F Rausch1, S Eisenacher1, H Elkin1, S Englisch1, S Kayser2, N Striepens2, M Lautenschlager3, A Heinz3, Y Gudlowski3, B Janssen4, W Gaebel4, T M Michel5, F Schneider5, M Lambert6, D Naber6, G Juckel7, S Krueger-Oezguerdal7, T Wobrock8, A Hasan9, M Riedel9, S Moritz6, H Müller10, J Klosterkötter10, A Bechdolf10, M Zink1, M Wagner2. 1. Central Institute of Mental Health,Medical Faculty Mannheim,Heidelberg University,Germany. 2. Department of Psychiatry and Psychotherapy,University of Bonn,Germany. 3. Department of Psychiatry and Psychotherapy,Charité University Medicine Campus Mitte,Berlin,Germany. 4. Department of Psychiatry and Psychotherapy,Heinrich-Heine-University Duesseldorf,Germany. 5. Department of Psychiatry, Psychotherapy and Psychosomatics,University Aachen,Germany. 6. Department for Psychiatry and Psychotherapy,University Medical Center Hamburg-Eppendorf,Germany. 7. Department of Psychiatry, Psychotherapy, and Preventive Medicine,Ruhr University Bochum,Germany. 8. Department of Psychiatry and Psychotherapy,Georg-August-University Goettingen,Goettingen,Germany. 9. Department of Psychiatry and Psychotherapy,Ludwig-Maximilians-University,Munich,Germany. 10. Department of Psychiatry and Psychotherapy,University of Cologne,Germany.
Abstract
BACKGROUND: Patients with psychosis display the so-called 'Jumping to Conclusions' bias (JTC) - a tendency for hasty decision-making in probabilistic reasoning tasks. So far, only a few studies have evaluated the JTC bias in 'at-risk mental state' (ARMS) patients, specifically in ARMS samples fulfilling 'ultra-high risk' (UHR) criteria, thus not allowing for comparisons between different ARMS subgroups. METHOD: In the framework of the PREVENT (secondary prevention of schizophrenia) study, a JTC task was applied to 188 patients either fulfilling UHR criteria or presenting with cognitive basic symptoms (BS). Similar data were available for 30 healthy control participants matched for age, gender, education and premorbid verbal intelligence. ARMS patients were identified by the Structured Interview for Prodromal Symptoms (SIPS) and the Schizophrenia Proneness Instrument - Adult Version (SPI-A). RESULTS: The mean number of draws to decision (DTD) significantly differed between ARM -subgroups: UHR patients made significantly less draws to make a decision than ARMS patients with only cognitive BS. Furthermore, UHR patients tended to fulfil behavioural criteria for JTC more often than BS patients. In a secondary analysis, ARMS patients were much hastier in their decision-making than controls. In patients, DTD was moderately associated with positive and negative symptoms as well as disorganization and excitement. CONCLUSIONS: Our data indicate an enhanced JTC bias in the UHR group compared to ARMS patients with only cognitive BS. This underscores the importance of reasoning deficits within cognitive theories of the developing psychosis. Interactions with the liability to psychotic transitions and therapeutic interventions should be unravelled in longitudinal studies.
BACKGROUND:Patients with psychosis display the so-called 'Jumping to Conclusions' bias (JTC) - a tendency for hasty decision-making in probabilistic reasoning tasks. So far, only a few studies have evaluated the JTC bias in 'at-risk mental state' (ARMS) patients, specifically in ARMS samples fulfilling 'ultra-high risk' (UHR) criteria, thus not allowing for comparisons between different ARMS subgroups. METHOD: In the framework of the PREVENT (secondary prevention of schizophrenia) study, a JTC task was applied to 188 patients either fulfilling UHR criteria or presenting with cognitive basic symptoms (BS). Similar data were available for 30 healthy control participants matched for age, gender, education and premorbid verbal intelligence. ARMS patients were identified by the Structured Interview for Prodromal Symptoms (SIPS) and the Schizophrenia Proneness Instrument - Adult Version (SPI-A). RESULTS: The mean number of draws to decision (DTD) significantly differed between ARM -subgroups: UHR patients made significantly less draws to make a decision than ARMS patients with only cognitive BS. Furthermore, UHR patients tended to fulfil behavioural criteria for JTC more often than BS patients. In a secondary analysis, ARMS patients were much hastier in their decision-making than controls. In patients, DTD was moderately associated with positive and negative symptoms as well as disorganization and excitement. CONCLUSIONS: Our data indicate an enhanced JTC bias in the UHR group compared to ARMS patients with only cognitive BS. This underscores the importance of reasoning deficits within cognitive theories of the developing psychosis. Interactions with the liability to psychotic transitions and therapeutic interventions should be unravelled in longitudinal studies.
Authors: Ana Catalan; Stefania Tognin; Matthew J Kempton; Daniel Stahl; Gonzalo Salazar de Pablo; Barnaby Nelson; Christos Pantelis; Anita Riecher-Rössler; Rodrigo Bressan; Neus Barrantes-Vidal; Marie-Odile Krebs; Merete Nordentoft; Stephan Ruhrmann; Gabriele Sachs; Bart P F Rutten; Jim van Os; Lieuwe de Haan; Mark van der Gaag; Lucia R Valmaggia; Philip McGuire Journal: Psychol Med Date: 2020-10-06 Impact factor: 10.592