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Action selection in early stages of psychosis: an active inference approach

Knolle, Franziska; Sterner, Elisabeth; Moutoussis, Michael; Adams, Rick A; Griffin, Juliet D; Haarsma, Joost; Taverne, Hilde; ... NSPN, Consortium; + view all (2023) Action selection in early stages of psychosis: an active inference approach. Journal of Psychiatry & Neuroscience , 48 (1) E78-E89. 10.1503/jpn.220141. Green open access

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Abstract

BACKGROUND: To interact successfully with their environment, humans need to build a model to make sense of noisy and ambiguous inputs. An inaccurate model, as suggested to be the case for people with psychosis, disturbs optimal action selection. Recent computational models, such as active inference, have emphasized the importance of action selection, treating it as a key part of the inferential process. Based on an active inference framework, we sought to evaluate previous knowledge and belief precision in an action-based task, given that alterations in these parameters have been linked to the development of psychotic symptoms. We further sought to determine whether task performance and modelling parameters would be suitable for classification of patients and controls. METHODS: Twenty-three individuals with an at-risk mental state, 26 patients with first-episode psychosis and 31 controls completed a probabilistic task in which action choice (go/no-go) was dissociated from outcome valence (gain or loss). We evaluated group differences in performance and active inference model parameters and performed receiver operating characteristic (ROC) analyses to assess group classification. RESULTS: We found reduced overall performance in patients with psychosis. Active inference modelling revealed that patients showed increased forgetting, reduced confidence in policy selection and less optimal general choice behaviour, with poorer action-state associations. Importantly, ROC analysis showed fair-to-good classification performance for all groups, when combining modelling parameters and performance measures. LIMITATIONS: The sample size is moderate. CONCLUSION: Active inference modelling of this task provides further explanation for dysfunctional mechanisms underlying decision-making in psychosis and may be relevant for future research on the development of biomarkers for early identification of psychosis.

Type: Article
Title: Action selection in early stages of psychosis: an active inference approach
Location: Canada
Open access status: An open access version is available from UCL Discovery
DOI: 10.1503/jpn.220141
Publisher version: https://doi.org/10.1503/jpn.220141
Language: English
Additional information: © 2023 CMA Impact Inc. or its licensors. This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY-NCND 4.0) licence (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Keywords: Humans, Psychotic Disorders, Task Performance and Analysis, Choice Behavior, Models, Psychological
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry > Mental Health Neuroscience
URI: https://discovery.ucl.ac.uk/id/eprint/10165849
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