Rausch F, Eisenacher S, Elkin H, Englisch S, Kayser S, Striepens N, Lautenschlager M, Heinz A, Gudlowski Y, Janssen B, Gaebel W, Michel T M, Schneider F, Lambert M, Naber D, Juckel G, Krueger-Oezguerdal S, Wobrock T, Hasan A, Riedel M, Moritz S, Müller H, Klosterkötter J, Bechdolf A, Zink M, Wagner M
Central Institute of Mental Health,Medical Faculty Mannheim,Heidelberg University,Germany.
Department of Psychiatry and Psychotherapy,University of Bonn,Germany.
Psychol Med. 2016 Jul;46(10):2071-81. doi: 10.1017/S0033291716000465. Epub 2016 Apr 20.
Patients with psychosis display the so-called 'Jumping to Conclusions' bias (JTC) - a tendency for hasty decision-making in probabilistic reasoning tasks. So far, only a few studies have evaluated the JTC bias in 'at-risk mental state' (ARMS) patients, specifically in ARMS samples fulfilling 'ultra-high risk' (UHR) criteria, thus not allowing for comparisons between different ARMS subgroups.
In the framework of the PREVENT (secondary prevention of schizophrenia) study, a JTC task was applied to 188 patients either fulfilling UHR criteria or presenting with cognitive basic symptoms (BS). Similar data were available for 30 healthy control participants matched for age, gender, education and premorbid verbal intelligence. ARMS patients were identified by the Structured Interview for Prodromal Symptoms (SIPS) and the Schizophrenia Proneness Instrument - Adult Version (SPI-A).
The mean number of draws to decision (DTD) significantly differed between ARM -subgroups: UHR patients made significantly less draws to make a decision than ARMS patients with only cognitive BS. Furthermore, UHR patients tended to fulfil behavioural criteria for JTC more often than BS patients. In a secondary analysis, ARMS patients were much hastier in their decision-making than controls. In patients, DTD was moderately associated with positive and negative symptoms as well as disorganization and excitement.
Our data indicate an enhanced JTC bias in the UHR group compared to ARMS patients with only cognitive BS. This underscores the importance of reasoning deficits within cognitive theories of the developing psychosis. Interactions with the liability to psychotic transitions and therapeutic interventions should be unravelled in longitudinal studies.
精神病患者表现出所谓的“急于下结论”偏差（JTC）——即在概率推理任务中快速做决策的倾向。到目前为止，仅有少数研究评估了“精神病风险状态”（ARMS）患者中的JTC偏差，特别是在符合“超高风险”（UHR）标准的ARMS样本中，因此无法对不同的ARMS亚组进行比较。
在PREVENT（精神分裂症二级预防）研究框架内，对188名符合UHR标准或有认知基础症状（BS）的患者应用了JTC任务。30名在年龄、性别、教育程度和病前言语智力方面匹配的健康对照参与者也有类似数据。通过前驱症状结构化访谈（SIPS）和精神分裂症倾向量表-成人版（SPI-A）识别ARMS患者。
ARMS亚组之间做出决策所需的平均抽取次数（DTD）存在显著差异：UHR患者做出决策所需的抽取次数明显少于仅有认知BS的ARMS患者。此外，UHR患者比BS患者更倾向于符合JTC的行为标准。在二次分析中，ARMS患者在决策时比对照组要匆忙得多。在患者中，DTD与阳性和阴性症状以及紊乱和兴奋程度呈中度相关。
我们的数据表明，与仅有认知BS的ARMS患者相比，UHR组的JTC偏差更强。这突出了在精神病发展的认知理论中推理缺陷的重要性。在纵向研究中应阐明与精神病转变倾向和治疗干预的相互作用关系。
