scholarly journals O6.5. JUMPING TO CONCLUSIONS ABOUT DECISION NOISE? A COMPUTATIONAL ANALYSIS OF THE RELATIONSHIP BETWEEN BELIEF UPDATING AND PSYCHOTIC SYMPTOMS IN A LARGE UK BIRTH COHORT

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S15-S15
Author(s):  
Jazz Croft ◽  
Jon Heron ◽  
Christoph Teufel ◽  
Rick Adams ◽  
Anthony David ◽  
...  

Abstract Background A number of studies show that people with psychotic disorders have abnormal belief-updating processes. In a commonly-used decision-making task, the beads task, participants infer which of two jars, each with a different ratio of coloured beads, a presented bead is drawn from, with an option to request further beads before reaching a decision. Previous studies suggest that people with psychotic symptoms request fewer beads (draws to decision; DTD) indicative of a ‘Jumping to conclusion’ (JTC) bias. In a modified version of this task, participants estimate the probability that beads have been drawn from one of the two jars on a sliding scale over a sequence of beads and are also told that the jar the beads are drawn from may switch. In this task, people with psychotic symptoms revise their estimations disproportionately in response to a change in colour of beads in a sequence (overadjustment bias). It is not clear what specific belief-updating processes drive these biases, how they arise, or if their association with psychotic symptoms is independent of confounding. We examined whether abnormal belief-updating processes are associated with psychotic experiences in a large, population-based sample, and whether they mediate the association between trauma and psychotic symptoms. Methods We used data from the Avon Longitudinal Study of Parents and Children birth cohort (n=2,879). Past-year frequent or distressing psychotic experiences (PEs) were assessed using the semi-structured PLIKS interview at age 24. Performance on the DTD and probability estimation tasks at age 24 were assessed using behavioural indices and computational modelling parameters (using ‘costed Bayesian’ and Hidden Markov Models respectively). Logistic regression was used to examine the association between belief-updating parameters (DTD task: cost of sampling, decision noise; Probability estimation task: adjustment rate, inference length, decision confidence, prior expectation of reversal, decision noise) and PEs. Estimates were adjusted for confounders (genetic risk for schizophrenia, socio-economic status, cognitive function). Mediation analysis tested abnormal belief-updating processes as a mediator between exposure to trauma (assessed ages 0–17 years) and age-24 PEs. Results In the DTD task, increased decision noise was associated with PEs (adjusted OR=1.89, 95% CI: 1.14, 3.13, p=0.014). There was little evidence of an association between the JTC bias and PEs (OR= 1.13; 95% CI: 0.45, 2.82). For the probability estimation task, there was an association between a higher prior expectation that the jars that will switch during the sequence (expectation of reversal) and PEs (adjusted OR = 2.28; 95% CI 1.39, 3.74, p=0.001). Our findings were minimally attenuated by confounding (<10%). Exposure to trauma was also associated with greater decision noise in the DTD task, but there was little evidence that this abnormal belief-updating parameter mediated the relationship between trauma and PEs (<1% mediated). Discussion Our results suggest that abnormal belief-updating processes (increased decision noise; greater prior expectation of reversal) are associated with PEs, and that this is not explained by general cognitive ability, shared genetic risk, or social background. Previous observations of association between the JTC bias and psychosis may be due to sub-optimal performance rather than a bias for making a decision on less evidence. The results also suggest that an increased expectation of change is associated with the early stages of psychosis symptom development. Our mediation result does not support the hypothesis that the belief-updating processes examined here lie on the causal pathway between trauma exposure and PEs.

2020 ◽  
Author(s):  
Isabel Kreis ◽  
Lei Zhang ◽  
Matthias Mittner ◽  
Leonard Syla ◽  
Claus Lamm ◽  
...  

