Cavedini Paolo, Zorzi Claudia, Baraldi Clementina, Patrini Sara, Salomoni Giuliana, Bellodi Laura, Freire Rafael C, Perna Giampaolo
Department of Clinical Neurosciences, Villa San Benedetto Hospital, Hermanas Hospitalarias, Albese con Cassano, Italy.
Cogn Neuropsychiatry. 2012;17(2):177-90. doi: 10.1080/13546805.2011.614152. Epub 2011 Oct 12.
Patients with obsessive-compulsive disorder (OCD) demonstrate impairment in decisional processes in which both cognition and emotion play a crucial role.
We investigated the connection between decision-making performances and choice-related skin conductance responses (SCRs), to identify a somatic marker impairment affecting decisional processes in these patients. We explored SCRs during the Iowa Gambling Task in 20 OCD and 18 control, measuring anticipatory and posticipatory psychophysiological reactions according to card choices and to the outcomes of each selection.
Most patients exhibited weaker SCRs compared to HC, although there weren't substantial differences in magnitude between the two groups. In contrast with HC, patients with OCD showed no significant differences of SCRs activation according to card selections; they chose cards from neither favourable nor unfavourable decks.
The main finding of the study were the evidence of a dysfunctional biological marker in OCD subjects, affecting decision-making process. Dysfunctional patterns of SCRs could partially explain OCDs' impairment in this ability. Decision-making deficits in OCDs could be influenced in part by the lack of somatic differences in discriminating between advantageous and disadvantageous behaviour. These findings could lead to a more complete understanding of OCD.
强迫症（OCD）患者在决策过程中表现出功能障碍，其中认知和情感都起着至关重要的作用。
我们研究了决策表现与选择相关的皮肤电导率反应（SCR）之间的联系，以确定影响这些患者决策过程的躯体标记物损伤。我们在爱荷华赌博任务中对20名强迫症患者和18名对照组进行了SCR测量，根据卡片选择和每次选择的结果测量预期和事后的心理生理反应。
与健康对照组相比，大多数患者的SCR较弱，尽管两组之间在幅度上没有实质性差异。与健康对照组不同，强迫症患者根据卡片选择的SCR激活没有显著差异；他们既不从不有利的牌组也不从不有利的牌组中选择卡片。
该研究的主要发现是强迫症患者存在功能失调的生物学标记物的证据，这影响了决策过程。SCR的功能失调模式可以部分解释强迫症患者在这种能力上的损伤。强迫症患者的决策缺陷可能部分受到在区分有利和不利行为时缺乏躯体差异的影响。这些发现可能会导致对强迫症有更全面的理解。
