Is intuition allied with jumping to conclusions in decision-making? An intensive longitudinal study in patients with delusions and in non-clinical individuals.
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SUBMITTER: Zander-Schellenberg T
PROVIDER: S-EPMC8687575 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundJumping-to-conclusions (JTC) is a prominent reasoning bias in schizophrenia (SCZ). While it has been linked to not only psychopathological abnormalities (delusions and impulsive decision-making) but also unstable belief formation, its origin remains unclear. We here directly test to which extend JTC is associated with delusional ideation, impulsive decision-making, and unstable belief formation.MethodsIn total, 45 SCZ patients were compared with matched samples of 45 patients with major depressive disorder (MDD) and 45 healthy controls (HC) as delusions and JTC also occur in other mental disorders and the general population. Participants performed a probabilistic beads task. To test the association of JTC with measures of delusions (Positive and Negative Syndrome Scale [PANSS]positive, PANSSpositive-factor, and Peter Delusions Inventory [PDI]), Bayesian linear regressions were computed. For the link between JTC and impulsive decision-making and unstable beliefs, we conducted between-group comparisons of "draws to decision" (DTD), "decision times" (DT), and "disconfirmatory evidence scores" (DES).ResultsBayesian regression obtained no robust relationship between PDI and DTD (all |R2adj| ≤ .057, all P ≥ .022, all Bayes Factors [BF01] ≤ 0.046; α adj = .00833). Compared with MDD and HC, patients with SCZ needed more time to decide (significantly higher DT in ambiguous trials: all P ≤ .005, r2 ≥ .216; numerically higher DT in other trials). Further, SCZ had unstable beliefs about the correct source jar whenever unexpected changes in bead sequences (disconfirmatory evidence) occurred (compared with MDD: all P ≤ .004 and all r2 ≥ .232; compared with HC: numerically higher DES). No significant correlation was observed between DT and DTD (all P ≥ .050).ConclusionsOur findings point toward a relationship of JTC with unstable belief formation and do not support the assumption that JTC is associated with impulsive decision-making.
| S-EPMC8886605 | biostudies-literature
Project description:We did a systematic review and meta-analysis to investigate the magnitude and specificity of the "jumping to conclusions" (JTC) bias in psychosis and delusions. We examined the extent to which people with psychosis, and people with delusions specifically, required less information before making decisions. We examined (1) the average amount of information required to make a decision and (2) numbers who demonstrated an extreme JTC bias, as assessed by the "beads task." We compared people with psychosis to people with and without nonpsychotic mental health problems, and people with psychosis with and without delusions. We examined whether reduced data-gathering was associated with increased delusion severity. We identified 55 relevant studies, and acquired previously unpublished data from 16 authors. People with psychosis required significantly less information to make decisions than healthy individuals (k= 33,N= 1935,g= -0.53, 95% CI -0.69, -0.36) and those with nonpsychotic mental health problems (k= 13,N= 667,g= -0.58, 95% CI -0.80, -0.35). The odds of extreme responding in psychosis were between 4 and 6 times higher than the odds of extreme responding by healthy participants and participants with nonpsychotic mental health problems. The JTC bias was linked to a greater probability of delusion occurrence in psychosis (k= 14,N= 770, OR 1.52, 95% CI 1.12, 2.05). There was a trend-level inverse association between data-gathering and delusion severity (k= 18;N= 794;r= -.09, 95% CI -0.21, 0.03). Hence, nonaffective psychosis is characterized by a hasty decision-making style, which is linked to an increased probability of delusions.
| S-EPMC4838082 | biostudies-other
Project description:Multiple measures of decision-making under uncertainty (e.g. jumping to conclusions (JTC), bias against disconfirmatory evidence (BADE), win-switch behavior, random exploration) have been associated with delusional thinking in independent studies. Yet, it is unknown whether these variables explain shared or unique variance in delusional thinking, and whether these relationships are specific to paranoia or delusional ideation more broadly. Additionally, the underlying computational mechanisms require further investigation. To investigate these questions, task and self-report data were collected in 88 individuals (46 healthy controls, 42 schizophrenia-spectrum) and included measures of cognitive biases and behavior on probabilistic reversal learning and explore/exploit tasks. Of those, only win-switch rate significantly differed between groups. In regression, reversal learning performance, random exploration, and poor evidence integration during BADE showed significant, independent associations with paranoia. Only self-reported JTC was associated with delusional ideation, controlling for paranoia. Computational parameters increased the proportion of variance explained in paranoia. Overall, decision-making influenced by strong volatility and variability is specifically associated with paranoia, whereas self-reported hasty decision-making is specifically associated with other themes of delusional ideation. These aspects of decision-making under uncertainty may therefore represent distinct cognitive processes that, together, have the potential to worsen delusional thinking across the psychosis spectrum.
