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

Linda T. Betz, Paolo Brambilla, Andrej Ilankovic, Preethi Premkumar, Myung Sun Kim, Stéphane Raffard, Sophie Bayard, Hikaru Hori, Kyoung Uk Lee, Seung Jae Lee, Nikolaos Koutsouleris, Joseph Kambeitz

Research output: Contribution to journalArticle

2 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)7-15
JournalSchizophrenia Research
Volume204
DOIs
Publication statusPublished - Feb 1 2019

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Gambling
Reward
Meta-Analysis
Schizophrenia
Decision Making
Intelligence
Least-Squares Analysis
Short-Term Memory

Keywords

  • Decision-making
  • Iowa Gambling Task
  • Linear modeling
  • Meta-analysis
  • Reward
  • Schizophrenia

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

Cite this

Deciphering reward-based decision-making in schizophrenia : A meta-analysis and behavioral modeling of the Iowa Gambling Task. / Betz, Linda T.; Brambilla, Paolo; Ilankovic, Andrej; Premkumar, Preethi; Kim, Myung Sun; Raffard, Stéphane; Bayard, Sophie; Hori, Hikaru; Lee, Kyoung Uk; Lee, Seung Jae; Koutsouleris, Nikolaos; Kambeitz, Joseph.

In: Schizophrenia Research, Vol. 204, 01.02.2019, p. 7-15.

Research output: Contribution to journalArticle

Betz, LT, Brambilla, P, Ilankovic, A, Premkumar, P, Kim, MS, Raffard, S, Bayard, S, Hori, H, Lee, KU, Lee, SJ, Koutsouleris, N & Kambeitz, J 2019, 'Deciphering reward-based decision-making in schizophrenia: A meta-analysis and behavioral modeling of the Iowa Gambling Task', Schizophrenia Research, vol. 204, pp. 7-15. https://doi.org/10.1016/j.schres.2018.09.009
Betz, Linda T. ; Brambilla, Paolo ; Ilankovic, Andrej ; Premkumar, Preethi ; Kim, Myung Sun ; Raffard, Stéphane ; Bayard, Sophie ; Hori, Hikaru ; Lee, Kyoung Uk ; Lee, Seung Jae ; Koutsouleris, Nikolaos ; Kambeitz, Joseph. / Deciphering reward-based decision-making in schizophrenia : A meta-analysis and behavioral modeling of the Iowa Gambling Task. In: Schizophrenia Research. 2019 ; Vol. 204. pp. 7-15.
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AU - Ilankovic, Andrej

AU - Premkumar, Preethi

AU - Kim, Myung Sun

AU - Raffard, Stéphane

AU - Bayard, Sophie

AU - Hori, Hikaru

AU - Lee, Kyoung Uk

AU - Lee, Seung Jae

AU - Koutsouleris, Nikolaos

AU - Kambeitz, Joseph

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N2 - 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.

AB - 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.

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KW - Reward

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