Brazilian Portuguese version of the Iowa Gambling Task: transcultural adaptation and discriminant validity

Decision-Making Deficits in ADHD Are Not Related to Risk Seeking But to Suboptimal Decision-Making: Meta-Analytical and Novel Experimental Evidence

Objective: ADHD is related to decision-making deficits in real-life (e.g., substance abuse) and on experimental tasks (increased preference for risky options). In most tasks, risk and expected value are confounded (risky options have lowest expected value), making it impossible to disentangle risky from suboptimal (i.e., not choosing highest expected value) decision-making. We differentiated between risky and suboptimal decision-making in ADHD in two studies. Method and Results: First, on a multilevel meta-regression analysis (k = 48, n_ADHD = 1,144, n_Control = 1,108), ADHD and controls differed if the risky option was suboptimal (ADHD choosing more risky/suboptimal), whereas groups performed similar if the risky option was not suboptimal. Second, an empirical study showed that adults with ADHD (n = 40) made more suboptimal, but not more risky choices than controls (n = 40). Conclusion: These results contribute to a growing body of evidence that decision-making deficits in ADHD are driven by suboptimal decision-making and not by risk seeking.

Dissociation between decision making under ambiguity and risk in patients with juvenile myoclonic epilepsy

INTRODUCTION

Decision making (DM) is one aspect of impulsivity that can be defined by the ability to decide between two or more options in a given situation. To date, there are at least two types of DM that differ in the level of uncertainty, and how much information about consequences is provided. In this study, we aimed to evaluate the two domains of DM - under risk and ambiguous - with a comprehensive evaluation in a group of patients with juvenile myoclonic epilepsy (JME), and correlate with patients' characteristics, clinical variables, and neuropsychological evaluation for executive functions.

METHODS

We evaluated 35 patients with JME and 39 healthy controls using the Iowa Gambling Task for DM under ambiguity and the Game Dice Task for DM under risk. We assessed the performance in Iowa Gambling Task and Game Dice Task through net scores, safe and risky choices, besides the type of decisions across time.

RESULTS

Patients with JME had a higher number of risky choices compared to controls in the Game Dice Task. There was no significant difference between patients and controls in the Iowa Gambling Task. However, patients with higher seizure frequency had worse scores on decks C and D (safe choices) from the Iowa Gambling Task.

CONCLUSION

Patients with JME have worse performance on DM under risk. The same was not observed for DM under ambiguity. Epilepsy-related factors and the presence of psychiatric disorders, but not executive dysfunction, were associated with a lower tendency for safe choices. These findings showed a dissociation between DM processes in patients with JME and a tendency to make disadvantageous decisions with measurable risks.

Bad Choices Make Good Stories: The Impaired Decision-Making Process and Skin Conductance Response in Subjects With Smartphone Addiction

Introduction: Smartphone Addiction (SA) has caused negative consequences and functional impairments in college students, such as reduction of academic performance and impairment in sleep quality. Studies have shown that individuals with chemical and behavioral dependencies have a bias in decision-making process, which leads to short-term advantageous choices even if they cause long-term harm. This bias in decision-making process is accompanied by a change in somatic markers and is associated with the development and maintenance of addictive behavior. The decision-making process and the measurement of physiological parameters have not yet been analyzed in SA. The neuropsychological and physiological characterization of the SA can contribute to its approach with the other dependency syndromes and to its recognition as a disease. Objective: we aimed to evaluate the decision-making process under risk and under ambiguity in individuals with SA and to measure the physiological parameters that accompany this process. Method: We compared the performance in the Iowa Gambling Task (IGT), Game of Dice Task (GDT) and skin conductance response (SCR) between 50 individuals with SA and 50 controls. Results: Smartphone dependents presented a profile of impairment in decision-making under ambiguity, without impairment in decision-making under risk. They demonstrated lower SCR before disadvantageous choices, higher SCR after rewards and lower SCR after punishments during decision-making, which suggests difficulty in recognizing disadvantageous alternatives, high sensitivity to rewards, and low sensitivity to punishments. Conclusion: The impairment in the decision-making process in smartphone dependents is similar to that found in other chemical and behavioral addictions, such as alcohol addiction, gambling disorders and pathological buy. The impairment in decision under ambiguity with preservation of decision under risk may reflect dysfunction of implicit emotional processes without dysfunction of explicit cognitive process. This profile can contribute to the recognition of SA as a behavioral dependence and to guide specific preventive and therapeutic strategies.

