Primate Research Institute, Kyoto University, Inuyama, Aichi, Japan.
Kyowa Hospital, Obu, Aichi, Japan.
Int J Neuropsychopharmacol. 2020 Dec 10;23(10):662-672. doi: 10.1093/ijnp/pyaa044.
Accumulating evidence suggests that deficits in decision-making and judgment may be involved in several psychiatric disorders, including addiction. Behavioral addiction is a conceptually new psychiatric condition, raising a debate of what criteria define behavioral addiction, and several impulse control disorders are equivalently considered as types of behavioral addiction. In this preliminary study with a relatively small sample size, we investigated how decision-making and judgment were compromised in behavioral addiction to further characterize this psychiatric condition.
Healthy control subjects (n = 31) and patients with kleptomania and paraphilia as behavioral addictions (n = 16) were recruited. A battery of questionnaires for assessments of cognitive biases and economic decision-making were conducted, as was a psychological test for the assessment of the jumping-to-conclusions bias, using functional near-infrared spectroscopy recordings of prefrontal cortical (PFC) activity.
Although behavioral addicts exhibited stronger cognitive biases than controls in the questionnaire, the difference was primarily due to lower intelligence in the patients. Behavioral addicts also exhibited higher risk taking and worse performance in economic decision-making, indicating compromised probability judgment, along with diminished PFC activity in the right hemisphere.
Our study suggests that behavioral addiction may involve impairments of probability judgment associated with attenuated PFC activity, which consequently leads to higher risk taking in decision-making.
越来越多的证据表明，决策和判断缺陷可能与包括成瘾在内的几种精神障碍有关。行为成瘾是一种新的精神障碍概念，引发了关于哪些标准定义行为成瘾的争论，而几种冲动控制障碍也被认为是行为成瘾的类型。在这项初步研究中，样本量相对较小，我们研究了行为成瘾如何损害决策和判断，以进一步描述这种精神障碍。
招募了健康对照组（n=31）和行为成瘾（偷窃癖和性癖好障碍）患者（n=16）。进行了一系列认知偏差和经济决策的问卷调查，以及使用前额叶皮质（PFC）活动的功能近红外光谱记录进行跳跃结论偏差的心理测试。
尽管行为成瘾者在问卷调查中表现出比对照组更强的认知偏差，但这种差异主要是由于患者的智力较低。行为成瘾者在经济决策中也表现出更高的风险承担和更差的表现，表明概率判断受损，以及右半球 PFC 活动减弱。
我们的研究表明，行为成瘾可能涉及与减弱的 PFC 活动相关的概率判断受损，从而导致决策中的更高风险承担。
