To investigate the relationship between environmental volatility expectations and delusion severity in patients with schizophrenia-spectrum disorders.
Approach:
Study Design: Followed 75 patients with schizophrenia-spectrum disorders and 71 nonclinical participants over 6 months, assessing delusion severity and volatility priors.
Assessment Methods: Participants completed a probabilistic reversal-learning task and various self-reports and clinician ratings to evaluate delusions, paranoia, and other psychological factors.
Key Findings:
Patients with schizophrenia-spectrum disorders had higher volatility priors than nonclinical participants at baseline.
Higher volatility priors were associated with greater clinician-rated delusion severity over time.
Delusion severity, paranoia, and delusional ideation decreased among patients, but remained elevated compared to nonclinical participants.
Volatility priors decreased over the 6-month period but were still higher than those of the comparison group.
No significant longitudinal associations were found between volatility priors and depression, worry, well-being, or amotivation.
Interpretation:
Volatility priors may represent a state-sensitive marker of delusional thinking.
Limitations:
Attrition affected the study, with only 55% of patients completing all assessments.
Potential practice effects from repeated exposure to the learning task.
The full impact of attrition on findings remains unknown.
Conclusion:
The study suggests that volatility priors could be a cognitive mechanism in delusions and paranoia.
