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Clarke AT, Fineberg NA, Pellegrini L, Laws KR. The relationship between cognitive phenotypes of compulsivity and impulsivity and clinical variables in obsessive-compulsive disorder: A systematic review and Meta-analysis. Compr Psychiatry 2024; 133:152491. [PMID: 38714143 DOI: 10.1016/j.comppsych.2024.152491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 01/23/2024] [Accepted: 03/04/2024] [Indexed: 05/09/2024] Open
Abstract
BACKGROUND This systematic review and meta-analysis explored the relationship between cognitive phenotypes of compulsivity and impulsivity and clinical variables in obsessive-compulsive disorder (OCD). METHODS We searched Pubmed, Scopus, Cochrane Library and PsychINFO databases until February 2023 for studies comparing patients with OCD and healthy controls on cognitive tests of compulsivity and impulsivity. The study followed PRISMA guidelines and was pre-registered on PROSPERO (CRD42021299017). RESULTS Meta-analyses of 112 studies involving 8313 participants (4289 patients with OCD and 4024 healthy controls) identified significant impairments in compulsivity (g = -0.58, [95%CI -0.68, -0.47]; k = 76) and impulsivity (g = -0.48, [95%CI -0.57, -0.38]; k = 63); no significant difference between impairments. Medication use and comorbid psychiatric disorders were not significantly related to impairments. No associations were revealed with OCD severity, depression/anxiety, or illness duration. CONCLUSION Cognitive phenotypes of compulsivity and impulsivity in patients with OCD appear to be orthogonal to clinical variables, including severity of OCD symptomatology. Their clinical impact is poorly understood and may require different clinical assessment tools and interventions.
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Affiliation(s)
- Aaron T Clarke
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.
| | - Naomi A Fineberg
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK; Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, UK; University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Luca Pellegrini
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK; Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, UK; Centre for Psychedelic Research, Imperial College London, London, UK
| | - Keith R Laws
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
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Rajkumar RP. SAPAP3, SPRED2, and obsessive-compulsive disorder: the search for fundamental phenotypes. Front Mol Neurosci 2023; 16:1095455. [PMID: 37324590 PMCID: PMC10264593 DOI: 10.3389/fnmol.2023.1095455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 05/15/2023] [Indexed: 06/17/2023] Open
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Martín-González E, Olmedo-Córdoba M, Prados-Pardo Á, Cruz-Garzón DJ, Flores P, Mora S, Moreno-Montoya M. Behavioral domains in compulsive rats: implications for understanding compulsive spectrum disorders. Front Behav Neurosci 2023; 17:1175137. [PMID: 37273281 PMCID: PMC10234153 DOI: 10.3389/fnbeh.2023.1175137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 04/21/2023] [Indexed: 06/06/2023] Open
Abstract
Introduction Compulsive behavior has been proposed as a transdiagnostic trait observed in different neuropsychiatric disorders, such as obsessive-compulsive disorder, autism, and schizophrenia. Research Domain Criteria (RDoC) strategy could help to disentangle the neuropsychological basis of compulsivity for developing new therapeutic and preventive approaches. In preclinical research, the selection of high-drinker (HD) vs. low-drinker (LD) animals by schedule-induced polydipsia (SIP) is considered a putative model of compulsivity, which includes a well-differentiated behavioral pattern. Methods The purpose of this research was to assess the cognitive control and the negative valence system domains in a phenotype of compulsive HD rats. After the selection of animals as HD or LD, we assessed behavioral inflexibility by probabilistic spatial reversal learning (PSRL), motor and cognitive impulsivity by variable delay-to-signal (VDS), and risky decision-making by rodent gambling task (rGT). Results HD rats performed fewer reversals and showed less probability of pressing the same lever that was previously reinforced on PSRL, more premature responses after the exposure to longer delays on VDS, and more disadvantageous risky choices on rGT. Moreover, HD animals performed more perseverative responses under the punishment period on rGT. Discussion These results highlight that HD compulsive phenotype exhibits behavioral inflexibility, insensitivity to positive feedback, waiting impulsivity, risky decision-making, and frustrative non-reward responsiveness. Moreover, these findings demonstrate the importance of mapping different behavioral domains to prevent, treat, and diagnose compulsive spectrum disorders correctly.
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Affiliation(s)
- Elena Martín-González
- Department of Psychology and Health Research Centre (CEINSA), University of Almería, Almería, Spain
| | - Manuela Olmedo-Córdoba
- Department of Psychology and Health Research Centre (CEINSA), University of Almería, Almería, Spain
| | - Ángeles Prados-Pardo
- Department of Psychology and Health Research Centre (CEINSA), University of Almería, Almería, Spain
| | - Daniel J. Cruz-Garzón
- Department of Psychology and Health Research Centre (CEINSA), University of Almería, Almería, Spain
| | - Pilar Flores
- Department of Psychology and Health Research Centre (CEINSA), University of Almería, Almería, Spain
| | - Santiago Mora
- Department of Neuroscience and Panum Institute, University of Copenhagen, Copenhagen, Denmark
| | - Margarita Moreno-Montoya
- Department of Psychology and Health Research Centre (CEINSA), University of Almería, Almería, Spain
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Buelow MT, Barnhart WR, Crook T, Suhr JA. Are correlations among behavioral decision making tasks moderated by simulated cognitive impairment? APPLIED NEUROPSYCHOLOGY. ADULT 2022:1-16. [PMID: 35737425 DOI: 10.1080/23279095.2022.2088289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Behavioral decision making tasks are common in research settings, with only the Iowa Gambling Task available for clinical assessments. However, correlations among these tasks are low, indicating each may assess a distinct component of decision making. In addition, it is unclear whether these tasks are sensitive to invalid performance or even simulated impairment. The present study examined relationships among decision making tasks and whether simulated impairment moderates the relationships among them. Across two studies (Study 1: n = 166, Study 2: n = 130), undergraduate student participants were asked to try their best or to simulate a specific diagnosis (Attention-Deficit/Hyperactivity Disorder; Study 1), decision making impairment (Study 2), or general cognitive impairment (Study 2). They then completed a battery of tests including embedded and standalone performance validity tests (PVTs) and three behavioral decision making tasks. Across studies, participants simulating impairment were not distinguishable from controls on any of the behavioral tasks. Few significant correlations emerged among tasks across studies and the pattern of relationships between tasks did not differ on the basis of simulator or PVT failure status. Collectively, our findings suggest that these tasks may not be vulnerable to simulated cognitive impairment, and that the tasks measure largely non-overlapping aspects of decision making.
