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This dissertation, Self-referential Information Processing in Psychotic Disorders by Suet-chung, Lawson, Tang, 鄧雪松, was obtained from The University of Hong Kong (Pokfulam, Hong Kong) and is being sold pursuant to Creative Commons: Attribution 3.0 Hong Kong License. The content of this dissertation has not been altered in any way. We have altered the formatting in order to facilitate the ease of printing and reading of the dissertation. All rights not granted by the above license are retained by the author. Abstract: Motivations Ideas and delusions of reference (I/DOR) are common psychotic symptoms and can be defined as self-referential experiences in excess of the amount of evidence available in the immediate environment. A putative neurocognitive mechanism is increased automatic attention capture by self-referential (SR) information. This study was carried out to test the hypotheses that 1) compared with patients with no I/DOR, those who have the symptom have increased attentional shift to SR information and 2) there is a positive correlation between the severity of I/DOR and the extent of attentional shift to SR information. Clinical and cognitive correlates of I/DOR were also explored. Methods Patients with I/DOR (n=20, mean age 25.27.9 years, 4 men) and without I/DOR (n=17, mean age 28.68.2 years, 10 men) matched for age and education were assessed for positive symptoms, negative symptoms, mood symptoms and basic neurocognition. I/DOR were phenomenologically assessed using the Ideas of Reference Interview Scale (IRIS). In an interference task, patients were instructed to respond to computerized Stroop tasks while ignoring a voice clip presented binaurally with the subject's own name (SON) embedded in certain trials. Within-subject differences in reaction time and accuracy between Stroop trials with and without SON were used as parameters to measure the degree of attentional shift to SR information. Between-group and within-subject differences in the reaction time and accuracy in the interference task were analysed using 22 mixed-ANOVA. Bivariate correlation was used to explore the relationship between IRIS scores and performance in the interference task. Stepwise linear regression analysis was used to explore the correlates of I/DOR. Results There was statistically significant interaction between conditions with and without SON and patient groups on the reaction time of the interference task (p=0.048). Simple main effects showed the mean difference of reaction time between conditions with and without SON was statistically significant in patients with I/DOR (p=0.001) but not in patients without I/DOR (p=0.862). Parameters used in the interference task correlated highly with IRIS global score and subscores on pervasiveness, self-referential discrepancy, conviction and frequency (r=0.328-0.517, range; pDiscussion The significant interaction and simple main effect suggest that I/DOR are associated with a heightened attentional shift to SR information. The robust correlations between IRIS scores and attentional shift to SON provide some evidence to support the continuum hypothesis of I/DOR. The possible roles of emotions in the pathogenesis of I/DOR are discussed. Significance With the use of well-matched patient samples and an ecologically valid paradigm based on known human cognitive functions, the present study provided first empirical evidence for a theoretical link between cognitive anomaly and a key psychotic symptom. The SON paradigm provides a promising tool for further research and can potentially be developed into a neurocognitive parameter of I/DOR. The present study also shed light on the complexity of I/DOR in

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