Linda T Betz1, Paolo Brambilla2, Andrej Ilankovic3, Preethi Premkumar4, Myung-Sun Kim5, Stéphane Raffard6, Sophie Bayard7, Hikaru Hori8, Kyoung-Uk Lee9, Seung Jae Lee10, Nikolaos Koutsouleris11, Joseph Kambeitz12. 1. Department of Psychiatry, Ludwig-Maximilian-University Munich, Munich, Germany. Electronic address: linda.betz@med.uni-muenchen.de. 2. Scientific Institute IRCCS "E. Medea", Bosisio Parini, Lecco, Italy. Electronic address: paolo.brambilla1@unimi.it. 3. Psychiatry Clinic, Clinical Center of Serbia, University of Belgrade, Belgrade, Serbia. 4. Department of Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, UK. Electronic address: preethi.premkumar@ntu.ac.uk. 5. Department of Psychology, Sungshin Women's University, Seoul, Republic of Korea. Electronic address: kimms@sungshin.ac.kr. 6. University Department of Adult Psychiatry, La Colombière Hospital, CHRU Montpellier, Montpellier, France; Laboratoire Epsylon, EA 4556, Université Paul Valéry Montpellier 3, Montpellier, France. Electronic address: s-raffard@chu-montpellier.fr. 7. Laboratoire Epsylon, EA 4556, Université Paul Valéry Montpellier 3, Montpellier, France. Electronic address: sophie.bayard@univ-montp3.fr. 8. Department of Psychiatry, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 8078555, Japan. Electronic address: hori-h@med.uoeh-u.ac.jp. 9. Department of Psychiatry, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Uijeongbu, Republic of Korea. Electronic address: mindcure@catholic.ac.kr. 10. Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Republic of Korea. 11. Department of Psychiatry, Ludwig-Maximilian-University Munich, Munich, Germany. Electronic address: nikolaos.koutsouleris@med.uni-muenchen.de. 12. Department of Psychiatry, Ludwig-Maximilian-University Munich, Munich, Germany. Electronic address: joseph.kambeitz@med.uni-muenchen.de.
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.
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.
Entities:
Keywords:
Decision-making; Iowa Gambling Task; Linear modeling; Meta-analysis; Reward; Schizophrenia
Authors: Alexander D S Breslav; Nancy L Zucker; Julia C Schechter; Alesha Majors; Tatyana Bidopia; Bernard F Fuemmeler; Scott H Kollins; Scott A Huettel Journal: Psychol Sci Date: 2022-03-10
Authors: Mihai Avram; Michel J Grothe; Lena Meinhold; Claudia Leucht; Stefan Leucht; Stefan Borgwardt; Felix Brandl; Christian Sorg Journal: Neuropsychopharmacology Date: 2021-06-29 Impact factor: 7.853