1
|
Murayama K, Tomiyama H, Ohno A, Kato K, Matsuo A, Hasuzawa S, Sashikata K, Kang M, Nakao T. Decision-making deficits in obsessive-compulsive disorder are associated with abnormality of recency and response consistency parameter in prospect valence learning model. Front Psychiatry 2023; 14:1227057. [PMID: 37840793 PMCID: PMC10570432 DOI: 10.3389/fpsyt.2023.1227057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/07/2023] [Indexed: 10/17/2023] Open
Abstract
Background Patients with obsessive-compulsive disorder (OCD) have deficits in decision-making in the Iowa Gambling Task (IGT). However, no study has investigated the parameters of the prospect valence learning (PVL) model in the IGT for OCD. Aims This study aimed to investigate deficits in decision-making in OCD using the PVL model and identify whether the parameters of the PVL model were associated with obsessive-compulsive severity. Methods Forty-seven medication-free patients with OCD were compared with 47 healthy controls (HCs). Decision-making was measured using the total net and block net scores of the IGT. A PVL model with a decay-reinforcement learning rule (PVL-DecayRI) was used to investigate the parameters of the model. Correlation analysis was conducted between each parameter of the PVL-DecayRL and obsessive-compulsive symptoms. Results The total net score of patients with OCD was significantly lower than that of the HCs. The block net scores of the OCD group did not differ across the five blocks, whereas in the HCs, the fifth block net score was significantly higher than the block net scores of the first and second blocks. The values of the recency and response consistency parameters of the PVL-DecayRI in patients with OCD were significantly lower than those in HCs. The recency parameter positively correlated with the Y-BOCS obsessive score. Meanwhile, there was no correlation between consistency parameter values and symptom severity in OCD. Conclusion Our detailed analysis of the decision-making deficit in OCD suggests that the most recent outcome has a small influence on the expectancy of prospect valence, as indicated by the lower recency parameter, and is characterized by more impulsive choices, as indicated by the lower consistency parameter.
Collapse
Affiliation(s)
- Keitaro Murayama
- Department of Neuropsychiatry, Kyushu University Hospital, Fukuoka, Japan
| | - Hirofumi Tomiyama
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Aikana Ohno
- Integrated Center for Educational Research and Development, Faculty of Education, Saga University, Saga, Japan
- Graduate School of Human-Environment Studies, Kyushu University, Fukuoka, Japan
| | - Kenta Kato
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Akira Matsuo
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Suguru Hasuzawa
- Center for Health Sciences and Counseling, Kyushu University, Fukuoka, Japan
| | - Kenta Sashikata
- Graduate School of Human-Environment Studies, Kyushu University, Fukuoka, Japan
| | - Mingi Kang
- Graduate School of Human-Environment Studies, Kyushu University, Fukuoka, Japan
| | - Tomohiro Nakao
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| |
Collapse
|
2
|
Joo SW, Kim H, Jo YT, Ahn S, Choi YJ, Choi W, Lee J. Impact of the early phase of the COVID-19 pandemic on the use of mental health services in South Korea: a nationwide, health insurance data-based study. Soc Psychiatry Psychiatr Epidemiol 2023; 58:441-452. [PMID: 36350338 PMCID: PMC9644390 DOI: 10.1007/s00127-022-02382-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 10/28/2022] [Indexed: 11/10/2022]
Abstract
PURPOSE The coronavirus disease 2019 (COVID-19) pandemic has profoundly affected the utilization of mental health services. Existing evidence investigating this issue at the nationwide level is lacking, and it is uncertain whether the effects of the COVID-19 pandemic on the use of psychiatric services differs based on psychiatric diagnosis. METHODS Data from the claims database between October 2015 and August 2020 was obtained from the Health Insurance Review and Assessment agency in South Korea. Based on the main diagnostic codes, psychiatric patients were identified and categorized into diagnostic groups (anxiety disorders, bipolar and related disorders, depressive disorders, and schizophrenia spectrum disorders). We calculated the number of psychiatric inpatients and outpatients and the medication adherence of patients for each month. We compared the actual and predicted values of outcomes during the COVID-19 pandemic and performed interrupted time-series analyses to test the statistical significance of the impact of the pandemic. RESULTS During the COVID-19 pandemic, the number of inpatients and admissions to psychiatric hospitals decreased for bipolar and related disorders and depressive disorders. In addition, the number of patients admitted to psychiatric hospitals for schizophrenia spectrum disorders decreased. The number of psychiatric outpatients showed no significant change in all diagnostic groups. Increased medication adherence was observed for depressive, schizophrenia spectrum, and bipolar and related disorders. CONCLUSIONS In the early phase of the COVID-19 pandemic, there was a trend of a decreasing number of psychiatric inpatients and increasing medication adherence; however, the number of psychiatric outpatients remained unaltered.
