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Chapter 16 - Trust and Psychotic Disorders

Unraveling the Dynamics of Paranoia and Disturbed Social Interaction

from Part V - Neuropathological Level of Trust

Published online by Cambridge University Press:  09 December 2021

By
Imke L. J. Lemmers-Jansen  and
Anne-Kathrin J. Fett
Edited by
Frank Krueger
Frank Krueger
Affiliation:
George Mason University, Virginia
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Summary

Psychotic disorders are characterized by problems in interpersonal, social functioning. Paranoid ideation reflects severe suspiciousness and distrust in others. However, the neural mechanisms underlying these social symptoms are largely unknown. Here, we discuss studies investigating trust in psychosis by means of the interactive trust game, and through trustworthiness ratings of faces. Across all the stages of the continuum reduced baseline trust was found in various studies, possibly suggesting a trait-like vulnerability for psychosis. In repeated interactions chronic patients engage less in trust honouring interactions, although they show intact reactions to facial expressions. Overall, first-episode patients and individuals at high risk for psychosis also show reduced trust, but are able to learn to trust over repeated interactions. Several factors that can influence trust are discussed. At the neural level, differential activation in brain regions associated with theory of mind and reward processing were found in individuals with psychosis across illness stages. Theoretical accounts considering motivation, cognition and affect are discussed and suggestions for future research are formulated.

Keywords

psychosistrustsocial interactionstrust gameemotion recognitionmentalisingrewardcognitionneuroimaging
Type
Chapter
Information
The Neurobiology of Trust , pp. 389 - 429
Publisher: Cambridge University Press
Print publication year: 2021

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