Effects of metacognitive training on the neurophysiological correlates of the jumping-to-conclusions bias in schizophrenia

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The jumping-to-conclusions (JTC) bias, i.e. the tendency to arrive on decisions based on limited evidence, occupies a central place among theories of delusion generation. Since delusions constitute one of the core symptoms of schizophrenia, the JTC bias might represent an ideal target for treatment. Although not affected by dopaminergic antagonists, the JTC bias is amenable to specific psychotherapeutic interventions, which have been shown to be efficient in treating delusional symptoms as an adjunct to antipsychotic medication treatment in patients with schizophrenia. However, the neurobiological bases of JTC in schizophrenia have received little interest so far. A few studies have investigated data gathering in healthy subjects and have shown it to be associated with activity in brain areas different than (or additional to) those involved in decision making and reward processing. However, so far there have been no studies on the neurophysiological correlates of disturbed data gathering in patients with schizophrenia. The present study aims to provide a biological marker for the JTC bias and other aspects of data gathering abnormalities in patients with schizophrenia. This will be achieved by comparing brain activation and functional connectivity patterns in 24 unmedicated patients with schizophrenia and 24 healthy control subjects (matched in gender, age and education) during two different tasks assessing data gathering. Moreover, changes in brain activation/connectivity patterns in patients following a course of metacognitive training (MCT), an intervention specifically designed to address reasoning biases such as the JTC. The study aims to provide insights into the pathophysiology of schizophrenia that will further the development of new treatment options for the disorder.