Collapse
Affiliation(s)
- Sung Woo Joo
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, SongPa-Gu, Seoul, 05505, Republic of Korea
| | - Harin Kim
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, SongPa-Gu, Seoul, 05505, Republic of Korea
| | - Young Tak Jo
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, SongPa-Gu, Seoul, 05505, Republic of Korea
| | - Soojin Ahn
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, SongPa-Gu, Seoul, 05505, Republic of Korea
| | - Young Jae Choi
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, SongPa-Gu, Seoul, 05505, Republic of Korea
| | - Woohyeok Choi
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, SongPa-Gu, Seoul, 05505, Republic of Korea
| | - Jungsun Lee
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, SongPa-Gu, Seoul, 05505, Republic of Korea.
| |
Collapse
|
3
|
Hultman C, Tjernström N, Vadlin S, Rehn M, Nilsson KW, Roman E, Åslund C. Exploring decision-making strategies in the Iowa gambling task and rat gambling task. Front Behav Neurosci 2022; 16:964348. [PMID: 36408452 PMCID: PMC9669572 DOI: 10.3389/fnbeh.2022.964348] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 10/11/2022] [Indexed: 07/16/2024] Open
Abstract
Decision-making requires that individuals perceive the probabilities and risks associated with different options. Experimental human and animal laboratory testing provide complimentary insights on the psychobiological underpinnings of decision-making. The Iowa gambling task (IGT) is a widely used instrument that assesses decision-making under uncertainty and risk. In the task participants are faced with a choice conflict between cards with varying monetary reinforcer/loss contingencies. The rat gambling task (rGT) is a pre-clinical version using palatable reinforcers as wins and timeouts mimicking losses. However, interspecies studies elaborating on human and rat behavior in these tasks are lacking. This study explores decision-making strategies among young adults (N = 270) performing a computerized version of the IGT, and adult outbred male Lister Hooded rats (N = 72) performing the rGT. Both group and individual data were explored by normative scoring approaches and subgroup formations based on individual choices were investigated. Overall results showed that most humans and rats learned to favor the advantageous choices, but to a widely different extent. Human performance was characterized by both exploration and learning as the task progressed, while rats showed relatively consistent pronounced preferences for the advantageous choices throughout the task. Nevertheless, humans and rats showed similar variability in individual choice preferences during end performance. Procedural differences impacting on the performance in both tasks and their potential to study different aspects of decision-making are discussed. This is a first attempt to increase the understanding of similarities and differences regarding decision-making processes in the IGT and rGT from an explorative perspective.
Collapse
Affiliation(s)
- Cathrine Hultman
- Centre for Clinical Research, Västmanland Hospital Västerås, Region Västmanland, Uppsala University, Västerås, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Nikita Tjernström
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Sofia Vadlin
- Centre for Clinical Research, Västmanland Hospital Västerås, Region Västmanland, Uppsala University, Västerås, Sweden
| | - Mattias Rehn
- Centre for Clinical Research, Västmanland Hospital Västerås, Region Västmanland, Uppsala University, Västerås, Sweden
| | - Kent W. Nilsson
- Centre for Clinical Research, Västmanland Hospital Västerås, Region Västmanland, Uppsala University, Västerås, Sweden
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Erika Roman
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Cecilia Åslund
- Centre for Clinical Research, Västmanland Hospital Västerås, Region Västmanland, Uppsala University, Västerås, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| |
Collapse
|
4
|
Gupta N, Ahirwal MK, Atulkar M. Development of human decision making model with consideration of human factors through reinforcement learning and prospect utility theory. J EXP THEOR ARTIF IN 2022. [DOI: 10.1080/0952813x.2022.2117422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Nimisha Gupta
- Department of Computer Application, NIT, Raipur, India
| | | | | |
Collapse
|
5
|
Openshaw RL, Pratt JA, Morris BJ. The schizophrenia risk gene Map2k7 regulates responding in a novel contingency-shifting rodent touchscreen gambling task. Dis Model Mech 2022; 15:274684. [PMID: 35275161 PMCID: PMC8922023 DOI: 10.1242/dmm.049310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 12/22/2021] [Indexed: 11/20/2022] Open
Abstract
In schizophrenia, subjects show reduced ability to evaluate and update risk/reward contingencies, showing correspondingly suboptimal performance in the Iowa gambling task. JNK signalling gene variants are associated with schizophrenia risk, and JNK modulates aspects of cognition. We therefore studied the performance of mice hemizygous for genetic deletion of the JNK activator MKK7 (Map2k7+/- mice) in a touchscreen version of the Iowa gambling task, additionally incorporating a novel contingency-switching stage. Map2k7+/- mice performed slightly better than wild-type (WT) littermates in acquisition and performance of the task. Although Map2k7+/- mice adapted well to subtle changes in risk/reward contingencies, they were profoundly impaired when the positions of 'best' and 'worst' choice selections were switched, and still avoided the previous 'worst' choice location weeks after the switch. This demonstrates a precise role for MKK7-JNK signalling in flexibility of risk/reward assessment and suggests that genetic variants affecting this molecular pathway may underlie impairment in this cognitive domain in schizophrenia. Importantly, this new contingency shift adaptation of the rodent touchscreen gambling task has translational utility for characterising these cognitive subprocesses in models of neuropsychiatric disorders.
Collapse
Affiliation(s)
- Rebecca L Openshaw
- Institute of Neuroscience and Psychology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK
| | - Judith A Pratt
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK
| | - Brian J Morris
- Institute of Neuroscience and Psychology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK
| |
Collapse
|
6
|
Di Lodovico L, Versini A, Lachatre M, Marcheselli J, Ramoz N, Gorwood P. Is decision-making impairment an endophenotype of anorexia nervosa? Eur Psychiatry 2022; 65:e68. [DOI: 10.1192/j.eurpsy.2022.2327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Background
Patients with anorexia nervosa (AN) show impaired decision-making ability, but it is still unclear if this is a trait marker (i.e., being associated with AN at any stage of the disease) or a state parameter of the disease (i.e., being present only in acutely ill patients), and if it has endophenotypic characteristics. The aim of this study was to determine the endophenotypic, and state- or trait-associated nature of decision-making impairment in AN.