Spelling performance of public and private school students: A comparative study

Abstract To characterize and compare the spelling performance of private and public students. Three hundred 1st-5th graders from public and private schools in the city of Marília, São Paulo, Brazil, were evaluated, totalizing 30 students from each grade, respectively. Collective and individual versions of the Pró-Ortografia test (a renowned Brazilian spelling test) were administered. There were significant inter-group differences indicating that private school students achieved higher performance. The mean values of correct answers of higher grade level students were statistically greater than those of the lower grade level students. The results indicated that the mean values of correct answers of all versions of the spelling test administered increased across grades for both private and public school students. However, the data evaluated showed that private school students attained higher spelling performance than public school students from the 2nd grade onwards.

Influence of COMT Val158Met polymorphism on emotional decision-making: A sex-dependent relationship?

The biological underpinnings of sex-related differences in decision-making are still under-explored. The COMT gene is related to sexual dimorphism and with different choices made under uncertainty, albeit no study has specifically investigated a moderation effect of sex on the association between the COMT gene and the performance on decision-making paradigms. In this study, we investigated the influence of the COMT Val¹⁵⁸Met polymorphism on Iowa Gambling Task (IGT) performance depending on sex in a healthy adult sample. Participants were 192 healthy adults (84 men and 108 women). The first 40 choices in the IGT were considered decisions under ambiguity and the last 60 choices decisions under risk. To test our moderation hypothesis we used a separate regressions approach. The results revealed a sex-dependent effect of COMT Va l¹⁵⁸Met polymorphism on decision-making as measured by the IGT. Val/Val women showed the best performance in the last trials of the IGT. Therefore, the COMT Val¹⁵⁸Met polymorphism may be considered a genetic marker underlying sex differences in decision-making.

Decision-making in Cognitively Unimpaired Illiterate and Low-educated Older Women: Results on the Iowa Gambling Task

OBJECTIVE

This study investigated the pattern of decision-making (DM) on the Iowa Gambling Task (IGT) in a sample of Portuguese speaking healthy older women in Brazil with limited education: illiterate, 1-2 years, and 3-4 years of schooling.

METHODS

Around 164 non-demented community-dwelling women participated in the study. Among them 60 were illiterate, 52 had 1-2 years of schooling and 52 had 3-4 years of schooling. Participants completed the instruments: Brief Cognitive Screening Battery (BCSB), Mini-Mental State Examination, Verbal Fluency Test (animal category), Clock Drawing Test, Geriatric Depression Scale, Geriatric Anxiety Inventory, Digit Span Forward and Backward, Raven's Coloured Progressive Matrices, Wisconsin Card Sorting Test, and IGT.

RESULTS

The three education groups were equivalent as to age, number of diseases, medications taken daily, depression, and anxiety symptoms. In the IGT the literate older adults made more advantageous choices than the illiterate and IGT performance improved linearly with higher levels of education. IGT performance correlated significantly with all cognitive test scores with the exception of the memorization of the pictures on the BCSB.

CONCLUSION

The results suggested that education influences IGT performance, with worse scores among the illiterate. Results may be used by clinicians to interpret IGT performance among seniors with low literacy levels.