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Affiliation(s)
- Melissa T Buelow
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - Wesley R Barnhart
- Department of Psychology, Bowling Green State University, Bowling Green, OH, USA
| | - Thomas Crook
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - Julie A Suhr
- Department of Psychology, Ohio University, Athens, OH, USA
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Nisticò V, De Angelis A, Erro R, Demartini B, Ricciardi L. Obsessive-Compulsive Disorder and Decision Making under Ambiguity: A Systematic Review with Meta-Analysis. Brain Sci 2021; 11:brainsci11020143. [PMID: 33499211 PMCID: PMC7912249 DOI: 10.3390/brainsci11020143] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/18/2021] [Accepted: 01/20/2021] [Indexed: 12/11/2022] Open
Abstract
In the last decade, decision-making has been proposed to have a central role in obsessive-compulsive disorder (OCD) aetiology, since patients show pathological doubt and an apparent inability to make decisions. Here, we aimed to comprehensively review decision making under ambiguity, as measured by the Iowa Gambling Task (IGT), in OCD, using a meta-analytic approach. According to PRISMA Guidelines, we selected 26 studies for a systematic review and, amongst them, 16 studies were included in a meta-analysis, comprising a total of 846 OCD patients and 763 healthy controls (HC). Our results show that OCD patients perform significantly lower than HC at the IGT, pointing towards the direction of a decision making impairment. In particular, this deficit seems to emerge mainly in the last three blocks of the IGT. IGT scores in OCD patients under the age of 18 were still significantly lower than in HC. Finally, no difference emerged between medicated and unmedicated patients, since they both scored significantly lower at the IGT compared to HC. In conclusion, our results are in line with the hypothesis according to which decision making impairment might represent a potential endophenotype lying between the clinical manifestation of OCD and its neurobiological aetiology.
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Affiliation(s)
- Veronica Nisticò
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, 20142 Milano, Italy; (V.N.); (B.D.)
- Aldo Ravelli Research Center for Neurotechnology and Experimental Brain Therapeutics, Università degli Studi di Milano, 20142 Milano, Italy
| | - Andrea De Angelis
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George’s University of London, London SW17 0RE, UK;
- Department of Neuropsychiatry, St George’s Hospital, South West London and St George’s Mental Health NHS Trust, London SW17 0RE, UK
| | - Roberto Erro
- Dipartimento di Medicina, Chirurgia e Odontoiatria “Scuola Medica Salernitana”, Università di Salerno, 84018 Baronissi, Salerno, Italy;
| | - Benedetta Demartini
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, 20142 Milano, Italy; (V.N.); (B.D.)
- Aldo Ravelli Research Center for Neurotechnology and Experimental Brain Therapeutics, Università degli Studi di Milano, 20142 Milano, Italy
- Unità di Psichiatria II, Presidio San Paolo, ASST Santi Paolo e Carlo, 20142 Milano, Italy
| | - Lucia Ricciardi
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George’s University of London, London SW17 0RE, UK;
- Correspondence:
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Luo Y, Chen L, Li H, Dong Y, Zhou X, Qiu L, Zhang L, Gao Y, Zhu C, Yu F, Wang K. Do Individuals With Obsessive-Compulsive Disorder and Obsessive-Compulsive Personality Disorder Share Similar Neural Mechanisms of Decision-Making Under Ambiguous Circumstances? Front Hum Neurosci 2020; 14:585086. [PMID: 33192420 PMCID: PMC7643011 DOI: 10.3389/fnhum.2020.585086] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 09/22/2020] [Indexed: 01/22/2023] Open
Abstract
Impaired decision-making is well documented in obsessive-compulsive disorder (OCD) and a range of electrophysiological and functional neuroimaging measures have begun to reveal the pathological mechanisms that underlie the decision-making process. Obsessive-compulsive personality disorder (OCPD) has core symptoms that often overlap with OCD, but similarities between these disorders at the behavioral and neurological levels are often unclear, including whether OCPD exhibits similar decision-making deficits and shared neurological dysfunction. To address these issues, we examined 24 cases of OCD, 19 cases of OCPD, and 26 matched normal control (NC) subjects during the revised Iowa Gambling Task (IGT) using event-related potentials (ERPs). The net IGT scores were lower for OCD subjects than for OCPD or NC subjects, thus indicating that OCD subjects chose more disadvantageous options and were "short-sighted" with regards to information. The feedback-related negativity (FRN) waveform (lose-win) was larger in both OCD and OCPD subjects, which suggested that obstacles exist in the feedback process. Consequently, these subjects might share similar neural mechanisms under ambiguous decision-making circumstances. Furthermore, IGT net scores were significantly and negatively correlated with Hamilton Anxiety Rating Scale (HAMA) and Hamilton Depression Rating Scale (HAMD) scales. This implies that more severe obsessive-compulsive symptoms inspired more negative emotions that led to worse decision-making ability. Therefore, although similar neural mechanisms might exist, this led to different behaviors in which OCPD is associated with better behavioral performance compared to OCD patients.
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Affiliation(s)
- Yudan Luo
- Department of Medical Psychology, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.,School of Mental Health and Psychological Sciences, Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, China.,School of Mental Health and Psychological Sciences, Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Lu Chen
- Department of Medical Psychology, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.,School of Mental Health and Psychological Sciences, Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, China.,School of Mental Health and Psychological Sciences, Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Hongchen Li
- School of Civil Engineering, Wangjiang University of Technology, Ma'anshan, China
| | - Yi Dong
- School of Mental Health and Psychological Sciences, Anhui Mental Health Center, Hefei, China
| | - Xiaoqin Zhou
- The Chaohu Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Linlin Qiu
- Department of Medical Psychology, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Lei Zhang
- Department of Medical Psychology, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.,School of Mental Health and Psychological Sciences, Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, China.,School of Mental Health and Psychological Sciences, Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Yaxiang Gao
- Department of Medical Psychology, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Chunyan Zhu
- Department of Medical Psychology, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.,School of Mental Health and Psychological Sciences, Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, China.,School of Mental Health and Psychological Sciences, Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Fengqiong Yu
- Department of Medical Psychology, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.,School of Mental Health and Psychological Sciences, Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, China.,School of Mental Health and Psychological Sciences, Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Kai Wang
- Department of Medical Psychology, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.,School of Mental Health and Psychological Sciences, Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, China.,School of Mental Health and Psychological Sciences, Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.,Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
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Addicted to compulsion: assessing three core dimensions of addiction across obsessive-compulsive disorder and gambling disorder. CNS Spectr 2020; 25:392-401. [PMID: 31106718 PMCID: PMC6864250 DOI: 10.1017/s1092852919000993] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Several studies suggested that obsessive-compulsive disorder (OCD) patients display increased impulsivity, impaired decision-making, and reward system dysfunction. In a Research Domain Criteria (RDoC) perspective, these findings are prototypical for addiction and have led some authors to view OCD as a behavioral addiction. Thus, the aim of this study was to investigate similarities and differences on impulsivity, decision-making, and reward system, as core dimensions of addiction, across OCD and gambling disorder (GD) patients. METHODS Forty-four OCD patients, 26 GD patients, and 40 healthy controls (HCs) were included in the study. Impulsivity was assessed through the Barratt Impulsiveness Scale, decision-making through the Iowa Gambling Task, and reward system through a self-report clinical instrument (the Shaps-Hamilton Anhedonia Scale) assessing hedonic tone and through an olfactory test assessing hedonic appraisal to odors. RESULTS Both OCD and GD patients showed increased impulsivity when compared to HCs. More specifically, the OCD patients showed cognitive impulsivity, and the GD patients showed both increased cognitive and motor impulsivity. Furthermore, both OCD and GD patients showed impaired decision-making performances when compared to HCs. Finally, GD patients showed increased anhedonia and blunted hedonic response to pleasant odors unrelated to gambling or depression/anxiety symptoms, while OCD patients showed only increased anhedonia levels related to OC and depression/anxiety symptoms. CONCLUSION OCD patients showed several similarities and some differences with GD patients when compared to HCs on impulsivity, decision-making, and reward system, three core dimensions of addiction. These results could have relevant implications for the research of new treatment targets for OCD.
