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

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.

Associations between neuropsychological performance and appetite-regulating hormones in anorexia nervosa and healthy controls: Ghrelin's putative role as a mediator of decision-making

“…Performance in the IGT is linked in several studies to the activity of the orbitofrontal cortex (Bechara et al, 1999); interestingly, in patients with AN, significant volume decreases in the orbitofrontal cortex were associated with worse performance in the IGT (Bodell et al, 2014). In a recent study, lower IGT scores were positively associated with a higher risk for developing AN (Na et al, 2019).…”

Is decision-making impairment an endophenotype of anorexia nervosa?

“…Previous studies employing the PVL model found discrepant results [ 24 , 26 , 27 ]. Small samples of patients with AN [ 24 , 27 ] or at risk of AN [ 26 ] were compared with patients with bulimia nervosa [ 24 ], and healthy controls (HC) [ 24 , 26 , 27 ]. Patients with AN reported an alteration of the decision-making parameters identified by the PVL, such as lower learning scores [ 24 , 26 ], response consistency [ 26 ], and loss aversion [ 27 ].…”

“…Previous studies employing the PVL model found discrepant results [24, 26, 27]. Small samples of patients with AN [24, 27] or at risk of AN [26] were compared with patients with bulimia nervosa [24], and healthy controls (HC) [24, 26, 27].…”

“…The prospect valence learning (PVL) model is a performant and widely used model to explain the mechanisms underlying decision-making [ 25 ], already employed in studies on patients with AN [ 24 , 26 ].…”

“…Small samples of patients with AN [ 24 , 27 ] or at risk of AN [ 26 ] were compared with patients with bulimia nervosa [ 24 ], and healthy controls (HC) [ 24 , 26 , 27 ]. Patients with AN reported an alteration of the decision-making parameters identified by the PVL, such as lower learning scores [ 24 , 26 ], response consistency [ 26 ], and loss aversion [ 27 ]. Neither patients remitted from AN, nor unaffected relatives (UR) of patients have ever been tested with this model.…”