Misestimation of uncertainty and an increased perception of the world as volatile (i.e. unstable) have been linked to aberrant belief updating in autism and psychotic disorders. Pupil dilation tracks belief updating and volatility, but studies linking pupillometric data to autistic- or psychotic-like symptoms are scarce. Here we investigated the relationship between behavioral and pupillometric markers of subjective volatility (i.e. experience of the world as unstable), psychotic-like experiences, and autistic traits in a healthy sample with a probabilistic reversal learning task. Computational modelling revealed that participants with high psychotic-like experience scores overestimated volatility in low-volatile task periods and showed a decreased pupil response to stimuli that urged belief updating. For autistic-like traits, behavioral results indicated a reduced ability to differentiate between high- and low-risk trials. These findings provide new insights into the relationship between misestimation of uncertainties and autistic and psychotic symptoms.


2015 ◽  
Vol 207 (1) ◽  
pp. 23-29 ◽  
Author(s):  
A. Thompson ◽  
S. T. Lereya ◽  
G. Lewis ◽  
S. Zammit ◽  
H. L. Fisher ◽  
...  

BackgroundSleep disturbances are commonly reported in the psychosis prodrome, but rarely explored in relation to psychotic experiences.AimsTo investigate the relationship between specific parasomnias (nightmares, night terrors and sleepwalking) in childhood and later adolescent psychotic experiences.MethodThe sample comprised 4720 individuals from a UK birth cohort. Mothers reported on children's experience of regular nightmares at several time points between 2 and 9 years. Experience of nightmares, night terrors and sleepwalking was assessed using a semi-structured interview at age 12. Psychotic experiences were assessed at ages 12 and 18 using a semi-structured clinical interview.ResultsThere was a significant association between the presence of nightmares at 12 and psychotic experiences at 18 when adjusted for possible confounders and psychotic experiences at 12 (OR = 1.62, 95% CI 1.19–2.20). The odds ratios were larger for those who reported persistent psychotic experiences.ConclusionsThe presence of nightmares might be an early risk indicator for psychosis.


2020 ◽  
pp. 1-11
Author(s):  
J. B. Newbury ◽  
L. Arseneault ◽  
A. Caspi ◽  
T. E. Moffitt ◽  
C. L. Odgers ◽  
...  

Abstract Background Associations of socioenvironmental features like urbanicity and neighborhood deprivation with psychosis are well-established. An enduring question, however, is whether these associations are causal. Genetic confounding could occur due to downward mobility of individuals at high genetic risk for psychiatric problems into disadvantaged environments. Methods We examined correlations of five indices of genetic risk [polygenic risk scores (PRS) for schizophrenia and depression, maternal psychotic symptoms, family psychiatric history, and zygosity-based latent genetic risk] with multiple area-, neighborhood-, and family-level risks during upbringing. Data were from the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally-representative cohort of 2232 British twins born in 1994–1995 and followed to age 18 (93% retention). Socioenvironmental risks included urbanicity, air pollution, neighborhood deprivation, neighborhood crime, neighborhood disorder, social cohesion, residential mobility, family poverty, and a cumulative environmental risk scale. At age 18, participants were privately interviewed about psychotic experiences. Results Higher genetic risk on all indices was associated with riskier environments during upbringing. For example, participants with higher schizophrenia PRS (OR = 1.19, 95% CI = 1.06–1.33), depression PRS (OR = 1.20, 95% CI = 1.08–1.34), family history (OR = 1.25, 95% CI = 1.11–1.40), and latent genetic risk (OR = 1.21, 95% CI = 1.07–1.38) had accumulated more socioenvironmental risks for schizophrenia by age 18. However, associations between socioenvironmental risks and psychotic experiences mostly remained significant after covariate adjustment for genetic risk. Conclusion Genetic risk is correlated with socioenvironmental risk for schizophrenia during upbringing, but the associations between socioenvironmental risk and adolescent psychotic experiences appear, at present, to exist above and beyond this gene-environment correlation.


2020 ◽  
Vol 46 (5) ◽  
pp. 1104-1113 ◽  
Author(s):  
Eleanor Longden ◽  
Alison Branitsky ◽  
Andrew Moskowitz ◽  
Katherine Berry ◽  
Sandra Bucci ◽  
...  

