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

Abstract

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. Key words: behavior, obsessive-compulsive disorder, cognition, serotonin.Prejuízo no processo de tomada de decisão mensurado pelo Iowa Gambling Task no transtorno obsessivo-compulsivo RESUMO Objetivo: Avaliar o processo de tomada de decisão em pacientes com transtorno obsessivo-compulsivo (TOC) utilizando o Iowa Gambling Task. Pretende-se, também, avaliar características demográficas e clínicas que possam influenciar essa função executiva. Método: Nossa amostra é composta de 214 sujeitos (107 pacientes com diagnóstico de TOC e 107 controles) que foram avaliados do ponto de vista clínico, demográfico e neuropsicológico. O Iowa Gambling Task, um teste que avalia o processo de tomada de decisão, foi aplicado. Resultados: Observamos um prejuízo no desempenho dos pacientes com TOC no IGT. Características como sintomas depressivos e ansiosos não foram responsáveis por esse prejuízo. Conclusão: O prejuízo no processo de tomada de decisão parece ser um componente importante na fisiopatologia do TOC. Como o TOC é um transtorno heterogêneo, grupos mais homogêneos são necessários para uma melhor caracterização e confirmação dos nossos achados. Palavras-chave: comportamento, transtorno obsessivo-compulsivo, cognição, serotonina. CorrespondenceFelipe Filardi da Rocha Rua Sapucaia 83 35460-000 Brumadinho MG -Brasil

Further evidence of a dissociation between decision-making under ambiguity and decision-making under risk in obsessive–compulsive disorder

“…In accordance with the functional alteration of orbitofrontal-striatal circuits, previous studies have frequently demonstrated reduced IGT score in patients with OCD (Cavedini et al, 2002(Cavedini et al, , 2012(Cavedini et al, , 2010da Rocha et al, 2011a;Kashyap et al, 2013;Starcke et al, 2009Starcke et al, , 2010. On the other hand, two studies reported impaired performance in only subgroups of patients with OCD (Lawrence et al, 2006;Nielen et al, 2002), and one study revealed comparable performance in medication-naïve patients with OCD (Krishna et al, 2011).…”

Brazilian Portuguese transcultural adaptation of Barkley Deficits in Executive Functioning Scale (BDEFS)

“…The respondents have to select the best option based in a four-point Likert type-scale to describe the frequency of certain behaviors and situations linked with impulsivity. The BIS-11 has three subscales: attentional impulsivity (items 6,5,9,11,20,24,26,28), motor impulsivity (items 2,3,4,16,17,19,21,22,23,25,30) and non-planning impulsivity (items 1,7,8,10,12,13,14,15,18,27,29). Furthermore, the BIS-11 has a total score ranges from 30 to 120 points.…”

“…Several psychopathologies are associated with impairments in EF processes, such as Attention Deficit Hyperactivity Disorder (ADHD) 6 , Bipolar Disorder 7 , Obsessive Compulsive Disorder 8 , and Schizophrenia 9 . In clinical samples, as in ADHD, EF deficits are related to poor functional outcomes, such as educational fields 10 .…”

Interactions among attention-deficit hyperactivity disorder (ADHD) and problem gambling in a probabilistic reward-learning task

“…Some other outcome measures used in this regard include total money won [38], total of cards selected on individual decks [29], comparison between the number of cards selected from the decks A and C (lowfrequency loses) and decks B and D (high-frequency loses) [29], and analysis of selections in the later trials versus the earlier ones [30,37]. This issue motivated us to compare the normalized number of good bets in the first-300 versus the last-100 trials.…”

“…This measure was calculated within four quartile time bins to show subjects' learning trends over trials. We also explored the behavioral performance by using the total number of good bets as in previous studies [29,30]. Finally, we computed a metric of participants' tendency to re-engage with a previous bet despite a negative/positive outcome.…”