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Frydman I, Mattos P, de Oliveira-Souza R, Yücel M, Chamberlain SR, Moll J, Fontenelle LF. Self-reported and neurocognitive impulsivity in obsessive-compulsive disorder. Compr Psychiatry 2020; 97:152155. [PMID: 31864219 PMCID: PMC7102901 DOI: 10.1016/j.comppsych.2019.152155] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 11/22/2019] [Accepted: 12/07/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Although a behavioural addiction model of obsessive-compulsive disorder (OCD) has been proposed, it is still unclear if and how self-report and neurocognitive measures of impulsivity (such as risk-taking-, reflection- and motor-impulsivities) are impaired and/or inter-related in this particular clinical population. METHODS Seventeen OCD patients and 17 age-, gender-, education- and IQ-matched controls completed the Barratt Impulsivity Scale, the Obsessive-Compulsive Inventory-Revised, and the Beck Depression Inventory and were evaluated with the Yale-Brown Obsessive-Compulsive Scale and three computerized paradigms including reward (the Cambridge Gambling Task), reflection (the Information Sampling Task) and motor impulsivity (Stop Signal Task). RESULTS Despite not differing from healthy controls in any neurocognitive impulsivity domain, OCD patients demonstrated increased impulsivity in a self-report measure (particularly attentional impulsivity). Further, attentional impulsivity was predicted by severity of obsessive-compulsive symptoms. CONCLUSIONS Our findings suggest that OCD is characterized by a subjective (rather than objective) impulsivity; in addition, self-reported impulsivity was largely determined by severity of OCD symptoms.
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Affiliation(s)
- Ilana Frydman
- Obsessive, Compulsive, and Anxiety Spectrum Research Program. Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil,D’Or Institute for Research and Education, Rio de Janeiro, Brazil
| | - Paulo Mattos
- D’Or Institute for Research and Education, Rio de Janeiro, Brazil
| | | | - Murat Yücel
- Brain & Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Victoria, Australia
| | - Samuel R. Chamberlain
- Department of Psychiatry, University of Cambridge, Cambridge and Peterborough NHS Foundation Trust (CPFT), UK
| | - Jorge Moll
- D’Or Institute for Research and Education, Rio de Janeiro, Brazil
| | - Leonardo F. Fontenelle
- Obsessive, Compulsive, and Anxiety Spectrum Research Program. Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil,D’Or Institute for Research and Education, Rio de Janeiro, Brazil,Correspondence and reprints: Leonardo F. Fontenelle, M.D., Ph.D., Rua Visconde de Pirajá, 547, 617, Ipanema, Rio de Janeiro-RJ, Brazil, CEP: 22410-003, Fax and tel.+ 55-21-2239-4919,
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Merchán-Clavellino A, Salguero-Alcañiz MP, Barbosa F, Alameda-Bailén JR. Decision Making Profile of Positive and Negative Anticipatory Skin Conductance Responders in an Unlimited-Time Version of the IGT. Front Psychol 2019; 10:2237. [PMID: 31681074 PMCID: PMC6803756 DOI: 10.3389/fpsyg.2019.02237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 09/17/2019] [Indexed: 12/04/2022] Open
Abstract
Based on the somatic marker hypothesis (Damasio, 1994), many studies have examined whether or not physiological responses are “somatic markers” that implicitly guide the decision making process. Vegetative or motor reactions that are produced by negative or positive stimuli generate a series of somatic markers. So, when a similar stimuli is encountered in the future, these somatic marks will facilitate favorable decisions and inhibit the disadvantageous ones (Martínez-Selva et al., 2006). The most widely studied physiological responses, as indicators of these markers, are heart rate and the skin conductance response (Damasio, 1994; Bechara et al., 1996). The Iowa Gambling Task (IGT) has been the most widely used tool in this research. The common IGT protocol for psychophysiological studies comprises limited inter-trial intervals, and does not distinguish participants as a function of relevant physiological traits, such as the anticipatory skin conductance response (aSCR). The objectives of this work were to determine whether “somatic markers” guide the decision making process without time restrictions and to examine the effects of opposite aSCR profiles on this process. Participants were 29 healthy subjects, divided into two groups according to positive (+) and negative (−) aSCR. Two different data analysis strategies were applied: firstly, gambling indices were computed and, secondly, we examined the parameters of the probabilistic Prospect Valence Learning (PVL) model in three versions: maximum likelihood estimation (MLE), PVL-Delta and PVL-Decay simulations with Hierarchical Bayesian analysis (HBA) for parameter estimation. The results show a significant group effect in gambling indices, with the aSCR+ group presenting lower risk in the decision making process than the aSCR− group. Significant differences were also observed in the Utility parameter of MLE-PVL, with the aSCR− group have low sensitivity to feedback outcomes, than aSRC+ group. However, data from the PVL simulations do not show significant group differences and, in both cases, the utility value denotes low sensitivity to feedback outcomes.
