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三种精神疾病中的时间折扣:神经性厌食症、强迫症和社交焦虑症。

Temporal discounting across three psychiatric disorders: Anorexia nervosa, obsessive compulsive disorder, and social anxiety disorder.

作者信息

Steinglass Joanna E, Lempert Karolina M, Choo Tse-Hwei, Kimeldorf Marcia B, Wall Melanie, Walsh B Timothy, Fyer Abby J, Schneier Franklin R, Simpson H Blair

机构信息

Department of Psychiatry, Columbia University Medical Center, New York, NY, USA.

New York State Psychiatric Institute, New York, NY, USA.

出版信息

Depress Anxiety. 2017 May;34(5):463-470. doi: 10.1002/da.22586. Epub 2016 Dec 23.

Abstract

BACKGROUND

Temporal discounting refers to the tendency for rewards to lose value as the expected delay to receipt increases. Individuals with anorexia nervosa (AN) have been found to show reduced temporal discounting rates, indicating a greater preference for delayed rewards compared to healthy peers. Obsessive-compulsive disorder (OCD) and social anxiety disorder (SAD) commonly co-occur with AN, and anxiety has been related to development and prognosis of AN. We examined whether reduced temporal discounting is present across these potentially related disorders, and explored the relationship between temporal discounting and anxiety transdiagnostically.

METHODS

One hundred ninety six individuals (75 healthy controls (HC); 50 OCD; 27 AN; 44 SAD) completed two temporal discounting tasks in which they chose between smaller-sooner and larger-later monetary rewards. Two measures of discounting-discount rate and discount factor-were compared between diagnostic groups, and associations with anxious traits were examined.

RESULTS

Individuals with AN showed decreased temporal discounting compared to HC. OCD and SAD groups did not differ significantly from HC. Across the sample, anxiety was associated with decreased discounting; more anxious individuals showed a greater preference for delayed reward.

CONCLUSIONS

We replicated the findings that individuals with AN show an increased preference for delayed reward relative to HC and that individuals with OCD do not differ from HC. We also showed that individuals with SAD do not differ from HC in discounting. Across this large sample, two measures of anxious temperament were associated with temporal discounting. These data raise new questions about the relationship between this dimensional trait and psychopathology.

摘要

背景

时间折扣是指随着预期获得奖励的延迟增加,奖励的价值会降低的倾向。研究发现,神经性厌食症(AN)患者的时间折扣率降低,这表明与健康同龄人相比,他们更倾向于延迟奖励。强迫症(OCD)和社交焦虑障碍(SAD)通常与AN共病,并且焦虑与AN的发展和预后有关。我们研究了在这些可能相关的疾病中是否都存在时间折扣降低的情况,并从跨诊断的角度探讨了时间折扣与焦虑之间的关系。

方法

196名个体(75名健康对照者(HC);50名强迫症患者;27名神经性厌食症患者;44名社交焦虑障碍患者)完成了两项时间折扣任务,在任务中他们要在较小但更快获得的金钱奖励和较大但更晚获得的金钱奖励之间做出选择。比较了不同诊断组之间的两种折扣衡量指标——折扣率和折扣因子,并研究了它们与焦虑特质的关联。

结果

与健康对照者相比,神经性厌食症患者的时间折扣降低。强迫症组和社交焦虑障碍组与健康对照者没有显著差异。在整个样本中,焦虑与折扣降低有关;焦虑程度越高的个体越倾向于延迟奖励。

结论

我们重复了以下研究结果:与健康对照者相比,神经性厌食症患者对延迟奖励的偏好增加,而强迫症患者与健康对照者没有差异。我们还表明,社交焦虑障碍患者在折扣方面与健康对照者没有差异。在这个大样本中,两种焦虑气质衡量指标与时间折扣有关。这些数据对这种维度特征与精神病理学之间的关系提出了新的问题。

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