Decision-making in adult unipolar depressed patients and healthy subjects: significant differences in Net Score and in non-traditional alternative measures

Abstract

Alterations in executive functioning are frequent in depressive patients. One clinical characteristic of depression is difficulty and slowness in decision-making. This study aimed to compare the performance of a group of 30 non-psychotic unipolar depressed to 30 healthy controls in a version of the Iowa Gambling Task (IGT) from the Psychology Experiment Building Language (PEBL). Significant differences between depressed patients and healthy controls in traditional Net Score measures as well as in various alternative metrics were verified.

A transdiagnostic comparison of affective decision‐making in patients with schizophrenia, major depressive disorder, or bipolar disorder

“…A basic finding of our study was that patients with SCZ, MDD, and BD all showed significant impairments of affective decision‐making ability, with the evidence of a preference to select the disadvantageous decks but not advantageous decks compared to HCs. This finding was consistent with some previous studies (Adida et al, ; E. C. Brown et al, ; Cella et al, ; Moniz et al, ; Nestor et al, ). Decision‐making was thought to be an important psychological structure of positive valence systems dimension according to Research Domain Criteria (Sanislow et al, ).…”

“…Participants who prefer to choose high immediate rewards and great long‐term punishments (deck A/B, disadvantageous decisions) are thought to be “short‐insighted” and impaired in reversal learning (Waltz & Gold, ; Waltz et al, ), which was inferred to be related to damages in some brain areas, such as the ventromedial prefrontal cortex, orbitofrontal cortex (Bechara, Damasio, & Damasio, ), ventrolateral prefrontal cortex (Lawrence, Jollant, O'Daly, Zelaya, & Phillips, ), and amygdala (Bechara, Damasio, Damasio, & Lee, ). Previous studies using IGT have found affective decision‐making impairments in patients with SCZ (Saperia et al, ), MDD (Moniz, Jesus, Gonçalves, Pacheco, & Viseu, ), and BD (Adida et al, ), even in subclinical individuals (van Honk, Hermans, Putman, Montagne, & Schutter, ).…”

“…In this study, we aimed to make a transdiagnostic comparison of IGT performances in patients with SCZ, MDD, and BD. Based on previous studies (Adida et al, ; E. C. Brown et al, ; Cella et al, ; Moniz et al, ; Nestor et al, ), we hypothesized that all three diagnostic groups would show preference to disadvantageous decks (deck A/B) instead of advantageous decks (deck C/D) relative to HCs, with SCZ patients showing the worst preferences. Compared to HCs, patients with SCZ would show both insensitivity to punishment and impairment in calculation of the expected value over card selections and experienced outcomes.…”

“…However, the results in patients with MDD were inconsistent. Some studies found that patients with MDD exhibited lower net scores on IGT compared with HCs (Cella et al, ; Moniz et al, ; Must et al, ), while Smoski et al () reported an opposite result with a better performance of IGT in the MDD group. There are also some researchers reporting no significant difference in net scores of IGT between patients with MDD and HCs (Deisenhammer, Schmid, Kemmler, Moser, & Delazer, ; Ho, Hsu, Lu, Gossop, & Chen, ; Saperia et al, ).…”

Decision Making assessed by the Iowa Gambling Task and Major Depressive Disorder A systematic review

“…Geographic heterogeneity can be observed in these studies, since 2 studies took place in the USA, 15 , 16 1 in Hungary, 17 1 in the United Kingdom, 18 and 1 in Portugal. 19 The samples of all of the selected studies can be considered relatively small, ranging from 39 to 96 participants. Patients and controls did not differ significantly in relation to gender, age or education level in each study.…”