Abstract
Counterfactual thinking (CFT) is a type of conditional reasoning that enables the generation of mental simulations of alternatives to past factual events. Previous research has found this cognitive feature to be disrupted in schizophrenia (Hooker et al., 2000; Contreras et al., 2016). At the same time, the study of cognitive deficits in unaffected relatives of people with schizophrenia has significantly increased, supporting its potential endophenotypic role in this disorder. Using an exploratory approach, the current study examined CFT for the first time in a sample of non-psychotic first-degree relatives of schizophrenia patients (N = 43), in comparison with schizophrenia patients (N = 54) and healthy controls (N = 44). A series of tests that assessed the “causal order effect” in CFT and the ability to generate counterfactual thoughts and counterfactually derive inferences using the Counterfactual Inference Test was completed. Associations with variables of basic and social cognition, levels of schizotypy and psychotic-like experiences in addition to clinical and socio-demographic characteristics were also explored. Findings showed that first-degree relatives generated a lower number of counterfactual thoughts than controls, and were more adept at counterfactually deriving inferences, specifically in the scenarios related to regret and to judgments of avoidance in an unusual situation. No other significant results were found. These preliminary findings suggest that non-psychotic first-degree relatives of schizophrenia patients show a subtle disruption of global counterfactual thinking compared with what is normally expected in the general population. Due to the potential impact of such deficits, new treatments targeting CFT improvement might be considered in future management strategies.
Highlights
Counterfactual Thinking (CFT) is a specific type of conditional reasoning related to mental simulations of past events generally triggered to a great extent by negative outcomes
Concerning CFT’s neuroanatomical correlates, fMRI studies suggest that prefrontal cortex (PFC) regions are the primary regions activated in people engaged in counterfactual reasoning tasks, other regions have been found to be related such as the temporal lobes, the left temporal gyrus, and the left cerebellum (Barbey et al, 2009; Van Hoeck et al, 2012)
CFT seems to be related to specific cognitive biases such as the hindsight bias—enhancing memory distortions that contribute to suboptimal decision-making (Roese and Olson, 1996) and to Theory of Mind (ToM) deficits involved in the development of false belief (Byrne, 2016)
Summary
Counterfactual Thinking (CFT) is a specific type of conditional reasoning related to mental simulations of past events generally triggered to a great extent by negative outcomes. 1), CFT refers to the “remarkable ability to infer how an event might have unfolded differently, without directly experiencing this alternative reality.”. In this way, most people compare the actual result of the event with “what might have been” by generating different hypothetical outcomes “if only” an alternative event had taken place (Byrne, 2016). Concerning CFT’s neuroanatomical correlates, fMRI studies suggest that prefrontal cortex (PFC) regions are the primary regions activated in people engaged in counterfactual reasoning tasks, other regions have been found to be related such as the temporal lobes, the left temporal gyrus, and the left cerebellum (Barbey et al, 2009; Van Hoeck et al, 2012). CFT seems to be related to specific cognitive biases such as the hindsight bias—enhancing memory distortions that contribute to suboptimal decision-making (Roese and Olson, 1996) and to Theory of Mind (ToM) deficits involved in the development of false belief (Byrne, 2016)
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