Executive Functions in Children Who Experience Bullying Situations

Bullying is characterized by intentional, repetitive, and persistent aggressive behavior that causes damage to the victim. Many studies investigate the social and emotional aspects related to bullying, but few assess the cognitive aspects it involves. Studies with aggressive individuals indicate impairment in executive functioning and decision-making. The objective of this study was to assess hot and cold executive functions in children who experience bullying. A total of 60 children between 10 and 11 years of age were included in the study. They were divided into four groups: aggressors (bullies), victims, bully-victims, and control. Tests for decision-making, inhibitory control, working memory, and cognitive flexibility were used. The bully group made more unfavorable choices on the Iowa Gambling Task, which may indicate difficulties in the decision-making process. The victim group took longer to complete the Trail Making Test (Part B) than aggressors, suggesting lower cognitive flexibility in victims. The hypothesis that aggressors would have lower performance in other executive functions such as inhibitory control, working memory, and cognitive flexibility has not been confirmed. This study indicates that bullies have an impairment of hot executive functions whereas victims have a comparatively lower performance in cold executive functions. In addition to social and cultural variables, neurocognitive and emotional factors seem to influence the behavior of children in bullying situations.

Remission of lifelong episodic dyscontrol after bilateral dorsolateral temporal lobe damage

A 45-year-old married woman with fits of episodic dyscontrol since an early age suffered a bilateral injury of the dorsolateral temporal lobe after which such episodes vanished for good. The remission of her lifelong proneness to aggression was so remarkable that her relatives and friends unanimously welcomed her "new personality". The post-traumatic taming in this case was an unanticipated collateral effect of brain damage with a salutary change of personality. This change possibly resulted from the release, due to the bitemporal injury, of inclinations that had not hitherto been fully expressed in the patient's mind and behavior due to the overriding influence of episodic dyscontrol on her ordinary conduct.

Risky decision making in Attention-Deficit/Hyperactivity Disorder: A meta-regression analysis

ADHD has been associated with various forms of risky real life decision making, for example risky driving, unsafe sex and substance abuse. However, results from laboratory studies on decision making deficits in ADHD have been inconsistent, probably because of between study differences. We therefore performed a meta-regression analysis in which 37 studies (n ADHD=1175; n Control=1222) were included, containing 52 effect sizes. The overall analysis yielded a small to medium effect size (standardized mean difference=.36, p<.001, 95% CI [.22, .51]), indicating that groups with ADHD showed more risky decision making than control groups. There was a trend for a moderating influence of co-morbid Disruptive Behavior Disorders (DBD): studies including more participants with co-morbid DBD had larger effect sizes. No moderating influence of co-morbid internalizing disorders, age or task explicitness was found. These results indicate that ADHD is related to increased risky decision making in laboratory settings, which tended to be more pronounced if ADHD is accompanied by DBD. We therefore argue that risky decision making should have a more prominent role in research on the neuropsychological and -biological mechanisms of ADHD, which can be useful in ADHD assessment and intervention.

A naturalistic study of recovering gamblers: What gets better and when they get better

Gambling recovery has typically been assessed through the lens of gambling behavior and its consequences. Little attention has been given to less obvious features of gambling disorder, such as negative affectivity, gambling cognitive distortions, impulsivity, cognitive flexibility, planning, inhibitory control, and decision-making. The current study investigates how gambling treatment affected these variables and if any are related to gambling recovery. One hundred and thirteen patients were assigned to psycho-education and psychiatric treatment. A subset of 48 patients was additionally assigned to cognitive behavioral therapy (CBT). Seventy-two patients were reassessed 6 months after treatment onset. Recovered and non-recovered gamblers did not differ in pre-treatment demographic, gambling, and psychiatric profiles. Three outcome variables were strongly related with gambling recovery: negative affectivity, cognitive distortions and decision-making. Logistic regression identified reduction of gambling cognitive distortions and better performance on decision-making as the best predictors of gambling recovery, regardless of the type of treatment received. Beyond the standard outcome measures for gambling treatment, increased sensitivity to loss and decreased positive expectancies towards gambling are key targets to promote recovery in gambling treatment.

A meta-analysis of decision-making and attention in adults with ADHD

OBJECTIVE

Deficient reward processing has gained attention as an important aspect of ADHD, but little is known about reward-based decision-making (DM) in adults with ADHD. This article summarizes research on DM in adult ADHD and contextualizes DM deficits by comparing them to attention deficits.

METHOD

Meta-analytic methods were used to calculate average effect sizes for different DM domains and continuous performance task (CPT) measures.

