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早发性精神分裂症或双相情感障碍家族高危儿童的跳跃结论及其与精神病体验的关联——丹麦高危和复原力研究,VIA11。

Jumping to Conclusions and Its Associations With Psychotic Experiences in Preadolescent Children at Familial High Risk of Schizophrenia or Bipolar Disorder-The Danish High Risk and Resilience Study, VIA 11.

机构信息

CORE-Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark.

The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark.

出版信息

Schizophr Bull. 2022 Nov 18;48(6):1363-1372. doi: 10.1093/schbul/sbac060.

Abstract

BACKGROUND

The jumping to conclusions (JTC) bias, ie, making decisions based on inadequate evidence, is associated with psychosis in adults and is believed to underlie the formation of delusions. Knowledge on the early manifestations of JTC and its associations with psychotic experiences (PE) in children and adolescents is lacking.

DESIGN

Preadolescent children (mean age 11.9 y, SD 0.2) at familial high risk of schizophrenia (FHR-SZ, n = 169) or bipolar disorder (FHR-BP, n = 101), and controls (n = 173) were assessed with the Beads Task to examine JTC. The number of beads drawn before making a decision, "draws to decision" (DTD) was used as a primary outcome. PE were ascertained in face-to-face interviews. General intelligence was measured with Reynolds Intellectual Screening Test.

RESULTS

Children at FHR-SZ took fewer DTD than controls (4.9 vs 5.9, Cohen's d = 0.31, P = .004). Differences were attenuated when adjusting for IQ (Cohen's d = 0.24, P = .02). Higher IQ was associated with a higher number of DTD (B = 0.073, P < .001). Current subclinical delusions compared with no PE were associated with fewer DTD in children at FHR-SZ (P = .04) and controls (P < .05). Associations between delusions and DTD were nullified when accounting for IQ.

CONCLUSIONS

JTC marks familial risk of psychosis in preadolescence, not reducible to general intelligence. JTC is associated with subclinical delusions, but this may be an expression of intellectual impairment. Future studies should establish temporality between JTC and delusion formation and examine JTC as a target for early intervention.

摘要

背景

跳跃式结论偏差(JTC),即基于不充分的证据做出决策,与成人精神分裂症有关,被认为是妄想形成的基础。关于儿童和青少年 JTC 的早期表现及其与精神病体验(PE)的关联,目前知之甚少。

设计

对处于精神分裂症家族高风险(FHR-SZ,n=169)或双相情感障碍家族高风险(FHR-BP,n=101)的青春期前儿童(平均年龄 11.9 岁,SD 0.2)和对照组(n=173)进行 Beads 任务评估,以检查 JTC。做出决策前绘制的珠子数量,即“决定前绘制”(DTD),作为主要结果。通过面对面访谈确定 PE。一般智力用 Reynolds 智力筛查测试进行测量。

结果

与对照组相比,FHR-SZ 组的儿童 DTD 更少(4.9 比 5.9,Cohen's d=0.31,P=0.004)。当调整 IQ 时,差异减弱(Cohen's d=0.24,P=0.02)。较高的 IQ 与较高的 DTD 相关(B=0.073,P<0.001)。与无 PE 相比,当前亚临床妄想与 FHR-SZ 组(P=0.04)和对照组(P<0.05)儿童的 DTD 较少有关。当考虑到 IQ 时,妄想与 DTD 之间的关联消失。

结论

JTC 标志着青春期前精神病的家族风险,不能归因于一般智力。JTC 与亚临床妄想有关,但这可能是智力障碍的表现。未来的研究应该建立 JTC 与妄想形成之间的时间关系,并将 JTC 作为早期干预的目标进行研究。

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Investigating the jumping to conclusion bias in bipolar disorder.探究双相情感障碍中的妄下结论偏差。
Cogn Neuropsychiatry. 2019 May;24(3):208-216. doi: 10.1080/13546805.2019.1606708. Epub 2019 Apr 16.

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