Woodward Todd S, Moritz Steffen, Cuttler Carrie, Whitman Jennifer C
University Hospital Hamburg-Eppendorf, Germany.
J Clin Exp Neuropsychol. 2006 May;28(4):605-17. doi: 10.1080/13803390590949511.
A neuropsychological paradigm is introduced that provides a measure of a bias against disconfirmatory evidence (BADE), and its correspondence with delusions in people with schizophrenia and schizoaffective disorder was investigated. Fifty-two patients diagnosed with schizophrenia or schizoaffective disorder (36 were acutely delusional) and 24 healthy control participants were presented with delusion-neutral pictures in each trial, and were asked to rate the plausibility of four written interpretations of the scenario depicted by that picture. Subsequently, new pictures that provided background information about the depicted scenario were successively presented, and participants were requested to adjust their ratings, taking into account this new information. Two of the interpretations appeared tenable initially but ultimately proved to be implausible, one appeared untenable initially but eventually proved to be plausible, and one appeared untenable at all stages. A BADE was observed for delusional compared to non-delusional patients, as well as for all patients compared to controls. In addition, regardless of symptom profile, patients were more accepting of implausible interpretations than controls. The present work suggests that deficits in reasoning may contribute to the maintenance of delusions via an impairment in the processing of disconfirmatory evidence.
引入了一种神经心理学范式，该范式提供了一种对反对证伪证据的偏差（BADE）的测量方法，并研究了其与精神分裂症和分裂情感性障碍患者妄想的相关性。在每次试验中，向52名被诊断为精神分裂症或分裂情感性障碍的患者（36名有急性妄想）和24名健康对照参与者展示与妄想无关的图片，并要求他们对描述该图片所描绘场景的四种书面解释的可信度进行评分。随后，依次展示提供所描绘场景背景信息的新图片，并要求参与者考虑这些新信息调整他们的评分。其中两种解释最初看似合理，但最终被证明是不可信的，一种最初看似不合理，但最终被证明是合理的，还有一种在所有阶段都看似不合理。与非妄想患者相比，妄想患者以及与对照组相比的所有患者都观察到了BADE。此外，无论症状特征如何，患者比对照组更容易接受不合理的解释。目前的研究表明，推理缺陷可能通过证伪证据处理受损而导致妄想的维持。
