Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, J5, 68159 Mannheim, Germany.
Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, J5, 68159 Mannheim, Germany.
Psychiatry Res. 2014 Sep 30;219(1):72-8. doi: 10.1016/j.psychres.2014.04.056. Epub 2014 May 14.
Previous studies have demonstrated a cognitive bias in the integration of disconfirmatory evidence (BADE) in patients with schizophrenia. This bias has been associated with delusions. So far, it is unclear how the integration of evidence is associated with neurocognitive capabilities. In the current study, 31 patients with schizophrenia and 29 healthy controls, matched on age, gender, education and premorbid verbal intelligence, underwent a BADE task. Written scenarios of three consecutive sentences each were presented, which progressively reduced the ambiguity of situations. Participants were asked to rate the plausibility of four possible interpretations and adjust their ratings in response to the provided sentences. Psychometric rating scales and a neuropsychological test battery were applied. Patients displayed a bias in the integration of confirmatory, but not disconfirmatory evidence and a liberal acceptance of belief formation. Correlation analyses revealed no associations of evidence integration with the severity of positive symptoms, but with neurocognitive domains, especially with processing speed, executive functioning, vigilance and working memory. In conclusion, patients with schizophrenia show a bias in evidence integration. Neurocognitive functioning emerged as a modulatory factor that should be considered in further research. Studies investigating BADE in earlier stages of psychosis will be necessary to reveal causal relationships.
先前的研究表明,精神分裂症患者在整合矛盾证据(BADE)时存在认知偏差。这种偏差与妄想有关。到目前为止,尚不清楚证据的整合与神经认知能力有何关联。在本研究中,31 名精神分裂症患者和 29 名健康对照者,年龄、性别、教育程度和病前言语智力相匹配,进行了 BADE 任务。呈现了三个连续句子的书面场景,每个句子的歧义性逐渐降低。参与者被要求对四种可能的解释的可能性进行评分,并根据提供的句子调整他们的评分。应用了心理评定量表和神经心理学测试组合。患者在整合证实性证据时表现出偏差,但在整合矛盾性证据时没有偏差,并且对信念形成的接受度较宽。相关分析显示,证据整合与阳性症状的严重程度无关,而是与神经认知领域有关,特别是与加工速度、执行功能、警觉性和工作记忆有关。总之,精神分裂症患者在证据整合方面存在偏差。神经认知功能是一个调节因素,在进一步的研究中应予以考虑。有必要在精神病早期阶段进行 BADE 研究,以揭示因果关系。