Methods
Ninety-one patients with acute AN (A-AN), 90 unaffected relatives (UR), 23 patients remitted from AN (R-AN), and 204 healthy controls (HC) carried out the Iowa gambling task (IGT). Prospective valence learning (PVL) model was employed to distinguish the cognitive dimensions underlying the decision-making process, that is, learning, consistency, feedback sensitivity, and loss aversion. IGT performance and decision-making dimensions were compared among groups to assess whether they had endophenotypic (i.e., being present in A-AN, UR, and R-AN, but not in HC) and/or trait-associated features (i.e., present in A-AN and R-AN but not in HC).
Results
Patients with A-AN had lower performance at the IGT (p < 0.01), while UR, R-AN, and HC had comparable results. PVL-feedback sensitivity was lower in patients with R-AN and A-AN than in HC (p < 0.01).
Conclusions
Alteration of decision-making ability did not show endophenotypic features. Impaired decision-making seems a state-associated characteristic of AN, resulting from the interplay between trait-associated low feedback sensitivity and state-associated features of the disease.
Collapse
|
7
|
Xu M, Lee WK, Ko CH, Chiu YC, Lin CH. The Prominent Deck B Phenomenon in Schizophrenia: An Empirical Study on Iowa Gambling Task. Front Psychol 2021; 12:619855. [PMID: 34539474 PMCID: PMC8446202 DOI: 10.3389/fpsyg.2021.619855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 05/21/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The Iowa Gambling Task (IGT) was established to evaluate emotion-based decision-making ability under uncertain circumstances in clinical populations, including schizophrenia (Sz). However, there remains a lack of stable behavioral measures regarding discrimination for decision-making performance in IGT between schizophrenic cases and healthy participants. None of the Sz-IGT studies has specifically verified the prominent deck B (PDB) phenomenon gradually revealed in other populations. Here, we provided a global review and empirical study to verify these Sz-IGT issues. Methods: Seeking reliable and valid behavioral measures, we reviewed 38 studies using IGT to investigate decision-making behavior in Sz groups. The IGT, the Wisconsin Card Sorting Test (WCST), and clinical symptoms evaluations were administered to 61 schizophrenia or schizoaffective cases diagnosed by psychiatrists and 62 demographically matched healthy participants. Results: There were no valid behavioral measures in IGT that could significantly identify the decision-making dysfunction of Sz. However, Sz cases, on average, made more choices from disadvantageous deck B relative to other decks, particularly in the later learning process (block 3-5). Compared to the control group, the Sz group was more impaired on the WCST. The high-gain frequency decks B and D showed significant correlations with WCST but no correlation between clinical symptoms and IGT/WCST. Conclusions: Gain-loss frequency (GLF) has a dominant and stable impact on the decision-making process in both Sz and control groups. PDB phenomenon is essentially challenging to be observed on the ground of the expected value (EV) viewpoint approach on the IGT in both populations. Consequently, caution should be exercised when launching the IGT to assess the decision-making ability of Sz under a clinical scenario.
Collapse
Affiliation(s)
- Mei Xu
- Department of Psychology, Kaohsiung Medical University, Kaohsiung, Taiwan.,School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - We-Kang Lee
- Sleep Center, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.,Department of Psychology, Soochow University, Taipei, Taiwan
| | - Chih-Hung Ko
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Psychiatry, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan.,College of Medicine, Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yao-Chu Chiu
- Department of Psychology, Soochow University, Taipei, Taiwan
| | - Ching-Hung Lin
- Department of Psychology, Kaohsiung Medical University, Kaohsiung, Taiwan.,Research Center for Non-linear Analysis and Optimization, Kaohsiung Medical University, Kaohsiung, Taiwan
| |
Collapse
|
8
|
Granero R, Fernández-Aranda F, Pino-Gutierrez AD, Etxandi M, Baenas I, Gómez-Peña M, Moragas L, Valenciano-Mendoza E, Mora-Maltas B, Valero-Solís S, Codina E, Guillén-Guzmán E, Lara-Huallipe M, Caravaca E, Mestre-Bach G, Menchón JM, Jiménez-Murcia S. The prevalence and features of schizophrenia among individuals with gambling disorder. J Psychiatr Res 2021; 136:374-383. [PMID: 33639330 DOI: 10.1016/j.jpsychires.2021.02.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/29/2021] [Accepted: 02/08/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND-OBJECTIVES Few studies have analyzed the comorbid presence of gambling disorder (GD) with schizophrenia, its sociodemographic correlates and clinical implications. This study estimated the prevalence of the dual diagnosis (GD with schizophrenia) and the differences in the profiles of patients with and without the dual condition. METHOD The sample included n = 3,754 patients consecutively accepted for treatment for GD. Sociodemographics, gambling-related variables, psychopathological state and personality traits were assessed and compared between the groups. RESULTS The prevalence of schizophrenia within patients who met clinical criteria for GD was 4.4% (95% confidence interval: 3.8%-5.1%). Variables related to the dual presence of GD with schizophrenia were single marital status, lower education level, inactive working status, socioeconomic disadvantage, younger age, earlier onset of gambling problems, worse global psychopathological state and more dysfunctional personality profile (higher level in harm avoidance and lower level in cooperativeness, reward dependence, persistence and self-directedness). CONCLUSION The presence of schizophrenia among patients with GD was around 4 times higher than the prevalence rate estimated in the reference general population. The differences in the profiles of GD patients with and without schizophrenia suggest that individuals with the dual diagnosis condition require unique assessment considerations and tailored treatment interventions specifically designed for the clinical and functioning higher risk.