| S-EPMC10257713 | biostudies-literature
Project description:BackgroundReasoning biases such as the jumping-to-conclusions bias (JTC) are thought to contribute to delusions. Interventions targeting these biases such as metacognitive training (MCT) may improve delusions. So far, it is not clear whether JTC depends on dopaminergic reward areas that constitute the main action locus of antipsychotic drugs, or on additional cortical areas. The present study aimed to investigate fMRI activation and functional connectivity patterns underlying JTC, and their changes following MCT, in patients with delusions.MethodsParticipants were 25 healthy individuals and 26 patients with current delusions who were either medication-free or on stable medication without sufficient response. We assessed (1) BOLD activity in the task-positive (TPN), task-negative (TNN), and subcortical reward network (RN); (2) Psychophysiological interactions (PPI) of peak activation areas.ResultsPresence of JTC (irrespective of group) was associated with lower RN activity during conclusion events, and with increased effective connectivity between TPN and TNN during draw events. Following MCT, changes were observed in TPN activity and in effective connectivity of inferior parietal cortex (part of the TPN) with all three target networks.ConclusionJTC is associated not only with reward system areas that constitute the main target of antipsychotic drugs, but also with cortical areas, particularly of the TPN.
| S-EPMC6077165 | biostudies-literature
Project description:We completed a meta-analysis to investigate the relationship between delusions in psychosis and 4 cognitive biases: "jumping to conclusions" (JTC), the "bias against disconfirmatory evidence" (BADE), the "bias against confirmatory evidence" (BACE), and "liberal acceptance" (LA). Building on recent meta-analyses we compared more narrowly defined groups. We identified 35 JTC, 8 BADE, 7 BACE, and 6 LA studies for inclusion. Groups with schizophrenia who were currently experiencing delusions demonstrated greater JTC, BADE, BACE, and LA than groups with schizophrenia who were not currently experiencing delusions, who in turn demonstrated no more JTC than healthy control groups. Hence JTC, BADE, BACE, and LA co-vary with delusions in cross-sectional samples of people with schizophrenia. Groups who were experiencing delusions due to other psychiatric illnesses also demonstrated greater JTC than healthy controls, and equivalent JTC to groups with schizophrenia currently experiencing delusions. Hence JTC is associated with delusions across a range of diagnoses. Groups with other, non-delusional psychiatric illnesses demonstrated less JTC, BADE, BACE, and LA than groups with schizophrenia currently experiencing delusions, less JTC than groups experiencing delusions due to other diagnoses, and no more JTC, BADE, BACE, or LA than healthy control groups. Hence JTC, BADE, BACE, and LA were not associated with psychiatric illnesses in general. Our results indicate all 4 biases are associated with delusions specifically rather than merely with a diagnosis of schizophrenia or with being psychiatrically ill, consistent with the possibility that they contribute to delusional severity.
| S-EPMC5605251 | biostudies-literature
Project description:BackgroundEvidence-based psychological interventions to support treatment decision-making capacity (capacity) in psychosis do not currently exist. This study sought to establish whether reducing the extent to which this group form conclusions based on limited evidence, also known as the "jumping-to-conclusions" (JTC) bias, could improve capacity.MethodsIn a randomized controlled open trial, 37 patients aged 16-65 years diagnosed with schizophrenia-spectrum disorders were randomly assigned (1:1) to receive a single-session intervention designed to reduce the JTC bias (MCT-JTC; adapted from Metacognitive Training [MCT]) or an attention control (AC) condition designed to control for therapist attention, duration, modality, and face validity. Primary outcomes were treatment decision-making capacity measured by the MacArthur Competency Assessment Tool for Treatment (MacCAT-T) and the jumping-to-conclusions reasoning bias measured by draws to decision on the beads task, each of which were administered by the psychologist delivering the intervention.ResultsThose receiving MCT-JTC had large improvements in overall capacity (d = 0.96, P < .05) and appreciation (d = 0.87, P < .05) compared to those receiving AC. Reduction in JTC mediated a large proportion of the effect of group allocation on understanding, appreciation, reasoning, and overall MacCAT-T scores.ConclusionThis is the first experimental investigation of the effect of a psychological intervention on treatment decision-making capacity in psychosis. It provides early evidence that reducing the JTC bias is associated with large and rapid improvements in capacity. Due to limited resources, assessments were administered by the researchers delivering the intervention. Results should therefore be considered preliminary and a larger, definitive trial addressing methodological limitations is warranted.
