Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.
Schizophr Bull. 2019 Jun 18;45(4):871-882. doi: 10.1093/schbul/sby116.
Cognitive models of psychosis posit that reasoning biases are an important mechanism contributing to the formation of psychotic symptoms, in part through transforming anomalous experiences of aberrant salience into frank psychotic symptoms. This study aimed to investigate the interplay of liberal acceptance (LA) bias, which is a specific type of reasoning bias, and momentary aberrant salience in the development of paranoid and psychotic experiences in daily life in first-episode psychosis patients (FEP), at-risk mental state participants (ARMS), and controls. We used a novel experimental Experience Sampling Methodology (eESM) task for measuring LA bias (ie, decisions based on low probability estimates) and ESM measures of momentary aberrant salience and paranoid and psychotic experiences in 51 FEP, 46 ARMS, and 53 controls. We found evidence that LA bias was more likely to occur in FEP than in controls. Further, LA bias was associated with psychotic and paranoid experiences (all P < .007) and modified the association between momentary aberrant salience and psychotic experiences (χ2(df) = 7.4(2), P = .025) in ARMS, such that momentary salience was associated with more intense psychotic experiences in the presence of LA bias in ARMS, but not in FEP and controls. Our findings suggest that LA bias may be central for anomalous experiences such as momentary aberrant salience to increase intensity of psychotic experiences in at-risk individuals. Further, LA bias appears to be more likely to be present, but not directly linked to current intensity of psychotic experiences, in treated FEP. Novel eESM tasks open new avenues for targeting psychological processes under real-world conditions.
精神病认知模型假设，推理偏差是导致精神病症状形成的一个重要机制，部分原因是通过将异常的突显体验转化为明显的精神病症状。本研究旨在探讨自由接受（LA）偏差与瞬间异常突显在首发精神病患者（FEP）、有风险精神状态参与者（ARMS）和对照组的日常生活中偏执和精神病体验发展中的相互作用。我们使用了一种新颖的实验体验抽样方法（eESM）任务来测量 LA 偏差（即基于低概率估计的决策）和 ESM 对瞬间异常突显和偏执及精神病体验的测量，共纳入 51 名 FEP、46 名 ARMS 和 53 名对照组参与者。我们发现，与对照组相比，FEP 更有可能出现 LA 偏差。此外，LA 偏差与精神病和偏执体验相关（均 P <.007），并改变了 ARMS 中瞬间异常突显与精神病体验之间的关联（χ2(df) = 7.4(2), P =.025），即 ARMS 中存在 LA 偏差时，瞬间突显与更强烈的精神病体验相关，而在 FEP 和对照组中则不然。我们的研究结果表明，LA 偏差可能是异常体验（如瞬间异常突显）增加高危个体精神病体验强度的核心因素。此外，在接受治疗的 FEP 中，LA 偏差似乎更有可能出现，但与当前精神病体验的强度没有直接联系。新颖的 eESM 任务为在现实环境下靶向心理过程开辟了新途径。