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Affiliation(s)
- Ana Merchán-Clavellino
- Social Psychology Area, Faculty of Education Sciences, University of Cádiz, Cádiz, Spain
| | | | - Fernando Barbosa
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Jose R Alameda-Bailén
- Basic Psychology Area, Faculty of Education Sciences, University of Huelva, Huelva, Spain
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Cillo A, Bonetti M, Burro G, Di Serio C, De Filippis R, Martoni RM. Neurocognitive assessment in obsessive compulsive disorder patients: Adherence to behavioral decision models. PLoS One 2019; 14:e0211856. [PMID: 30768599 PMCID: PMC6377126 DOI: 10.1371/journal.pone.0211856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Accepted: 01/23/2019] [Indexed: 01/07/2023] Open
Abstract
In economics, models of decision-making under risk are widely investigated. Since many empirical studies have shown patterns in choice behavior that classical models fail to predict, several descriptive theories have been developed. Due to an evident phenotypic heterogeneity, obsessive compulsive disorder (OCD) patients have shown a general deficit in decision making when compared to healthy control subjects (HCs). However, the direction for impairment in decision-making in OCD patients is still unclear. Hence, bridging decision-making models widely used in the economic literature with mental health research may improve the understanding of preference relations in severe patients, and may enhance intervention designs. We investigate the behavior of OCD patients with respect to HCs by means of decision making economic models within a typical neuropsychological setting, such as the Cambridge Gambling Task. In this task subjects have to decide the amount of their initial wealth to invest in each risky decision. To account for heterogenous preferences, we have analyzed the micro-level data for a more informative analysis of the choices made by the subjects. We consider two influential models in economics: the expected value (EV), which assumes risk neutrality, and a multiple reference points model, an alternative formulation of Disappointment theory. We find evidence that (medicated) OCD patients are more consistent with EV than HCs. The former appear to be more risk neutral, namely, less sensitive to risk than HCs. They also seem to base their decisions on disappointment avoidance less than HCs.
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Affiliation(s)
- Alessandra Cillo
- Department of Decision Sciences and IGIER, Bocconi University, Milan, Italy
| | - Marco Bonetti
- Department of Social and Political Sciences and Dondena Research Center, Bocconi University, Milan, Italy
- * E-mail:
| | - Giovanni Burro
- Department of Statistics, University of Warwick, Coventry, United Kingdom
| | - Clelia Di Serio
- University Centre of Statistics in the Biomedical Sciences, Vita-Salute San Raffaele University, Milan, Italy
| | - Roberta De Filippis
- Department of Clinical Neurosciences, IRCCS San Raffaele Turro, Milan, Italy
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Impulsivity and decision-making in obsessive-compulsive disorder after effective deep brain stimulation or treatment as usual. CNS Spectr 2018; 23:333-339. [PMID: 29860948 DOI: 10.1017/s1092852918000846] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Impulsivity and impaired decision-making have been proposed as obsessive-compulsive disorder (OCD) endophenotypes, running in OCD and their healthy relatives independently of symptom severity and medication status. Deep brain stimulation (DBS) targeting the ventral limb of the internal capsule (vALIC) and the nucleus accumbens (Nacc) is an effective treatment strategy for treatment-refractory OCD. The effectiveness of vALIC-DBS for OCD has been linked to its effects on a frontostriatal network that is also implicated in reward, impulse control, and decision-making. While vALIC-DBS has been shown to restore reward dysfunction in OCD patients, little is known about the effects of vALIC-DBS on impulsivity and decision-making. The aim of the study was to compare cognitive impulsivity and decision-making between OCD patients undergoing effective vALIC-DBS or treatment as usual (TAU), and healthy controls. METHODS We used decision-making performances under ambiguity on the Iowa Gambling Task and reflection impulsivity on the Beads Task to compare 20 OCD patients effectively treated with vALIC-DBS, 40 matched OCD patients undergoing effective TAU (medication and/or cognitive behavioural therapy), and 40 healthy subjects. Effective treatment was defined as at least 35% improvement of OCD symptoms. RESULTS OCD patients, irrespective of treatment modality (DBS or TAU), showed increased reflection impulsivity and impaired decision-making compared to healthy controls. No differences were observed between OCD patients treated with DBS or TAU. CONCLUSION OCD patients effectively treated with vALIC-DBS or TAU display increased reflection impulsivity and impaired decision-making independent of the type of treatment.
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12
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Abstract
OBJECTIVE We aimed to determine whether individuals with obsessive-compulsive disorder (OCD) and demographically matched healthy individuals can be clustered into distinct clinical subtypes based on dimensional measures of their self-reported compulsivity (OBQ-44 and IUS-12) and impulsivity (UPPS-P). METHODS Participants (n=217) were 103 patients with a clinical diagnosis of OCD; 79 individuals from the community who were "OCD-likely" according to self-report (Obsessive-Compulsive Inventory-Revised scores equal or greater than 21); and 35 healthy controls. All data were collected between 2013 and 2015 using self-report measures that assessed different aspects of compulsivity and impulsivity. Principal component analysis revealed two components broadly representing an individual's level of compulsivity and impulsivity. Unsupervised clustering grouped participants into four subgroups, each representing one part of an orthogonal compulsive-impulsive phenotype. RESULTS Clustering converged to yield four subgroups: one group low on both compulsivity and impulsivity, comprised mostly of healthy controls and demonstrating the lowest OCD symptom severity; two groups showing roughly equal clinical severity, but with opposing drivers (i.e., high compulsivity and low impulsivity, and vice versa); and a final group high on both compulsivity and impulsivity and recording the highest clinical severity. Notably, the largest cluster of individuals with OCD was characterized by high impulsivity and low compulsivity. Our results suggest that both impulsivity and compulsivity mediate obsessive-compulsive symptomatology. CONCLUSIONS Individuals with OCD can be clustered into distinct subtypes based on measures of compulsivity and impulsivity, with the latter being found to be one of the more defining characteristics of the disorder. These dimensions may serve as viable and novel treatment targets.
