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Increased salience of gains versus decreased associative learning differentiate bipolar disorder from schizophrenia during incentive decision making

Published online by Cambridge University Press:  12 June 2012

P. Brambilla ,
C. Perlini ,
M. Bellani ,
L. Tomelleri ,
A. Ferro ,
S. Cerruti ,
V. Marinelli ,
G. Rambaldelli ,
T. Christodoulou  and
J. Jogia
...Show all authors
P. Brambilla
Affiliation:
DISM, Inter-University Centre for Behavioural Neurosciences (ICBN), University of Udine, Italy IRCCS ‘E. Medea’ Scientific Institute, Udine, Italy
C. Perlini
Affiliation:
Section of Psychiatry and Clinical Psychology, DMSP, Inter-University Centre for Behavioural Neurosciences (ICBN), University of Verona, Italy
M. Bellani
Affiliation:
Section of Psychiatry and Clinical Psychology, DMSP, Inter-University Centre for Behavioural Neurosciences (ICBN), University of Verona, Italy
L. Tomelleri
Affiliation:
Section of Psychiatry and Clinical Psychology, DMSP, Inter-University Centre for Behavioural Neurosciences (ICBN), University of Verona, Italy
A. Ferro
Affiliation:
Section of Psychiatry and Clinical Psychology, DMSP, Inter-University Centre for Behavioural Neurosciences (ICBN), University of Verona, Italy
S. Cerruti
Affiliation:
Section of Psychiatry and Clinical Psychology, DMSP, Inter-University Centre for Behavioural Neurosciences (ICBN), University of Verona, Italy
V. Marinelli
Affiliation:
Section of Psychiatry and Clinical Psychology, DMSP, Inter-University Centre for Behavioural Neurosciences (ICBN), University of Verona, Italy
G. Rambaldelli
Affiliation:
Section of Psychiatry and Clinical Psychology, DMSP, Inter-University Centre for Behavioural Neurosciences (ICBN), University of Verona, Italy
T. Christodoulou
Affiliation:
Section of Neurobiology of Psychosis, Institute of Psychiatry, King's College London, UK
J. Jogia
Affiliation:
Section of Neurobiology of Psychosis, Institute of Psychiatry, King's College London, UK
D. Dima
Affiliation:
Section of Neurobiology of Psychosis, Institute of Psychiatry, King's College London, UK
M. Tansella
Affiliation:
Section of Psychiatry and Clinical Psychology, DMSP, Inter-University Centre for Behavioural Neurosciences (ICBN), University of Verona, Italy
M. Balestrieri
Affiliation:
DISM, Inter-University Centre for Behavioural Neurosciences (ICBN), University of Udine, Italy
S. Frangou*
Affiliation:
Section of Neurobiology of Psychosis, Institute of Psychiatry, King's College London, UK
*
*Address for correspondence: Dr S. Frangou, Section of Neurobiology of Psychosis, Department of Psychosis Studies, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK. (Email: [email protected])
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Abstract

Background

Abnormalities in incentive decision making, typically assessed using the Iowa Gambling Task (IGT), have been reported in both schizophrenia (SZ) and bipolar disorder (BD). We applied the Expectancy–Valence (E–V) model to determine whether motivational, cognitive and response selection component processes of IGT performance are differentially affected in SZ and BD.

Method

Performance on the IGT was assessed in 280 individuals comprising 70 remitted patients with SZ, 70 remitted patients with BD and 140 age-, sex- and IQ-matched healthy individuals. Based on the E–V model, we extracted three parameters, ‘attention to gains or loses’, ‘expectancy learning’ and ‘response consistency’, that respectively reflect motivational, cognitive and response selection influences on IGT performance.

Results

Both patient groups underperformed in the IGT compared to healthy individuals. However, the source of these deficits was diagnosis specific. Associative learning underlying the representation of expectancies was disrupted in SZ whereas BD was associated with increased incentive salience of gains. These findings were not attributable to non-specific effects of sex, IQ, psychopathology or medication.

Conclusions

Our results point to dissociable processes underlying abnormal incentive decision making in BD and SZ that could potentially be mapped to different neural circuits.

Keywords

Bipolar disorderdecision makingexpectancy–valencegamblingmotivationrewardsalienceschizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 3 , March 2013 , pp. 571 - 580
Copyright
Copyright © Cambridge University Press 2012

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