RESULTS

None of the 59 included studies (DM: 12 studies; CPT: 43; both: 4) had indications of publication bias. DM and CPT measures showed robust, small to medium effects. Large effect sizes were found for a drift diffusion model analysis of the CPT.

CONCLUSION

The results support the existence of DM deficits in adults with ADHD, which are of similar magnitude as attention deficits. These findings warrant further examination of DM in adults with ADHD to improve the understanding of underlying neurocognitive mechanisms.

Brazilian adaptation of the Hotel Task: A tool for the ecological assessment of executive functions

Over recent years, neuropsychological research has been increasingly concerned with the need to develop more ecologically valid instruments for the assessment of executive functions. The Hotel Task is one of the most widely used ecological measures of executive functioning, and provides an assessment of planning, organization, self-monitoring and cognitive flexibility.

Affective decision-making and tactical behavior of under-15 soccer players

Affective decision-making is a type of Executive Function related to cost benefit analysis in situations where gains and losses imply direct consequences for the subject. The purpose of this study was to explore the influence of the affective decision-making on tactical behavior in soccer players under the age of 15 years old. The System of Tactical Assessment in Soccer (FUT-SAT) was used to assess tactical behavior. To evaluate affective decision-making, we used the neuropsychological test called The Iowa Gambling Task (IGT). The values of the offensive, defensive and game tactical behavior of participants were used to create performance groups. The low (≤25%) and high (≥75%) groups, according to offensive, defensive and game tactical behavior, were compared and shown to be different. The values of the IGT net score of the participants with low and high tactical behavior were compared using the non-parametric Mann-Whitney test. Statistically significant differences between the groups were observed for Defensive Tactical Behavior (Z = −3.133; p = 0.002; r = −0.355) and Game Tactical Behavior (Z = −2.267; p = 0.023; r = −0.260). According to these results, it is possible to state that affective decision-making can influence the tactical behavior of under-15 soccer players.

Sex differences in dimensions of impulsivity in a non-clinical sample

Impulsivity has been more closely associated with men than with women because men are more often involved in illegal behaviors. The few studies that have investigated sex differences in impulsivity have used self-report questionnaires and have obtained contradictory results. Two computerized behavioral tests were administered to 125 healthy undergraduate students (75 women, M age 23.8 yr.; 50 men, M age 25.0 yr.). Men exhibited higher scores on motor impulsivity, but there were no significant differences between men and women on attentional and non-planning impulsivity scores. These findings are discussed in terms of the relationship between impulsivity and low- and high-order control.

The impact of frontal and cerebellar lesions on decision making: evidence from the Iowa Gambling Task

Although the frontal lobes have traditionally been considered the neural substrates of executive functioning (EF), recent studies have suggested that other structures, such as the cerebellum, may be associated with these abilities. The role of the cerebellum has only been sparsely investigated in connection with decision making (DM), an important component of EF, and the few results obtained on this front have been inconclusive. The current study sought to investigate the role of the cerebellum in DM by comparing the performance of patients with cerebellar strokes, frontal-damaged patients, and a healthy control group on the Iowa Gambling Task (IGT). A total of nine cerebellar-damaged adults participated in the study, as well as nine individuals with frontal strokes and 18 control individuals. Patients were administered a version of the IGT adapted to the population of Southern Brazil. There was a marginal difference in mean IGT net scores between the two clinical groups, although both displayed impaired performance as compared to the control group. Overall, the DM ability of patients with cerebellar damage proved to be more preserved than that of individuals with frontal lobe strokes, but less preserved than that of the control group. These data suggested that, while the frontal lobes may be the most important brain structures for DM, the cerebellum might also play an active role in this cognitive function. Future studies assessing participants with lesions in different cerebellar regions and hemispheres will prove invaluable for the understanding of the neural structures involved in DM, and make significant contributions to the globalist-localizationist debate in DM neuroscience.

