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Related Experiment Video

Updated: Jul 27, 2025

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Relationships between cognitive biases, decision-making, and delusions.

Julia M Sheffield1, Ryan Smith2, Praveen Suthaharan3

  • 1Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Ave S, Nashville, TN, 37209, USA. Julia.sheffield@vumc.org.

Scientific Reports
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Decision-making under uncertainty, including win-switch behavior and evidence integration, is linked to paranoia. Hasty decision-making (jumping to conclusions) is associated with broader delusional ideation, suggesting distinct cognitive processes contribute to psychosis.

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Area of Science:

  • Cognitive Neuroscience
  • Psychiatry
  • Computational Psychiatry

Background:

  • Decision-making under uncertainty is linked to delusional thinking.
  • Existing research has not clarified shared or unique variance explained by different decision-making measures.
  • Computational mechanisms underlying these associations require further investigation.

Purpose of the Study:

  • To determine if measures of decision-making under uncertainty explain shared or unique variance in delusional thinking.
  • To investigate if these relationships are specific to paranoia or broader delusional ideation.
  • To explore the underlying computational mechanisms.

Main Methods:

  • Collected task and self-report data from 88 individuals (46 healthy controls, 42 schizophrenia-spectrum).
  • Assessed cognitive biases and behavior using probabilistic reversal learning and explore/exploit tasks.
  • Employed regression analyses and computational modeling.

Main Results:

  • Win-switch rate differed significantly between groups.
  • Reversal learning performance, random exploration, and poor evidence integration in bias against disconfirmatory evidence (BADE) independently associated with paranoia.
  • Self-reported jumping to conclusions (JTC) associated with delusional ideation, controlling for paranoia.
  • Computational parameters enhanced variance explained in paranoia.

Conclusions:

  • Decision-making characterized by high volatility and variability is specifically linked to paranoia.
  • Self-reported hasty decision-making (JTC) is specifically linked to other delusional themes.
  • These distinct decision-making processes may exacerbate delusional thinking across the psychosis spectrum.