Distinct alterations in probabilistic reversal learning across at-risk mental state, first episode psychosis and persistent schizophrenia.
Scientific Reports July 30, 2024 J. D. Griffin, K. M. J. Diederen, J. Haarsma et al. 5 citations
People with first episode psychosis and treatment-resistant schizophrenia show reduced ability to stabilize their decision-making strategies in uncertain environments, resembling effects previously seen with the drug ketamine. In two studies, participants completed a probabilistic reversal learning task. Those with first episode psychosis made more errors and shifted strategies too often after misleading feedback. The treatment-resistant schizophrenia group also shifted strategies more, though their overall accuracy was not significantly reduced. Computational modeling revealed that only the treatment-resistant schizophrenia group showed altered confidence-based modulation of responding, similar to ketamine effects, though these modeling results are considered preliminary due to model limitations.