Staying and shifting patterns across IGT trials distinguish children with externalizing disorders from controls

The Iowa Gambling Task (IGT) is the most widely instrument used in the assessment of affective decision-making in several populations with frontal impairment. The standard performance measure on the IGT is obtained by calculating the difference between the advantageous and the disadvantageous choices. This standard score does not allows the assessment of the use of different strategies to deal with contingencies of gain and losses across the task. This study aims to compare the standard score method used in IGT with a method that analyses the patterns of staying and shifting among different decks across the 100 choices, considering contingencies of choices with and without losses. We compared the IGT performance of 24 children with externalizing disorders (Attention Deficit Hyperactivity Disorder and Oppositional Defiant Disorder) and 24 healthy age-matched children. The analyses of the standard score across all blocks failed to show differences among children with externalizing disorders and control children. However, healthy children showed a pattern of shifting more from disadvantageous decks to advantageous decks and choosing more consecutive cards from the advantageous decks across all blocks, independently of the contingency of losses. On the other hand, children with externalizing disorders presented a pattern of shifting more from advantageous decks to disadvantageous ones in comparison to healthy children and repeatedly chose cards from the B deck across all blocks. This findings show that even though differences among groups might not be found when using the standard analyses, a different type of analysis might be able to show distinct strategies on the execution of the test.

Risky behavior in gambling tasks in individuals with ADHD--a systematic literature review

OBJECTIVE

The aim of this review was to gain insight into the relationship between Attention deficit hyperactivity disorder (ADHD) and risky performance in gambling tasks and to identify any potential alternate explanatory factors.

METHODS

PsycINFO, PubMed, and Web of Knowledge were searched for relevant literature comparing individuals with ADHD to normal controls (NCs) in relation to their risky performance on a gambling task. In total, fourteen studies in children/adolescents and eleven studies in adults were included in the review.

RESULTS

Half of the studies looking at children/adolescents with ADHD found evidence that they run more risks on gambling tasks when compared to NCs. Only a minority of the studies on adults with ADHD reported aberrant risky behavior. The effect sizes ranged from small to large for both age groups and the outcome pattern did not differ between studies that applied an implicit or explicit gambling task. Two studies demonstrated that comorbid oppositional defiant disorder (ODD) and conduct disorder (CD) increased risky behavior in ADHD. Limited and/or inconsistent evidence was found that comorbid internalizing disorders (IDs), ADHD subtype, methylphenidate use, and different forms of reward influenced the outcomes.

CONCLUSION

The evidence for increased risky performance of individuals with ADHD on gambling tasks is mixed, but is stronger for children/adolescents with ADHD than for adults with ADHD, which may point to developmental changes in reward and/or penalty sensitivity or a publication bias for positive findings in children/adolescents. The literature suggests that comorbid ODD/CD is a risk factor in ADHD for increased risky behavior. Comorbid IDs, ADHD subtype, methylphenidate use, and the form of reward received may affect risky performance in gambling tasks; however, these factors need further examination. Finally, the implications of the findings for ADHD models and the ecological validity of gambling tasks are discussed.

Association between the Catechol O-methyltransferase (COMT) Val158met polymorphism and different dimensions of impulsivity

Background

Impulsivity is a multidimensional construct which has been associated with dopaminergic neurotransmission. Nonetheless, until this moment, few studies addressed the relationship between different types of impulsivity and the single nucleotide polymorphism caused by a substitution of valine (val) with methionine (met) in the 158 codon of the Catechol-o-Methyltransferase gene (COMT-val158met). The present study aimed to investigate the association between val158met COMT polymorphism and impulsive behavior measured by two neuropsychological tests.

Methodology/Principal Findings

We administered two neuropsychological tests, a Continuous Performance Task and the Iowa Gambling Task were applied to 195 healthy participants to characterize their levels of motor, attentional and non-planning impulsivity. Then, subjects were grouped by genotype, and their scores on impulsivity measures were compared. There were no significant differences between group scores on attentional and motor impulsivity. Those participants who were homozygous for the met allele performed worse in the Iowa Gambling Task than val/val and val/met subjects.

Conclusions/Significance

Our results suggest that met allele of val158met COMT polymorphism is associated with poor performance in decision-making/cognitive impulsivity task. The results reinforce the hypothesis that val and met alleles of the val158met polymorphism show functional dissociation and are related to different prefrontal processes.

