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Deficits in emotion based decision-making in schizophrenia; a new insight based on the Iowa Gambling Task.

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Deficits in emotion based decision-making in schizophrenia; a new insight based on the Iowa Gambling Task.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Matsuzawa, Daisuke Shirayama, Yukihiko Niitsu, Tomihisa Hashimoto, Kenji Iyo, Masaomi
Description	Country affiliation: Japan Author Affiliation: Matsuzawa D ( Department of Cognitive Behavioral Physiology, Chiba University Graduate School of Medicine, Chiba, Japan); Shirayama Y ( Department of Psychiatry, Teikyo University Chiba Medical Center, Ichihara, Japan); Niitsu T ( Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan.); Hashimoto K ( Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba, Japan.); Iyo M ( Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan.)
Abstract	BACKGROUND: Defective decision-making is a symptom of impaired cognitive function observed in patients with schizophrenia. Impairment on the Iowa Gambling Task (IGT) has been reported in patients with schizophrenia, but these results are inconsistent among studies. METHODS: We differentiated subjects based on whether they expressed certainty at having deciphered an advantageous strategy in the course of the task. We investigated this impairment using the IGT in patients with schizophrenia and performed analysis different to standard advantageous decks minus disadvantageous decks in all 100 card choices, [C+D]-[A+B](1-100). We examined the effects on behavior after receiving a big penalty. RESULTS: Results were dependent on participants utilizing with or without certainty, the best strategy for positive gain. Schizophrenic patients without certainty failed to show card choice shift, from disadvantageous to advantageous decks. Differences in card choices on the IGT were clearly shown between patients with schizophrenia and normal controls by the use of improvement from block 1 to blocks 3-5, [C+D]-[A+B]([41-100]-[1-20]) (P<0.001), rather than by the composite value of blocks 3-5, [C+D]-[A+B](41-100) (P=0.011). The deficit of emotion-based learning in schizophrenia without uncertainty were related to scores on the SANS and S5 attention. In addition, S1 affective flattering and S4 anhedonia-asociality were also related to these deficits. For a while, normal controls showed a smooth shift from disadvantageous to advantageous decks after big penalties, with or without a certainty for strategy. However, patients with schizophrenia failed to show switching from disadvantageous to advantageous decks, even after big penalties, under the same conditions. CONCLUSIONS: Our results highlight certainty of strategy and behavior after a big penalty, as two points of difference between patients with schizophrenia and normal controls in the accumulation of net scores.
File Format	HTM / HTML
ISSN	02785846
Volume Number	57
e-ISSN	18784216
Journal	Progress in Neuro-Psychopharmacology and Biological Psychiatry
Language	English
Publisher	Elsevier
Publisher Date	2015-03-03
Publisher Place	Great Britain (UK)
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Psychiatry Decision Making Emotions Gambling Psychology Schizophrenic Psychology Adult Case-control Studies Female Humans Male Neuropsychological Tests Psychiatric Status Rating Scales Punishment Schizophrenia Diagnosis Young Adult Journal Article Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Biological Psychiatry Pharmacology

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