Elliot C Brown1, Samantha M Hack2, James M Gold1, William T Carpenter3, Bernard A Fischer3, Kristen P Prentice1, James A Waltz4. 1. Maryland Psychiatric Research Center (MPRC), Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA. 2. Veterans Affairs Capital Network (VISN 5) Mental Illness Research, Education, and Clinical Center (MIRECC), Baltimore, MD, USA. 3. Maryland Psychiatric Research Center (MPRC), Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA; Veterans Affairs Capital Network (VISN 5) Mental Illness Research, Education, and Clinical Center (MIRECC), Baltimore, MD, USA. 4. Maryland Psychiatric Research Center (MPRC), Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA. Electronic address: jwaltz@mprc.umaryland.edu.
Abstract
BACKGROUND: The Iowa Gambling Task (IGT; Bechara et al., 1994) has frequently been used to assess risky decision making in clinical populations, including patients with schizophrenia (SZ). Poor performance on the IGT is often attributed to reduced sensitivity to punishment, which contrasts with recent findings from reinforcement learning studies in schizophrenia. METHODS: In order to investigate possible sources of IGT performance deficits in SZ patients, we combined data from the IGT from 59 SZ patients and 43 demographically-matched controls with data from the Balloon Analog Risk Task (BART) in the same participants. Our analyses sought to specifically uncover the role of punishment sensitivity and delineate the capacity to integrate frequency and magnitude information in decision-making under risk. RESULTS: Although SZ patients, on average, made more choices from disadvantageous decks than controls did on the IGT, they avoided decks with frequent punishments at a rate similar to controls. Patients also exhibited excessive loss-avoidance behavior on the BART. CONCLUSIONS: We argue that, rather than stemming from reduced sensitivity to negative consequences, performance deficits on the IGT in SZ patients are more likely the result of a reinforcement learning deficit, specifically involving the integration of frequencies and magnitudes of rewards and punishments in the trial-by-trial estimation of expected value.
BACKGROUND: The Iowa Gambling Task (IGT; Bechara et al., 1994) has frequently been used to assess risky decision making in clinical populations, including patients with schizophrenia (SZ). Poor performance on the IGT is often attributed to reduced sensitivity to punishment, which contrasts with recent findings from reinforcement learning studies in schizophrenia. METHODS: In order to investigate possible sources of IGT performance deficits in SZ patients, we combined data from the IGT from 59 SZ patients and 43 demographically-matched controls with data from the Balloon Analog Risk Task (BART) in the same participants. Our analyses sought to specifically uncover the role of punishment sensitivity and delineate the capacity to integrate frequency and magnitude information in decision-making under risk. RESULTS: Although SZ patients, on average, made more choices from disadvantageous decks than controls did on the IGT, they avoided decks with frequent punishments at a rate similar to controls. Patients also exhibited excessive loss-avoidance behavior on the BART. CONCLUSIONS: We argue that, rather than stemming from reduced sensitivity to negative consequences, performance deficits on the IGT in SZ patients are more likely the result of a reinforcement learning deficit, specifically involving the integration of frequencies and magnitudes of rewards and punishments in the trial-by-trial estimation of expected value.
Authors: Hana M Kester; Serge Sevy; Eldad Yechiam; Katherine E Burdick; Kelly L Cervellione; Sanjiv Kumra Journal: Schizophr Res Date: 2006-06-02 Impact factor: 4.939
Authors: P Brambilla; C Perlini; M Bellani; L Tomelleri; A Ferro; S Cerruti; V Marinelli; G Rambaldelli; T Christodoulou; J Jogia; D Dima; M Tansella; M Balestrieri; S Frangou Journal: Psychol Med Date: 2012-06-12 Impact factor: 7.723
Authors: L Felice Reddy; Junghee Lee; Michael C Davis; Lori Altshuler; David C Glahn; David J Miklowitz; Michael F Green Journal: Neuropsychopharmacology Date: 2013-08-21 Impact factor: 7.853
Authors: James M Gold; Gregory P Strauss; James A Waltz; Benjamin M Robinson; Jamie K Brown; Michael J Frank Journal: Biol Psychiatry Date: 2013-02-07 Impact factor: 13.382
Authors: Sabrina Schneider; Thomas Juergen Bahmer; Florian Gerhard Metzger; Andreas Reif; Thomas Polak; Bruno Pfuhlmann; Gudrun Walter; Mark-Christian Eberle; Lena Helene Ernst; Andreas Jochen Fallgatter; Ann-Christine Ehlis Journal: Int J Neuropsychopharmacol Date: 2013-06-12 Impact factor: 5.176
Authors: James A Waltz; Zuzana Kasanova; Thomas J Ross; Betty J Salmeron; Robert P McMahon; James M Gold; Elliot A Stein Journal: PLoS One Date: 2013-02-27 Impact factor: 3.240
Authors: James A Waltz; Ziye Xu; Elliot C Brown; Rebecca R Ruiz; Michael J Frank; James M Gold Journal: Biol Psychiatry Cogn Neurosci Neuroimaging Date: 2017-08-12
Authors: Dennis Hernaus; Michael J Frank; Elliot C Brown; Jaime K Brown; James M Gold; James A Waltz Journal: Biol Psychiatry Cogn Neurosci Neuroimaging Date: 2018-12-07
Authors: Lena Felice Reddy; James A Waltz; Michael F Green; Jonathan K Wynn; William P Horan Journal: Schizophr Bull Date: 2016-02-16 Impact factor: 9.306