Collapse
Affiliation(s)
- Roser Granero
- Department of Psychobiology and Methodology, Universitat Autònoma de Barcelona - UAB, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain.
| | - Fernando Fernández-Aranda
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona - UB, L'Hospitalet de Llobregat, Spain.
| | - Amparo Del Pino-Gutierrez
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Department of Public Health, Mental Health and Mother-Infant Nursing, School of Nursing, University of Barcelona, Barcelona, Spain.
| | - Mikel Etxandi
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain.
| | - Isabel Baenas
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain.
| | - Mónica Gómez-Peña
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain.
| | - Laura Moragas
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain.
| | | | - Bernat Mora-Maltas
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain.
| | - Susana Valero-Solís
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain.
| | - Ester Codina
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain.
| | - Elías Guillén-Guzmán
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic Universitari, Barcelona, Spain.
| | - Milagros Lara-Huallipe
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain.
| | - Elena Caravaca
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain.
| | - Gemma Mestre-Bach
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain; Universidad Internacional de La Rioja, Logroño, La Rioja, Spain.
| | - José M Menchón
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona - UB, L'Hospitalet de Llobregat, Spain; CIBER Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain.
| | - Susana Jiménez-Murcia
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona - UB, L'Hospitalet de Llobregat, Spain.
| |
Collapse
|
9
|
Wu Y, Wang L, Yu F, Ji GJ, Xiao G, Feifei X, Chunyan Z, Xingui C, Wang K. Intermittent Theta Burst Stimulation (iTBS) as an Optimal Treatment for Schizophrenia Risk Decision: an ERSP Study. Front Psychiatry 2021; 12:594102. [PMID: 34040546 PMCID: PMC8143028 DOI: 10.3389/fpsyt.2021.594102] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 04/07/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: People with schizophrenia have serious impairments in social function, especially in decision-making ability. Transcranial magnetic stimulation modified intermittent theta burst transcranial magnetic stimulation (iTBS) has been shown to regulate the functional connection of brain networks. Our study explored the therapeutic effect of iTBS on decision-making disorders in schizophrenia. Methods: Participants were pseudorandomized and assigned to iTBS (n = 16) or sham (n = 16) group. iTBS group was administered 1,800 pulses on the target of the left dorsol lateral prefrontal cortex (L-DLPFC) per day for 14 consecutive days. We compared Iowa gambling task performance and associated event-related spectral perturbation results (ERSP) among two groups. Results: The results show that participants' performance in the high-lose in the iTBS group had stronger stimulation of theta spectral power than those in the sham group. Specifically, we found that under high-risk conditions, compared with the control group, the iTBS group showed significant activation of the theta spectrum power in the FPZ, FZ, FCZ, and CZ regions after treatment. Conclusions: Our results provide evidence that long-term iTBS stimulation effectively improves the decision-making ability of schizophrenia. After receiving negative feedback, patients can turn to safety options. These findings support that iTBS may be a potential treatment for clinical decision-making disorders.
Collapse
Affiliation(s)
- Yang Wu
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.,Department of Neurology, First Affiliated Hospital, Anhui Medical University, Hefei, China.,Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, China
| | - Lu Wang
- Department of Neurology, First Affiliated Hospital, Anhui Medical University, Hefei, China.,Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Anhui Medical University, Hefei, China
| | - Fengqiong Yu
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.,Department of Neurology, First Affiliated Hospital, Anhui Medical University, Hefei, China.,Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, China
| | - Gong-Jun Ji
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.,Department of Neurology, First Affiliated Hospital, Anhui Medical University, Hefei, China.,Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, China
| | - Guixian Xiao
- Department of Neurology, First Affiliated Hospital, Anhui Medical University, Hefei, China.,Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Anhui Medical University, Hefei, China
| | - Xu Feifei
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.,Department of Neurology, First Affiliated Hospital, Anhui Medical University, Hefei, China.,Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, China
| | - Zhu Chunyan
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.,Department of Neurology, First Affiliated Hospital, Anhui Medical University, Hefei, China.,Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, China
| | - Chen Xingui
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.,Department of Neurology, First Affiliated Hospital, Anhui Medical University, Hefei, China.,Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, China
| | - Kai Wang
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.,Department of Neurology, First Affiliated Hospital, Anhui Medical University, Hefei, China.,Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Anhui Medical University, Hefei, China.,Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Hefei, China
| |
Collapse
|
10
|
Thomson DM, Openshaw RL, Mitchell EJ, Kouskou M, Millan MJ, Mannoury la Cour C, Morris BJ, Pratt JA. Impaired working memory, cognitive flexibility and reward processing in mice genetically lacking Gpr88: Evidence for a key role for Gpr88 in multiple cortico-striatal-thalamic circuits. GENES BRAIN AND BEHAVIOR 2020; 20:e12710. [PMID: 33078498 DOI: 10.1111/gbb.12710] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 10/08/2020] [Accepted: 10/19/2020] [Indexed: 12/22/2022]
Abstract
The GPR88 orphan G protein-coupled receptor is expressed throughout the striatum, being preferentially localised in medium spiny neurons. It is also present in lower densities in frontal cortex and thalamus. Rare mutations in humans suggest a role in cognition and motor function, while common variants are associated with psychosis. Here we evaluate the influence of genetic deletion of GPR88 upon performance in translational tasks interrogating motivation, reward evaluation and cognitive function. In an automated radial arm maze 'N-back' working memory task, Gpr88 KO mice showed impaired correct responding, suggesting a role for GPR88 receptors in working memory circuitry. Associative learning performance was similar to wild-type controls in a touchscreen task but performance was impaired at the reversal learning stage, suggesting cognitive inflexibility. Gpr88 KO mice showed higher breakpoints, reduced latencies and lengthened session time in a progressive ratio task consistent with enhanced motivation. Simultaneously, locomotor hyperactivity was apparent in this task, supporting previous findings of actions of GPR88 in a cortico-striatal-thalamic motor loop. Evidence for a role of GPR88 in reward processing was demonstrated in a touchscreen-based equivalent of the Iowa gambling task. Although both Gpr88 KO and wild-type mice showed a preference for an optimum contingency choice, Gpr88 KO mice selected more risky choices at the expense of more advantageous lower risk options. Together these novel data suggest that striatal GPR88 receptors influence activity in a range of procedures integrated by prefrontal, orbitofrontal and anterior cingulate cortico-striatal-thalamic loops leading to altered cognitive, motivational and reward evaluation processes.