The Effect of Age on Decision Making According to the Iowa Gambling Task

Aging has been associated with several brain changes that often affect the cognitive functioning of adults, but changes in executive functions, particularly in the field of decision making, have not been fully investigated. The Iowa Gambling Task (IGT) is a widely used tool to evaluate decision making, but little is known about the effect of age on its results. This study used the IGT and compared healthy young (n= 40) and elderly (n = 40) adults to evaluate their decision making processes. There were significant differences in the learning curve of the two age groups, but no difference in overall IGT performance. The results for the first IGT block were different from those of the rest of the task, and the group of elderly adults had a better performance in this block. Elderly adults also showed a preference for deck A, the one that resulted in greater losses. Findings confirmed the results of other studies, which reported that the IGT block score is the variable with the greatest sensitivity to age in this instrument.

The Iowa Gambling Task (IGT) in Brazil: a systematic review

Background: Decision-making is a complex, multidimensional cognitive function that requires the choice between two or more options and also the predictive analysis of its consequences. One of the tools most widely used to assess decision-making in neuropsychological research is the Iowa Gambling Task (IGT). Objective: To conduct a systematic review of articles reporting empirical IGT studies based in Brazil. Method: Articles were obtained from multiple journal databases including ISI Web of Knowledge, Scopus, SciELO, LILACS, and Scholar Google. Results: Thirty-six studies were included in this review and divided into four categories according to main subject matter (psychiatry & personality; demographic & cultural variables; medical/clinic; and psychometric properties & test administration standardization). In general, there was a significant growth in research employing IGT (Χ² = 17.6, df = 5, p = 0.0003), but this growth was restricted to a few geographic areas of Brazil. The psychiatry & personality subject matter was the most abundant, accounting for 14 publications (39% of the total sample). Conclusion: Since its first adaptation to Brazilian Portuguese in 2006, a growing interest in decision-making as measured by the IGT can be observed, with psychiatry & personality topics representing a large portion of the scientific inquiry to date. Nevertheless, in order to extend the initial results of Brazilian IGT decision-making research, more studies are necessary - across a more diverse range of topics, including demographic & cultural variables, and psychometric properties & test administration standardization, the areas least studied -, as is the dissemination of the IGT to more regions of the country.

Translation and cultural adaptation of the Game Dice Task to Brazilian population

OBJECTIVE: The Game Dice Task (GDT) was developed to measure decision making under known risk. The aim of this study was to translate and adapt the GDT to a Brazilian population. METHOD: After the GDT was translated and back-translated to Brazilian Portuguese and evaluated by eight bilingual judges, 175 Brazilian adults were divided into two groups - 160 healthy volunteers and 15 traumatic brain injury (TBI) patients - and had completed the GDT. RESULTS: Differences between genders, but not age, were observed in the healthy volunteer sample. Males more frequently chose a combination of three dice while females preferred four dice. TBI patients were more impulsive than healthy volunteers; they less frequently chose a combination of three dice and made more risky decisions. CONCLUSION: Because of the rigorous process used to translate and adapt the GDT and the differences observed between patients with TBI and healthy volunteers, the Brazilian GDT was considered satisfactory for research purposes.

The 5-HTTLPR polymorphism, impulsivity and suicide behavior in euthymic bipolar patients

BACKGROUND

Suicide behavior is very frequent in Bipolar Disorder (BD) and they are both closely associated with impulsivity. Furthermore they are, impulsivity, BD and suicide behavior, associated with serotonergic function, at least partially, under genetic determinism and somewhat associated with the serotonin transporter gene polymorphism, the 5-HTTLPR. We aimed to assess different impulsivity components in BD sub-grouped by suicidal attempt and healthy controls. We hypothesized that the non-planning/cognitive impulsivity, could be more closely associated with suicidal behavior. We further associated 5-HTTLPR genotypes with neuropsychological results to test the hypothesis that this polymorphism is associated with cognitive impulsivity.

