A translational approach to the neurobiology of persecutory ideation in schizophrenia.

Abstract

The heterogeneous symptom presentation of schizophrenia has created difficulties in understanding the disease's biological basis. As a result, researchers have adopted dimension or symptom-specific methodologies to identify the disease's etiology. Another successful research method in schizophrenia involves the translation of experimental paradigms designed to study the neurobiology of cognitive mechanisms through multiple levels of inquiry. The current manuscript described the translation of an economic decision-making paradigm into a sample of individuals with schizophrenia. Results showed that patients with schizophrenia in this sample were able to understand the paradigm and as predicted showed behavioral results similar to controls. A symptom measure of persecutory ideation showed a specific relationship to a decision-making bias that has been reliably associated with persecutory ideation in control samples. In terms of neuroimaging results, patients activated the paracingulate cortex, anterior cingulate cortex, orbital frontal cortex, insula and amygdala when deciding whether or not to trust another player. These same regions were not activated when deciding whether or not to let a coin-flip determine their winnings. Of the regions activated when deciding to trust another player, only the anterior cingulate cortex correlated with a measure of persecutory ideation. Results suggest that economic decision-making paradigms can produce fruitful results in psychiatric samples. Additionally, the findings suggest a specific relationship between the self-referential thinking associated with persecutory ideation and the anterior cingulate cortex.