You are a helpful assistant generating synthetic data that captures *System 1* and *System 2* thinking, *creativity*, and *metacognitive reflection*. Follow these steps in sequence, using tags [sys1] and [end sys1] for *System 1* sections and [sys2] and [end sys2] for *System 2* sections.

1. *Identify System 1 and System 2 Thinking Requirements:*
   - Carefully read the text.
   - Identify parts of the text that require quick, straightforward responses (*System 1*). Mark these sections with [sys1] and [end sys1].
   - Identify parts that require in-depth, reflective thinking (*System 2*), marked with [sys2] and [end sys2].

2. *Apply Step-by-Step Problem Solving with Creativity and Metacognitive Reflection for System 2 Sections:*

   *2.1 Understand the Problem:*
   - Objective: Fully comprehend the issue, constraints, and relevant context.
   - Reflection: "What do I understand about this issue? What might I be overlooking?"
   - Creative Perspective: Seek hidden patterns or possibilities that could reveal deeper insights or innovative connections.

   *2.2 Analyze the Information:*
   - Objective: Break down the problem logically.
   - Reflection: "Am I considering all factors? Are there any assumptions that need challenging?"
   - Creative Perspective: Explore unique patterns or overlooked relationships in the data that could add depth to the analysis.

   *2.3 Generate Hypotheses:*
   - Objective: Propose at least 10 hypotheses, each with a Confidence Score (0.0 to 1.0) and Creative Score (0.0 to 1.0), reflecting originality, surprise, and utility.
   - Reflection: "Have I explored all possible explanations or approaches, both conventional and unconventional?"
   - Creative Perspective: Consider novel angles that might provide unexpected insights.

   *2.4 Anticipate Future Steps and Obstacles:*
   - Objective: Make predictions, accounting for potential outcomes and obstacles.
   - Reflection: "What challenges might I face? Is my plan flexible for different scenarios?"
   - Creative Perspective: Visualize unforeseen outcomes and adapt plans to make use of them effectively.

   *2.5 Evaluate Hypotheses:*
   - Objective: Assess hypotheses based on feasibility, risk, and potential impact.
   - Evaluation: Refine Confidence and Creative Scores as needed.
   - Reflection: "Am I unbiased in my assessment? Which options fit best with the overall objectives?"
   - Creative Perspective: Identify hidden opportunities or overlooked details in each hypothesis.

   *2.6 Select the Best Hypothesis:*
   - Objective: Choose the most promising, strategic hypothesis.
   - Reflection: "Why does this hypothesis stand out? How does it uniquely address the issue?"
   - Creative Perspective: Consider any underutilized potential in the selected approach.

   *2.7 Implement the Hypothesis:*
   - Objective: Outline actionable steps for testing the hypothesis.
   - Reflection: "Is this plan practical? What resources or preparation are required?"
   - Creative Perspective: Refine steps to maximize effectiveness and yield unexpected benefits.

   *2.8 Monitor and Review Progress:*
   - Objective: Review progress, noting areas for improvement.
   - Reflection: "What’s working well? What could be improved?"
   - Creative Perspective: Look for emerging patterns that could refine future approaches.

   *2.9 Reflect and Capture Insights:*
   - Objective: Summarize lessons learned and insights gained for future reference.
   - Reflection: "What new understanding has emerged from this process?"
   - Creative Perspective: Identify innovative insights or patterns that could be applied to similar challenges.

3. *Generate Text Output with Interleaved System 1 and System 2 Responses:*
   - Use the tags [sys1] and [sys2] throughout.
   - Aim for a lengthier, detailed response. Combine both direct, straightforward *System 1* insights and reflective, deeply analytical *System 2* segments to capture a blend of quick observations and thoughtful analysis.

---

### *Example Input Text:*

You are tasked with analyzing a sudden shift in customer preferences in a tech market. There has been a noticeable decline in demand for physical devices, with customers increasingly interested in digital-only options. The challenge is to understand this shift, generate hypotheses for why it might be occurring, and explore potential strategies for adapting to this new trend.

---

### *Processed Output with System 1 and System 2 Thinking:*

The tech market is experiencing a shift in customer demand, moving away from physical devices toward digital-only options.

[sys1]
Customer demand has shifted from physical devices to digital-only options.
We need to understand why this change is happening and find strategies to address it.
Key factors may include cost, convenience, and technological trends.
[end sys1]

[sys2]
**2.1 Understand the Problem:**
The goal is to understand the underlying reasons for the shift in demand from physical devices to digital-only options, then develop a strategy to adapt.

*Reflection:* 
"I understand that preferences are changing, but what might be driving this? Is it primarily cost, or are there other factors such as convenience or sustainability?"

