Neuropsychological functioning and jumping to conclusions in delusions (original) (raw)
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Schizophrenia Research: Cognition, 2015
Patients with delusions exhibit an increased tendency to arrive at decisions based on very limited evidence (jumping-to-conclusions; JTC), making this reasoning bias relevant for the treatment of delusions. Neurocognitive deficits contribute to JTC, but it is not known whether this has any bearing on the clinical syndrome of delusions. We addressed this question by reanalyzing data from an efficacy study of nonpharmacological interventions as adjunctive treatments in schizophrenia. We investigated the longitudinal associations of cognitive functioning, JTC and delusions in patients with psychotic disorders receiving either a metacognitive intervention addressing reasoning biases (n = 59), or cognitive remediation (n = 58). Both interventions improved JTC; in the cognitive remediation group, tentative evidence suggested that better neurocognitive performance contributed to this improvement. However, JTC gains were associated with delusion improvement only in the metacognitive intervention group, suggesting a content-specific mechanism of action.
Schizophrenia Bulletin, 2014
The "jumping to conclusions" (JTC) datagathering bias is implicated in the development and maintenance of psychosis but has only recently been studied in first episode psychosis (FEP). In this study, we set out to establish the relationship of JTC in FEP with delusions and neuropsychological functioning. Methods: One hundred and eight FEP patients and 101 age-matched controls completed assessments of delusions, general intelligence (IQ), working memory (WM), and JTC (the probabilistic reasoning "beads" task). Results: Half the FEP participants jumped to conclusions on at least 1 task, compared with 25% of controls (OR range 2.1 to 3.9; 95% CI range 1.5 to 8.0, P values ≤ .02). JTC was associated with clinical, but not nonclinical delusion severity, and with neuropsychological functioning, irrespective of clinical status. Both IQ and delusion severity, but not WM, were independently associated with JTC in the FEP group. Conclusions: JTC is present in FEP. The specific association of JTC with clinical delusions supports a state, maintaining role for the bias. The associations of JTC with neuropsychological functioning indicate a separable, trait aspect to the bias, which may confer vulnerability to psychosis. The work has potential to inform emerging interventions targeting reasoning biases in early psychosis.
The jumping to conclusions bias in delusions: Specificity and changeability
Journal of Abnormal Psychology, 2010
There are indications that a jumping to conclusions bias (JTC) plays a role in the formation and maintenance of delusions and should be targeted in therapy. However, it is unclear whether (a) JTC is uniquely associated with delusions or simply an epiphenomenon of schizophrenia or impaired intellectual functioning and (b) it can be changed by varying task demands, motivational factors, or feedback. Seventy-one patients with schizophrenia spectrum disorders and either acute or remitted delusions and 68 healthy controls were included. Patients were assessed with self-and observer-rated symptom measures. All participants were assessed for intellectual ability and performed the classic beads task with a ratio of 80:20. They were then presented with task variations that involved increasing the difficulty of the ratio to 60:40, introducing a rule for which correct decisions were rewarded by monetary gains and false decisions led to financial losses, and providing feedback on the accuracy of the previous decisions. Participants with current delusional symptoms took fewer draws to decision (DTD) than did those in remission and healthy controls. DTD were associated with observer-rated delusions, but controlling for negative symptoms or intelligence rendered this association insignificant. DTD increased after the difficulty of the task increased and after feedback. The study demonstrated that JTC is linked to delusions but that this association is not unique. Patients with delusions are principally able to adapt their decisions to altered conditions but still decide relatively quickly even when decisions have negative consequences. These difficulties might stem in part from impaired intellectual functioning.
Change in delusions is associated with change in “jumping to conclusions”
Psychiatry Research, 2009
Evidence has been put forward that premature termination of data collection and jumping to conclusions behavior (JTC) is associated with delusions. However, few investigations have attempted to track associations between changes in delusions and changes in JTC measures. In the current study individuals with schizophrenia spectrum disorders completed a version of the JTC task (involving fishing from lakes as opposed to drawing beads from a jar) at two timepoints 12 weeks apart. The results revealed significant negative correlations between change in task performance (number of requested pieces of information) and change in delusion scores over time. This evidence is consistent with the contention that the JTC task is sensitive to the cognitive systems underlying delusions in schizophrenia spectrum disorders.
'Jumping to conclusions' and delusions in psychosis: Relationship and response to treatment
Schizophrenia research, 2008
Jumping to conclusions' (JTC) on probabilistic reasoning tasks has been shown to be related with delusions in schizophrenia. However, whether JTC is merely correlated with, moderate or mediate delusions is not known. Further, it is unclear how antipsychotics affect JTC and its relationship to delusions. We examined the effect of treatment on JTC in a sample of patients (N = 19) who were initiated on treatment and followed. Two versions of the task were usedthe 'beads' version of the task and an emotionally salient version. Within two weeks of treatment, we found an increase in the number of trials to decision on the emotionally salient version and a reduction in intensity of psychotic symptoms and delusions (measured by the change on P1 and PANSS-P scores). While, these two measures, or changes in these measures, showed no reliable correlation, the baseline performance on the emotionally salient version of the task helped predict patients who would show improvements in their PANSS-P and global PANSS scores in response to medication. The findings suggest that JTC might moderate the effects of treatment on symptomatology, but it does not mediate the treatment induced reduction in delusional intensity.
Journal of Abnormal Psychology, 2012
Two reasoning biases, jumping to conclusions (JTC) and belief inflexibility, have been found to be associated with delusions. We examined these biases and their relationship with delusional conviction in a longitudinal cohort of people with schizophrenia-spectrum psychosis. We hypothesized that JTC, lack of belief flexibility, and delusional conviction would form distinct factors, and that JTC and lack of belief flexibility would predict less change in delusional conviction over time. Two hundred seventy-three patients with delusions were assessed over twelve months of a treatment trial . Forty-one percent of the sample had 100% conviction in their delusions, 50% showed a JTC bias, and 50%-75% showed a lack of belief flexibility. Delusional conviction, JTC, and belief flexibility formed distinct factors although conviction was negatively correlated with belief flexibility. Conviction declined slightly over the year in this established psychosis group, whereas the reasoning biases were stable. There was little evidence that reasoning predicted the slight decline in conviction. The degree to which people believe their delusions, their ability to think that they may be mistaken and to consider alternative explanations, and their hastiness in decision making are three distinct processes although belief flexibility and conviction are related. In this established psychosis sample, reasoning biases changed little in response to medication or psychological therapy. Required now is examination of these processes in psychosis groups where there is greater change in delusion conviction, as well as tests of the effects on delusions when these reasoning biases are specifically targeted.
Prediction of Severity of Delusion Based on Jumping-toConclusion Bias in Schizophrenia Patients
Objectives: New cognitive theories of delusions have proposed that deficit or bias in inference stage (a stage of normal belief formation) is significant in delusion formation. The aim of this study was predicting the severity of delusions based on jumping-to-conclusion bias in patients with schizophrenia. Methods: The sample consisted of 60 deluded patients with schizophrenia who were selected from the Ebnesina and Razi hospitals in Shiraz using convenience sampling method. The Similarity Task was used to measure the jumping-to-conclusion biases. Results: Its results have shown that the jumping-to-conclusion biases could predict a great part of the variance of delusions. Discussion: These results generally indicated that the jumping to conclusion biases may provide a more useful explanation for the delusion formation.