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Biernacki K, Terrett G, McLennan SN, Labuschagne I, Morton P, Rendell PG. Decision-making, somatic markers and emotion processing in opiate users. Psychopharmacology (Berl) 2018; 235:223-232. [PMID: 29063138 DOI: 10.1007/s00213-017-4760-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 10/11/2017] [Indexed: 02/06/2023]
Abstract
RATIONALE Opiate use is associated with deficits in decision-making. A possible explanation for these deficits is provided by the somatic marker hypothesis, which suggests that substance users may experience abnormal emotional responses during decision-making involving reward and punishment. This in turn may interfere with the brief physiological arousal, i.e. somatic markers that normally occur in anticipation of risky decisions. To date, the applicability of the somatic marker hypothesis to explain decision-making deficits has not been investigated in opiate users. OBJECTIVES This study assessed whether decision-making deficits in opiate users were related to abnormal emotional responses and reduced somatic markers. METHODS Opiate users enrolled in an opiate substitute treatment program (n = 28) and healthy controls (n = 32) completed the Iowa Gambling Task (IGT) while their skin conductance responses (SCRs) were recorded. Participants' emotional responses to emotion-eliciting videos were also recorded using SCRs and subjective ratings. RESULTS Opiate users displayed poorer decision-making on the IGT than did controls. However, there were no differences between the groups in SCRs; both groups displayed stronger SCRs following punishment than following reward, and both groups displayed stronger anticipatory SCRs prior to disadvantageous decisions than advantageous decisions. There were no group differences in objective or subjective measures of emotional responses to the videos. CONCLUSIONS The results suggest that deficits in emotional responsiveness are not apparent in opiate users who are receiving pharmacological treatment. Thus, the somatic marker hypothesis does not provide a good explanation for the decision-making deficits in this group.
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Affiliation(s)
- Kathryn Biernacki
- Cognition and Emotion Research Centre, School of Psychology, Australian Catholic University, Melbourne, Australia.
| | - Gill Terrett
- Cognition and Emotion Research Centre, School of Psychology, Australian Catholic University, Melbourne, Australia
| | - Skye N McLennan
- Cognition and Emotion Research Centre, School of Psychology, Australian Catholic University, Melbourne, Australia
| | - Izelle Labuschagne
- Cognition and Emotion Research Centre, School of Psychology, Australian Catholic University, Melbourne, Australia
| | - Phoebe Morton
- Cognition and Emotion Research Centre, School of Psychology, Australian Catholic University, Melbourne, Australia
| | - Peter G Rendell
- Cognition and Emotion Research Centre, School of Psychology, Australian Catholic University, Melbourne, Australia
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14
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Zhang L, Wang X, Zhu Y, Li H, Zhu C, Yu F, Wang K. Selective impairment of decision making under ambiguity in alexithymia. BMC Psychiatry 2017; 17:378. [PMID: 29179707 PMCID: PMC5704455 DOI: 10.1186/s12888-017-1537-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 11/10/2017] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Alexithymia is characterised by difficulties identifying and describing emotions. Few studies have investigated how alexithymia influences decision-making under different conditions (ambiguity and risk). This study aimed to examine whether alexithymia contributes to impairment in decision-making. METHOD This study included 42 participants with high scores in the Chinese version of Toronto Alexithymia Scale (alexithymia group), and 44 matched subjects with low scores (control group). Decision-making was measured using the Iowa Gambling Task (IGT) and the Game of Dice Task (GDT). RESULTS The main findings of this study revealed selective deficits in IGT performance for the alexithymia group, while GDT performance was unimpaired when compared with the control group. In IGT, total netscores were lower for the alexithymia group compared to the control group, particularly with regard to block 5. Moreover, the alexithymia individuals selected significantly more adverse cards than the controls, indicating significant decision-making impairments. CONCLUSION Alexithymia selectively influences decision-making under ambiguity.
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Affiliation(s)
- Lei Zhang
- 0000 0000 9490 772Xgrid.186775.aDepartment of Medical Psychology, Chaohu Clinical Medical College, Anhui Medical University, Hefei, China ,Collaborative Innovation Center of Neuropsychiatric Disorder and Mental Health, Hefei, Anhui Province China ,0000 0000 9490 772Xgrid.186775.aAnhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Anhui Medical University, Hefei, China
| | - Xue Wang
- 0000 0000 9490 772Xgrid.186775.aDepartment of Medical Psychology, Chaohu Clinical Medical College, Anhui Medical University, Hefei, China ,Collaborative Innovation Center of Neuropsychiatric Disorder and Mental Health, Hefei, Anhui Province China
| | - Yu Zhu
- 0000 0000 9490 772Xgrid.186775.aDepartment of Medical Psychology, Chaohu Clinical Medical College, Anhui Medical University, Hefei, China ,Collaborative Innovation Center of Neuropsychiatric Disorder and Mental Health, Hefei, Anhui Province China
| | - Hongchen Li
- 0000 0000 9490 772Xgrid.186775.aDepartment of Medical Psychology, Chaohu Clinical Medical College, Anhui Medical University, Hefei, China ,Collaborative Innovation Center of Neuropsychiatric Disorder and Mental Health, Hefei, Anhui Province China
| | - Chunyan Zhu
- 0000 0000 9490 772Xgrid.186775.aDepartment of Medical Psychology, Chaohu Clinical Medical College, Anhui Medical University, Hefei, China ,Collaborative Innovation Center of Neuropsychiatric Disorder and Mental Health, Hefei, Anhui Province China ,0000 0000 9490 772Xgrid.186775.aAnhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Anhui Medical University, Hefei, China
| | - Fengqiong Yu
- 0000 0000 9490 772Xgrid.186775.aDepartment of Medical Psychology, Chaohu Clinical Medical College, Anhui Medical University, Hefei, China ,Collaborative Innovation Center of Neuropsychiatric Disorder and Mental Health, Hefei, Anhui Province China ,0000 0000 9490 772Xgrid.186775.aAnhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Anhui Medical University, Hefei, China
| | - Kai Wang
- Department of Medical Psychology, Chaohu Clinical Medical College, Anhui Medical University, Hefei, China. .,Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, China. .,Collaborative Innovation Center of Neuropsychiatric Disorder and Mental Health, Hefei, Anhui Province, China. .,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Anhui Medical University, Hefei, China.
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15
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Grassi G, Pallanti S, Righi L, Figee M, Mantione M, Denys D, Piccagliani D, Rossi A, Stratta P. Think twice: Impulsivity and decision making in obsessive-compulsive disorder. J Behav Addict 2015; 4:263-72. [PMID: 26690621 PMCID: PMC4712760 DOI: 10.1556/2006.4.2015.039] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND AND AIMS Recent studies have challenged the anxiety-avoidance model of obsessive-compulsive disorder (OCD), linking OCD to impulsivity, risky-decision-making and reward-system dysfunction, which can also be found in addiction and might support the conceptualization of OCD as a behavioral addiction. Here, we conducted an exploratory investigation of the behavioral addiction model of OCD by assessing whether OCD patients are more impulsive, have impaired decision-making, and biased probabilistic reasoning, three core dimensions of addiction, in a sample of OCD patients and healthy controls. METHODS We assessed these dimensions on 38 OCD patients and 39 healthy controls with the Barratt Impulsiveness Scale (BIS-11), the Iowa Gambling Task (IGT) and the Beads Task. RESULTS OCD patients had significantly higher BIS-11 scores than controls, in particular on the cognitive subscales. They performed significantly worse than controls on the IGT preferring immediate reward despite negative future consequences, and did not learn from losses. Finally, OCD patients demonstrated biased probabilistic reasoning as reflected by significantly fewer draws to decision than controls on the Beads Task. CONCLUSIONS OCD patients are more impulsive than controls and demonstrate risky decision-making and biased probabilistic reasoning. These results might suggest that other conceptualizations of OCD, such as the behavioral addiction model, may be more suitable than the anxiety-avoidance one. However, further studies directly comparing OCD and behavioral addiction patients are needed in order to scrutinize this model.
