Is decision making really impaired in eating disorders?

Objective: Decision making has been reported to be reduced in eating disorders. However, studies are sparse and have been carried out in various selected populations. In the current study we arranged to confirm previous observations and to assess the relationship between decision making and dimensions relevant to eating disorders. Method: Patients suffering from anorexia nervosa (n = 49), bulimia nervosa (n = 38), and healthy controls (n = 83) were assessed using the Iowa Gambling Task (IGT). All patients were euthymic and free of psychotropic medication. Self-questionnaires (Eating Disorder Inventory–2; Gardner, 1991; and Eating Attitude Test; Garner & Garfinkel, 1979) were used to assess clinical dimensions relevant to eating disorders. Results: No significant differences in IGT performance were observed between patients and healthy controls or between restrictive and purging types of anorexia nervosa. No correlations were found between IGT performance and eating disorder questionnaires. Conclusion: These results do not support reduced decision making in patients with eating disorders, and suggest that previously reported alterations could be related to other clinical characteristics. This should stimulate new topic-related studies designed to reach a firm conclusion. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Deficits in emotional and social cognition in amyotrophic lateral sclerosis.

Objective: These studies investigated whether non-demented ALS patients display impairments on tests of emotional decision making and social and emotional cognition, sensitive to frontal variant Frontotemporal Dementia (fvFTD). Previous studies have shown predominant executive dysfunction and dorsolateral prefrontal involvement in ALS, but evidence of other prefrontal dysfunction implicated in fvFTD is sparse. Method: In Study A, 19 ALS patients and 20 healthy controls undertook a test of affective decision making, modified Iowa Gambling Task (IGT). Behavioral measures included the Frontal Systems Behavior Scale. In Study B, 14 ALS patients and 20 controls undertook tests of social and emotional cognition (Judgment of Preference based on eye gaze, the Mind in the Eyes, recognition of Facial Expressions of Emotion). Results: In Study A, ALS patients demonstrated a significantly different performance profile from healthy controls on the IGT and did not learn to avoid the disadvantageous stimuli (Block 3, d = 0.60, Block 4 days = 0.68). Behavior ratings showed increased apathy from premorbid levels. In Study B, ALS patients were impaired on attentionally demanding (d = 3.12) and undemanding (d = 7.52) conditions of the Judgment of Preference task, despite many showing intact executive functions. A smaller subset showed impaired emotion recognition. Behavior change was also evident. Conclusions: The findings reveal a Theory of Mind deficit on a simple test that was dissociated from the presence of executive dysfunction and suggests a profile of cognitive and behavioral dysfunction indicative of a subclinical fvFTD syndrome. The relative contribution of prefrontal pathways to the cognitive profile in ALS is considered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Associations between event-related potentials and measures of attention and inhibition in the Continuous Performance Task in children with ADHD and normal controls

OBJECTIVES: First, to differentiate between inattention and impulsivity based on type of errors made in the AX version of the Continuous Performance Task (CPT), and second, to investigate whether differences in performance between children with attention-deficit hyperactivity disorder (ADHD) and normal controls also occur in specific forms of brain activity, namely event-related potentials (ERPs), presumably related to inattention and impulsivity or inhibition. METHOD: Sixteen ADHD and 16 normal control children performed the CPT-AX. ERPs were recorded at occipital (Oz), parietal (Pz), central (Cz), and frontal (Fz) leads. RESULTS: The ADHD children had a higher CPT-Inattention score and showed smaller parietal positive waves at a latency of approximately 300 msec in reaction to target stimuli, target P3s, likewise indicating less attention. In contrast, they showed neither higher CPT-Impulsivity nor a smaller frontocentral negative wave at about 200 msec (N2); the N2 is generally seen as reflecting inhibition. A subgroup of children with ADHD and oppositional defiant disorder (n = 6) had smaller N2 waves than controls, however. CONCLUSIONS: The ADHD group studied showed deficits in attention but not in impulsivity (or inhibition).     

A functional magnetic resonance imaging study of auditory vigilance with low and high information processing demands.

