Department of Educational Neuroscience, Faculty of Psychology and Education, VU University Amsterdam, The Netherlands.
Brain. 2012 Mar;135(Pt 3):976-84. doi: 10.1093/brain/awr359.
Psychotic illness is a disorder of social interaction unique to humans. However, up to now research has failed to pin down the exact determinants of the complex and interactive processes associated with the development of trust and reciprocity in psychosis. Utilizing a novel multi-round version of an interactive trust game experiment, we show that patients with psychosis and healthy relatives with a heightened risk for the illness exhibit lower baseline levels of trust compared with healthy controls. This effect partly overlapped with a reduced general intelligence. Furthermore, patients were unable to modify their trusting behaviour neither in response to information about the general trustworthiness of their interaction partner, nor in response to their partners' specific direct behavioural feedback. Relatives, in contrast, modified their trusting behaviour towards similar levels as healthy subjects in response to both. The results show that behavioural flexibility in response to socially relevant information is a critical determinant of success in the instantiation and maintenance of social relationships. A lack thereof may drive social dysfunction and the progression from subclinical symptoms to a full-blown psychosis. This offers a testable mechanistic hypothesis for progression from prodrome to psychotic illness, and may provide a therapeutic avenue to grapple the psychotic symptoms of social dysfunction.
精神病是一种独特于人类的社交互动障碍。然而，迄今为止，研究尚未确定与信任和互惠关系发展相关的复杂和互动过程的确切决定因素。我们利用一种新颖的多轮互动信任游戏实验版本，发现精神病患者和具有较高患病风险的健康亲属与健康对照组相比，信任水平较低。这种效应部分与一般智力下降重叠。此外，患者既不能根据其互动伙伴的普遍可信度信息，也不能根据其伙伴的具体直接行为反馈来调整其信任行为。相比之下，亲属则可以根据这两种信息，将其信任行为调整到与健康受试者相似的水平。研究结果表明，对社会相关信息的行为灵活性是成功实现和维持社会关系的关键决定因素。缺乏这种灵活性可能会导致社交功能障碍，并从亚临床症状发展为全面的精神病。这为从前驱症状到精神病的发展提供了一个可检验的机制假说，并可能为解决社交功能障碍的精神病症状提供一个治疗途径。
