Department of Neurosciences, Padua Neuroscience Center, University of Padova, Italy.
Eur Eat Disord Rev. 2018 Jul;26(4):302-314. doi: 10.1002/erv.2595. Epub 2018 Apr 17.
Patients with anorexia nervosa (AN) often report difficulties in decision making, which may interfere with treatment. The aim of this study was to investigate decision making in a large sample of adolescent and adult patients with AN, by using the Iowa gambling task.
Participants were 611 female individuals (310 patients and 301 controls) who underwent neuropsychological and clinical assessment.
Significantly poorer decision-making performance was observed in adult patients, whereas no difference emerged between affected and nonaffected adolescents. Both adolescent and adult patients were characterized by trends for higher levels of attention to losses in comparison with healthy controls. Although healthy adult women exhibited better decision-making performance than healthy adolescents, in AN, there was no improvement of decision making with age. A cluster analysis identified 2 different styles of decision making in both patients and controls: a conservative style and an impulsive style.
Our study provides evidence of dysfunctional decision making in adult patients with AN and reveals an association between poor decision making and excessive punishment sensitivity in AN. The clinical and scientific implications of these findings merit further exploration.
神经性厌食症（AN）患者常报告决策困难，这可能会干扰治疗。本研究旨在通过使用爱荷华赌博任务来研究大量青少年和成年 AN 患者的决策能力。
参与者为 611 名女性个体（310 名患者和 301 名对照），她们接受了神经心理学和临床评估。
成年患者的决策表现明显较差，而受影响的青少年和未受影响的青少年之间没有差异。与健康对照组相比，青少年和成年患者均表现出对损失的注意力水平较高的趋势。尽管健康成年女性的决策表现优于健康青少年，但在 AN 中，决策能力并没有随着年龄的增长而提高。聚类分析在患者和对照组中均确定了两种不同的决策风格：保守型和冲动型。
本研究提供了成人 AN 患者决策功能障碍的证据，并揭示了不良决策与 AN 中过度惩罚敏感性之间的关联。这些发现的临床和科学意义值得进一步探讨。
