Probabilistic reasoning in obsessive-compulsive and delusional disorders
Probabilistic reasoning in obsessive-compulsive and delusional disorders
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DOI：
10.1017/s0033291796004175
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发表时间：
1997-01-01
影响因子：
6.9
通讯作者：
Healy, D
中科院分区：
文献类型：
--
作者：
Fear, CF;Healy, D
背景。妄想障碍（DD）和强迫症（OCD）在以往的研究中使用概率推理范式进行了研究，并报道了每组的异常情况。到目前为止，还没有研究比较过这两组之间的结果。本研究比较了有上述两种症状的患者和同时有上述两种症状的患者。30名DD患者，29名OCD患者，16名强迫妄想患者与30名正常对照者进行了概率推理研究，使用了两种不同的涉及贝叶斯范式的计算机任务。被迷惑的受试者表现出“直接下结论”的推理风格，但在给他们的选择添加结果的测试中，他们的选择与正常人并没有什么不同。强迫症受试者比DD受试者更严重地偏离贝叶斯规范和控制规范。在具有混合精神病理的受试者中，这两种现象的存在似乎使这些概率估计“正常化”。我们的发现延伸了其他人的发现，但需要谨慎解释概率推理在妄想或痴迷的起源中的作用。强迫症组和混合型组的强迫症患者都表现出对贝叶斯准则的严重偏离，这表明强迫症导致的推理方式比妄想患者更不“正常”。需要进一步的工作来调查这些发现的临床相关性，这些研究结果为以下建议提供了适度的支持：强迫症和妄想的结合比单纯的妄想或妄想具有更大的功能优势。
Background. Delusional disorder (DD) and obsessive-compulsive disorder (OCD) have been investigated in previous studies using probabilistic reasoning paradigms and abnormalities in each group have been reported. No study to date has compared results between these groups. This study compares patients with these disorders with those who have both phenomena.Methods. Thirty subjects with DD, 29 with OCD and 16 with obsessive and delusional features were compared with 30 normal controls in a study of probabilistic reasoning using two different computer-based tasks involving a Bayesian paradigm.Results. Deluded subjects showed a 'jump to conclusions' reasoning style, but on a test that added a consequence to their choices did not differ from normals. OCD subjects deviated from Bayesian and control norms to a greater degree than did DD subjects. In subjects with mixed psychopathology, the presence of both phenomena appeared to 'normalize' these probability estimates.Conclusions. Our findings extend those of others but require cautious interpretation as to the role of probabilistic reasoning in the genesis of delusions or obsessions. Obsessionals in both the OCD and Mixed groups, showed substantial deviation from Bayesian norms, suggesting that obsessionality leads to a reasoning style that is less 'normal' than that of delusionals. Further work is required to investigate clinical correlates of these findings which provide modest support for the proposal that the combination of obsessions and delusions confers greater functional advantages than simply having delusions or obsessions.