| S-EPMC6581146 | biostudies-literature
Project description:Links between impulsive-compulsive behaviors (ICBs) in treated Parkinson's disease (PD), behavioral addictions, and substance abuse have been postulated, but no direct comparisons have been carried out so far. We directly compared patients with PD with and without ICBs with illicit drug abusers, pathological gamblers, and age-matched healthy controls using the beads task, a test of reflection impulsivity, and a working memory task. We found that all patients with PD made more impulsive and irrational choices than the control group. PD patients who had an ICB showed similar behavior to illicit substance abusers, whereas patients without ICBs more closely resembled pathological gamblers. In contrast, we found no difference in working memory performance within the PD groups. However, PD patients without ICBs remembered distractors significantly less than all other patients during working memory tests. We were able to correctly classify 96% of the PD patients with respect to whether or not they had an ICB by analyzing three trials of the 80/20 loss condition of the beads task with a negative prediction value of 92.3%, and we propose that this task may prove to be a powerful screening tool to detect an ICB in PD. Our results also suggest that intact cortical processing and less distractibility in PD patients without ICBs may protect them from developing behavioral addictions.
| S-EPMC3412901 | biostudies-literature
Project description:Recent studies suggest that cooperative decision-making in one-shot interactions is a history-dependent dynamic process: promoting intuition versus deliberation typically has a positive effect on cooperation (dynamism) among people living in a cooperative setting and with no previous experience in economic games on cooperation (history dependence). Here, we report on a laboratory experiment exploring how these findings transfer to a non-cooperative setting. We find two major results: (i) promoting intuition versus deliberation has no effect on cooperative behaviour among inexperienced subjects living in a non-cooperative setting; (ii) experienced subjects cooperate more than inexperienced subjects, but only under time pressure. These results suggest that cooperation is a learning process, rather than an instinctive impulse or a self-controlled choice, and that experience operates primarily via the channel of intuition. Our findings shed further light on the cognitive basis of human cooperative decision-making and provide further support for the recently proposed social heuristics hypothesis.
| S-EPMC4528537 | biostudies-literature
Project description:ObjectivesCognitive and other biases can influence the quality of healthcare decision making. While substantial research has explored how biases can lead to diagnostic or other errors in medicine, fewer studies have examined how they impact the decision making of other healthcare professionals. This scoping review aimed to identify and synthesise a broad range of research investigating whether decisions made by allied health professionals are influenced by cognitive, affective or other biases.Materials and methodsA systematic literature search was conducted in five electronic databases. Title, abstract and full text screening was undertaken in duplicate, using prespecified eligibility criteria designed to identify studies attempting to demonstrate the presence of bias when allied healthcare professionals make decisions. A narrative synthesis was undertaken, focussing on the type of allied health profession, type of decision, and type of bias reported within the included studies.ResultsThe search strategy identified 149 studies. Of these, 119 studies came from the field of psychology, with substantially fewer from social work, physical and occupational therapy, speech pathology, audiology and genetic counselling. Diagnostic and assessment decisions were the most common decision types, with fewer studies assessing treatment, prognostic or other clinical decisions. Studies investigated the presence of over 30 cognitive, affective and other decision making biases, including stereotyping biases, anchoring, and confirmation bias. Overall, 77% of the studies reported at least one outcome that represented the presence of a bias.ConclusionThis scoping review provides an overview of studies investigating whether decisions made by allied health professionals are influenced by cognitive, affective or other biases. Biases have the potential to seriously impact the quality, consistency and accuracy of decision making in allied health practice. The findings highlight a need for further research particularly in professional disciplines outside of psychology, using methods that reflect real life healthcare decision making.
| S-EPMC7575084 | biostudies-literature
Project description:Background/aimThe law on consent has changed in Scotland with the introduction of the Adults with Incapacity (Scotland) Act 2000. This Act introduces the concept of proxy consent in Scotland. Many patients in intensive care are unable to participate in the decision making process because of their illness and its treatment. It is normal practice to provide relatives with information on the patient's condition, treatment, and prognosis as a substitute for discussion directly with the patient. The relatives of intensive care patients appeared to believe that they already had the right to consent on behalf of an incapacitated adult. The authors' aim was to assess the level of knowledge among relatives of intensive care patients of both the old and new law using a structured questionnaire.MethodsThe next of kin of 100 consecutive patients completed a structured questionnaire. Each participant had the questions read to them and their answers recorded. Patients were not involved in the study.ResultsFew (10%) were aware of the changes. Most (88%) thought that they previously could give consent on behalf of an incapacitated adult. Only 13% have ever discussed the preferences for life sustaining treatment with the patient but 84% felt that they could accurately represent the patient's wishes.ConclusionsThere appeared to be a lack of public awareness of the impending changes. The effectiveness of the Act at improving the care of the mentally incapacitated adult will depend largely on how successful it is at encouraging communication and decision making in advance of incapacity occurring.
| S-EPMC1733945 | biostudies-literature