When does jumping-to-conclusions reach its peak? The interaction of vulnerability and situation-characteristics in social reasoning

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Abstract

Background and Objectives

Persons with delusions tend to display a jumping-to-conclusions (JTC) bias which is considered relevant to delusion formation. However, its contribution in real life social scenarios is unknown. This study investigates whether JTC increases when decisions have to be made in delusion-relevant situations and whether the increase is uniquely moderated by delusion-proneness.

Methods

JTC was assessed by a social reasoning paradigm in 92 healthy participants that were classified as high, medium or low in paranoid ideation and social anxiety. Decisions had to be made for emotionally salient scenarios without direct self-relevance, self-relevant scenarios and delusion-relevant scenarios, by successively drawing pieces of information.

Results

All participants drew less information in the scenarios that were self-relevant and delusion-relevant compared to non-self-relevant scenarios. Participants with higher paranoid ideation generally drew less information than persons with medium or low levels of paranoid ideation. However, the hypothesized interaction of delusion-proneness and type of scenario was not significant. Social anxiety had no effect on draws to decision in any of the task types.

Limitations

The description of social encounters in the task does still not capture the full perceptual experience in real life encounters.

Conclusions

The data support the assumption that the formation of persecutory delusions might arise as a function of a delusion-specific JTC-bias in combination with a normal and functional tendency to collect less information in self-relevant situations.

Research highlights

► Jumping-to conclusions in emotionally salient tasks is associated with delusion-proneness. ► Jumping-to-conclusions increases with self-relevance of the situation. ►·Delusions might arise from a combination of a specific reasoning bias and situational factors.

Introduction

Compared to healthy controls, persons with delusions tend to collect less information before deciding. Following a first study by Huq, Garety and Hemsley (1988), this ‘Jumping to Conclusions Bias’ (Garety & Freeman, 1999) in persons with delusions can now be considered a well replicated finding (Fine, Gardner, Craigie, & Gold, 2007).

Limited data collection increases the probability of drawing incorrect conclusions and may therefore contribute to the development or maintenance of delusions. The notion that the JTC-bias could be causal to delusions is also supported by several studies that find it in healthy persons characterized by attenuated psychotic symptoms that typically precede psychosis (Broome et al., 2007, Colbert and Peters, 2002, Freeman et al., 2008, Ziegler et al., 2008). Accordingly, JTC has been incorporated into cognitive models of delusions (Garety, Bebbington, Fowler, Freeman, & Kuipers, 2007) and is becoming a target of cognitive behavioural interventions for psychosis (Moritz and Woodward, 2007, Ross et al., in press).

However, it is not known whether persons with delusions are prone to draw premature and wrong conclusions in all areas of life and whether some areas, such as dealing with delusion-related issues, are particularly affected by the bias. Delusions tend to revolve around reoccurring themes, most frequently to do with evaluating the trustworthiness of other people (persecutory delusions) and with topics that refer to the self- and to self-evaluation (delusions of reference, grandiose delusions). Possibly, JTC becomes more pronounced in situations that involve such self- and threat-related themes. Some studies have demonstrated that the JTC bias is not limited to probabilistic tasks (John and Dodgson, 1994, Moritz et al., 2006). Furthermore, studies that have used stimulus material that is closer to reality and emotionally salient (Dudley et al., 1997, Menon et al., 2006, Warman et al., 2007, Young and Bentall, 1997) demonstrate that delusional patients tend to be hasty with regard to different types of material. Several studies even found delusions or delusion proneness only to be associated with reasoning biases when the stimulus material was more emotional (Warman & Martin, 2006), self-referent (Warman et al., 2007) or based on visual or auditory material (Colbert et al., 2010, Ziegler et al., 2008). In addition, several recent studies in clinical and non-clinical populations have shown that JTC increases under emotional arousal (Ellett et al., 2008, Keefe and Warman, in press, Lincoln et al., 2010, Moritz et al., in press). Although these findings indicate that the JTC bias might become stronger the more emotionally salient or self-referent a situation is, no study has directly investigated whether it becomes more pronounced when persons have to deal with delusion-relevant situations.

