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Reasoning and problem solving

What is reasoning and problem solving in bipolar disorder?

Reasoning refers to the ability to logically gather information to solve problems and form conclusions. Reasoning bias may affect problem solving skills and is measured in three ways: ‘jumping to conclusions’ (JTC); ‘belief inflexibility’; and an ‘externalising attribution style’.

JTC can be measured with the Bead task that presents participants with two jars containing different ratios of coloured beads (eg. 80 red: 20 blue). Beads are drawn from one of the jars, and based on the string of coloured beads drawn, participants must guess which jar they were drawn from. Within the JTC task, “draws to decision” refers to the number of beads required to decide which jar they were drawn from. Extreme JTC responding refers to when a decision is made after little information is gathered. The “draws to certainty” condition is when participants are asked about their certainty regarding which jar beads are being drawn from. “Response to disconfirmatory evidence” refers to the change in certainty after a single bead contradicts their response. “Response to reversal” is when a participant makes a decision based on the initial evidence, then reverses their decision based on later evidence.

Belief inflexibility is an inability to change a belief when presented with contradictory evidence, and can be measured by the Bias Against Disconfirmatory Evidence (BADE) task.

Attribution bias refers to when available evidence is incorrectly used to attribute an event to internal or external causes and is measured by the Pragmatic Inference Task or Attribution questionnaire where participants are asked to explain events. Reasoning and problem solving may also be measured using Mazes or the Matrix Reasoning where participants select the missing design in a patterned sequence.

What is the evidence regarding reasoning ability in people with bipolar disorder?

High quality evidence shows a small effect of poor reasoning and problem solving ability in people with bipolar disorder, including those with first-episode bipolar disorder, compared to people without bipolar disorder (controls). There were no significant differences in reasoning ability when comparing people with first-episode bipolar disorder to people with first-episode schizophrenia, nor when comparing euthymic youth (aged 13 years) with bipolar disorder to age and IQ-matched controls. This evidence was graded as moderate to high quality. Moderate to high quality evidence also suggests a small association between poor reasoning/problem solving and poor general functioning in people with bipolar disorder.

October 2021

Image: ©Nikolas Hoffmann – stock.adobe.com

Last updated at: 5:18 pm, 20th March 2022
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