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Affiliation(s)
- Giacomo Grassi
- Department of Neurofarba, University of Florence, Florence, Italy,Corresponding author: Giacomo Grassi, MD; Department of Neurofarba, University of Florence, via delle Gore 2H, 50141 Florence, Italy; Phone: 00390557949707; Fax: 0039055794707; E-mail:
| | - Stefano Pallanti
- Department of Neurofarba, University of Florence, Florence, Italy
| | - Lorenzo Righi
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Martijn Figee
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Mariska Mantione
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Damiaan Denys
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | | | - Alessandro Rossi
- Department of Mental Health, University of L’Aquila, L’Aquila, Italy
| | - Paolo Stratta
- Department of Mental Health, University of L’Aquila, L’Aquila, Italy
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16
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Zhang L, Dong Y, Ji Y, Tao R, Chen X, Ye J, Zhang L, Yu F, Zhu C, Wang K. Trait-related decision making impairment in obsessive-compulsive disorder: evidence from decision making under ambiguity but not decision making under risk. Sci Rep 2015; 5:17312. [PMID: 26601899 PMCID: PMC4658550 DOI: 10.1038/srep17312] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 10/28/2015] [Indexed: 11/09/2022] Open
Abstract
This study aimed to investigate whether deficits in decision making were potential
endophenotype markers for OCD considering different phases of the disease.
Fifty-seven non-medicated OCD patients (nmOCD), 77 medicated OCD patients (mOCD), 48
remitted patients with OCD (rOCD) and 115 healthy controls were assessed with the
Iowa Gambling Task (IGT), which measured decision making under ambiguity, and the
Game of Dice Task (GDT), which measured decision making under risk. While the three
patients groups showed impaired performance on the IGT compared with healthy
controls, all patients showed intact performance on the GDT. Furthermore, the rOCD
patients showed a preference for deck B, indicating that they showed more
sensitivity to the frequency of loss than to the magnitude of loss, whereas the mOCD
patients showed a preference for deck A, indicating that they had more sensitivity
to the magnitude of loss than to the frequency of loss. These data suggested that
OCD patients had trait-related impairments in decision making under ambiguity but
not under risk, and that dissociation of decision making under ambiguity and under
risk is an appropriate potential neurocognitive endophenotype for OCD. The subtle
but meaningful differences in decision making performance between the OCD groups
require further study.
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Affiliation(s)
- Long Zhang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Laboratory of Neuropsychology, Anhui Medical University, Hefei, China
| | - Yi Dong
- Mental Health Center of Anhui Province, Hefei, China
| | - Yifu Ji
- Mental Health Center of Anhui Province, Hefei, China
| | - Rui Tao
- Mental Health Center of Anhui Province, Hefei, China
| | - Xuequan Chen
- Mental Health Center of Anhui Province, Hefei, China
| | - Jianguo Ye
- Psychological Consultation Center of Anhui Medical University, Hefei, China
| | - Lei Zhang
- Laboratory of Neuropsychology, Anhui Medical University, Hefei, China
| | - Fengqiong Yu
- Laboratory of Neuropsychology, Anhui Medical University, Hefei, China
| | - Chunyan Zhu
- Laboratory of Neuropsychology, Anhui Medical University, Hefei, China
| | - Kai Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Laboratory of Neuropsychology, Anhui Medical University, Hefei, China
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17
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Olsen VV, Lugo RG, Sütterlin S. The somatic marker theory in the context of addiction: contributions to understanding development and maintenance. Psychol Res Behav Manag 2015; 8:187-200. [PMID: 26185474 PMCID: PMC4501162 DOI: 10.2147/prbm.s68695] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Recent theoretical accounts of addiction have acknowledged that addiction to substances and behaviors share inherent similarities (eg, insensitivity to future consequences and self-regulatory deficits). This recognition is corroborated by inquiries into the neurobiological correlates of addiction, which has indicated that different manifestations of addictive pathology share common neural mechanisms. This review of the literature will explore the feasibility of the somatic marker hypothesis as a unifying explanatory framework of the decision-making deficits that are believed to be involved in addiction development and maintenance. The somatic marker hypothesis provides a neuroanatomical and cognitive framework of decision making, which posits that decisional processes are biased toward long-term prospects by emotional marker signals engendered by a neuronal architecture comprising both cortical and subcortical circuits. Addicts display markedly impulsive and compulsive behavioral patterns that might be understood as manifestations of decision-making processes that fail to take into account the long-term consequences of actions. Evidence demonstrates that substance dependence, pathological gambling, and Internet addiction are characterized by structural and functional abnormalities in neural regions, as outlined by the somatic marker hypothesis. Furthermore, both substance dependents and behavioral addicts show similar impairments on a measure of decision making that is sensitive to somatic marker functioning. The decision-making deficits that characterize addiction might exist a priori to addiction development; however, they may be worsened by ingestion of substances with neurotoxic properties. It is concluded that the somatic marker model of addiction contributes a plausible account of the underlying neurobiology of decision-making deficits in addictive disorders that is supported by the current neuroimaging and behavioral evidence. Implications for future research are outlined.
