Revisiting the jumping to conclusions bias in functional movement disorders, 2024, Sainz-Amo et al.

SNT Gatchaman

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Revisiting the jumping to conclusions bias in functional movement disorders
Raquel Sainz-Amo; Jessenia Morillo-González; Jorge Gómez-Corral; Cristina Moreno; Araceli Alonso Cánovas; Juan Carlos Martinez Castrillo; Mark J Edwards; Daniel Hernández-Huerta; Isabel Pareés

No abstract. Letter starts —

Functional movement disorders (FMD) are part of the spectrum of functional neurological disorders (FND), which are common and disabling. Nowadays, it is widely accepted that key aspects of the underlying pathophysiology include the tendency to form abnormal beliefs about symptoms, disturbance of attentional control and disruption of mechanisms regulating sense of agency.1 ‘Jumping to conclusions’ bias (JTC) is a probabilistic reasoning style characterised by making firm decisions based on insufficient evidence. This cognitive bias has been studied to assess erroneous belief formation in delusions by using the classical paradigm of ‘the bead task’.2 In 2012, we explored the JTC bias for the first time in patients with FMD. We found that they required less evidence to reach a decision than healthy controls.3 Here, we aimed to confirm the presence of the JTC bias in a new and larger cohort of patients with FMD and compare the results with a control group of patients diagnosed with major depressive disorder (MDD). Additionally, we evaluated whether changing uncertainty by manipulating the initial information in the bead task might impact participants’ behaviour. We recruited 23 consecutive patients with FMD from the Neurology and 26 patients with MDD from the Psychiatry Department of the Ramon y Cajal Hospital, Madrid, Spain.

Link | PDF (Journal of Neurology, Neurosurgery & Psychiatry)
 
Depending on if/how structural abnormalities end up explaining what's going on it may not read particularly well in hindsight.

In a recent metaanalysis, patients with FND have been suggested to display elevated suggestibility on behavioural scales and in response to suggestive symptom induction protocols.

Suggestibility has been proposed to reflect a generalised tendency to form precise beliefs (priors) that override motor and perceptual systems and functional symptoms are thought to result from ‘overly precise priors’ that can override sensory input. Indeed, a maladaptive tendency to drift towards such priors is a cardinal feature of FND.

It is possible that the tendency to form strong beliefs based on insufficient evidence that we found in ‘the bead task’, regardless of task difficulty, is at least partially mediated by a general tendency towards suggestibility, as a traitlike factor in patients with FND.

The last passage may end up being reflected as "It is possible that the tendency to form strong beliefs based on insufficient evidence that we found in FND research, is at least partially mediated by a general tendency towards suggestibility, as a traitlike factor in FND researchers." I very much doubt that suggestibility is an explanation for all FND-motor diagnoses (or sensory or cognitive for that matter).
 
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