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Learning to trust: social feedback normalizes trust behavior in first-episode psychosis and clinical high risk

Published online by Cambridge University Press:  13 June 2018

Imke L. J. Lemmers-Jansen ,
Anne-Kathrin J. Fett ,
Esther Hanssen ,
Dick J. Veltman  and
Lydia Krabbendam
Imke L. J. Lemmers-Jansen*
Affiliation:
Department of Educational and Family studies, Faculty of Behavioral and Movement Sciences, and Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands
Anne-Kathrin J. Fett
Affiliation:
Department of Psychology, City, University of London, Northampton Square, London EC1V 0HB, UK Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioral and Movement Sciences, and Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, London SE5 8AF, Great Britain
Esther Hanssen
Affiliation:
Department of Educational and Family studies, Faculty of Behavioral and Movement Sciences, and Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands
Dick J. Veltman
Affiliation:
Department of Psychiatry, VU Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands Neuroscience Campus Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
Lydia Krabbendam
Affiliation:
Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioral and Movement Sciences, and Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, London SE5 8AF, Great Britain
*
Author for correspondence: Imke L.J. Lemmers-Jansen, E-mail: [email protected]
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Abstract

Background

Psychosis is characterized by problems in social functioning that exist well before illness onset, and in individuals at clinical high risk (CHR) for psychosis. Trust is an essential element for social interactions that is impaired in psychosis. In the trust game, chronic patients showed reduced baseline trust, impaired response to positive social feedback, and attenuated brain activation in reward and mentalizing areas. We investigated whether first-episode psychosis patients (FEP) and CHR show similar abnormalities in the neural and behavioral mechanisms underlying trust.

Methods

Twenty-two FEP, 17 CHR, and 43 healthy controls performed two trust games, with a cooperative and an unfair partner in the fMRI scanner. Region of interest analyses were performed on mentalizing and reward processing areas, during the investment and outcome phases of the games.

Results

Compared with healthy controls, FEP and CHR showed reduced baseline trust, but like controls, learned to trust in response to cooperative and unfair feedback. Symptom severity was not associated with baseline trust, however in FEP associated with reduced response to feedback. The only group differences in brain activation were that CHR recruited the temporo-parietal junction (TPJ) more than FEP and controls during investment in the unfair condition. This hyper-activation in CHR was associated with greater symptom severity.

Conclusions

Reduced baseline trust may be associated with risk for psychotic illness, or generally with poor mental health. Feedback learning is still intact in CHR and FEP, as opposed to chronic patients. CHR however show distinct neural activation patterns of hyper-activation of the TPJ.

Keywords

Clinical high riskfirst-episode psychosisfMRIsocial feedbacktrust
Type
Original Articles
Information
Psychological Medicine , Volume 49 , Issue 5 , April 2019 , pp. 780 - 790
Copyright
Copyright © Cambridge University Press 2018 

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