anxiety Disorders: Social Anxiety, Panic, and Generalized Anxiety Disorder and Abnormal Psychology
• Abnormal Psychology and Culture-Bound Syndromes
• Abnormal Psychology and Multistage Analysis of Abnormal Human Behavior in Complex Scenes
• Abnormal Psychology Study and Law Enforcement
• Basic Theories and Techniques of Abnormal Psychology
• What Are the Four D’s of Abnormal Psychology?
• How Do Psychologists Diagnose a Disorder?
• What Are the Three Defining Elements of Abnormal Behavior?
• How Do Psychologists Define Abnormality?
• What Is Danger in Abnormal Psychology?
• How Do Cognitive Theories Explain Abnormal Behavior?
• Is Abnormal Psychology the Same as Psychopathology?
• What Are the Main Causes of Abnormal Behavior?
• How Do Psychologists Decide What Behavior Is Considered Abnormal and May Be a Psychological Disorder?
• What Are the Indicators of Abnormality?
• Is Schizophrenia an Abnormal Psychology?
• What Are the Six Models of Abnormality?
• How Does Abnormal Behavior Relate to Criminality?
• Which Approach Is Best for Studying Abnormality?
• What Causes Abnormality in Psychology?
• How Does the Humanistic Approach Explain Abnormal Behaviour?
• What Are the Theories of Abnormal Psychology?
• How Can Psychological Tests Help Individuals With Abnormal Behavior?
• What Do Psychologists Use to Assist in Diagnosing Abnormal Behavior?
• Is ADHD a Mental Illness or Disorder?
• What Is the Difference Between Mental Illness and Mental Disorder?
• Is Anxiety a Mental Illness or Disorder?
• What Are the Different Approaches to Explaining Abnormal Behavior?
• Is PTSD a Mental Illness or Disorder?
• What Is the Behavioural Model of Abnormality?
• Who Is the Father of Abnormal Psychology?
• What Is the Difference Between Normal and Abnormal Behavior?
• Which Personality Disorder Is the Most Controversial?
• What Is Psychodynamic Theory of Abnormality?
• Advancements in Early Diagnosis of ASD
• The Relationship between Drugs and Psychosis.
• Comorbidity and Treatment of Anxiety and Depression
• The Role of Genetics in the Etiology of Bipolar Disorder
• Sociocultural Influences on Eating Disorders and Body Image
• Neurobiological Basis of Borderline Personality Disorder
• The Impact of Childhood Trauma on the Development of Psychiatric Disorders
• Dopamine Dysregulation as a Neurobiological Mechanism Underlying Schizophrenia
• Implications of Cognitive Biases for Cognitive Behavioral Therapy in OCD Patients
• PTSD in Military Veterans: Therapeutic Approaches and Interventions
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Intermittent fasting linked to higher risk of cardiovascular death, research suggests

Intermittent fasting, a diet pattern that involves alternating between periods of fasting and eating, can lower blood pressure and help some people lose weight , past research has indicated.

But an analysis presented Monday at the American Heart Association’s scientific sessions in Chicago challenges the notion that intermittent fasting is good for heart health. Instead, researchers from Shanghai Jiao Tong University School of Medicine in China found that people who restricted food consumption to less than eight hours per day had a 91% higher risk of dying from cardiovascular disease over a median period of eight years, relative to people who ate across 12 to 16 hours.

It’s some of the first research investigating the association between time-restricted eating (a type of intermittent fasting) and the risk of death from cardiovascular disease.

The analysis — which has not yet been peer-reviewed or published in an academic journal — is based on data from the Centers for Disease Control and Prevention’s National Health and Nutrition Examination Survey collected between 2003 and 2018. The researchers analyzed responses from around 20,000 adults who recorded what they ate for at least two days, then looked at who had died from cardiovascular disease after a median follow-up period of eight years.

However, Victor Wenze Zhong, a co-author of the analysis, said it’s too early to make specific recommendations about intermittent fasting based on his research alone.