Abstract Evidence suggests that dissociation is associated with psychotic experiences, particularly hallucinations, but also other symptoms. However, until now, symptom-specific relationships with dissociation have not been comprehensively synthesized. This is the first prospectively registered (CRD42017058214) meta-analysis to quantify the magnitude of association between dissociative experiences and all symptoms of psychosis. MEDLINE, PsycINFO, PubMed, and Scopus databases were searched using exhaustive terms denoting dissociation and psychotic symptoms. We included both nonclinical (58 studies; 16 557 participants) and clinical (46 studies; 3879 patient participants) samples and evaluated study quality. Ninety-three eligible articles considering 20 436 participants were retained for analysis. There was a robust association between dissociation and clinical and nonclinical positive psychotic symptoms (r = .437; 95%CI: .386 −.486), with the observed effect larger in nonclinical studies. Symptom-specific associations were also evident across clinical and nonclinical studies, and included significant summary effects for hallucinations (r = .461; 95%CI: .386 −.531), delusions (r = .418; 95%CI: .370 −.464), paranoia (r = .447; 95%CI: .393 −.499), and disorganization (r = .346; 95%CI: .249 −.436). Associations with negative symptoms were small and, in some cases, not significant. Overall, these findings confirm that dissociative phenomena are not only robustly related to hallucinations but also to multiple positive symptoms, and less robustly related to negative symptoms. Our findings are consistent with proposals that suggest certain psychotic symptoms might be better conceptualized as dissociative in nature and support the development of interventions targeting dissociation in formulating and treating psychotic experiences.


Author(s):  
Rosa Ritunnano ◽  
Lisa Bortolotti

AbstractDelusions are often portrayed as paradigmatic instances of incomprehensibility and meaninglessness. Here we investigate the relationship between delusions and meaning from a philosophical perspective, integrating arguments and evidence from cognitive psychology and phenomenological psychopathology. We review some of the empirical and philosophical literature relevant to two claims about delusions and meaning: (1) delusions are meaningful, despite being described as irrational and implausible beliefs; (2) some delusions can also enhance the sense that one’s life is meaningful, supporting agency and creativity in some circumstances. Delusions are not incomprehensible representations of reality. Rather, they can help make sense of one’s unusual experiences and in some circumstances even support one’s endeavours, albeit temporarily and imperfectly. Acknowledging that delusions have meaning and can also give meaning to people’s lives has implications for our understanding of psychotic symptoms and for addressing the stigma associated with psychiatric conditions.


1986 ◽  
Vol 1 (2) ◽  
pp. 108-122 ◽  
Author(s):  
Nancy C. Andreasen ◽  
William M. Grove

SummaryMost investigators concur that schizophrenia is probably a heterogeneous group of disorders that share the common features of psychotic symptoms, partial response to neuroleptics, and a relatively poor outcome. The subdivision of schizophrenia into two subtypes, positive versus negative, has achieved wide acceptance throughout the world during recent years. This distinction has heuristic and theoretical appeal because it unites phenomenology, pathophysiology, and etiology into a single comprehensive hypothesis.In spite of its wide appeal, the distinction has a number of problems. These include the failure to distinguish between symptom syndromes and diseases; failure to deal with the mixed patient; failure to take longitudinal course into account; and failure to address conceptually and methodologically the distinction between positive and negative symptoms.This paper focuses primarily on the conceptual basis for two instruments designed to measure positive and negative symptoms, the Scale for the Assessment of Negative Symptoms (SANS) and the Scale for the Assessment of Positive Symptoms (SAPS), originally described in 1982. Since their description, these scales have been used in a variety of other centers. These scales are based on the hypothesis that negative symptoms represent a deficit or diminution in normal psychological functions wliile positive symptoms represent an excess or distortion of normal functions. Reliability data are now available from Italy, Spain, and Japan which suggest that these scales can be used reliably in cultural settings outside the United States. The results of these studies are summarized in this paper. In addition, a replication study involving a new sample of 117 schizophrenics collected at the University of Iowa is described. In this second study of the SANS and SAPS, internal consistency is found to be quite high in the SANS. Thus negative symptoms appear to be more internally correlated with one another than are positive symptoms. The implications of this result are discussed. A principal components analysis is used to explore the relationship between positive and negative symptoms. While the study reported in 1982 suggested that positive and negative symptoms are negatively correlated, in the present study they appear to be uncorrelated. Overall, the results suggest that the SANS and SAPS are useful comprehensive instruments for the evaluation of positive and negative symptoms. The relationship between these symptoms and external validators such as cognitive functioning or CT scan abnormalities will be reported in a subsequent investigation.


