Jumping to conclusions in schizophrenia

Abstract

Schizophrenia is a mental disorder associated with a variety of symptoms, including hallucinations, delusions, social withdrawal, and cognitive dysfunction. Impairments on decision-making tasks are routinely reported: evidence points to a particular deficit in learning from and revising behavior following feedback. In addition, patients tend to make hasty decisions when probabilistic judgments are required. This is known as “jumping to conclusions” (JTC) and has typically been demonstrated by presenting participants with colored beads drawn from one of two “urns” until they claim to be sure which urn the beads are being drawn from (the proportions of colors vary in each urn). Patients tend to make early decisions on this task, and there is evidence to suggest that a hasty decision-making style might be linked to delusion formation and thus be of clinical relevance. Various accounts have been proposed regarding what underlies this behavior. In this review, we briefly introduce the disorder and the decision-making deficits associated with it. We then explore the evidence for each account of JTC in the context of a wider decision-making deficit and then go on to summarize work exploring JTC in healthy controls using pharmacological manipulations and functional imaging. Finally, we assess whether JTC might have a role in therapy.

Haste makes waste: Decision making in patients with restless legs syndrome with and without augmentation

“…Sampling less information before making a decision, or “jumping to conclusions”, as well as irrational decision making is common in drug naïve PD patients [21], PD patients with impulse control disorders [20], patients with schizophrenia [31], binge drinkers [19], and substance abusers [18,22]. A neuroimaging study in healthy controls showed that a wide brain network including the parietal and prefrontal cortex, the anterior insula, and also the striatum are activated during the beads task [32].…”

“…have a lower decision threshold), overvalue the evidence they have already (e.g. overconfidence) or a combination of both factors [31]. It is likely that dopamine agonists contribute to the impairment in decision making on the beads task.…”

“…It is likely that dopamine agonists contribute to the impairment in decision making on the beads task. Dopamine agonists are known to contribute to jumping to conclusion behaviour in PD [23], impulsive choice, temporal discounting [33] and delusional thinking, which has been linked with poor performance on the beads task [31,34]. Impairment of information sampling, regardless of whether it is due to overconfidence or a lower decision threshold, is possibly caused by reduced “top down” cortical inhibition.…”

“…Furthermore, patients with augmentation made significantly more often irrational decisions than controls and RLS patients without augmentation. This behaviour is often seen in patients with substance abuse [18,20], patients with schizophrenia [31] and those with behavioural addictions [20,39]. Whether this trait is also found in RLS patients treated with alpha-2-delta ligands needs to be explored in future studies.…”

Analytic cognitive style, not delusional ideation, predicts data gathering in a large beads task study

“…Nevertheless, there is considerable debate about how best to interpret the JTC bias literature (Dudley, Cavanagh, Daley, & Smith, 2015;Evans, Averbeck, & Furl, 2015). Notably, the most widely used versions of the task do not provide any objective basis for classifying responses as correct or incorrect (van der Leer, Hartig, Goldmanis, & McKay, 2015), meaning that performance on this task cannot be directly evaluated in terms of normative standards of reasoning.…”