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探讨精神分裂症患者的信念和信心。

Examining belief and confidence in schizophrenia.

机构信息

Cognition Schizophrenia and Imaging Laboratory, Department of Psychosis Studies, Institute of Psychiatry, King's College London, UK.

出版信息

Psychol Med. 2013 Nov;43(11):2327-38. doi: 10.1017/S0033291713000263. Epub 2013 Mar 22.

Abstract

BACKGROUND

People with psychoses often report fixed, delusional beliefs that are sustained even in the presence of unequivocal contrary evidence. Such delusional beliefs are the result of integrating new and old evidence inappropriately in forming a cognitive model. We propose and test a cognitive model of belief formation using experimental data from an interactive 'Rock Paper Scissors' (RPS) game.

METHOD

Participants (33 controls and 27 people with schizophrenia) played a competitive, time-pressured interactive two-player game (RPS). Participants' behavior was modeled by a generative computational model using leaky integrator and temporal difference methods. This model describes how new and old evidence is integrated to form a playing strategy to beat the opponent and to provide a mechanism for reporting confidence in one's playing strategy to win against the opponent.

RESULTS

People with schizophrenia fail to appropriately model their opponent's play despite consistent (rather than random) patterns that can be exploited in the simulated opponent's play. This is manifest as a failure to weigh existing evidence appropriately against new evidence. Furthermore, participants with schizophrenia show a 'jumping to conclusions' (JTC) bias, reporting successful discovery of a winning strategy with insufficient evidence.

CONCLUSIONS

The model presented suggests two tentative mechanisms in delusional belief formation: (i) one for modeling patterns in other's behavior, where people with schizophrenia fail to use old evidence appropriately, and (ii) a metacognitive mechanism for 'confidence' in such beliefs, where people with schizophrenia overweight recent reward history in deciding on the value of beliefs about the opponent.

摘要

背景

精神病人常报告固定的、妄想性的信念,即使存在明确的相反证据,这些信念也能持续存在。这种妄想性信念是在形成认知模型时不恰当地整合新的和旧的证据的结果。我们使用来自互动“石头剪刀布”(RPS)游戏的实验数据提出并测试了一种信念形成的认知模型。

方法

参与者(33 名对照组和 27 名精神分裂症患者)玩了一个具有竞争性和时间压力的互动式两人游戏(RPS)。参与者的行为由一个使用漏积分器和时间差分方法的生成计算模型来建模。该模型描述了如何整合新的和旧的证据来形成一种击败对手的游戏策略,并提供了一种机制来报告对击败对手的游戏策略的信心。

结果

精神分裂症患者无法适当地对其对手的行为进行建模,尽管对手的行为模式是一致的(而不是随机的),可以在模拟对手的行为中利用这些模式。这表现为未能适当地权衡现有证据与新证据。此外,精神分裂症患者表现出“草率下结论”(JTC)的偏见,即报告在没有足够证据的情况下成功发现了一种获胜策略。

结论

提出的模型表明了妄想性信念形成中的两个试探性机制:(i)一种用于对他人行为模式进行建模的机制,其中精神分裂症患者未能适当地利用旧证据;(ii)一种用于“置信度”的元认知机制,其中精神分裂症患者在决定对手信念的价值时,会过度强调最近的奖励历史。

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