Trait-Related Decision-Making Impairment in the Three Phases of Bipolar Disorder

Adida, M.; Jollant, Fabrice; Clark, Luke; Besnier, N.; Guillaume, Sébastien; Kaladjian, Arthur; Mazzola-Pomietto, Pascale; Jeanningros, Régine; Goodwin, Guy M.; Azorin, Jean‐Michel; Courtet, Philippe

doi:10.1016/j.biopsych.2011.01.018

Cited by 115 publications

(132 citation statements)

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“…Manic BD patients are hypersensitive to rewards (Cassidy et al, 1998). Schizophrenia patients exhibit disrupted contingency learning (Brambilla et al, 2012), whereas depressed patients are more sensitive to punishment (Adida et al, 2011;Must et al, 2013). Collectively, these findings support differing mechanisms underlying poor decision making in these disorders.…”

Section: Introductionmentioning

confidence: 84%

“…The Iowa Gambling Task (IGT) utilizes highyield/high-risk versus low-yield/low-risk options to measure decision making with real-world translational validity in one test-session (Bechara et al, 1994). Patients with bipolar disorder (BD) exhibit poor IGT performance (Adida et al, 2011;Ibanez et al, 2012). Moreover, a diagnosis-specific performance profile can be discerned.…”

Section: Introductionmentioning

confidence: 99%

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Reduced Dopamine Transporter Functioning Induces High-Reward Risk-Preference Consistent with Bipolar Disorder

Enkhuizen

Henry

Minassian

et al. 2014

Neuropsychopharmacol

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Individuals with bipolar disorder (BD) exhibit deleterious decision making, negatively impacting their lives. Such aberrant decision making can be quantified using the Iowa Gambling Task (IGT), which requires choosing between advantageous and disadvantageous options based on different reward/punishment schedules. The mechanisms underlying this behavioral deficit are unknown, but may include the reduced dopamine transporter (DAT) functioning reported in BD patients. Using both human and mouse IGTs, we tested whether reduced DAT functioning would recreate patterns of deficient decision making of BD patients. We assessed the IGT performance of 16 BD subjects (7 female) and 17 healthy control (HC) subjects (12 female). We recorded standard IGT performance measures and novel post-reward and post-punishment decision-making strategies. We characterized a novel single-session mouse IGT using C57BL/6J mice (n ¼ 44). The BD and HC IGT performances were compared with the effects of chronic (genetic knockdown (KD; n ¼ 31) and wild-type (n ¼ 28) mice) and acute (C57BL/6J mice (n ¼ 89) treated with the DAT inhibitor GBR12909) reductions of DAT functioning in mice performing this novel IGT. BD patients exhibited impaired decision making compared with HC subjects. Both the good-performing DAT KD and GBR12909-treated mice exhibited poor decision making in the mouse IGT. The deficit of each population was driven by highreward sensitivity. The single-session mouse IGT measures dynamic risk-based decision making similar to humans. Chronic and acute reductions of DAT functioning in mice impaired decision-making consistent with poor IGT performance of BD patients. Hyperdopaminergia caused by reduced DAT may impact poor decision making in BD patients, which should be confirmed in future studies.

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Section: Introductionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Reduced Dopamine Transporter Functioning Induces High-Reward Risk-Preference Consistent with Bipolar Disorder

Enkhuizen

Henry

Minassian

et al. 2014

Neuropsychopharmacol

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“…Bipolar patients exhibit impulsive behaviors, such as increased spending and hypersexual activity during periods of manic exacerbations, and when tested in the laboratory they consistently demonstrate deficits on decision-making tasks compared with healthy controls (Adida et al, 2008(Adida et al, , 2011Jollant et al, 2007;Martino et al, 2011;Yechiam et al, 2008). Even during periods of remission, patients with BPD demonstrate decreased reward-based learning (Pizzagalli et al, 2008), which may be related to reduced sensitivity to emotional contexts that highlight rewards or punishments (Chandler et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

“…As there are no empirical data on the prevalence of pramipexole exposure in BD patients in the community, it is impossible to establish the rarity of such a case or to compare it with similar side effects associated with other medications. Nonetheless, given the convergent data in PD and in healthy control subjects alongside a predisposition toward impulsive behaviors in BPD (Adida et al, 2008(Adida et al, , 2011Jollant et al, 2007;Martino et al, 2011;Yechiam et al, 2008), it would be reasonable to predict that BPD patients might be especially susceptible to the development of impulse-control disorders or behaviors associated with poor emotional decision making when taking a DA agonist.…”

Section: Introductionmentioning

confidence: 99%

Dopaminergic Influences on Emotional Decision Making in Euthymic Bipolar Patients

