Enhanced Risk Aversion, But Not Loss Aversion, in Unmedicated Pathological Anxiety.
Enhanced Risk Aversion, But Not Loss Aversion, in Unmedicated Pathological Anxiety.
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DOI：
10.1016/j.biopsych.2016.12.010
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发表时间：
2017-06-15
影响因子：
10.6
通讯作者：
Robinson OJ
中科院分区：
文献类型：
--
作者：
Charpentier CJ;Aylward J;Roiser JP;Robinson OJ
焦虑症与情绪处理和决策的干扰有关。因此，焦虑的人常常会做出有利于避免伤害的决定。然而，这种偏见可能是由于对决策结果的不确定性（例如风险）或负面结果（例如损失）的厌恶加剧而导致的。区分这些可能性可能会提供对焦虑症更好的认知理解，从而为治疗策略提供信息。为了解决这个问题，患有病理性焦虑症的未接受药物治疗的个体（n = 25）和匹配的健康对照受试者（n = 23）完成了一项赌博任务，该任务的特点是在每次试验中在赌博和安全（某些）选项之间做出决定。对一种类型的赌博的选择——涉及权衡潜在的胜利和潜在的损失（混合）——可能是由损失和风险厌恶共同驱动的，而另一种类型的选择——只包含胜利（仅收益）——完全是由风险厌恶驱动的。通过将计算前景理论模型与参与者的选择进行拟合，我们能够可靠地估计风险和损失厌恶以及它们各自对赌博决策的贡献。相对于健康对照受试者，病理性焦虑的参与者表现出更强的风险厌恶情绪，但损失厌恶程度相当。患有病理性焦虑的人在决策中表现出明显的回避偏见。这些发现表明，这可能是由于承担风险的倾向降低而不是对损失的强烈厌恶所致。这一重要的澄清表明，针对焦虑的心理干预应侧重于降低风险敏感性，而不是降低对负面结果本身的敏感性。
Anxiety disorders are associated with disruptions in both emotional processing and decision making. As a result, anxious individuals often make decisions that favor harm avoidance. However, this bias could be driven by enhanced aversion to uncertainty about the decision outcome (e.g., risk) or aversion to negative outcomes (e.g., loss). Distinguishing between these possibilities may provide a better cognitive understanding of anxiety disorders and hence inform treatment strategies. To address this question, unmedicated individuals with pathological anxiety (n = 25) and matched healthy control subjects (n = 23) completed a gambling task featuring a decision between a gamble and a safe (certain) option on every trial. Choices on one type of gamble—involving weighing a potential win against a potential loss (mixed)—could be driven by both loss and risk aversion, whereas choices on the other type—featuring only wins (gain only)—were exclusively driven by risk aversion. By fitting a computational prospect theory model to participants’ choices, we were able to reliably estimate risk and loss aversion and their respective contribution to gambling decisions. Relative to healthy control subjects, pathologically anxious participants exhibited enhanced risk aversion but equivalent levels of loss aversion. Individuals with pathological anxiety demonstrate clear avoidance biases in their decision making. These findings suggest that this may be driven by a reduced propensity to take risks rather than a stronger aversion to losses. This important clarification suggests that psychological interventions for anxiety should focus on reducing risk sensitivity rather than reducing sensitivity to negative outcomes per se.