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Revisiting the jumping to conclusions bias in functional movement disorders
  1. Raquel Sainz-Amo1,
  2. Jessenia Morillo-González2,
  3. Jorge Gómez-Corral1,
  4. Cristina Moreno1,
  5. Araceli Alonso Cánovas1,
  6. Juan Carlos Martinez Castrillo3,
  7. Mark J Edwards4,
  8. Daniel Hernández-Huerta2,
  9. Isabel Pareés1
  1. 1 Neurology Department, Hospital Universitario Ramon y Cajal, Madrid, Spain
  2. 2 Psychiatry Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
  3. 3 Servicio de Neurología, Hospital Universitario Ramón y Cajal, Madrid, Spain
  4. 4 Department of Basic and Clinical Neuroscience, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
  1. Correspondence to Dr Isabel Pareés; isabel.parees{at}salud.madrid.org

https://doi.org/10.1136/jnnp-2023-333179

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    Functional movement disorders (FMD) are part of the spectrum of functional neurological disorders (FND), which are common and disabling. Nowadays, it is widely accepted that key aspects of the underlying pathophysiology include the tendency to form abnormal beliefs about symptoms, disturbance of attentional control and disruption of mechanisms regulating sense of agency.1

    ‘Jumping to conclusions’ bias (JTC) is a probabilistic reasoning style characterised by making firm decisions based on insufficient evidence. This cognitive bias has been studied to assess erroneous belief formation in delusions by using the classical paradigm of ‘the bead task’.2 In 2012, we explored the JTC bias for the first time in patients with FMD. We found that they required less evidence to reach a decision than healthy controls.3

    Here, we aimed to confirm the presence of the JTC bias in a new and larger cohort of patients with FMD and compare the results with a control group of patients diagnosed with major depressive disorder (MDD). Additionally, we evaluated whether changing uncertainty by manipulating the initial information in the bead task might impact participants’ behaviour.

    We recruited 23 consecutive patients with FMD from the Neurology and 26 patients with MDD from the Psychiatry Department of the Ramón y Cajal Hospital, Madrid, Spain. Participants ≥18 years with a clinically established/documented FMD were included. A Mini-mental State Examination (MMSE) score ≤26 was an exclusion criterion.

    The reasoning task was like previous designs.2 3 In the ‘draws to decision’ methodology, participants were presented with 2 jars each containing 100 beads. In condition 1, jar A contained 85 red and 15 blue beads and jar B contained 85 blue and 15 red beads. …

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    Footnotes

    • Contributors All coauthors have read and approved the submitted manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests RS-A reports no dislosures. JM-G reports personal fees and non-financial support from Otsuka and Angelini over the past year. JG-C reports no disclosures. CM reports no disclosures. AAC has received travel grants from Abbvie, Italfarmaco and Zambon, consultancies from Ipsen and speaker honoraria from Ipsen and Zambon. JCMC has received research support from Lundbeck, Italfarmaco, Allergan, Zambon, Merz and Abbvie. He has received speaking honoraria from AbbVie, Bial, Italfarmaco, Lundbeck, Krka, TEVA, UCB, Zambon, Allergan, Ipsen and Merz. MJE does medical expert reporting in personal injury and clinical negligence cases, including in cases of functional neurological disorder (FND). MJE has shares in Brain & Mind, which provides neuropsychiatric and neurological rehabilitation in the independent medical sector, including in people with functional neurological disorder. MJE has received financial support for lectures from the International Parkinson’s and Movement Disorders Society and the FND Society (FNDS). MJE receives royalties from Oxford University Press for his book The Oxford Specialist Handbook of Parkinson’s Disease and Other Movement Disorder. MJE has received honoraria for medical advice to Teva Pharmaceuticals. MJE receives grant funding, including for studies related to FND, from the National Institute for Health and Care Research (NIHR) and the Medical Research Council (MRC). MJE is an associate editor of the European Journal of Neurology. MJE is a member of the international executive committee of the International Parkinson’s and Movement Disorders Society and a board member of the FNDS. MJE is on the medical advisory boards of the charities FND Hope UK and Dystonia UK. DH-H reports personal fees and non-financial support from Janssen and Otsuka. IP has received honoraria as a speaker in scientific meetings from Zambon, Abbvie, Exeltis Healthcare SL Sociedad Extremeña de Neurología, Sociedad Española de Neurología and travel support for scientific meetings from Esteve.

    • Provenance and peer review Not commissioned; internally peer reviewed.