The misattribution of salience in delusional patients with schizophrenia.
BACKGROUND
Delusions may arise from abnormalities in emotional perception. In this study, we tested the hypothesis that delusional schizophrenia patients are more likely than non-delusional schizophrenia patients and healthy participants to assign affective meanings to neutral stimuli.


METHODS
Unpleasant, pleasant, and neutral words were randomly presented to three subject groups--patients with schizophrenia with prominent delusions, patients with schizophrenia without delusions, and healthy participants. Participants performed three tasks: one in which they decided whether a letter string was a word or a non-word (lexical decision) and two affective classification tasks in which they judged whether words were 1) neutral or unpleasant, or 2) neutral or pleasant.


RESULTS
While there were no significant between-group differences in lexical decision performance, patients with delusions showed selective performance deficits in both affective classification tasks. First, delusional patients were significantly more likely than non-delusional patients and healthy participants to classify words as unpleasant. Second, delusional patients took significantly longer than both other groups to correctly classify neutral words in both affective classification tasks.


CONCLUSIONS
Taken together, these findings suggest that delusions are associated with the explicit misattribution of salience to neutral stimuli.
Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02129, United States. dholt@partners.org
Daphne J
DJ
Holt
Debra
D
Titone
L Stephen
LS
Long
Donald C
DC
Goff
Corinne
C
Cather
Scott L
SL
Rauch
Abigail
A
Judge
Gina R
GR
Kuperberg
D000328:Adult; D000704:Analysis of Variance; D003702:Delusions / Q000523:psychology*; D004192:Discrimination, Psychological / Q000502:physiology; D004644:Emotions / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D010775:Photic Stimulation / Q000379:methods; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011930:Reaction Time / Q000502:physiology; D012559:Schizophrenia / Q000150:complications* / Q000503:physiopathology*; D012565:Schizophrenic Psychology