Decision-making and context processing (DECOP)

Profound impairments in social functioning are a core feature of non-affective psychosis. They are associated with deficits in social cognition and reflected in key symptoms of the illness, in particular paranoia. Successful social interactions require the ability to evaluate others’ social signals within situational contexts. Deficits in this ability have been suggested to underlie patients’ social cognitive and functional deficits. To date, few studies have investigated the specific impact of social contextual cues on social cognitive processing. These studies provided initial evidence for a reduced ability of patients to integrate social context in basic social cognitive processes.

Understanding social impairment in psychosis requires consideration of patients’ social interactions. However until recently, research on social cognition in the field failed to incorporate the interactive nature of social relationships. Neuroeconomics, a discipline that resulted from the fusion of neuroscience and game theory, has generated suitable paradigms (e.g. the trust game) to investigate the behavioural and neural mechanisms of social interaction. These paradigms have the high potential to elucidate the social character of psychiatric illnesses.

Dr Anne Fett's research was the first to use a neuroeconomic trust game to investigate social context processing in psychosis. Utilising a novel version of this interactive paradigm, she found that patients and healthy relatives with a heightened illness risk exhibit lower levels of baseline trust than controls. Within patients and relatives lower trust was associated with (subclinical) psychotic symptoms. Interestingly, patients were unable to modify their distrust in response to information about the trustworthiness of their game partner (top-down processing) or in response to their partners’ behavioural feedback (bottom-up processing). This resulted in less successful social interactions. Relatives, however, increased their trust towards similar levels as controls in response to positive social signals.

Taken together, behavioural flexibility in response to social information is a critical determinant of success in social relationships. A lack of flexibility may drive social dysfunction and progression from subclinical symptoms to full-blown psychosis. These findings highlight the utility of incorporating groups with increased illness risk to clarify the mechanisms that may lead to shifts along the psychosis continuum and offer an exciting paradigm to explore new therapeutic ventures to tackle psychotic symptoms and social dysfunction.

The aims of this project are to 1) use neuroeconomics in conjunction with functional Magnetic Resonance Imaging (fMRI) to investigate the neural and behavioural mechanisms of social context processing during social interactions; 2) investigate how these processes relate to social behaviour and symptoms in real-life.

Researchers: Anne Fett