Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Deparment of Mental Health, Biocruces Bizkaia Health Research Institute. Basurto University Hospital. Facultad de Medicina y Odontología, Campus de Leioa, University of the Basque Country, UPV/EHU. Plaza de Cruces 12. 48903, Barakaldo, Bizkaia, Spain.
Psychol Med. 2022 Jun;52(8):1569-1577. doi: 10.1017/S0033291720003396. Epub 2020 Oct 6.
Psychosis is associated with a reasoning bias, which manifests as a tendency to 'jump to conclusions'. We examined this bias in people at clinical high-risk for psychosis (CHR) and investigated its relationship with their clinical outcomes.
In total, 303 CHR subjects and 57 healthy controls (HC) were included. Both groups were assessed at baseline, and after 1 and 2 years. A 'beads' task was used to assess reasoning bias. Symptoms and level of functioning were assessed using the Comprehensive Assessment of At-Risk Mental States scale (CAARMS) and the Global Assessment of Functioning (GAF), respectively. During follow up, 58 (16.1%) of the CHR group developed psychosis (CHR-T), and 245 did not (CHR-NT). Logistic regressions, multilevel mixed models, and Cox regression were used to analyse the relationship between reasoning bias and transition to psychosis and level of functioning, at each time point.
There was no association between reasoning bias at baseline and the subsequent onset of psychosis. However, when assessed after the transition to psychosis, CHR-T participants showed a greater tendency to jump to conclusions than CHR-NT and HC participants (55, 17, 17%; χ2 = 8.13, = 0.012). There was a significant association between jumping to conclusions (JTC) at baseline and a reduced level of functioning at 2-year follow-up in the CHR group after adjusting for transition, gender, ethnicity, age, and IQ.
In CHR participants, JTC at baseline was associated with adverse functioning at the follow-up. Interventions designed to improve JTC could be beneficial in the CHR population.
精神病与推理偏差有关，这种偏差表现为“仓促下结论”的倾向。我们在处于精神病高危状态（CHR）的人群中研究了这种偏差，并探讨了其与临床结局的关系。
共纳入 303 名 CHR 受试者和 57 名健康对照者（HC）。两组均在基线、1 年和 2 年时进行评估。使用“珠子”任务评估推理偏差。使用风险意识心理状态综合评估量表（CAARMS）和总体功能评估量表（GAF）分别评估症状和功能水平。在随访期间，58 名（16.1%）CHR 组发生精神病（CHR-T），245 名未发生（CHR-NT）。使用逻辑回归、多级混合模型和 Cox 回归分析推理偏差与向精神病转化和功能水平之间的关系，在每个时间点进行分析。
基线时的推理偏差与随后精神病的发生无关。然而，在向精神病转化后评估时，CHR-T 组参与者比 CHR-NT 和 HC 组参与者更倾向于仓促下结论（55%、17%、17%；χ2=8.13，=0.012）。在调整了转化、性别、种族、年龄和智商后，CHR 组基线时的仓促下结论（JTC）与 2 年随访时功能水平下降显著相关。
在 CHR 参与者中，基线时的 JTC 与随访时的不良功能相关。旨在改善 JTC 的干预措施可能对 CHR 人群有益。
