Deciphering reward-based decision-making in schizophrenia: a meta-analysis and behavioral modeling of the Iowa Gambling Task

Betz, LT, Brambilla, P, Ilankovic, A, Premkumar, P ORCID: https://orcid.org/0000-0003-1934-6741, Kim, M-S, Raffard, S, Bayard, S, Hori, H, Lee, K-U, Lee, SJ, Koutsouleris, N and Kambeitz, J, 2018. Deciphering reward-based decision-making in schizophrenia: a meta-analysis and behavioral modeling of the Iowa Gambling Task. Schizophrenia Research. ISSN 0920-9964

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Abstract

Background: Patients with schizophrenia (SZP) have been reported to exhibit impairments in reward-based decision-making, but results are heterogeneous with multiple potential confounds such as age, intelligence level, clinical symptoms or medication, making it difficult to evaluate the robustness of these impairments.

Methods: We conducted a meta-analysis of studies comparing the performance of SZP and healthy controls (HC) in the Iowa Gambling Task (IGT) as well as comprehensive analyses based on subject-level data (n = 303 SZP, n = 188 HC) to investigate reward-based decision-making in SZP. To quantify differences in the influence of individual deck features (immediate gain, gain frequency, net loss) between SZP and HC, we additionally employed a least-squares model.

Results: SZP showed statistically significant suboptimal decisions as indicated by disadvantageous deck choices (d from 0.51 to −0.62) and lower net scores (d from −0.35 to −1.03) in a meta-analysis of k = 29 samples (n = 1127 SZP, n = 1149 HC) and these results were confirmed in a complementary subject-level analysis. Moreover, decision-making in SZP was characterized by a relative overweighting of immediate gain and net losses and an underweighting of gain frequency. Moderator analyses revealed that in part, decision-making in the IGT was moderated by intelligence level, medication and general symptom scores.

Conclusion: Our results indicate robust impairments in reward-based decision-making in SZP and suggest that decreased cognitive resources, such as working memory, may contribute to these alterations.

Item Type:	Journal article
Publication Title:	Schizophrenia Research
Creators:	Betz, L.T., Brambilla, P., Ilankovic, A., Premkumar, P., Kim, M.-S., Raffard, S., Bayard, S., Hori, H., Lee, K.-U., Lee, S.J., Koutsouleris, N. and Kambeitz, J.
Publisher:	Elsevier
Date:	25 September 2018
ISSN:	0920-9964
Identifiers:	Number Type 10.1016/j.schres.2018.09.009 DOI S0920996418305590 Publisher Item Identifier
Divisions:	Schools > School of Social Sciences
Record created by:	Linda Sullivan
Date Added:	09 Oct 2018 10:51
Last Modified:	30 Oct 2018 13:45
URI:	https://irep.ntu.ac.uk/id/eprint/34625

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