ArticleMolecular psychiatry2016
Confidence and psychosis: a neuro-computational account of contingency learning disruption by NMDA blockade.
Article in Molecular psychiatry, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 2 of them syntheses that pooled it.
What it found
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
36 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- A review on exploration-exploitation trade-off in psychiatric disorders.BMC psychiatry · 2025Pooled it
- The psychopathology of NMDAR-antibody encephalitis in adults: a systematic review and phenotypic analysis of individual patient data.The lancet. Psychiatry · 2019Pooled it
- Premature commitment to uncertain decisions during human NMDA receptor hypofunction.Nature communications · 2022Trial
- The Computational, Pharmacological, and Physiological Determinants of Sensory Learning under Uncertainty.Current biology : CB · 2021Trial
- Levodopa does not affect expression of reinforcement learning in older adults.Scientific reports · 2019Trial
- From neuroinflammation to neural inference: computational psychiatry meets precision medicine.Schizophrenia (Heidelberg, Germany) · 2026Review
- Antidepressant drugs have pharmacological- and time-dependent effects on reinforcement learning in healthy volunteers: An 8 weeks randomized double-blind placebo-controlled study.medRxiv : the preprint server for health sciences · 2026Article
- Ketamine disrupts consciousness in healthy participants in relation with psychotic-like symptoms.bioRxiv : the preprint server for biology · 2025Article
- A nonlinear relationship between prediction errors and learning rates in human reinforcement-learning.PLoS computational biology · 2025Article
- Navigating Uncertainty: The Role of Mood and Confidence in Decision-Making Flexibility and Performance.Behavioral sciences (Basel, Switzerland) · 2024Article
- Distinct alterations in probabilistic reversal learning across at-risk mental state, first episode psychosis and persistent schizophrenia.Scientific reports · 2024Article
- Anxiety associated with perceived uncontrollable stress enhances expectations of environmental volatility and impairs reward learning.Scientific reports · 2023Article
- Reinforcement learning with associative or discriminative generalization across states and actions: fMRI at 3 T and 7 T.Human brain mapping · 2022Article
- Motivational signals disrupt metacognitive signals in the human ventromedial prefrontal cortex.Communications biology · 2022Article
- Models of Dynamic Belief Updating in Psychosis-A Review Across Different Computational Approaches.Frontiers in psychiatry · 2022Review
- Article
- A New Look on an Old Issue: Comprehensive Review of Neurotransmitter Studies in Cerebrospinal Fluid of Patients with Schizophrenia and Antipsychotic Effect on Monoamine's Metabolism.Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology · 2021Review
- Robust valence-induced biases on motor response and confidence in human reinforcement learning.Cognitive, affective & behavioral neuroscience · 2020Article
- [The next psychoactive drugs: From imipramine to ketamine].Bulletin de l'Academie nationale de medecine · 2020Review
- The next psychoactive drugs: From imipramine to ketamine.Bulletin de l'Academie nationale de medecine · 2020Review
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
A state of pathological uncertainty about environmental regularities might represent a key step in the pathway to psychotic illness. Early psychosis can be investigated in healthy volunteers under ketamine, an NMDA receptor antagonist. Here, we explored the effects of ketamine on contingency learning using a placebo-controlled, double-blind, crossover design. During functional magnetic resonance imaging, participants performed an instrumental learning task, in which cue-outcome contingencies were probabilistic and reversed between blocks. Bayesian model comparison indicated that in such an unstable environment, reinforcement learning parameters are downregulated depending on confidence level, an adaptive mechanism that was specifically disrupted by ketamine administration. Drug effects were underpinned by altered neural activity in a fronto-parietal network, which reflected the confidence-based shift to exploitation of learned contingencies. Our findings suggest that an early characteristic of psychosis lies in a persistent doubt that undermines the stabilization of behavioral policy resulting in a failure to exploit regularities in the environment.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.