Collapse
Affiliation(s)
- David M Thomson
- Strathclyde Institute of Pharmacy and Biomedical Science, University of Strathclyde, Glasgow, G4 0RE, United Kingdom
| | - Rebecca L Openshaw
- Strathclyde Institute of Pharmacy and Biomedical Science, University of Strathclyde, Glasgow, G4 0RE, United Kingdom
| | - Emma J Mitchell
- Strathclyde Institute of Pharmacy and Biomedical Science, University of Strathclyde, Glasgow, G4 0RE, United Kingdom
| | - Marianna Kouskou
- Strathclyde Institute of Pharmacy and Biomedical Science, University of Strathclyde, Glasgow, G4 0RE, United Kingdom
| | - Mark J Millan
- Centre for Therapeutic Innovation-CNS, Institute de Recherche Servier, Croissy-sur-Seine, France
| | | | - Brian J Morris
- Institute of Neuroscience and Psychology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Judith A Pratt
- Strathclyde Institute of Pharmacy and Biomedical Science, University of Strathclyde, Glasgow, G4 0RE, United Kingdom
| |
Collapse
|
11
|
Giustiniani J, Nicolier M, Teti Mayer J, Chabin T, Masse C, Galmès N, Pazart L, Trojak B, Bennabi D, Vandel P, Haffen E, Gabriel D. Behavioral and Neural Arguments of Motivational Influence on Decision Making During Uncertainty. Front Neurosci 2020; 14:583. [PMID: 32581698 PMCID: PMC7290000 DOI: 10.3389/fnins.2020.00583] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 05/12/2020] [Indexed: 11/24/2022] Open
Abstract
The scientific world is increasingly interested in motivation, primarily due to the suspected impact on decision-making abilities, particularly in uncertain conditions. To explore this plausible relationship, 28 healthy participants were included in the study and performed decision-making and motivational tasks while their neural activity was recorded. All participants performed the Iowa Gambling Task (IGT) and were split into two groups based on their score, one favorable group with 14 participants who performed advantageously and one undecided group with 14 participants who failed to develop the correct strategy on the IGT. In addition, all participants performed the Effort Expenditure for Reward Task (EEfRT), which defines the motivational level of each participant by the effort that participants agree to do in function of reward magnitudes and probabilities to receive these reward (10, 50, and 90%). The completion of both tasks allowed for the exploration of the relationship between the motivational level and decision-making abilities. The EEfRT was adapted to electroencephalography (EEG) recordings to explore how motivation could influence reward experience. Behavioral results showed no difference in EEfRT performances on the whole task between the two groups’ performances on the IGT. However, there was a negative correlation between the difficulty to develop an optimal strategy on the IGT and the percentage of difficult choices at the 90% condition on the EEfRT. Each probability condition has been previously associated to different motivational and emotional states, with the 90% condition associated to the reward sensitivity. This behavioral result leads to the hypothesis that reward sensitivity may induce an inability to develop an optimal strategy on the IGT. Group analysis demonstrated that only the undecided group showed a P300 during the processing of the outcome, whereas the favorable group showed a blunted P300. Similarly, there was a negative correlation between the P300 amplitude and the ability to develop an optimal strategy on the IGT. In conclusion, behavioral and neuronal data provides evidence that the propensity to focus only on the immediate outcomes is related to the development of an inefficient strategy on the IGT, without influence of motivation.
