Inductive and deductive reasoning in obsessive-compulsive disorder

BACKGROUND AND OBJECTIVES

This study examined the hypothesis that participants diagnosed with obsessive-compulsive disorder (OCD) show a selective deficit in inductive reasoning but are equivalent to controls in deductive reasoning.

METHODS

Twenty-five participants with OCD and 25 non-clinical controls made inductive and deductive judgments about a common set of arguments that varied in logical validity and the amount of positive evidence provided (premise sample size). A second inductive reasoning task required participants to make forced-choice decisions and rate the usefulness of diverse evidence or non-diverse evidence for evaluating arguments.

RESULTS

No differences in deductive reasoning were found between participants diagnosed with OCD and control participants. Both groups saw that the amount of positive evidence supporting a conclusion was an important guide for evaluating inductive arguments. However, those with OCD showed less sensitivity to premise diversity in inductive reasoning than controls. The findings were similar for both emotionally neutral and OCD-relevant stimuli.

LIMITATIONS

The absence of a clinical control group means that it is difficult to know whether the deficit in diversity-based reasoning is specific to those with OCD.

CONCLUSIONS

People with OCD are impaired in some forms of inductive reasoning (using diverse evidence) but not others (use of sample size). Deductive reasoning appears intact in those with OCD. Difficulties using evidence diversity when reasoning inductively may maintain OCD symptoms through reduced generalization of learned safety information.

Differential roles of polar orbital prefrontal cortex and parietal lobes in logical reasoning with neutral and negative emotional content

To answer the question of how brain pathology affects reasoning about negative emotional content, we administered a disjunctive logical reasoning task involving arguments with neutral content (e.g. Either there are tigers or women in NYC, but not both; There are no tigers in NYC; There are women in NYC) and emotionally laden content (e.g. Either there are pedophiles or politicians in Texas, but not both; There are politicians in Texas; There are no pedophiles in Texas) to 92 neurological patients with focal lesions to various parts of the brain. A Voxel Lesion Symptom Mapping (VLSM) analysis identified 16 patients, all with lesions to the orbital polar prefrontal cortex (BA 10 & 11), as being selectively impaired in the emotional reasoning condition. Another 17 patients, all with lesions to the parietal cortex, were identified as being impaired in the neutral content condition. The reasoning scores of these two patient groups, along with 23 matched normal controls, underwent additional analysis to explore the effect of belief bias. This analysis revealed that the differences identified above were largely driven by trials where there was an incongruency between the believability of the conclusion and the validity of the argument (i.e. valid argument/false conclusion or invalid argument/true conclusion). Patients with lesions to polar orbital prefrontal cortex underperformed in incongruent emotional content trials and over performed in incongruent neutral content trials (compared to both normal controls and patients with parietal lobe lesions). Patients with lesions to parietal lobes underperformed normal controls (at a trend level) in neutral trials where there was a congruency between the believability of the conclusion and the validity of the argument (i.e. valid argument/true conclusion or invalid argument/false conclusion). We conclude that lesions to the polar orbital prefrontal cortex (i) prevent these patients from enjoying any emotionally induced cognitive boost, and (ii) block the belief bias processing route in the neutral condition. Lesions to parietal lobes result in a generalized impairment in logical reasoning with neutral content.

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Polar/orbital PFC lesions result in impaired reasoning in emotional content reasoning.

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Polar/orbital PFC lesion patients overperform in neutral content reasoning trials.

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These differences were driven by incongruent reasoning trials.

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Parietal lesions result in impaired reasoning with neutral but not emotional content.

"What I believe is true": Belief-confirming reasoning bias in social anxiety disorder

BACKGROUND AND OBJECTIVES

Research shows that people tend to consider believable conclusions as valid and unbelievable conclusions as invalid (belief bias). When applied to anxiogenic beliefs, this belief bias could well hinder the correction of dysfunctional convictions. Previous work has shown that high socially anxious students indeed display such fear-confirming, belief biased, reasoning. A critical next question is whether these findings translate to a clinical population of people with social anxiety disorder (SAD). We test whether (i) patients with SAD show belief bias with regard to SAD-relevant themes, (ii) this belief bias is specific for SAD patients or can also be found in panic disorder (PD) patients, (iii) differential belief bias effects in SAD are restricted to social anxiety concerns or are also evident in the context of reasoning with neutral themes.

METHOD

45 SAD patients, 24 PD patients, and 45 non-symptomatic controls (NSCs) completed a syllogistic belief bias task with SAD-relevant and neutral content.

RESULTS

SAD patients displayed belief bias for social anxiety related materials, while the PD group and the NSC group did not. Yet, the difference between SAD and PD was not significant. All groups showed similar belief bias effects for neutral content.

LIMITATIONS

Content of the belief bias task was not tailored to idiosyncratic beliefs. The study lacked power to detect medium or small differences.

CONCLUSIONS

SAD patients showed concern-congruent belief biased interference effects when judging the logical validity of social anxiety relevant syllogisms. Such concern-relevant belief bias may contribute to the persistence of anxiogenic beliefs.

Processes Contributing to the Maintenance of Flying Phobia: A Narrative Review

Flying phobia is a highly prevalent anxiety disorder, which causes sufferers significant distress and life interference. The processes which maintain flying phobia remain poorly understood. A systematic search of the literature was performed to identify what research has been conducted into the processes which may be involved in the fear of flying and whether processes which are believed to maintain other anxiety disorder diagnoses have been investigated in flying phobia. The results of the literature review are presented and related to existing cognitive behavioral theory and research. The results indicate that little research has been conducted into a number of areas considered important in the wider cognitive behavioral literature on anxiety disorders: namely attention, mental imagery, memory, worry, and safety-seeking behaviors. The review proposes a hypothetical model, derived from cognitive behavioral theory, for the processes which may be involved in maintaining flying phobia, and considers a number of areas for future research.