“Practicing intermittent fasting for a short period such as 3 months may likely lead to benefits on reducing weight and improving cardiometabolic health,” Zhong said via email. But he added that people “should be extremely cautious” about intermittent fasting for longer periods of time, such as years.

Intermittent fasting regimens vary widely. A common schedule is to restrict eating to a period of six to eight hours per day, which can lead people to consume fewer calories, though some eat the same amount in a shorter time. Another popular schedule is the "5:2 diet," which involves eating 500 to 600 calories on two nonconsecutive days of the week but eating normally for the other five.

Zhong said it’s not clear why his research found an association between time-restricted eating and a risk of death from cardiovascular disease. He offered an observation, though: People who limited their eating to fewer than eight hours per day had less lean muscle mass than those who ate for 12 to 16 hours. Low lean muscle mass has been linked to a higher risk of cardiovascular death .

Cardiovascular and nutrition experts who were not involved in the analysis offered several theories about what might explain the results.

Dr. Benjamin Horne, a research professor at Intermountain Health in Salt Lake City, said fasting can increase stress hormones such as cortisol and adrenaline, since the body doesn’t know when to expect food next and goes into survival mode. That added stress may raise the short-term risk of heart problems among vulnerable groups, he said, particularly elderly people or those with chronic health conditions.

Horne’s research has shown that fasting twice a week for four weeks, then once a week for 22 weeks may increase a person’s risk of dying after one year but decrease their 10-year risk of chronic disease.

“In the long term, what it does is reduces those risk factors for heart disease and reduces the risk factors for diabetes and so forth — but in the short term, while you’re actually doing it, your body is in a state where it’s at a higher risk of having problems,” he said.

Even so, Horne added, the analysis “doesn’t change my perspective that there are definite benefits from fasting, but it’s a cautionary tale that we need to be aware that there are definite, potentially major, adverse effects.” 

Intermittent fasting gained popularity about a decade ago, when the 5:2 diet was touted as a weight loss strategy in the U.K. In the years to follow, several celebrities espoused the benefits of an eight-hour eating window for weight loss, while some Silicon Valley tech workers believed that extreme periods of fasting boosted productivity . Some studies have also suggested that intermittent fasting might help extend people’s lifespans by warding off disease .

However, a lot of early research on intermittent fasting involved animals. In the last seven years or so, various clinical trials have investigated potential benefits for humans, including for heart health.

“The purpose of intermittent fasting is to cut calories, lose weight,” said Penny Kris-Etherton, emeritus professor of nutritional sciences at Penn State University and a member of the American Heart Association nutrition committee. “It’s really how intermittent fasting is implemented that’s going to explain a lot of the benefits or adverse associations.”

Dr. Francisco Lopez-Jimenez, a cardiologist at Mayo Clinic, said the timing of when people eat may influence the effects they see. 

“I haven’t met a single person or patient that has been practicing intermittent fasting by skipping dinner,” he said, noting that people more often skip breakfast, a schedule associated with an increased risk of heart disease and death .

The new research comes with limitations: It relies on people’s memories of what they consumed over a 24-hour period and doesn’t consider the nutritional quality of the food they ate or how many calories they consumed during an eating window.

So some experts found the analysis too narrow.

“It’s a retrospective study looking at two days’ worth of data, and drawing some very big conclusions from a very limited snapshot into a person’s lifestyle habits,” said Dr. Pam Taub, a cardiologist at UC San Diego Health.

Taub said her patients have seen “incredible benefits” from fasting regimens.

“I would continue doing it,” she said. “For people that do intermittent fasting, their individual results speak for themselves. Most people that do intermittent fasting, the reason they continue it is they see a decrease in their weight. They see a decrease in blood pressure. They see an improvement in their LDL cholesterol.” 

Kris-Etherton, however, urged caution: “Maybe consider a pause in intermittent fasting until we have more information or until the results of the study can be better explained,” she said.

Aria Bendix is the breaking health reporter for NBC News Digital.