This study identified the brain activations associated with auditory vigilance tasks, using functional magnetic resonance imaging. We created auditory continuous performance tests (CPTs) in which a demanding task (working memory task) was made more difficult than a simple vigilance task by increasing working memory and interference filtering demands. Two cohorts of normal male controls performed significantly worse on the working memory CPT than on the vigilance task. Compared to the vigilance task, performance of the working memory task produced significant signal change in lateral and medial prefrontal cortex, precentral cortex, temporal lobe, including insula and hippocampus, parietal-occipital cortex, cingulate, thalamus, and superior colliculus. Performance and degree of activation was associated with an estimate of IQ. Further research should clarify the contributions of working memory and interference filtering to the activated network. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological Processes Underlying Risky Decisions in Drug Abusers.

Decision-making deficits are considered to be a significant contributing factor for drug abuse. Drug abusers performed poorly on a simulated gambling task (A. Bechara, H. Damasio, D. Tranel, & S. Anderson, 1994); however, the psychological processes that contribute to these deficits are unknown. The authors used cognitive decision models with a simulated gambling task (SGT) to examine underlying processes of decision making in 66 drug abusers and 58 control participants. As expected, male drug abusers performed more poorly than male controls, and model results showed that male drug abusers placed greater emphasis on wins. The findings for women were less clear because control women performed at chance level on the SGT. Additional studies of gender differences on the SGT are needed to clarify these findings of discrepant performance in the control women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Older Adults as Adaptive Decision Makers: Evidence From the Iowa Gambling Task.

Older adults process emotional information differently than younger adults and may demonstrate less of a negativity bias on cognitive tasks. The Iowa Gambling Task designed by A. Bechara, H. Damasio, D. Tranel, and A. R. Damasio (1997) has been used to examine the integration of emotion and cognition in a risky-choice decision task and may give insight into differences in the decision-making strategies in younger and older adults. Eighty-eight younger adults (18-34 years) and 67 older adults (65-88 years) completed the Iowa Gambling Task. Using a theoretical decomposition of the task designed by J. R. Busemeyer and J. C. Stout (2002), the authors found that both groups were successful at solving the task but used very different strategies that reflected each group's strength. For younger adults, that strength was learning and memory. For older adults, that strength was an accurate representation of wins and losses (valence). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sustained attention after severe closed head injury.

Sustained attention was assessed in 20 patients with severe closed head injury (CHI) and 20 normal matched controls. Participants were presented with a visual continuous performance task (CPT) with 3 levels of complexity. Performance was assessed by examining response latencies and error rates. Across all levels of complexity, the CHI patients demonstrated a vigilance decrement, whereas the performance of the matched controls was stable across time. The vigilance decrement was not differentially affected by the manipulation of task complexity in the CHI patients. However, findings suggest that the overall vigilance performance of CHI patients was differentially affected by increasing the complexity of the task. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evidence for higher reaction time variability for children with ADHD on a range of cognitive tasks including reward and event rate manipulations.

Objective: The purpose of the research study was to examine the manifestation of variability in reaction times (RT) in children with attention deficit hyperactivity disorder (ADHD) and to examine whether RT variability presented differently across a variety of neuropsychological tasks, was present across the two most common ADHD subtypes, and whether it was affected by reward and event rate (ER) manipulations. Method: Children with ADHD-combined type (n = 51), ADHD-predominantly inattentive type (n = 53), and 47 controls completed five neuropsychological tasks (Choice Discrimination Task, Child Attentional Network Task, Go/No-Go task, Stop Signal Task, and N-back task), each allowing trial-by-trial assessment of RTs. Multiple indicators of RT variability including RT standard deviation, coefficient of variation and ex-Gaussian tau were used. Results: Children with ADHD demonstrated greater RT variability than controls across all five tasks as measured by the ex-Gaussian indicator tau. There were minimal differences in RT variability across the ADHD subtypes. Children with ADHD also had poorer task accuracy than controls across all tasks except the Choice Discrimination task. Although ER and reward manipulations did affect children's RT variability and task accuracy, these manipulations largely did not differentially affect children with ADHD compared to controls. RT variability and task accuracy were highly correlated across tasks. Removing variance attributable to RT variability from task accuracy did not appreciably affect between-groups differences in task accuracy. Conclusions: High RT variability is a ubiquitous and robust phenomenon in children with ADHD. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Attentional biases for threatening faces in children: Vigilant and avoidant processes.