2021 ◽  
pp. 1-8
Author(s):  
Joseph M. Boden ◽  
James A. Foulds ◽  
Giles Newton-Howes ◽  
Rebecca McKetin

Abstract Background This study examined the association between methamphetamine use and psychotic symptoms in a New Zealand general population birth cohort (n = 1265 at birth). Methods At age 18, 21, 25, 30, and 35, participants reported on their methamphetamine use and psychotic symptoms in the period since the previous interview. Generalized estimating equations modelled the association between methamphetamine use and psychotic symptoms (percentage reporting any symptom, and number of symptoms per participant). Confounding factors included childhood individual characteristics, family socioeconomic circumstances and family functioning. Long term effects of methamphetamine use on psychotic symptoms were assessed by comparing the incidence of psychotic symptoms at age 30–35 for those with and without a history of methamphetamine use prior to age 30. Results After adjusting for confounding factors and time-varying covariate factors including concurrent cannabis use, methamphetamine use was associated with a modest increase in psychosis risk over five waves of data (adjusted odds ratio (OR) 1.33, 95% confidence interval (CI) 1.03–1.72 for the percentage measure; and IRR 1.24, 95% CI 1.02–1.50 for the symptom count measure). The increased risk of psychotic symptoms was concentrated among participants who had used at least weekly at any point (adjusted OR 2.85, 95% CI 1.21–6.69). Use of methamphetamine less than weekly was not associated with increased psychosis risk. We found no evidence for a persistent vulnerability to psychosis in the absence of continuing methamphetamine use. Conclusion Methamphetamine use is associated with increased risk of psychotic symptoms in the general population. Increased risk is chiefly confined to people who ever used regularly (at least weekly), and recently.


Author(s):  
Gemma Modinos ◽  
Anja Richter ◽  
Alice Egerton ◽  
Ilaria Bonoldi ◽  
Matilda Azis ◽  
...  

AbstractPreclinical models propose that increased hippocampal activity drives subcortical dopaminergic dysfunction and leads to psychosis-like symptoms and behaviors. Here, we used multimodal neuroimaging to examine the relationship between hippocampal regional cerebral blood flow (rCBF) and striatal dopamine synthesis capacity in people at clinical high risk (CHR) for psychosis and investigated its association with subsequent clinical and functional outcomes. Ninety-five participants (67 CHR and 28 healthy controls) underwent arterial spin labeling MRI and 18F-DOPA PET imaging at baseline. CHR participants were followed up for a median of 15 months to determine functional outcomes with the global assessment of function (GAF) scale and clinical outcomes using the comprehensive assessment of at-risk mental states (CAARMS). CHR participants with poor functional outcomes (follow-up GAF < 65, n = 25) showed higher rCBF in the right hippocampus compared to CHRs with good functional outcomes (GAF ≥ 65, n = 25) (pfwe = 0.026). The relationship between rCBF in this right hippocampal region and striatal dopamine synthesis capacity was also significantly different between groups (pfwe = 0.035); the association was negative in CHR with poor outcomes (pfwe = 0.012), but non-significant in CHR with good outcomes. Furthermore, the correlation between right hippocampal rCBF and striatal dopamine function predicted a longitudinal increase in the severity of positive psychotic symptoms within the total CHR group (p = 0.041). There were no differences in rCBF, dopamine, or their associations in the total CHR group relative to controls. These findings indicate that altered interactions between the hippocampus and the subcortical dopamine system are implicated in the pathophysiology of adverse outcomes in the CHR state.


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