Altered Risk-Aversion and Risk-Seeking Behavior in Bipolar Disorder
Altered Risk-Aversion and Risk-Seeking Behavior in Bipolar Disorder
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DOI：
10.1016/j.biopsych.2009.05.011
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发表时间：
2009-11-01
影响因子：
10.6
通讯作者：
Rogers, Robert D.
中科院分区：
文献类型：
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作者：
Chandler, Rebecca A.;Wakeley, Judi;Rogers, Robert D.
背景：双相情感障碍（BD）与高风险行为有关，如赌博和冲动。然而，人们对影响这些行为的心理因素或它们对这种疾病发展的意义知之甚少。在本研究中，我们研究了强调奖励和强调惩罚对双相情感障碍优生个体风险决策的影响。方法：20名患有未确诊的双相情感障碍II或双相情感障碍的健康无药男性和女性以及20名年龄和智商匹配的健康男性和女性完成了一项计算机化的风险决策任务，在该任务中，数学上相等的困境以获得奖励的机会（“积极框架”）或避免遭受损失（“消极框架”）的方式呈现。依赖度量是在积极和消极框架困境中做出决策时寻求风险的选择（和审议时间）的比例。结果：正如预期的那样，健康对照组的参与者在面对消极框架困境时比面对积极框架困境时做出了更多的寻求风险的选择。然而，这种影响在双相障碍参与者中显著减弱，他们对积极框架困境做出风险厌恶反应的时间也明显更长。BD参与者高估了由积极框架困境产生的不良结果的数量。结论：这些数据表明，双相障碍患者的风险选择与对强调奖励或惩罚的情绪环境的敏感性降低有关，可能反映了与行为选择相关的预期收益和损失的改变估值。
Background: Bipolar disorder (BD) is associated with high-risk behaviors, such as gambling and impulsivity. However, little is known about the psychological factors that influence these behaviors or their significance for the development of the disorder. In this study, we investigated the effects of highlighting rewards versus highlighting punishments in the risky decision-making of euthymic individuals with bipolar disorder.Methods: Twenty euthymic, medication-free men and women with previously undiagnosed bipolar II or bipolar disorder not otherwise specified and 20 age- and IQ-matched healthy men and women completed a computerized risky decision-making task in which mathematically equivalent dilemmas were presented in terms of opportunities to gain rewards ("positively-framed") or to avoid suffering losses ("negatively-framed"). The dependent measures were the proportion of risk-seeking choices (and deliberation times) when making decisions in positively versus negatively framed dilemmas.Results: As expected, healthy control participants made more risky-seeking choices in response to the negatively framed dilemmas compared with the positively framed dilemmas. However, this effect was significantly attenuated in BD participants who also took significantly longer to make risk-averse responses to the positively framed dilemmas. The BD participants overestimated the number of bad outcomes arising out of positively framed dilemmas.Conclusions: These data demonstrate that risky choice in BD is associated with reduced sensitivity to emotional contexts that highlight rewards or punishments, possibly reflecting altered valuations of prospective gains and losses associated with behavioral options.