Collapse
Affiliation(s)
- Julie Giustiniani
- Department of Clinical Psychiatry, University Hospital of Besançon, Besançon, France.,EA 481, Laboratory of Neurosciences, University of Burgundy Franche-Comté, Besançon, France.,Clinical Investigation Centre, University Hospital of Besançon, Besançon, France
| | - Magali Nicolier
- Department of Clinical Psychiatry, University Hospital of Besançon, Besançon, France.,EA 481, Laboratory of Neurosciences, University of Burgundy Franche-Comté, Besançon, France.,Clinical Investigation Centre, University Hospital of Besançon, Besançon, France.,Neuroimaging and neurostimulation department Neuraxess, University of Burgundy Franche-Comté, Besançon, France
| | - Juliana Teti Mayer
- Department of Clinical Psychiatry, University Hospital of Besançon, Besançon, France.,EA 481, Laboratory of Neurosciences, University of Burgundy Franche-Comté, Besançon, France
| | - Thibault Chabin
- EA 481, Laboratory of Neurosciences, University of Burgundy Franche-Comté, Besançon, France
| | - Caroline Masse
- Department of Clinical Psychiatry, University Hospital of Besançon, Besançon, France.,EA 481, Laboratory of Neurosciences, University of Burgundy Franche-Comté, Besançon, France
| | - Nathan Galmès
- EA 481, Laboratory of Neurosciences, University of Burgundy Franche-Comté, Besançon, France
| | - Lionel Pazart
- EA 481, Laboratory of Neurosciences, University of Burgundy Franche-Comté, Besançon, France.,Clinical Investigation Centre, University Hospital of Besançon, Besançon, France
| | - Benoit Trojak
- Fondation FondaMental, Hôpital Albert Chenevier, Créteil, France.,Department of Psychiatry and Addictology, University Hospital of Dijon, Dijon, France.,EA 4452, LPPM, University of Burgundy Franche-Comté, Dijon, France
| | - Djamila Bennabi
- Department of Clinical Psychiatry, University Hospital of Besançon, Besançon, France.,EA 481, Laboratory of Neurosciences, University of Burgundy Franche-Comté, Besançon, France.,Fondation FondaMental, Hôpital Albert Chenevier, Créteil, France
| | - Pierre Vandel
- Department of Clinical Psychiatry, University Hospital of Besançon, Besançon, France.,EA 481, Laboratory of Neurosciences, University of Burgundy Franche-Comté, Besançon, France.,Clinical Investigation Centre, University Hospital of Besançon, Besançon, France
| | - Emmanuel Haffen
- Department of Clinical Psychiatry, University Hospital of Besançon, Besançon, France.,EA 481, Laboratory of Neurosciences, University of Burgundy Franche-Comté, Besançon, France.,Clinical Investigation Centre, University Hospital of Besançon, Besançon, France.,Fondation FondaMental, Hôpital Albert Chenevier, Créteil, France
| | - Damien Gabriel
- EA 481, Laboratory of Neurosciences, University of Burgundy Franche-Comté, Besançon, France.,Clinical Investigation Centre, University Hospital of Besançon, Besançon, France.,Neuroimaging and neurostimulation department Neuraxess, University of Burgundy Franche-Comté, Besançon, France
| |
Collapse
|
12
|
Novel insights into "hot" executive functioning profiles in elderly individuals. Int Psychogeriatr 2020; 32:669-671. [PMID: 32616116 DOI: 10.1017/s1041610219001169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
13
|
Karyadi KA, Nitch SR, Kinney DI, Britt WG. Decision making of forensic psychiatric inpatients deemed incompetent to stand trial. APPLIED NEUROPSYCHOLOGY-ADULT 2020; 29:66-76. [PMID: 31957489 DOI: 10.1080/23279095.2019.1709847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study examined decision making and its correlates among forensic psychiatric inpatients deemed incompetent to stand trial (IST). This study utilized archival data (n = 41; Mean Age = 44.27, SD = 15.89, 79.1% Male; 34.1% Caucasian). Decision making was measured using the Iowa Gambling Task (IGT), which is purported to simulate real-life decision making. Correlates included cognitive functioning, psychiatric symptom severity, and impulsivity. Participants selected more frequently from disadvantageous decks, which yield larger immediate monetary gains with a larger long-term monetary losses (Mean NET = -9.51, SD = 26.70), but avoided decks yielding frequent monetary losses (Mean GLF = 10.10, SD = 26.70). Consistently, participants selected most frequently from a deck yielding the most immediate monetary gains and the least frequent monetary losses compared to other decks (ps < 0.05). Based upon their selections, participants lost a significant amount of money (M = -$1,493.22, SD = $1,182.26). IGT outcomes were differentially associated with cognitive functioning (rs = -0.26 to 0.47), psychiatric symptom severity (rs = -0.41 to 0.37), and impulsivity (rs = -0.47 to 0.28; all ps = 0.003-0.98). Findings can guide future research, as well as guide competency restoration and decision-making interventions, for this population.
Collapse
Affiliation(s)
- Kenny A Karyadi
- Department of Psychology, Patton State Hospital, Patton, CA, USA.,Behavioral Health Institute, Loma Linda University, Redlands, CA, USA
| | - Stephen R Nitch
- Department of Psychology, Patton State Hospital, Patton, CA, USA
| | | | - William G Britt
- Department of Psychology, Patton State Hospital, Patton, CA, USA.,Behavioral Health Institute, Loma Linda University, Redlands, CA, USA
| |
Collapse
|
14
|
Siddiqui I, Saperia S, Fervaha G, Da Silva S, Jeffay E, Zakzanis KK, Agid O, Remington G, Foussias G. Goal-directed planning and action impairments in schizophrenia evaluated in a virtual environment. Schizophr Res 2019; 206:400-406. [PMID: 30471980 DOI: 10.1016/j.schres.2018.10.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 10/07/2018] [Accepted: 10/18/2018] [Indexed: 11/24/2022]
Abstract
Planning and executing goal-directed behaviours are critical final steps in translating motivation into action. Amotivation is a key feature of schizophrenia, but its impact on goal-directed functioning has not been extensively studied in an objective and ecologically valid manner. To address this, we investigated goal-directed planning and action in schizophrenia using a virtual reality task, the Multitasking in the City Test (MCT). The MCT was administered to 49 outpatients with schizophrenia and 55 healthy controls, and required participants to complete a series of errands in a virtual city. Ability to complete the task as directed was assessed by a performance score based on errands completed and errors committed. Task efficiency was evaluated by the total distance travelled, and an index of path efficiency comparing an optimal route with the traversed route. Schizophrenia participants had lower performance scores, travelled farther, and had reduced path efficiency compared to healthy controls. Greater distance travelled and lower path efficiency in schizophrenia were related to amotivation. Path efficiency in schizophrenia was also related to neurocognition, including planning ability; notably, this relationship appeared to be independent of the relationship with amotivation. Individuals with schizophrenia demonstrated impaired goal-directed planning and action in the context of a simulated everyday errands task, both in terms of reduced capacity to complete errands and reduced efficiency in doing so. The latter may manifest as diminished real-world motivated and functional behaviour in patients with schizophrenia and indicates a specific deficit in the execution of planned behaviour.