Threat-confirming belief bias and symptoms of anxiety disorders

This study tested the hypothesis that a generally enhanced threat-confirming reasoning style would set people at risk for the development of anxiety disorders. Therefore, a non-clinical student sample (N=146) was presented with a series of linear syllogisms referring to threatening and safety themes and with the anxiety subscale of the SCL-90 and trait anxiety in order to correlate reasoning with anxiety. Half of the syllogisms' conclusions were in line and half were in conflict with generally believable threat and safety related convictions (e.g., potassium cyanide is more toxic than tylenol; The Netherlands are safer than Afghanistan). For each type of syllogism, half was logically valid and half invalid. Overall, participants showed a clear interference of believability on logical reasoning, which is known as the belief bias effect. Furthermore, in line with the idea that people are generally characterized by a better safe than sorry strategy, the pattern indicated that the participants took more time to solve invalid threat related syllogisms as well as valid safety related syllogisms. This threat-confirming belief bias was however not especially pronounced in participants reporting relatively intense anxiety symptoms. Thus, the present findings do not lend support to the idea that a generally enhanced threat-confirming belief bias is a diathesis for the development of anxious psychopathology.

Deductive Reasoning and Social Anxiety: Evidence for a Fear-confirming Belief Bias

This study investigated the relationship between belief bias and fear of negative evaluation. Belief bias refers to a bias in deductive reasoning that acts to confirm rather than falsify prior beliefs. Participants (N = 52) with varying levels of fear of negative evaluation completed a belief bias task by means of linear syllogisms, with stimuli covering both social anxiety convictions and factual neutral statements. A linear relationship was found between fear of negative evaluation and belief bias for the social anxiety conviction category. No differences in reasoning were found for the neutral syllogisms. These results support the view that highly socially anxious individuals do not have a reasoning abnormality, but do have difficulty judging anxiogenic information as false and reassuring convictions-contradicting information as true. Such belief bias logically prevents dysfunctional cognitions from being corrected, thereby sustaining phobic fear.

Effects of verbal information on fear-related reasoning biases in children

The present study made an attempt to induce fear-related reasoning biases by providing children with negative information about a novel stimulus. For this purpose, non-clinical children aged 9-12 years (N=318) were shown a picture of an unknown animal for which they received either negative, ambiguous, positive, or no information. Then children completed a series of tests for measuring various types of reasoning biases (i.e., confirmation bias and covariation bias) in relation to this animal. Results indicated that children in the negative and, to a lesser extent, the ambiguous information groups displayed higher scores on tests of fear-related reasoning biases than children in the positive and no information groups. Altogether, these results support the idea that learning via negatively tinted information plays a role in the development of fear-related cognitive distortions in youths.

Control theory and psychopathology: an integrative approach

Perceptual control theory (PCT; Powers, 1973) is presented and adapted as a framework to understand the causes, maintenance, and treatment of psychological disorders. PCT provides dynamic, working models based on the principle that goal-directed activity arises from a hierarchy of negative feedback loops that control perception through control of the environment. The theory proposes that psychological distress arises from the unresolved conflict between goals. The present paper integrates PCT, control theory, and self-regulatory approaches to psychopathology and psychotherapy and recent empirical findings, particularly in the field of cognitive therapy. The approach aims to offer fresh insights into the role of goal conflict, automatic processes, imagery, perceptual distortion, and loss of control in psychological disorders. Implications for psychological therapy are discussed, including an integration of the existing work on the assessment of control profiles and the use of assertive versus yielding modes of control.

If you suffer from a headache, then you have a brain tumour: domain-specific reasoning 'bias' and hypochondriasis

We explored whether hypochondriacal patients selectively search for threat-confirming information when asked to judge the validity of conditional rules in the context of general and health threats. We also explored several factors that may underly participants' information selection (e.g., believability of the rule). Hypochondriacal patients (n = 20) and healthy controls (n = 20) were presented with modified Wason Selection Tasks (WSTs). The WSTs contained safety rules and danger rules. In the context of general threat, both groups of participants adopted a verificationistic strategy in the case of danger rules and a Popperian strategy in the case of safety rules. Importantly, only hypochondriacal persons showed a similar threat-confirming reasoning pattern in the context of health threat. The latter finding contrasts with the earlier study of de Jong et al. (1998) [de Jong, P. J., Haenen, M.-A., Schmidt, A., & Mayer, B. (1998a). Hypochondriasis: the role of fear-confirming reasoning. Behaviour Research and Therapy, 36, 65-74; de Jong, P. J., Mayer, B., van der Hijden, B., Bögels, S., & van den Hout, M. (1998b). Better safe than sorry: reasoning with conditionals in the context of threat. Submitted for publication.] in which both hypochondriacs and healthy controls showed a threat-confirming strategy in the domain of health threat. The WSTs in that study however, contained a (unintended) worry manipulation ("after hearing this, you get worried"), which might have induced a reasoning strategy in controls that is normally restricted to hypochondriacs. Taken together, the present results sustain the idea that the perception of threat activates a better safe than sorry strategy. In the case of phobic threats, such a reasoning strategy immunizes against refutation of phobic convictions.