The jumping to conclusions bias in delusions: Specificity and changeability.

Abstract

There are indications that a jumping to conclusions bias (JTC) plays a role in the formation and maintenance of delusions and should be targeted in therapy. However, it is unclear whether (a) JTC is uniquely associated with delusions or simply an epiphenomenon of schizophrenia or impaired intellectual functioning and (b) it can be changed by varying task demands, motivational factors, or feedback. Seventy-one patients with schizophrenia spectrum disorders and either acute or remitted delusions and 68 healthy controls were included. Patients were assessed with self- and observer-rated symptom measures. All participants were assessed for intellectual ability and performed the classic beads task with a ratio of 80:20. They were then presented with task variations that involved increasing the difficulty of the ratio to 60:40, introducing a rule for which correct decisions were rewarded by monetary gains and false decisions led to financial losses, and providing feedback on the accuracy of the previous decisions. Participants with current delusional symptoms took fewer draws to decision (DTD) than did those in remission and healthy controls. DTD were associated with observer-rated delusions, but controlling for negative symptoms or intelligence rendered this association insignificant. DTD increased after the difficulty of the task increased and after feedback. The study demonstrated that JTC is linked to delusions but that this association is not unique. Patients with delusions are principally able to adapt their decisions to altered conditions but still decide relatively quickly even when decisions have negative consequences. These difficulties might stem in part from impaired intellectual functioning.

Healthy people with delusional ideation change their mind with conviction

“…Moreover, as proposed by Freeman (2007), anxiety might have a stronger role in delusion maintenance where the purpose of the delusional belief could be to lower the anxiety levels in patients. Interestingly, induced anxiety states are associated with enhanced JTC bias and with paranoid ideation in healthy people (Lincoln et al, 2010a(Lincoln et al, , 2010b. In healthy participants, this relationship between delusional ideas and anxiety might be dependent of the environmental condition and be triggered in specific situations only.…”

“…However, it appears likely that the increased JTC was observed because of the increased paranoia. In healthy people, some found that inducing anxiety significantly increases the JTC bias and the levels of state paranoia in high scorers on the CAPE, a psychotic experiences questionnaire (Lincoln et al, 2010a(Lincoln et al, , 2010b) whilst others did not find effect of induced anxiety on the JTC bias (Keefe and Warman, 2011). Given the lack of strong rationale behind an association between JTC and depression or anxiety, we hypothesise that delusions are independently related to JTC and emotions.…”

“…The total score of this subscale ranges from 0 to 28. Measures of intelligence were collected as Lincoln et al (2010aLincoln et al ( , 2010b reported that the relationship between a hasty decision making and delusions in patients was cancelled if IQ was controlled for. In addition, in healthy people, Freeman et al (2008) reported a trend to observe lower IQ in those who jump to conclusions relative to those who did not and Colbert and Peters (2002) reported a negative correlation between IQ and change to disconfirmatory evidence.…”

“…However, it remains unclear whether depression or anxiety is the best predictor of delusional ideation. Anxiety has been clearly linked to paranoia Lincoln et al, 2010aLincoln et al, , 2010b, but depressive symptoms as well (Chapman et al, 1994;Kwapil et al, 1997;Warman et al, 2010). Therapy to improve anxiety differs greatly from that to improve depression.…”

Preserved, deteriorated, and premorbidly impaired patterns of intellectual ability in schizophrenia.

“…The notion of bias or style in cognitive processing refers to both formal and social reasoning partiality and includes a propensity to make decisions based on inadequate data, a resistance to disconfirmatory information, and 'self-serving' attributions in social situations. For example, the most often cited effect originates from the observation that schizophrenia patients with persecutory delusions are inclined to 'jump to conclusions' and make impulsive and premature decisions exclusive of sufficient information on probabilistic reasoning tasks (Dudley et al, 2015;Lincoln, Ziegler, Mehl, & Rief, 2010;Garety et al, 1991;Garety et al, 2005;So, Garety, Peters, & Kapur, 2010). Delusional patients also tend to rigidly hold their beliefs and refuse to consider any disconfirmatory evidence (Woodward, Moritz, Cuttler, & Whitman, 2006).…”