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Schizophrenia / Psychotic Disorders

(PS7-99) The Role of Salience in Delusion Formation: A Pilot Study Using a Modified Box Task

Saturday, November 16, 2024
8:30 AM – 9:30 AM EST
Location: Franklin Hall, Level 4, Marriott Downtown
Abstract Text: Cognitive biases play a role in the development and maintenance of delusional ideation in psychotic disorders such as schizophrenia. Delusions are frequently distressing and are associated with deficits in real world outcomes such as social functioning and independent living. Refining our understanding of the mechanisms underlying cognitive biases, such as jumping to conclusions bias (JTC), can improve cognitive behavior therapy for psychosis. Despite robust evidence of heightened JTC bias in schizophrenia, recent work utilizing a novel data gathering task, the Box Task, found decreased JTC bias by high delusion-prone participants and participants with schizophrenia (Balzan et al., 2017; Moritz et al., 2020). The current study aimed to replicate findings of decreased JTC bias by high delusion-prone participants on the Box Task and investigate the role of salience as a moderator between delusional ideation and JTC bias. To our knowledge, this study is the first to modify the Box Task using a high salience condition with 9 boxes and a low salience condition with 64 boxes. The study recruited 35 participants (mean age=52; 51% female) online from Amazon Mechanical Turk. Participants completed a demographic questionnaire, Peters Delusions Inventory (PDI) and the modified Box Task for monetary compensation. There was a significant difference in data gathering behavior (i.e., draws to decision and JTC bias) between salience conditions. Results showed the mean number of draws to decision on the Box Task was significantly higher in the low salience condition, where participants were presented with 64 boxes of evidence (t=4.33, p< 0.001) compared to the high salience condition with 9 boxes (t=6.39, p< 0.001). Participants demonstrated significantly higher JTC bias in the high salience condition (t=7.05, p< 0.001) compared to low salience (t=7.04, p< 0.001). PDI scores were positively correlated with draws to decision (r=0.16) and JTC bias (r=.021) although neither relationship was significant. Consistent with study hypotheses, high delusion-prone participants requested more evidence when salience was low compared to low delusion-prone participants. High delusion-prone participants also requested less evidence when salience was high, but their average draws to decision was still higher compared to low delusion-prone participants. The increased conservative decision-making style observed in high delusion-prone participants replicated previous findings and provided additional evidence for a hypersalience mechanism in delusion formation. The current study piloted a modified Box Task, providing evidence of feasibility and successful manipulation of salience. Future directions will include expanding sample size, recruitment of a clinical sample of patients with first episode psychosis, and adding probability estimates and confidence ratings on the Box Task.