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Affiliation(s)
- Vegard V Olsen
- Section of Psychology, Lillehammer University College, Lillehammer, Norway
| | - Ricardo G Lugo
- Section of Psychology, Lillehammer University College, Lillehammer, Norway
| | - Stefan Sütterlin
- Section of Psychology, Lillehammer University College, Lillehammer, Norway ; Department of Psychosomatic Medicine, Division of Surgery and Clinical Neuroscience, Oslo University Hospital - Rikshospitalet, Oslo, Norway
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18
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Martoni RM, Brombin C, Nonis A, Salgari GC, Buongiorno A, Cavallini MC, Galimberti E, Bellodi L. Evaluating effect of symptoms heterogeneity on decision-making ability in obsessive-compulsive disorder. Psychiatry Clin Neurosci 2015; 69:402-10. [PMID: 25522816 DOI: 10.1111/pcn.12264] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 09/25/2014] [Accepted: 12/11/2014] [Indexed: 12/19/2022]
Abstract
AIMS Despite having a univocal definition, obsessive-compulsive disorder (OCD) shows a remarkably phenotypic heterogeneity. The published reports show impaired decision-making in OCD patients, using tasks such as the Iowa Gambling Task (IGT). We wanted to verify the hypothesis of an IGT worse performance in a large sample of OCD patients and healthy control (HC) subjects and to examine the relation between neuropsychological performance in IGT and the OCD symptoms heterogeneity. METHODS Binary data from the Yale-Brown Obsessive Compulsive Scale collected on a large sample of OCD patients were analyzed using a multidimensional item response theory model to explore the underlying structure of data, thus revealing latent factors. Factor scores were categorized into quartiles. Then, for each factor, we identified patients respectively with the highest versus lowest score. We evaluated whether symptom dimensions affect the probability of a correct answer over time generalized, during IGT performance, fitting a generalized linear mixed model. RESULTS We found a general deficit in ambiguous decision-making in OCD compared to HC. Moreover, our findings suggested that OCD symptoms heterogeneity affects decision-making learning abilities during IGT. In fact, while 'Symmetry' and 'Washing' patients showed a learning curve during the task, other subgroups did not. CONCLUSIONS Our study confirmed previous findings suggesting that OCD is characterized by a deficit in decision-making under uncertainty. Moreover, our study gave evidence about biological specificity for each symptom dimension in OCD. Data were discussed in the context of the somatic marker hypothesis, which was hypothesized to be reduced in OCD patients.
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Affiliation(s)
- Riccardo Maria Martoni
- Department of Clinical Neurosciences, San Raffaele Scientific Institute, Milan, Italy.,Decision Theory in Neuroscience, Vita-Salute San Raffaele University, Milan, Italy
| | - Chiara Brombin
- Faculty of Psychology, Vita-Salute San Raffaele University, Milan, Italy.,CUSSB, University Center for Statistics in the Biomedical Sciences, Vita-Salute San Raffaele University, Milan, Italy
| | - Alessandro Nonis
- CUSSB, University Center for Statistics in the Biomedical Sciences, Vita-Salute San Raffaele University, Milan, Italy
| | | | - Angela Buongiorno
- Department of Clinical Neurosciences, San Raffaele Scientific Institute, Milan, Italy
| | | | - Elisa Galimberti
- Department of Clinical Neurosciences, San Raffaele Scientific Institute, Milan, Italy
| | - Laura Bellodi
- Department of Clinical Neurosciences, San Raffaele Scientific Institute, Milan, Italy.,Faculty of Psychology, Vita-Salute San Raffaele University, Milan, Italy
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19
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Zhang L, Wang K, Zhu C, Yu F, Chen X. Trait Anxiety Has Effect on Decision Making under Ambiguity but Not Decision Making under Risk. PLoS One 2015; 10:e0127189. [PMID: 26000629 PMCID: PMC4441420 DOI: 10.1371/journal.pone.0127189] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 04/12/2015] [Indexed: 01/30/2023] Open
Abstract
Previous studies have reported that trait anxiety (TA) affects decision making. However, results remain largely inconsistent across studies. The aim of the current study was to further address the interaction between TA and decision making. 304 subjects without depression from a sample consisting of 642 participants were grouped into high TA (HTA), medium TA (MTA) and low TA (LTA) groups based on their TA scores from State Trait Anxiety Inventory. All subjects were assessed with the Iowa Gambling Task (IGT) that measures decision making under ambiguity and the Game of Dice Task (GDT) that measures decision making under risk. While the HTA and LTA groups performed worse on the IGT compared to the MTA group, performances on the GDT between the three groups did not differ. Furthermore, the LTA and HTA groups showed different individual deck level preferences in the IGT: the former showed a preference for deck B indicating that these subjects focused more on the magnitude of rewards, and the latter showed a preference for deck A indicating significant decision making impairment. Our findings suggest that trait anxiety has effect on decision making under ambiguity but not decision making under risk and different levels of trait anxiety related differently to individual deck level preferences in the IGT.
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Affiliation(s)
- Long Zhang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Laboratory of Neuropsychology, Anhui Medical University, Hefei, China
| | - Kai Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Laboratory of Neuropsychology, Anhui Medical University, Hefei, China
- * E-mail:
| | - Chunyan Zhu
- Laboratory of Neuropsychology, Anhui Medical University, Hefei, China
| | - Fengqiong Yu
- Laboratory of Neuropsychology, Anhui Medical University, Hefei, China
| | - Xingui Chen
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Laboratory of Neuropsychology, Anhui Medical University, Hefei, China
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20
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Kim HW, Kang JI, Namkoong K, Jhung K, Ha RY, Kim SJ. Further evidence of a dissociation between decision-making under ambiguity and decision-making under risk in obsessive-compulsive disorder. J Affect Disord 2015; 176:118-24. [PMID: 25704564 DOI: 10.1016/j.jad.2015.01.060] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 01/29/2015] [Accepted: 01/29/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Deficits in decision-making have been suggested as a key concept in understanding the symptoms of obsessive-compulsive disorder (OCD). However, evidence in the extant literature remains inconclusive on whether patients with OCD show inferior performance on laboratory decision-making tasks. The aims of the present study were therefore to (1) assess decision-making under ambiguity and under risk in patients with OCD and (2) study the influence of neuropsychological and clinical variables on decision-making in OCD. METHODS The sample consisted of 65 patients with OCD and 58 controls. The Iowa gambling task (IGT) and the game of dice task (GDT) were used to examine decision-making under ambiguity and decision-making under risk, respectively. In addition, reversal learning and executive function were assessed in terms of their relationship with decision-making tasks. RESULTS Patients with OCD showed impairment in the IGT, but not in the GDT. Reversal learning was neither impaired nor correlated with IGT performance. Among the clinical variables, illness severity and depression were associated with IGT scores. Executive function was impaired, but no significant relationship was found between executive function and GDT performance in OCD patients. LIMITATIONS Almost all OCD patients were on medication when they performed decision-making tasks. CONCLUSIONS Patients with OCD are impaired in decision-making under ambiguity, but not under risk. These findings demonstrate that decision-making processes are dissociated in OCD.
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Affiliation(s)
- Hae Won Kim
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Jee In Kang
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Kee Namkoong
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Kyungun Jhung
- Department of Adolescent Psychiatry, National Center for Child and Adolescent Psychiatry, Seoul National Hospital, Seoul, South Korea
| | - Ra Yeon Ha
- Department of Psychiatry, Seoul Bukbu Hospital, Seoul, South Korea
| | - Se Joo Kim
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea.
