慢性精神分裂症中情绪决策与认知决策的分离

Dissociation of emotional decision-making from cognitive decision-making in chronic schizophrenia.

作者信息

Lee Yanghyun, Kim Yang-Tae, Seo Eugene, Park Oaktae, Jeong Sung-Hun, Kim Sang Heon, Lee Seung-Jae

机构信息

Department of Psychiatry, College of Medicine, Kyungpook National University, Daegu, South Korea.

出版信息

Psychiatry Res. 2007 Aug 30;152(2-3):113-20. doi: 10.1016/j.psychres.2006.02.001. Epub 2007 Apr 25.

Abstract

Recent studies have examined the decision-making ability of schizophrenic patients using the Iowa Gambling Task (IGT). These studies, however, were restricted to the assessment of emotional decision-making. Decision-making depends on cognitive functions as well as on emotion. The purpose of this study was to examine the performance of schizophrenic patients on the IGT and the Game of Dice Task (GDT), a decision-making task with explicit rules for gains and losses. In addition, it was intended to test whether poor performance on IGT is attributable to impairments in reversal learning within the schizophrenia group using the Simple Reversal Learning Task (SRLT), which is sensitive to measure the deficit of reversal learning following ventromedial prefrontal cortex damage. A group of 23 stable schizophrenic patients and 28 control subjects performed computerized versions of the IGT, GDT, SRLT and Wisconsin Card Sorting Test (WCST). While schizophrenic patients performed poorly on the IGT relative to normal controls, there was no significant difference between the two groups on GDT performance. The performance of the schizophrenia group on the SRLT was poorer than that of controls, but was not related to IGT performance. These data suggest that schizophrenic patients have impaired emotional decision-making but intact cognitive decision-making, suggesting that these two processes of decision-making are different. Furthermore, the impairments in reversal learning did not contribute to poor performance on the IGT in schizophrenia. Therefore, schizophrenic patients have difficulty in making decisions under ambiguous and uncertain situations whereas they make choices easily in clear and unequivocal ones. The emotional decision-making deficits in schizophrenia might be attributable more to another mechanism such as a somatic marker hypothesis than to an impairment in reversal learning.

摘要

近期研究使用爱荷华赌博任务(IGT)检验了精神分裂症患者的决策能力。然而,这些研究仅限于对情绪决策的评估。决策既依赖于认知功能,也依赖于情绪。本研究的目的是检验精神分裂症患者在IGT和掷骰子任务(GDT)中的表现,GDT是一种有明确得失规则的决策任务。此外,本研究旨在使用简单反转学习任务(SRLT)来测试IGT表现不佳是否归因于精神分裂症组内反转学习的损伤,SRLT对测量腹内侧前额叶皮质损伤后的反转学习缺陷很敏感。一组23名病情稳定的精神分裂症患者和28名对照受试者进行了IGT、GDT、SRLT和威斯康星卡片分类测验(WCST)的计算机化版本测试。与正常对照组相比,精神分裂症患者在IGT上表现较差,但两组在GDT表现上没有显著差异。精神分裂症组在SRLT上的表现比对照组差,但与IGT表现无关。这些数据表明,精神分裂症患者的情绪决策受损,但认知决策完好,这表明这两种决策过程是不同的。此外,反转学习的损伤并没有导致精神分裂症患者在IGT上表现不佳。因此,精神分裂症患者在模糊和不确定的情况下难以做出决策,而在清晰明确的情况下则很容易做出选择。精神分裂症患者的情绪决策缺陷可能更多地归因于另一种机制,如躯体标记假说,而不是反转学习的损伤。

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