METHOD

We assessed 95 euthymic bipolar patients sub-grouped by suicidal attempt history in comparison with 94 healthy controls. All subjects underwent a laboratory assessment of impulsivity (Continuous Performance Test and Iowa Gambling Test). Furthermore the genotyping of 5-HTTLPR was performed in all subjects.

RESULTS

We found that bipolar patients are more impulsive than healthy controls in all impulsivity dimensions we studied. Furthermore bipolar patients with a suicide attempt history have a greater cognitive impulsivity when compared to both bipolar patients without such a history as well when compared to healthy controls. No association was found between 5-HTTLPR genotypes and neuropsychological measures of impulsive behavior.

LIMITATIONS

The sample studied can be considered small and a potentially confounding variable - medication status - was not controlled.

CONCLUSION

A lifetime suicide attempt seems associated with cognitive impulsivity independently of the socio-demographic and clinical variables studied as well with 5-HTTLPR genotype. Further studies in larger samples are necessary.

Decision-making impairment in obsessive-compulsive disorder as measured by the Iowa Gambling Task

OBJECTIVE: This study aims to evaluate the process of decision-making in patients with obsessive-compulsive disorder (OCD) using the Iowa Gambling Task (IGT). In addition, we intend to expand the understanding of clinical and demographic characteristics that influence decision-making. METHOD: Our sample consisted of 214 subjects (107 diagnosed with OCD and 107 healthy controls) who were evaluated on their clinical, demographic and neuropsychological features. Moreover, the Iowa Gambling Task (IGT), a task that detects and measures decision-making impairments, was used. RESULTS: We found that OCD patients performed significantly worse on the IGT. Furthermore, features such as symptoms of anxiety did not influence IGT performance. CONCLUSION: Impaired decision-making seems to be a key feature of OCD. Given that OCD is a complex heterogeneous disorder, homogeneous groups are necessary for an accurate characterization of our findings.

Impulsivity and the 5-HTTLPR polymorphism in a non-clinical sample

Background

Impulsivity has been associated with serotonergic system functions. However, few researchers have investigated the relationship between a polymorphism in the promoter of the serotonin transporter gene (5-HTTLPR) and the different components of impulsivity in a non-clinical population. The aim of this study was to investigate the relationship between a polymorphism in the promoter region of the serotonin transporter gene (5-HTTLPR) and the different components of impulsivity in a non-clinical population.

Methodology/Principal Findings

We administered two neuropsychological tests, the Continuous Performance Task and the Iowa Gambling Task, to 127 healthy participants to measure their levels of motor, attentional and non-planning impulsivity. Then, these participants were grouped by genotype and gender, and their scores on impulsivity measures were compared. There were no significant differences between group scores on attentional, motor and non-planning impulsivity.

Conclusions/Significance

Our results suggest that 5-HTTLPR genotype is not significantly associated with subsets of impulsive behavior in a non-clinical sample when measured by neuropsychological tests. These findings are discussed in terms of the sensitivity of neuropsychological tests to detect impulsivity in a non-clinical population and the role of gender and race in the relationship between the 5-HTTLPR and impulsivity.

Assessment of psychosocial adjustment in patients with temporal lobe epilepsy using a standard measure

Despite the growing evidence of poor psychosocial adjustment, at present there is no formal method of assessment of social adjustment in patients with temporal lobe epilepsy (TLE). First, we assessed social adjustment in patients with TLE using a self-report questionnaire and compared the results with those from quality-of-life (QOL) scales. Second, we verified the influence of cognitive performance and clinical variables of epilepsy on social adjustment and QOL. We evaluated 35 people with TLE and 38 healthy controls. Patients had worse social adjustment, and it was correlated with worse perception of cognitive function. Attention and verbal memory dysfunctions were negatively correlated with social adjustment. However, there was no significant correlation between cognitive performance and QOL. Regarding clinical variables, persons with left TLE showed worse social adjustment and patients with frequent seizures showed worse QOL. These findings indicate the relevance of evaluating social adjustment and emphasize the importance of cognitive rehabilitation to improved social adjustment.

