Jolley Suzanne, Thompson Claire, Hurley James, Medin Evelina, Butler Lucy, Bebbington Paul, Dunn Graham, Freeman Daniel, Fowler David, Kuipers Elizabeth, Garety Philippa
King׳s College London, Institute of Psychiatry, Department of Psychology, London, UK.
King׳s College London, Institute of Psychiatry, Department of Psychology, London, UK.
Psychiatry Res. 2014 Oct 30;219(2):275-82. doi: 10.1016/j.psychres.2014.05.051. Epub 2014 Jun 4.
Understanding how people with delusions arrive at false conclusions is central to the refinement of cognitive behavioural interventions. Making hasty decisions based on limited data ('jumping to conclusions', JTC) is one potential causal mechanism, but reasoning errors may also result from other processes. In this study, we investigated the correlates of reasoning errors under differing task conditions in 204 participants with schizophrenia spectrum psychosis who completed three probabilistic reasoning tasks. Psychotic symptoms, affect, and IQ were also evaluated. We found that hasty decision makers were more likely to draw false conclusions, but only 37% of their reasoning errors were consistent with the limited data they had gathered. The remainder directly contradicted all the presented evidence. Reasoning errors showed task-dependent associations with IQ, affect, and psychotic symptoms. We conclude that limited data-gathering contributes to false conclusions but is not the only mechanism involved. Delusions may also be maintained by a tendency to disregard evidence. Low IQ and emotional biases may contribute to reasoning errors in more complex situations. Cognitive strategies to reduce reasoning errors should therefore extend beyond encouragement to gather more data, and incorporate interventions focused directly on these difficulties.
理解妄想症患者如何得出错误结论是改进认知行为干预措施的核心。基于有限数据做出仓促决定(“急于下结论”,JTC)是一种潜在的因果机制,但推理错误也可能由其他过程导致。在本研究中,我们调查了204名患有精神分裂症谱系精神病的参与者在不同任务条件下推理错误的相关因素,这些参与者完成了三项概率推理任务。我们还评估了他们的精神症状、情感和智商。我们发现,急于做决定的人更有可能得出错误结论,但他们的推理错误中只有37%与他们收集到的有限数据相符。其余的则直接与所有呈现的证据相矛盾。推理错误显示出与智商、情感和精神症状的任务依赖性关联。我们得出结论,有限的数据收集会导致错误结论,但不是唯一涉及的机制。妄想也可能因无视证据的倾向而持续存在。低智商和情感偏见可能会在更复杂的情况下导致推理错误。因此,减少推理错误的认知策略不应仅仅局限于鼓励收集更多数据,还应纳入直接针对这些困难的干预措施。