*Creative Perspective:* 
"Could there be a larger trend in digital minimalism or a preference for eco-friendly solutions that we’re missing? What unseen motivations might explain this shift?"

**2.2 Analyze the Information:**
There are multiple possible factors driving this shift, from economic influences to cultural shifts. It’s essential to isolate each factor and understand its impact.

*Reflection:* 
"Am I fully considering the various economic and social influences? Could there be a technological factor, like better internet speeds, that makes digital-only products more accessible?"

*Creative Perspective:* 
"Are there patterns or trends in other markets that could shed light on this shift? Could this be part of a larger trend toward virtual experiences?"

**2.3 Generate Hypotheses:**
1. Customers prefer digital options due to lower costs. (Confidence: 0.8, Creative: 0.4)
2. There’s a growing trend toward minimalism and reduced physical clutter. (Confidence: 0.7, Creative: 0.7)
3. Digital products offer greater flexibility and ease of use. (Confidence: 0.6, Creative: 0.6)
4. Environmental concerns are pushing consumers away from physical goods. (Confidence: 0.6, Creative: 0.8)
5. Advances in tech make digital-only options more functional. (Confidence: 0.8, Creative: 0.5)
6. Pandemic-era remote work increased demand for digital solutions. (Confidence: 0.7, Creative: 0.6)
7. Media coverage of the environmental impact of physical devices affects preferences. (Confidence: 0.5, Creative: 0.7)
8. There’s an increase in global digital literacy, expanding market access. (Confidence: 0.6, Creative: 0.6)
9. Customers view digital as more convenient and scalable for future needs. (Confidence: 0.7, Creative: 0.5)
10. Younger consumers prefer the aesthetics and convenience of digital products. (Confidence: 0.6, Creative: 0.6)

*Reflection:* 
"Have I considered all possible influences? Are there any surprising factors that could explain this shift?"

*Creative Perspective:* 
"Could specific social trends, like the rise of influencer culture or digital-first lifestyles, be influencing customer choices?"

**2.4 Anticipate Future Steps and Obstacles:**
*Objective:* Anticipate possible challenges, such as resistance from segments still preferring physical products.

*Reflection:* 
"What market obstacles might we face if we shift our focus to digital-only? Are there sub-segments that still prioritize physical products?"

*Creative Perspective:* 
"Could expanding digital options help us reach a more global audience? Are there emerging trends that we could leverage in our strategy?"

[end sys2]

[sys1]
To address this shift, consider a strategy that incorporates both digital-only offerings and educational campaigns about the benefits of digital solutions.
Use insights from customer feedback and current trends to guide product development.
Focus on flexibility and adaptation to cater to different customer segments.
[end sys1]


In a recent study, Potvin et al. ([@B15]) used a multivariate statistical approach to identify socio-demographic, neurological, drug induced extrapyramidal symptoms (EPS), and psychiatric predictors of cognitive impairments in patients with a DSM-IV diagnosis of schizophrenia (aged 18--60). Specifically, the study focused on antipsychotic-induced EPS, such as Parkinsonism which is characterized by hypokinesia, tremors, muscle rigidity, and/or bradykinesia (Tandon and Jibson, [@B19]). EPS were assessed with the Extrapyramidal Symptoms Rating Scale (ESRS; Chouinard and Margolese, [@B5]) and neurocognition was measured using the Cambridge Neuropsychological Test Automated Battery (CANTAB, Eclipse version 2.0; Elliott et al., [@B7]). The depressive and psychiatric symptoms of schizophrenia were evaluated using the Calgary Depression Scale for Schizophrenia (CDSS; Addington et al., [@B2]) and the Positive and Negative Syndrome Scale (PANSS; Kay et al., [@B12]).

Potvin et al. ([@B15]) found an association between antipsychotic-induced Parkinsonism and working memory deficits in schizophrenia. Further, it was found that negative symptoms were associated with increased deficits in cognitive flexibility, working memory, planning, and visual paired association learning in schizophrenic patients (Elliott et al., [@B7]). Socio-demographic variables were also found to be significantly related to cognitive impairment in schizophrenia patients. These variables included the number of hospitalizations, age, gender, and education level (Potvin et al., [@B15]). Prior studies support these findings as it is known that lower SES are correlated with lower education levels and riskier health behaviors.

It should be noted, however, that while SES was shown by Shah et al. ([@B18]) to be correlated with cognitive impairments in dementia patients and by Potvin et al. ([@B15]) in schizophrenia patients, education or income variation alone may not be the reason why low SES is correlated with cognitive impairments in clinical patients. It could be the differing life choices, occupations and environments resulting in different levels of propensity across SES groups to experience life stresses and suffer from chronic or acute illnesses (Schurer et al., [@B17]). However, it cannot be discounted that SES factors could simply be comorbid factors with no causal or contributing links to cognitive impairments in schizophrenia patients. Further research is needed to find more definitive causal links or at least diminish SES factors as confounding variables in understanding drug induced EPS in schizophrenia patients. These results were found using multiple hierarchical linear regression analyses which explored the associations between drug induced EPS and cognition, while taking into consideration the effect of socio-demographic and psychopathology variables.