Collapse
Affiliation(s)
- Ishraq Siddiqui
- Schizophrenia Division and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, Ontario M5T 1R8, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, Ontario M5S 1A8, Canada.
| | - Sarah Saperia
- Schizophrenia Division and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, Ontario M5T 1R8, Canada
| | - Gagan Fervaha
- Schizophrenia Division and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, Ontario M5T 1R8, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, Ontario M5S 1A8, Canada
| | - Susana Da Silva
- Schizophrenia Division and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, Ontario M5T 1R8, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, Ontario M5S 1A8, Canada
| | - Eliyas Jeffay
- Department of Psychology, University of Toronto Scarborough, 1265 Military Trail, Toronto, Ontario M1C 1A4, Canada
| | - Konstantine K Zakzanis
- Department of Psychology, University of Toronto Scarborough, 1265 Military Trail, Toronto, Ontario M1C 1A4, Canada
| | - Ofer Agid
- Schizophrenia Division and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, Ontario M5T 1R8, Canada; Department of Psychiatry, University of Toronto, 250 College St., Toronto, Ontario M5T 1R8, Canada
| | - Gary Remington
- Schizophrenia Division and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, Ontario M5T 1R8, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, Ontario M5S 1A8, Canada; Department of Psychiatry, University of Toronto, 250 College St., Toronto, Ontario M5T 1R8, Canada
| | - George Foussias
- Schizophrenia Division and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, Ontario M5T 1R8, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, Ontario M5S 1A8, Canada; Department of Psychiatry, University of Toronto, 250 College St., Toronto, Ontario M5T 1R8, Canada
| |
Collapse
|
15
|
Betz LT, Brambilla P, Ilankovic A, Premkumar P, Kim MS, Raffard S, Bayard S, Hori H, Lee KU, Lee SJ, Koutsouleris N, Kambeitz J. Deciphering reward-based decision-making in schizophrenia: A meta-analysis and behavioral modeling of the Iowa Gambling Task. Schizophr Res 2019; 204:7-15. [PMID: 30262254 DOI: 10.1016/j.schres.2018.09.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 08/26/2018] [Accepted: 09/11/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Patients with schizophrenia (SZP) have been reported to exhibit impairments in reward-based decision-making, but results are heterogeneous with multiple potential confounds such as age, intelligence level, clinical symptoms or medication, making it difficult to evaluate the robustness of these impairments. METHODS We conducted a meta-analysis of studies comparing the performance of SZP and healthy controls (HC) in the Iowa Gambling Task (IGT) as well as comprehensive analyses based on subject-level data (n = 303 SZP, n = 188 HC) to investigate reward-based decision-making in SZP. To quantify differences in the influence of individual deck features (immediate gain, gain frequency, net loss) between SZP and HC, we additionally employed a least-squares model. RESULTS SZP showed statistically significant suboptimal decisions as indicated by disadvantageous deck choices (d from 0.51 to −0.62) and lower net scores (d from −0.35 to −1.03) in a meta-analysis of k = 29 samples (n = 1127 SZP, n = 1149 HC) and these results were confirmed in a complementary subject-level analysis. Moreover, decision-making in SZP was characterized by a relative overweighting of immediate gain and net losses and an underweighting of gain frequency. Moderator analyses revealed that in part, decision-making in the IGT was moderated by intelligence level, medication and general symptom scores. CONCLUSION Our results indicate robust impairments in reward-based decision-making in SZP and suggest that decreased cognitive resources, such as working memory, may contribute to these alterations.
Collapse
Affiliation(s)
- Linda T Betz
- Department of Psychiatry, Ludwig-Maximilian-University Munich, Munich, Germany.
| | - Paolo Brambilla
- Scientific Institute IRCCS "E. Medea", Bosisio Parini, Lecco, Italy.
| | - Andrej Ilankovic
- Psychiatry Clinic, Clinical Center of Serbia, University of Belgrade, Belgrade, Serbia
| | - Preethi Premkumar
- Department of Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, UK.
| | - Myung-Sun Kim
- Department of Psychology, Sungshin Women's University, Seoul, Republic of Korea.
| | - Stéphane Raffard
- University Department of Adult Psychiatry, La Colombière Hospital, CHRU Montpellier, Montpellier, France; Laboratoire Epsylon, EA 4556, Université Paul Valéry Montpellier 3, Montpellier, France.
| | - Sophie Bayard
- Laboratoire Epsylon, EA 4556, Université Paul Valéry Montpellier 3, Montpellier, France.
