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      Data Gathering Bias: Trait Vulnerability to Psychotic Symptoms?

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          Abstract

          Background

          Jumping to conclusions (JTC) is associated with psychotic disorder and psychotic symptoms. If JTC represents a trait, the rate should be (i) increased in people with elevated levels of psychosis proneness such as individuals diagnosed with borderline personality disorder (BPD), and (ii) show a degree of stability over time.

          Methods

          The JTC rate was examined in 3 groups: patients with first episode psychosis (FEP), BPD patients and controls, using the Beads Task. PANSS, SIS-R and CAPE scales were used to assess positive psychotic symptoms. Four WAIS III subtests were used to assess IQ.

          Results

          A total of 61 FEP, 26 BPD and 150 controls were evaluated. 29 FEP were revaluated after one year. 44% of FEP (OR = 8.4, 95% CI: 3.9–17.9) displayed a JTC reasoning bias versus 19% of BPD (OR = 2.5, 95% CI: 0.8–7.8) and 9% of controls. JTC was not associated with level of psychotic symptoms or specifically delusionality across the different groups. Differences between FEP and controls were independent of sex, educational level, cannabis use and IQ. After one year, 47.8% of FEP with JTC at baseline again displayed JTC.

          Conclusions

          JTC in part reflects trait vulnerability to develop disorders with expression of psychotic symptoms.

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          Most cited references36

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          Psychosis as a state of aberrant salience: a framework linking biology, phenomenology, and pharmacology in schizophrenia.

          Shitij Kapur (2002)
          The clinical hallmark of schizophrenia is psychosis. The objective of this overview is to link the neurobiology (brain), the phenomenological experience (mind), and pharmacological aspects of psychosis-in-schizophrenia into a unitary framework. Current ideas regarding the neurobiology and phenomenology of psychosis and schizophrenia, the role of dopamine, and the mechanism of action of antipsychotic medication were integrated to develop this framework. A central role of dopamine is to mediate the "salience" of environmental events and internal representations. It is proposed that a dysregulated, hyperdopaminergic state, at a "brain" level of description and analysis, leads to an aberrant assignment of salience to the elements of one's experience, at a "mind" level. Delusions are a cognitive effort by the patient to make sense of these aberrantly salient experiences, whereas hallucinations reflect a direct experience of the aberrant salience of internal representations. Antipsychotics "dampen the salience" of these abnormal experiences and by doing so permit the resolution of symptoms. The antipsychotics do not erase the symptoms but provide the platform for a process of psychological resolution. However, if antipsychotic treatment is stopped, the dysregulated neurochemistry returns, the dormant ideas and experiences become reinvested with aberrant salience, and a relapse occurs. The article provides a heuristic framework for linking the psychological and biological in psychosis. Predictions of this hypothesis, particularly regarding the possibility of synergy between psychological and pharmacological therapies, are presented. The author describes how the hypothesis is complementary to other ideas about psychosis and also discusses its limitations.
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            Short form of the WAIS-III for use with patients with schizophrenia.

            Crystal Blyler, James Gold, Virginia N. Iannone … (2000)
            The recent publication of the Wechsler Adult Intelligence Scale (WAIS-III), the most widely used standard test of intelligence, requires the development of a new short form for use with patients with schizophrenia for many clinical and research purposes. We used regression analyses of complete WAIS-III data on 41 outpatients with schizophrenia and 41 education-, and age-matched healthy subjects to determine the best combination of subtests to use as a short form. Excluding three subtests that are time-consuming to administer, and requiring that the solution includes one subtest from each of the four WAIS index scores, the combination that most fully accounted for the variance in full-scale IQ (FSIQ) for both participants with schizophrenia (R(2)=0.90) and healthy controls (R(2)=0.86) included the information, block design, arithmetic, and digit symbol subtests. When the restrictions regarding which subtests could enter were relaxed, the best four-subtest solution included information, block design, comprehension, and similarities. Although the latter explained 95% of the variance in FSIQ for schizophrenia participants and 90% of the variance for healthy controls, it consistently overestimated FSIQ for the schizophrenia group. We recommend the four-factor short form for use in future research and clinical practice in which a quick, accurate IQ estimate is desired.
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              The contribution of hypersalience to the "jumping to conclusions" bias associated with delusions in schizophrenia.