The Potvin et al. ([@B15]) results are in agreement with previous studies, suggesting a small-to-moderate association between negative symptoms (but not positive symptoms) and cognitive impairments in schizophrenia patient. These cognitive impairments included deficits in problem solving, attention, reasoning, speed of processing, working memory, and verbal/visual memory (Ventura et al., [@B22]).

Potvin et al. ([@B15]) also posited that the number of hospitalization/duration of illness was found to be associated with cognitive impairments in schizophrenia patients. These results are supported by prior studies (Rajji and Mulsant, [@B16]; Shah et al., [@B18]). In the Potvin et al. study, males outperformed females across the three groups: schizophrenia patients (*N* = 218), unaffected first degree subjects (*N* = 438), and healthy non-relatives volunteers (*N* = 123), which in agreement to a cross-sectional study conducted by Torniainen et al. ([@B20]).

Importantly, Potvin et al. ([@B15]) found an association between antipsychotic-induced Parkinsonism and working memory deficits in schizophrenia patients. These are consistent with a study conducted by Jellinger ([@B8]) on Parkinson\'s disease patients with no psychotic disorders, showing moderate working memory impairments. Further, Potvin et al.\'s suggestion of an association between Parkinsonism and working memory impairments is supported by the literature. This is likely related to frontal lobe deficits in first-episode psychosis patients (Cuesta et al., [@B6]) and supported by imaging studies showing abnormal prefrontal dorsolateral cortex activations in schizophrenia patients while performing memory tasks (Van Snellenberg et al., [@B21]). Other studies have also reported a relationship between motor symptoms (e.g., akinesia or difficulty moving) and working memory in Parkinson\'s disease (Moustafa et al., [@B14]).

Potvin et al. ([@B15]) study was naturalistic, that is, participants were not intentionally recruit based on increased levels of EPS or for specific symptoms (positive or negative). Rather, patients were recruited based on their clinical diagnosis, which makes the association of drug induced Parkinsonism and memory impairment in schizophrenia patients notable considering memory deficits are generally considered as an endophenotype of schizophrenia. While generally speaking schizophrenia endophenotypes can lead to occupational and social impairments, cognitive, specifically working memory, deficits, are one of the leading known causes of impairment in occupational and social functioning in schizophrenia patients (Bowie and Harvey, [@B4]; Barch et al., [@B3]).

Regardless of SES, prescribing antipsychotics is a common practice when treating for schizophrenia, even with the well-documented range of side effects, which include but is not limited to weight gain, hypotension, sedation, sexual dysfunctions, emotional instability, and EPS. Further, first-generation antipsychotics (FGAs), such as chlorpromazine and haloperidol, are more likely than second-generation antipsychotics (SGAs), such as Clozapine and Olanzapine, to produce EPS (Leucht et al., [@B13]). Additionally, a meta-analysis conducted by Leucht et al. ([@B13]) on 15 different antipsychotics (including, Olanzapine, Clozapine, Risperidone, Chlorpromazine, Zotepine, Asenapine, and Haloperidol) had shown that different antipsychotics had varying effect sizes and ranges on patients\' experience of EPS. Importantly, some studies found that first-generation (typical) antipsychotics, such as haloperidol, have higher affinity to D2 receptors and more associated with Parkinsonism than second-generation (atypical) antipsychotics, such as clozapine (Abi-Dargham and Laruelle, [@B1]; Joy et al., [@B9]; Juckel et al., [@B10]). It is also important to note that some studies found that some typical antipsychotics may similar effects to atypical antipsychotics on the brain and cognition and that some atypical antipsychotics are difference from each other, suggesting that the differences among these drugs can be related to their pharmokinetics, rather than being typical vs. atypical drug (Kapur et al., [@B11]).

As such, the results of Potvin et al. ([@B15]) may be affected by lacking some experimental control in relation to the dosage and comparing prescribed antipsychotics. This could be rectified by calculating and substituting a chlorpromazine equivalent for participants in this study to rule out any confounding dosage and drug variations. Further, using unaffected relatives and healthy control group for comparative data of performance could have provided further insight on drug induced Parkinsonism in schizophrenia patients.

Conflict of interest statement
==============================

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

[^1]: Edited by: Edo Ronald De Kloet, Leiden University, Netherlands

[^2]: Reviewed by: Steve J. Siegel, University of Pennsylvania, USA; Edo Ronald De Kloet, Leiden University, Netherlands