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21
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Zhang L, Dong Y, Ji Y, Zhu C, Yu F, Ma H, Chen X, Wang K. Dissociation of decision making under ambiguity and decision making under risk: a neurocognitive endophenotype candidate for obsessive-compulsive disorder. Prog Neuropsychopharmacol Biol Psychiatry 2015; 57:60-8. [PMID: 25315855 DOI: 10.1016/j.pnpbp.2014.09.005] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 09/05/2014] [Accepted: 09/18/2014] [Indexed: 10/24/2022]
Abstract
Evidence in the literature suggests that executive dysfunction is regarded as an endophenotype candidate for obsessive-compulsive disorder (OCD). Decision making is an important domain of executive function. However, few studies that have investigated whether decision making is a potential endophenotype for OCD have produced inconsistent results. Differences in the findings across these studies may be attributed to several factors: different study materials, comorbidity, medication, etc. There are at least two types of decision making that differ mainly in the degree of uncertainty and how much useful information about consequences and their probabilities are provided to the decision maker: decision making under ambiguity and decision making under risk. The aim of the present study was to simultaneously examine decision making under ambiguity as assessed by the Iowa Gambling Task (IGT) and decision making under risk as measured by the Game of Dice Task (GDT) in OCD patients and their unaffected first-degree relative (UFDR) for the first time. The study analyzed 55 medication-naïve, non-depressed OCD patient probands, 55 UFDRs of the OCD patients and 55 healthy matched comparison subjects (CS) without a family history of OCD with the IGT, the GDT and a neuropsychological test battery. While the OCD patients and the UFDRs performed worse than the CS on the IGT, they were unimpaired on the GDT. Our study supports the claim that decision making under ambiguity differs from decision making under risk and suggests that dissociation of decision making under ambiguity and decision making under risk may qualify to be a neurocognitive endophenotypes for OCD.
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Affiliation(s)
- Long Zhang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China; Laboratory of Neuropsychology, Anhui Medical University, Hefei, China
| | - Yi Dong
- Mental Health Center of Anhui Province, Hefei, China
| | - Yifu Ji
- Mental Health Center of Anhui Province, Hefei, China
| | - Chunyan Zhu
- Laboratory of Neuropsychology, Anhui Medical University, Hefei, China
| | - Fengqiong Yu
- Laboratory of Neuropsychology, Anhui Medical University, Hefei, China
| | - Huijuan Ma
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China; Laboratory of Neuropsychology, Anhui Medical University, Hefei, China
| | - Xingui Chen
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China; Laboratory of Neuropsychology, Anhui Medical University, Hefei, China
| | - Kai Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China; Laboratory of Neuropsychology, Anhui Medical University, Hefei, China.
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22
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Elvemo NA, Nilsen KB, Landrø NI, Borchgrevink PC, Håberg AK. Patients with chronic pain lack somatic markers during decision-making. J Pain Res 2014; 7:425-37. [PMID: 25075199 PMCID: PMC4107170 DOI: 10.2147/jpr.s62492] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Patients with chronic pain have impaired cognitive functions, including decision making, as shown with the Iowa gambling task (IGT). The main aim of this study was to elucidate whether patients’ decision making is associated with a lack of the anticipatory skin conductance response (SCR). An increase in anticipatory SCR before making unfavorable choices is known to guide decisions in healthy controls during the IGT. Since several brain regions involved in decision making are reported to have altered morphology in patients with chronic pain, the second aim was to explore the associations between IGT performance and brain structure volumes. Eighteen patients with chronic pain of mixed etiology and 19 healthy controls matched in terms of age, sex, and education were investigated with a computerized IGT during the recording of SCR, heart rate, and blood pressure. The participants also underwent neuropsychological testing, and three-dimensional T1-weighted cerebral magnetic resonance images were obtained. Contrary to controls, patients did not generate anticipatory SCRs before making unfavorable choices, and they switched between decks of cards during the late phase of the IGT significantly more often, and this was still observed after adjusting for depression scores. None of the other autonomic measures differed during IGT performance in either group or between groups. In patients, IGT scores correlated positively with total cortical grey matter volume. In controls, there was no such association, but their IGT scores correlated with the anticipatory SCR. It may be speculated that the reduction in anticipatory SCRs makes the chronic pain patients rely more on cortical resources during decision making.
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Affiliation(s)
- Nicolas-Andreas Elvemo
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kristian Bernhard Nilsen
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway ; Department of Neurology, Section for Clinical Neurophysiology, Oslo University Hospital, Oslo, Norway
| | - Nils Inge Landrø
- Clinical Neuroscience Research Group, Department of Psychology, University of Oslo, Oslo, Norway ; Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Petter Christian Borchgrevink
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway ; Department of Anesthesiology, St Olav University Hospital, Trondheim, Norway
| | - Asta Kristine Håberg
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway ; Department of Medical Imaging, St Olav University Hospital, Trondheim, Norway
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23
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Wen SL, Cheng MF, Cheng MH, Yue JH, Li JF, Xie LJ. Neurocognitive dysfunction and regional cerebral blood flow in medically naïve patients with obsessive-compulsive disorder. Dev Neuropsychol 2014; 39:37-50. [PMID: 24405183 DOI: 10.1080/87565641.2013.839682] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Previous research characterizes obsessive compulsive disorder (OCD) as a complex neurobehavioral disorder that may have multiple etiologies ( den Braber et al., 2008 ). This study analyzed neurocognitive function and change in regional cerebral blood flow (rCBF) to characterize OCD. Neurocognitive function and rCBF were examined in medically naïve patients with OCD and contrasted with controls. Results of this study indicated that the neurocognitive functions impaired in OCD are memory, attention, and executive function, which are primarily associated with the frontal and occipital lobes. Dysfunction in the basal ganglia and occipital lobes were associated with OCD and may be an etiological factor in the disorder.
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Affiliation(s)
- Sheng-lin Wen
- a Department of Psychology, Third Affiliated Hospital , Sun Yat-sen University , Guangzhou , China
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Lazarov A, Dar R, Liberman N, Oded Y. Obsessive–compulsive tendencies may be associated with attenuated access to internal states: Evidence from a biofeedback-aided muscle tensing task. Conscious Cogn 2012; 21:1401-9. [DOI: 10.1016/j.concog.2012.07.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2012] [Revised: 06/22/2012] [Accepted: 07/01/2012] [Indexed: 10/28/2022]
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