              William Speechley, Stewart Whitman, Todd S. Woodward (2009)
              Previous schizophrenia research involving the "beads task" has suggested an association between delusions and 2 reasoning biases: (1) "jumping to conclusions" (JTC), whereby early, resolute decisions are formed on the basis of little evidence and (2) over-adjustment of probability estimates following a single instance of disconfirmatory evidence. In the current study, we used a novel JTC-style paradigm to provide new information about a cognitive operation common to these 2 reasoning biases. Using a task that required participants to rate the likelihood that a fisherman was catching a series of black or white fish from Lake A and not Lake B, and vice versa, we compared the responses of 4 groups (healthy, bipolar, nondelusional schizophrenia and delusional schizophrenia) when we manipulated 2 elements of the Bayesian formula: incoming data and prior odds. Regardless of our manipulations of the Bayesian formula, the delusional schizophrenia group gave significantly higher likelihood ratings for the lake that best matched the colour of the presented fish, but the ratings for the nonmatching lake did not differ from the other groups. The limitations of this study include a small sample size for the group of severely delusional patients and a preponderance of men in the schizophrenia sample. Delusions in schizophrenia are associated with hypersalience of evidence-hypothesis matches but normal salience of nonmatches. When the colour of the incoming data is uniform (fish of only one colour), this manifests as JTC early in a series, and when the colour of incoming data varies (both black and white fish), this manifests as an overadjustment midseries. This account can provide a unifying explanation for delusion-associated performance patterns previously observed in the beads task in schizophrenia.
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                Author and article information

                Contributors
                Keith Laws: Role: Editor
                Journal
                Journal ID (nlm-ta): PLoS One
                Journal ID (iso-abbrev): PLoS ONE
                Journal ID (publisher-id): plos
                Journal ID (pmc): plosone
                Title: PLoS ONE
                Publisher: Public Library of Science (San Francisco, CA USA )
                ISSN (Electronic): 1932-6203
                Publication date (Electronic): 6 July 2015
                Publication date Collection: 2015
                Volume: 10
                Issue: 7
                Electronic Location Identifier: e0132442
                Affiliations
                [1 ]Department of Neuroscience, University of the Basque Country, Basque Country, Spain
                [2 ]Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
                [3 ]Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands
                [4 ]GGzE, Eindhoven, The Netherlands
                [5 ]Clínica Servicios Médicos AMSA, Bilbao, Vizcaya, Spain
                [6 ]King’s College London, King’s Health Partners, Department of Psychosis Studies, Institute of Psychiatry, London, United Kingdom
                University of Hertfordshire, UNITED KINGDOM
                Author notes

                Competing Interests: The authors confirm that co-author Jim van Os is a PLOS ONE Editorial Board Member. The authors have a strictly nonprofit interest in the development and dissemination of PsyMate technology. This does not alter the authors’ adherence to PLOS ONE Editorial policies and criteria.

                Conceived and designed the experiments: AC MAGT JVO. Performed the experiments: MGA AP ER NO AG CM. Analyzed the data: AC CJPS AP JVO. Contributed reagents/materials/analysis tools: AC MGA NO ER AP CM AG. Wrote the paper: AC SB MAGT JVO.

                Article
                Publisher ID: PONE-D-15-00240
                DOI: 10.1371/journal.pone.0132442
                PMC ID: 4493127
                PubMed ID: 26147948
                SO-VID: 45a0052b-cc8f-42f0-bde7-1a2d40fe161a
                Copyright statement: Copyright @ 2015
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

                History
                Date received : 9 January 2015
                Date accepted : 15 June 2015
                Page count
                Figures: 0, Tables: 4, Pages: 13
                Funding
                The authors have no support or funding to report.
                Categories
                Subject: Research Article
                Custom metadata
                Data Availability Data are available upon request to the first author (Ana Catalan) due to hospital ethical concerns and restrictions regarding to access to patient data.

                ScienceOpen disciplines: Uncategorized
                Data availability:
                ScienceOpen disciplines: Uncategorized

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