Brand Matthias, Franke-Sievert Christiane, Jacoby Georg E, Markowitsch Hans J, Tuschen-Caffier Brunna
Department of Physiological Psychology, University of Bielefeld, Bielefeld, Germany.
Neuropsychology. 2007 Nov;21(6):742-50. doi: 10.1037/0894-4105.21.6.742.
In addition to the core psychopathology of bulimia nervosa (BN), patients with BN often show impulsive behavior that has been related to decision making deficits in other patient groups, such as individuals with anorexia nervosa and pathological gamblers. However, it remains unclear whether BN patients also show difficulties in decision making. In this study, 14 patients with BN and 14 healthy comparison subjects, matched for age, gender, education, body mass index, and intelligence, were examined with the Game of Dice Task (M. Brand, E. Fujiwara, et al., 2005), a gambling task that has fixed winning probabilities and explicit rules for gains and losses, as well as with a neuropsychological test battery and personality questionnaires. On the task, the patients with BN chose the disadvantageous alternatives more frequently than did the comparison subjects. Performance on the Game of Dice Task was related to executive functioning but not to other neuropsychological functions, personality, or disease-specific variables in the BN group. Thus, in patients with BN, decision making abnormalities and executive reductions can be demonstrated and might be neuropsychological correlates of the patients' dysfunctional everyday-life decision making behavior. Neurocognitive functions should be considered in the treatment of BN.
除了神经性贪食症（BN）的核心精神病理学特征外，BN患者常表现出冲动行为，这在其他患者群体中，如神经性厌食症患者和病态赌徒，已被证明与决策缺陷有关。然而，BN患者在决策方面是否也存在困难仍不明确。在本研究中，我们使用了骰子游戏任务（M. Brand、E. Fujiwara等人，2005年）对14名BN患者和14名年龄、性别、教育程度、体重指数和智力相匹配的健康对照者进行了检查，这是一项具有固定获胜概率以及明确输赢规则的赌博任务，同时还使用了一套神经心理测试组合和人格问卷。在该任务中，BN患者比对照者更频繁地选择不利选项。骰子游戏任务的表现与执行功能相关，但与BN组的其他神经心理功能、人格或疾病特异性变量无关。因此，在BN患者中，可以证明存在决策异常和执行功能减退，这可能是患者日常生活中功能失调的决策行为的神经心理学相关因素。在BN的治疗中应考虑神经认知功能。