Burdick

Braga

Gopin

et al. 2013

Neuropsychopharmacol

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We recently reported that the D2/D3 agonist pramipexole may have pro-cognitive effects in euthymic patients with bipolar disorder (BPD); however, the emergence of impulse-control disorders has been documented in Parkinson's disease (PD) after pramipexole treatment. Performance on reward-based tasks is altered in healthy subjects after a single dose of pramipexole, but its potential to induce abnormalities in BPD patients is unknown. We assessed reward-dependent decision making in euthymic BPD patients pre-and post 8 weeks of treatment with pramipexole or placebo by using the Iowa Gambling Task (IGT). The IGT requires subjects to choose among four card decks (two risky and two conservative) and is designed to promote learning to make advantageous (conservative) choices over time. Thirty-four BPD patients completed both assessments (18 placebo and 16 pramipexole). Baseline performance did not differ by treatment group (F ¼ 0.63; p ¼ 0.64); however, at week 8, BPD patients on pramipexole demonstrated a significantly greater tendency to make increasingly high-risk, high-reward choices across the five blocks, whereas the placebo group's pattern was similar to that reported in healthy individuals (treatment Â time Â block interaction, po0.05). Analyses of choice strategy using the expectancy valence model revealed that after 8 weeks on pramipexole, BPD patients attended more readily to feedback related to gains than to losses, which could explain the impaired learning. There were no significant changes in mood symptoms over the 8 weeks, and no increased propensity toward manic-like behaviors were reported. Our results suggest that the enhancement of dopaminergic activity influences risk-associated decision-making performance in euthymic BPD. The clinical implications remain unknown.

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“…14,15 Most investigations of DM impairment, especially in psychiatric populations, rely on instruments designed for performance measurement, such as the Iowa Gambling Task (IGT), 16 a computerized instrument which evaluates DM under uncertainty or risk in a simulated card game. This task has been used to study DM impairments in BD, 17 major depressive disorder (MDD), 5 schizophrenia, 1 and obsessive-compulsive disorder. 18 Although these studies have made important contributions to the literature, additional measures of DM could complement these findings and perhaps address some of the limitations associated with the use of the IGT.…”

Section: Introductionmentioning

confidence: 99%

Adaptation and validation of the Melbourne Decision Making Questionnaire to Brazilian Portuguese

Cotrena

Branco

Fonseca

2017

Trends Psychiatry Psychother.

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Trends in Psychiatry and Psychotherapy Original ArticleResumo Introdução: A tomada de decisão (TD) é uma das habilidades mais relevantes para a funcionalidade. No entanto, esta habilidade é geralmente avaliada por meio de tarefas comportamentais, cuja validade ecológica tem sido questionada. De acordo com a literatura, a avaliação da TD deve ser complementada por questionários ou escalas, instrumentos estes que não estão disponíveis no português brasileiro. Desta forma, o objetivo deste estudo foi a tradução e validação de uma versão do Melbourne Decision Making Questionnaire (MDMQ), o instrumento mais amplamente utilizado na avaliação da TD, para uso em português. Métodos: A adaptação da MDMQ foi realizada através da tradução, retrotradução, avaliação por painel de juízes e estudo piloto. A versão da escala produzida neste processo foi submetida a análise fatorial e avaliação de consistência interna, levando a exclusão de 4 itens da escala original. A versão resultante da MDMQ, contando com 18 itens no total, foi então utilizada em estudo de validação, em que a TD foi comparada entre adultos saudáveis e portadores de depressão e transtorno bipolar. Resultados:O instrumento demonstrou consistência interna satisfatória, apesar da obtenção de alfas de Cronbach relativamente baixos para a subescala de hipervigilância. A estrutura fatorial do questionário traduzido foi semelhante a observada no instrumento original. Todas as medidas derivadas da MDMQ, mostraram-se discriminativas na comparação entre adultos saudáveis e portadores de transtornos mentais. Conclusão: A versão da MDMQ produzida neste estudo poderá realizar uma importante contribuição para a prática clínica e pesquisa neuropsicológica acerca da TD. Descritores: Tomada de decisões; inquéritos e questionários; psicometria; neuropsicologia. AbstractIntroduction: Decision making (DM) is among the most important abilities for everyday functioning. However, the most widely used measures of DM come from behavioral paradigms, whose ecological validity and standalone use has been criticized in the literature. Though these issues could be addressed by the use of DM questionnaires as a complementary assessment method, no such instruments have been validated for use in Brazilian Portuguese. Therefore, the aim of this study was to conduct the translation and validation of the Melbourne Decision Making Questionnaire (MDMQ) for use in a Brazilian population. Methods: The adaptation of the MDMQ involved the following steps: translation, back-translation, expert review and pilot study. These steps were followed by factor analysis and internal consistency measurements, which led to the exclusion of 4 items from the scale. The 18-item version of the MDMQ was then administered to a validation sample consisting of healthy adults, as well as patients with bipolar disorder (BD) and major depressive disorder (MDD). Results: The instrument displayed good internal consistency, with the hypervigilance subscale showing the lowest, though still acceptable, Cronbach's alpha value. It...

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Trait-Related Decision-Making Impairment in the Three Phases of Bipolar Disorder

Cited by 115 publications

References 54 publications

Reduced Dopamine Transporter Functioning Induces High-Reward Risk-Preference Consistent with Bipolar Disorder

Reduced Dopamine Transporter Functioning Induces High-Reward Risk-Preference Consistent with Bipolar Disorder

Dopaminergic Influences on Emotional Decision Making in Euthymic Bipolar Patients

Adaptation and validation of the Melbourne Decision Making Questionnaire to Brazilian Portuguese

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