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Betz LT, Brambilla P, Ilankovic A, et al. Deciphering reward-based decision-making in schizophrenia: A meta-analysis and behavioral modeling of the Iowa Gambling Task. Schizophr Res. 2018;204:7-15doi: 10.1016/j.schres.2018.09.009.
Betz, L. T., Brambilla, P., Ilankovic, A., Premkumar, P., Kim, M. S., Raffard, S., Bayard, S., Hori, H., Lee, K. U., Lee, S. J., Koutsouleris, N., & Kambeitz, J. (2019). Deciphering reward-based decision-making in schizophrenia: A meta-analysis and behavioral modeling of the Iowa Gambling Task. Schizophrenia research, 2047-15. https://doi.org/10.1016/j.schres.2018.09.009
Betz, Linda T, et al. "Deciphering reward-based decision-making in schizophrenia: A meta-analysis and behavioral modeling of the Iowa Gambling Task." Schizophrenia research vol. 204 (2019): 7-15. doi: https://doi.org/10.1016/j.schres.2018.09.009
Betz LT, Brambilla P, Ilankovic A, Premkumar P, Kim MS, Raffard S, Bayard S, Hori H, Lee KU, Lee SJ, Koutsouleris N, Kambeitz J. Deciphering reward-based decision-making in schizophrenia: A meta-analysis and behavioral modeling of the Iowa Gambling Task. Schizophr Res. 2019 Feb;204:7-15. doi: 10.1016/j.schres.2018.09.009. Epub 2018 Sep 25. PMID: 30262254.
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Schizophr Res. 2019 Feb;204:7-15. doi: 10.1016/j.schres.2018.09.009. Epub 2018 Sep 25.

Deciphering reward-based decision-making in schizophrenia: A meta-analysis and behavioral modeling of the Iowa Gambling Task.

Schizophrenia research

Linda T Betz, Paolo Brambilla, Andrej Ilankovic, Preethi Premkumar, Myung-Sun Kim, Stéphane Raffard, Sophie Bayard, Hikaru Hori, Kyoung-Uk Lee, Seung Jae Lee, Nikolaos Koutsouleris, Joseph Kambeitz

Affiliations

  1. Department of Psychiatry, Ludwig-Maximilian-University Munich, Munich, Germany. Electronic address: [email protected].
  2. Scientific Institute IRCCS "E. Medea", Bosisio Parini, Lecco, Italy. Electronic address: [email protected].
  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: [email protected].
  5. Department of Psychology, Sungshin Women's University, Seoul, Republic of Korea. Electronic address: [email protected].
  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: [email protected].
  7. Laboratoire Epsylon, EA 4556, Université Paul Valéry Montpellier 3, Montpellier, France. Electronic address: [email protected].
  8. Department of Psychiatry, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 8078555, Japan. Electronic address: [email protected].
  9. Department of Psychiatry, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Uijeongbu, Republic of Korea. Electronic address: [email protected].
  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: [email protected].
  12. Department of Psychiatry, Ludwig-Maximilian-University Munich, Munich, Germany. Electronic address: [email protected].

PMID: 30262254 DOI: 10.1016/j.schres.2018.09.009

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.

Keywords: Decision-making; Iowa Gambling Task; Linear modeling; Meta-analysis; Reward; Schizophrenia

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