The authors examined the processing of threat-related information in childhood anxiety with the emotional Stroop task and the dot probe task. In study 1, a nonclinical sample of 112 pupils (mean age = 9 years) performed pictorial versions of both tasks. For each task, an index indicating a bias for threat processing was computed. Positive correlations were found between these indices and anxiety. When compared with the original emotional Stroop index, the absolute value of the emotional Stroop index was a better predictor of anxiety. It was possible to replicate this result in study 2 with 80 pupils (mean age = 8.6 years). Results are discussed with regard to vigilance and avoidance as basic mechanisms underlying performance on the tasks. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differences in impulsivity and risk-taking propensity between primary users of crack cocaine and primary users of heroin in a residential substance-use program.

Crack cocaine use is more associated with impulsivity and a propensity to take risks than heroin use, yet no studies have examined this relationship in the absence of acute drug effects. The current study examined impulsivity (using the Delay Discounting Task) and risk-taking propensity (using the Balloon Analogue Risk Task) across independent groups of primary crack cocaine users with minimal heroin use (n=16) and primary heroin users with minimal crack cocaine use (n=11) in residential treatment, with all participants drug abstinent during participation. Crack cocaine users evidenced greater levels of impulsivity and risk-taking propensity, with only the difference in impulsivity persisting after controlling for age and gender. These data hold potential theoretical importance in understanding differences between crack cocaine and heroin users, as the findings cannot be attributed solely to acute pharmacological drug effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Response inhibition deficit is involved in poor decision making under risk in nonamnesic individuals with alcoholism.

Individuals with alcoholism exhibit poor decision making as reflected by their continued alcohol use despite encountering problems and by low performance in laboratory tasks of decision making. Here, the authors investigated the relative contribution of several distinct processes of executive functions in performance on the Iowa Gambling Task (IGT; A. Bechara, A. R. Damasio, H. Damasio, & S. W. Anderson, 1994) in recently detoxified individuals with alcoholism. Compared to matched healthy participants, individuals with alcoholism showed below-normal scores in the last 20 trials of the IGT as well as on other tasks of executive functions, specifically those assessing the capacity to manipulate information stored in working memory, detect abstract rules, or inhibit prepotent responses. Prepotent response inhibition best predicted performance in the late trials of the IGT, that is, when participants have likely acquired knowledge about the reward/punishment contingencies of the task. These results underline the important role that response inhibition plays in decision making, especially in risky situations, when knowledge of the probability of a given outcome becomes available (i.e. decisions under risk). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of Negative Emotional Content on Working Memory and Long-Term Memory.

In long-term memory, negative information is better remembered than neutral information. Differences in processes important to working memory may contribute to this emotional memory enhancement. To examine the effect that the emotional content of stimuli has on working memory performance, the authors asked participants to perform working memory tasks with negative and neutral stimuli. Task accuracy was unaffected by the emotional content of the stimuli. Reaction times also did not differ for negative relative to neutral words, but on an n-back task using faces, participants were slower to respond to fearful faces than to neutral faces. These results suggest that although emotional content does not have a robust effect on working memory, in some instances emotional salience can impede working memory performance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Common cancers in the elderly

Twenty-three children with autism and two control groups completed an attention battery comprising three versions of the continuous performance test (CPT), a digit cancellation task, the Wisconsin Card Sorting Test (WCST), and two novel, computerized tests of shifting attention (i.e., the Same-Different Computerized Task and the Computerized Matching Task). Children with autism could focus on a particular stimulus and sustain this focus as indicated by their performance on the digit cancellation task and the CPT. Their performance on the WCST suggested problems in some aspects of shifting attention (i.e., disengaging attention). The autism group performed as well as controls on the Same-Different Computerized Task, however, that required successive comparisons between stimuli. This implies that they could, in fact, shift their attention continuously. In addition, they did not differ from controls on the Computerized Matching Task, an analog of the WCST, suggesting that they do not have a general deficit in shifting attention.     