| | - Hikaru Hori
- Department of Psychiatry, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 8078555, Japan.
| | - Kyoung-Uk Lee
- Department of Psychiatry, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Uijeongbu, Republic of Korea.
| | - Seung Jae Lee
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | | | - Joseph Kambeitz
- Department of Psychiatry, Ludwig-Maximilian-University Munich, Munich, Germany.
| |
Collapse
|
16
|
Hernaus D, Frank MJ, Brown EC, Brown JK, Gold JM, Waltz JA. Impaired Expected Value Computations in Schizophrenia Are Associated With a Reduced Ability to Integrate Reward Probability and Magnitude of Recent Outcomes. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2018; 4:280-290. [PMID: 30683607 DOI: 10.1016/j.bpsc.2018.11.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 11/08/2018] [Accepted: 11/27/2018] [Indexed: 01/05/2023]
Abstract
BACKGROUND Motivational deficits in people with schizophrenia (PSZ) are associated with an inability to integrate the magnitude and probability of previous outcomes. The mechanisms that underlie probability-magnitude integration deficits, however, are poorly understood. We hypothesized that increased reliance on "valueless" stimulus-response associations, in lieu of expected value (EV)-based learning, could drive probability-magnitude integration deficits in PSZ with motivational deficits. METHODS Healthy volunteers (n = 38) and PSZ (n = 49) completed a learning paradigm consisting of four stimulus pairs. Reward magnitude (3, 2, 1, 0 points) and probability (90%, 80%, 20%, 10%) determined each stimulus's EV. Following a learning phase, new and familiar stimulus pairings were presented. Participants were asked to select stimuli with the highest reward value. RESULTS PSZ with high motivational deficits made increasingly less optimal choices as the difference in reward value (probability × magnitude) between two competing stimuli increased. Using a previously validated computational hybrid model, PSZ relied less on EV ("Q-learning") and more on stimulus-response learning ("actor-critic"), which correlated with Scale for the Assessment of Negative Symptoms motivational deficit severity. PSZ specifically failed to represent reward magnitude, consistent with model demonstrations showing that response tendencies in the actor-critic were preferentially driven by reward probability. CONCLUSIONS Probability-magnitude deficits in PSZ with motivational deficits arise from underutilization of EV in favor of reliance on valueless stimulus-response associations. Confirmed by our computational hybrid framework, probability-magnitude integration deficits were driven specifically by a failure to represent reward magnitude. This work provides a first mechanistic explanation of complex EV-based learning deficits in PSZ with motivational deficits that arise from an inability to combine information from different reward modalities.
Collapse
Affiliation(s)
- Dennis Hernaus
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands; Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland.
| | - Michael J Frank
- Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Providence, Rhode Island; Department of Psychiatry and Brown Institute for Brain Science, Brown University, Providence, Rhode Island
| | - Elliot C Brown
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland; Institute for Psychology, University of Lübeck, Lübeck, Germany
| | - Jaime K Brown
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| | - James M Gold
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| | - James A Waltz
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| |
Collapse
|
17
|
Na E, Kang B, Kim MS. Decision-Making Deficits Are Associated With Learning Impairments in Female College Students at High Risk for Anorexia Nervosa: Iowa Gambling Task and Prospect Valence Learning Model. Front Psychiatry 2018; 9:759. [PMID: 30740067 PMCID: PMC6357925 DOI: 10.3389/fpsyt.2018.00759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Accepted: 12/20/2018] [Indexed: 11/13/2022] Open
Abstract
This study investigated deficits in decision-making ability in female college students at high risk for anorexia nervosa (AN) using the Iowa Gambling Task (IGT) and the prospect valence learning (PVL) model. Based on scores on the Korean version of the Eating Attitude Test-26 (KEAT-26), participants were assigned to either the high risk for AN group (n = 42) or the control group (n = 43). The high risk for AN group exhibited significantly lower total net scores and block net scores on the third, fourth, and fifth blocks of the IGT than the control group did. The high risk for AN group selected cards significantly more often from the disadvantageous A and B decks and less often from the advantageous D deck than the control group did. In addition, the block net scores of the high risk for AN group did not differ across the five blocks, whereas those of the control group increased as the trials progressed. There was a significant negative correlation between IGT total net score and total score on the KEAT-26. The high risk for AN group had significantly lower values than the control group on the learning and response consistency parameters of the PVL model. These results indicate that female college students at high risk for AN have deficits in decision-making ability, and that these deficits are related to difficulties in remembering experience obtained from earlier trials and applying it to later trials. These difficulties further lead them to make decisions randomly.
Collapse
Affiliation(s)
- Eunchan Na
- Department of Psychology, Sungshin Women's University, Seoul, South Korea
| | - Bitna Kang
- Jakwang Child & Family Clinic, Seoul, South Korea
| | - Myung-Sun Kim
- Department of Psychology, Sungshin Women's University, Seoul, South Korea
| |
Collapse
|
18
|
Shalev D, Brewster K, Arbuckle MR, Levenson JA. A staggered edge: End-of-life care in patients with severe mental illness. Gen Hosp Psychiatry 2017; 44:1-3. [PMID: 28041569 PMCID: PMC5849470 DOI: 10.1016/j.genhosppsych.2016.10.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 10/15/2016] [Accepted: 10/18/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Daniel Shalev
- New York State Psychiatric Institute/Columbia University Department of Psychiatry, 1051 Riverside Drive, Box 103, New York, NY 10032, United States.
| | | | | | | |
Collapse
|