Estudo de fidedignidade do instrumento neuropsicológico Iowa Gambling Task

OBJETIVO: O objetivo do presente estudo foi verificar evidências de fidedignidade do instrumento neuropsicológico Iowa Gambling Task (IGT) a partir do método teste-reteste. MÉTODO: Participaram 50 indivíduos saudáveis, de 19 a 75 anos de idade, com no mínimo cinco anos de educação formal. A aplicação foi realizada de forma individual, em dois encontros, com intervalo de um a seis meses entre teste e reteste. RESULTADOS: Os resultados evidenciaram uma correlação positiva moderada significativa entre teste-reteste no cálculo global. Na análise por segmentos, os blocos 4 e 5 apresentaram uma correlação positiva moderada, mas não foram observadas correlações significativas nos blocos 1, 2 e 3. CONCLUSÃO: Esses dados corroboram estudos atuais que encontraram correlações moderadas entre teste-reteste em medidas de funções executivas e sugerem que o IGT pode ser empregado para avaliar o processo de tomada de decisão de forma confiável ao longo do tempo, desde que sejam considerados estudos de fidedignidade com populações saudáveis mais amplas e com populações clínicas.

Neuropsychological differences between attention deficit hyperactivity disorder and control children and adolescents referred for academic impairment

OBJECTIVE: To compare the performances of children and adolescents with attention deficit hyperactivity disorder with a group of control comparison subjects, both taken from a large clinical sample, using some of the most widely employed attention-based Brazilian tests. METHOD: The performances of 186 children and adolescents with attention deficit hyperactivity disorder were compared to that of 80 control individuals based on attention and working memory scores. Both groups had been referred due to academic impairment. All individuals were submitted to the TAVIS-3 sustained, shifted and focused attention tests, as well as to the working memory tests that make up the WISC-III Freedom from Distractibility Index (Digit Span and Arithmetic). RESULTS: The control group was slightly older than the attention deficit hyperactivity disorder group (p = 0.07); IQ and schooling did not differ between groups (p = 0.34 and p = 0.38, respectively). While performing a test requiring sustained attention for a longer period of time, the attention deficit hyperactivity disorder group showed a significantly higher number of commission errors compared to the controls, thus presenting sustained attention deficits (p = 0.003); when the influence of IQ, age and schooling was reduced, the attention deficit hyperactivity disorder group also made more omission errors during a sustained attention task in comparison to the control group, thus achieving a borderline significance level (p = 0.08); the attention deficit hyperactivity disorder group also performed worse in Digit Span forward and backward (p = 0.013 and p = 0.01, respectively) and in Arithmetic (p = 0.008). Other scores did not achieve significance. CONCLUSION : Our findings suggest that some of the most commonly used Brazilian attention-based tests - especially the sustained attention and working memory tests - may be useful to help distinguish subjects with attention deficit hyperactivity disorder from control subjects.

Neuropsychological assessment of impulsive behavior in abstinent alcohol-dependent subjects

OBJECTIVE: Poor impulse control is thought to be one of the characteristics of alcohol addiction. The capacity to remain abstinent may be linked to cognitive bias related to three dimensions of impulsivity: motor, non-planning, and attentional impulsivity. The aim of this study was to evaluate the neuropsychological profile related to these impulsivity dimensions in alcohol-dependent patients within 15 -120 days of abstinence. METHOD: We compared 31 alcohol-dependent patients to 30 matched healthy controls regarding their performances on the Continuous Performance Task, the Iowa Gambling Test, and the Wisconsin Card Sorting Test, each of which is thought to tax primarily one of the three dimensions of impulsivity just outlined. RESULTS: When compared to controls, alcohol-dependent patients presented more commission errors on the Continuous Performance Task; made more disadvantageous choices on the Iowa Gambling Test; and made more perseverative errors on the Wisconsin Card Sorting Test. There was no significant correlation between performance on these tests and the length of abstinence. CONCLUSIONS: These results suggest that deficits related to motor, non-planning and attentional components of impulsivity exist in alcohol-dependent patients, in the period immediately after acute alcohol withdrawal. These results may help guide interventions designed to prevent the risk of relapse in alcohol-abstinent patients.