Although several studies indicate that JTC is delusion-, rather than schizophrenia-specific (Lincoln et al., 2010, Peters et al., 2008) the finding that emotional arousal and the salience of stimuli tend to increase the JTC-bias raises the question to which extent JTC is merely a form of information processing that is typical for individuals with higher trait anxiety (Bensi & Giusberti, 2007) and for reasoning in emotionally salient situations. In this case, one might also expect to find JTC in persons with other types of anxiety-related disorders, in particular when they encounter anxiety-triggering situations. For example, persons with agoraphobia might tend to jump to conclusions in agoraphobic situations (e.g. taking the first jerk in an elevator as a sign that it will get stuck), persons with panic disorder might make premature decisions when it comes to deciding whether a bodily symptom is dangerous or not and socially anxious persons when it comes to assessing how they are being judged by others. Few studies have investigated JTC in anxiety disorders, and the findings have not been entirely conclusive (Brankovic and Paunovic, 1999, Fear and Healy, 1997, Fraser et al., 2006). Also, none of these studies have investigated data-gathering within clinically relevant, and therefore potentially anxiety-arousing situations.

In this study we investigate data-gathering in social situations that vary with regard to the extent of self- and delusion relevance. Specifically, we aim to tests the hypothesis that the number of draws to decision will decrease from non-self-relevant social situations (e.g. judging the behaviour of other persons) to situations with personal relevance (e.g. judging whether one is being accepted or rejected by others) and be the most pronounced in situations that are relevant to paranoid delusions (e.g. judging whether to trust another person). We expect persons with higher levels of paranoid ideation to show a more pronounced JTC bias in all situations. Finally, we expect the impact of paranoia proneness to increase with the self relevance of the scenarios and be particularly pronounced in the delusion-relevant scenarios (interaction effect). Furthermore, the study aims to investigate whether the JTC bias is unique to delusions by including social anxiety as an additional moderator. If JTC is merely a typical reasoning style in anxiety-prone individuals and in anxiety-provoking situations then it should also be affected by the extent of social anxiety, especially when decisions have to be made in situations that are typically considered as threatening by persons with social anxiety.

A sample of healthy participants, rather than patients, was chosen in order to demonstrate basic mechanisms on the pathway from vulnerability to psychosis. A focus on a single symptom, paranoid ideation, rather than delusions in general, was chosen, because delusions of persecution have been frequently investigated with regard to JTC and their continuity in the population is well studied (Freeman, 2007).

Section snippets

Participants

Participants (n = 100) were recruited via adverts in the faculty of psychology, in shopping centres, via a regional Internet portal and by contacting persons who had previously participated in studies. Persons with a self-reported acute clinical disorder or younger than 18 years were excluded. Participants received 10 € for participation or (in the case of student participants) were able to fulfill study requirements.

Eight data-sets were excluded, one because the participant had extreme

Draws to decision, info-value, subjective probability ratings and JTC by scenario and paranoia-proneness

The mean number of DTD, info-value at point of decision, rated probability at point of decision and percentages of JTC are depicted in Table 1 for the total group and divided by subgroups of participants with high, medium or low subclinical paranoid ideation. In 85% of all decisions the “correct” alternative (supported by eight, rather than two pieces of information) was selected. The high, medium and low paranoia groups did not differ in this respect (F (2, 89) = 0.78, p = .461), neither did

Discussion

As hypothesized, there was a general tendency to require less information in the self- and delusion-relevant situations than in the non self-relevant situations. Previous studies have found JTC to increase when material is used that is more relevant to everyday decisions. Young and Bentall (1997) and Fraser et al. (2006) found all their participants to reach high levels of certainty more quickly when having to decide on personality characteristics compared to more neutral material, such as

Conclusions

Taken together, it seems that the impact of JTC on the development of delusions might be due to a combination of a delusion-specific vulnerability which is characterized by a stable JTC-bias and a normal and probably functional tendency to base decisions on less information in self-relevant situations. The combination of bias and situational factors also seems to explain why JTC has been demonstrated for paranoid beliefs in particular (Freeman, 2007, Startup et al., 2008), as these type of

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      Hence, introducing a manipulation of social anxiety relating to performing a social task would likely help to identify whether there is a relationship between SAD and JTC, given that the JTC bias increases when stress and/or state anxiety is high (Ellett et al., 2008; Keefe & Warman, 2011). A second limitation of both the Lincoln et al. (2011) and Schlier et al. (2015) studies was that they did not include a measure for gauging fear of negative evaluation from others, which is a core feature of SAD (American Psychiatric Association, 2013) and a common symptom in people who experience persecutory delusions (Kinoshita et al., 2011). Neglecting to include this measure in the assessment of SAD could have contributed to the lack of significant findings between trait social anxiety and JTC.

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