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ABSTRACT: Individuals with schizophrenia often lack insight or awareness. Resulting impairment has been observed in various cognitive domains and, recently, linked to problems in emotion-based learning. The Iowa Gambling Task (IGT) has been used to assess emotion-based decision-making in patients with schizophrenia, but results have been inconclusive. The current study further investigates emotion-based decision-making in schizophrenia by elucidating the unique contribution of awareness. Twenty-five patients with schizophrenia and 24 healthy controls were assessed with a modified version of the IGT recording awareness at regular intervals. Symptom assessment, medication and medical history were recorded for the clinical group. Patients with schizophrenia underperformed on the IGT compared to controls. Subjective awareness levels were significantly lower in the schizophrenia group and were associated with hallucination severity. Cognitive decision modelling further indicated that patients with schizophrenia had impaired attention to losses, compared to controls. This parameter was positively correlated with awareness. We also found that positive symptoms altered awareness levels and suggest that this disruption may contribute to sub-optimal decision-making. Overall, a lack of awareness may be an important aspect in understanding impaired social cognitive functioning and emotion-based learning observed in schizophrenia.
Psychiatry Research 02/2012; 196(1):15-9. · 2.52 Impact Factor
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ABSTRACT: Deficits in emotion-based learning are implicated in many psychiatric disorders. Research conducted with patients with schizophrenia using one of the most popular tasks for the investigation of emotion-based learning, the Iowa Gambling Task (IGT), has largely been inconclusive. The present study employed a novel, contingency-shifting variant IGT with hallucination- and delusion-prone university students to determine whether previous findings were due merely to the presence of psychosis. Following initial screening of a sample of 253 students (mean age = 20.13 years, S.D. = 3.27), 28 high (10 male, 18 female) and 27 low (12 male, 15 female) hallucination-prone and 27 high (7 male, 20 female) and 26 low (11 male, 15 female) delusion-prone individuals completed the contingency-shifting variant IGT. Results showed no significant differences between the performances of high and low hallucination- and delusion-prone individuals during the original phase of the task. Differences only emerged following the onset of the contingency-shift phases, with individuals high in hallucination- and delusion-proneness having impaired performance compared with low hallucination- and delusion-prone individuals. Overall, the present findings demonstrate that impairments associated with hallucination- and delusion-proneness are specific to the shift phase of the contingency-shifting variant IGT, which supports previous findings with patients with schizophrenia.
Psychiatry Research 10/2009; 170(1):70-4. · 2.52 Impact Factor
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ABSTRACT: The contingency-shifting variant Iowa Gambling Task (IGT), in which the reward and punishment contingencies of different decks of cards are systematically altered, was investigated with a large group of healthy young adults (n = 208). Our findings demonstrate that the onset of unsignaled, contingency-shift phases initially disrupted learning but that performance subsequently improved during each shift. Subjective experience ratings were positively correlated with performance across all phases. A regression model showed that performance early in the task, in Blocks 3 and 4, significantly predicted later ability to shift to the changing contingencies. Subdividing participants into high performer and low performer groups revealed an increased number of selections of previously good-now-bad decks in the latter group. Overall, the contingency-shifting variant IGT may have potential as a novel measure of reversal learning in experimental and clinical settings.
Journal of Clinical and Experimental Neuropsychology 07/2009; 32(3):239-48. · 2.13 Impact Factor
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ABSTRACT: Research employing the Iowa Gambling Task (IGT) has frequently shown that learning is impaired in various clinical populations. However, precisely what constitutes "unimpaired" control group learning remains unclear. In order to understand some of the possible factors underlying variability in control group IGT performance, the present study sought to manipulate features of the task to intentionally disrupt learning. Specifically, the present study investigated the effects of time constraints on emotion-based learning during automated administration of the IGT. For two groups of participants, a time-constraint of either 2-s or 4-s was implemented during the critical decision making period, while a control group received no time constraint. We also evaluated participants' subjective experience after every block of 20 trials. Results demonstrated that the 2-s group differed significantly from the control group. Subjective experience measures revealed rapid development of awareness of the advantageous and disadvantageous decks among all three groups. Overall, our findings demonstrate, for the first time, the effects of decision-phase time constraints on emotion-based learning and indicate that the IGT reward/punishment schedules are to some extent cognitively penetrable.
Brain and Cognition 08/2007; 64(2):164-9. · 3.17 Impact Factor
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ABSTRACT: Previous research suggests that measures of dysphoria relate to positive schizophrenic symptoms. These relationships have rarely been studied within the dimensionality of psychopathology framework. The present study examined the relationship between 3 distinct aspects of dysphoria (depression and state and trait anxiety) and delusion and hallucination proneness in a nonclinical sample of young adults. A total of 472 participants were assessed on measures of dysphoria and delusion and hallucination proneness. Correlation analyses revealed significant associations between both anxiety and depression and hallucination and delusion proneness, suggesting that the association between dysphoria and positive symptoms is also present at a nonclinical level. Partial correlations, and hierarchical regression models, suggest an independent contribution of depression, over anxiety, in influencing hallucination and delusional proneness. The results are discussed in the framework of the cognitive account of schizophrenia and the dimensional model of psychopathology.
Comprehensive psychiatry 49(6):544-50. · 2.08 Impact Factor
