Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, Connecticut.
School of Naturopathic Medicine, Southwest College of Naturopathic Medicine and Health Sciences, Tempe, Arizona.
Biol Psychiatry. 2022 Nov 15;92(10):772-780. doi: 10.1016/j.biopsych.2022.05.007. Epub 2022 May 13.
BACKGROUND: Recent advances in computational psychiatry have identified latent cognitive and perceptual states that predispose to psychotic symptoms. Behavioral data fit to Bayesian models have demonstrated an overreliance on priors (i.e., prior overweighting) during perception in select samples of individuals with hallucinations, corresponding to increased precision of prior expectations over incoming sensory evidence. However, the clinical utility of this observation depends on the extent to which it reflects static symptom risk or current symptom state. METHODS: To determine whether task performance and estimated prior weighting relate to specific elements of symptom expression, a large, heterogeneous, and deeply phenotyped sample of hallucinators (n = 249) and nonhallucinators (n = 209) performed the conditioned hallucination (CH) task. RESULTS: We found that CH rates predicted stable measures of hallucination status (i.e., peak frequency). However, CH rates were more sensitive to hallucination state (i.e., recent frequency), significantly correlating with recent hallucination severity and driven by heightened reliance on past experiences (priors). To further test the sensitivity of CH rate and prior weighting to symptom severity, a subset of participants with hallucinations (n = 40) performed a repeated-measures version of the CH task. Changes in both CH frequency and prior weighting varied with changes in auditory hallucination frequency on follow-up. CONCLUSIONS: These results indicate that CH rate and prior overweighting are state markers of hallucination status, potentially useful in tracking disease development and treatment response.
背景:最近计算精神病学的进展已经确定了潜在的认知和知觉状态,这些状态容易导致精神病症状。贝叶斯模型拟合的行为数据表明,在有幻觉的个体的特定样本中,存在对先验的过度依赖(即先验过度加权),这对应于在先验期望相对于传入感觉证据方面的精度增加。然而,这种观察的临床实用性取决于它在多大程度上反映了静态症状风险或当前症状状态。
方法:为了确定任务表现和估计的先验加权是否与症状表达的特定元素相关,对大量、异质和深入表型的幻觉者(n=249)和非幻觉者(n=209)进行了条件性幻觉(CH)任务。
结果:我们发现 CH 率预测了稳定的幻觉状态测量(即峰值频率)。然而,CH 率对幻觉状态更敏感(即最近频率),与最近的幻觉严重程度显著相关,并受到过去经验(先验)的高度依赖驱动。为了进一步测试 CH 率和先验加权对症状严重程度的敏感性,一部分有幻觉的参与者(n=40)进行了 CH 任务的重复测量版本。在随访中,CH 频率和先验加权的变化都与听觉幻觉频率的变化相关。
结论:这些结果表明,CH 率和先验过度加权是幻觉状态的状态标志物,可能有助于跟踪疾病发展和治疗反应。
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