The performance of hyperactive and control preschoolers on a new computerized measure of visual vigilance: the Preschool Vigilance Task

This study examines the ability of a new visual vigilance task, the Preschool Vigilance Task (PVT), to differentiate between hyperactive and control preschoolers. The PVT was designed to be an objective measure of attention specifically for use with the preschool-age population. Hyperactive and control preschoolers were tested on the PVT and the Continuous Performance Task (CPT). Results indicated that both were useful in differentiating between hyperactive and control preschoolers. Implications for the utility of the PVT and future research directions are discussed.     

Borderline personality features moderate the effect of a fear induction on impulsivity.

This study examined the effects of laboratory-induced fear on impulsivity among participants who were high (n = 28) or low (n = 44) in borderline personality (BP) features. Participants were randomly assigned to complete a laboratory measure of impulsivity (passive avoidance learning task) following either a neutral mood induction or a fear induction. BP features moderated the association of the emotion condition (fear vs. neutral) with impulsivity: High-BP participants, but not low-BP participants, committed a greater number of impulsive responses in the fear condition compared with the neutral condition. Findings indicated that impulsivity among persons with BP features may not be a trait-like deficit, but rather, depends on emotional context. These findings suggest that future research should examine impulsivity under differing emotional conditions, and that clinical interventions to reduce impulsivity among persons with BP features should focus on responses to emotional contexts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The balloon analogue risk task (BART) differentiates smokers and nonsmokers.

In trying to better understand why individuals begin and continue to smoke despite the obvious health consequences, researchers have become interested in identifying relevant personality variables, such as risk taking. In this study, the authors compared the ability of 2 behavioral measures of risk taking, the Bechara Gambling Task (BGT) and the Balloon Analogue Risk Task (BART), to differentiate smokers and nonsmokers. Self-report measures of impulsivity and sensation seeking were taken for comparison with the 2 behavioral risk-taking tasks. Results indicate that behavior on the BART, and not the BGT, was related to smoking status. Further, when considered in a logistic regression analysis, only the Sensation Seeking total score and the BART score contributed uniquely to the differentiation of smokers and nonsmokers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Tourette’s syndrome (TS): Inhibitory performance in adults with uncomplicated TS.

Tourette’s syndrome (TS) is a neurodevelopmental disorder linked with frontostriatal dysfunction. Previous work has shown some evidence of mild performance deficits on a range of different tasks that involve inhibitory processes. The present study evaluated this in adult participants with uncomplicated TS. Interference control was measured using the Stroop and flanker tasks and a Stroop–flanker task that combined the inhibitory demands of both. Motor inhibition was measured using a letter continuous performance test (CPT) task and word CPT tasks that manipulated the inhibitory demands using compatible and incompatible words. The TS group was found to be slower than the control group on most measures, but showed differential slowing under conditions with enhanced inhibitory demands on the combined Stroop–flanker and the incompatible CPT tasks. The findings suggest that TS-alone is linked to mild impairments in aspects of inhibitory function, and that these can be detected by relatively powerful inhibitory manipulations. A range of different types of inhibitory tasks may be sensitive to TS-alone, and this may depend on both the type of inhibition and the strength of the inhibitory manipulation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intradimensional reversal shift performance in brain-damaged and chronic alcoholic patients.

Examined impaired set-shifting behavior frequently reported in brain-damaged Ss. Using a simple E-paced, 2-choice, visual, intradimensional reversal shift task, samples of brain-damaged (n = 24), alcoholic (n = 28), and control (n = 24) male patients were compared on errors, reaction time, and behavioral impulsivity (finger lift before signal). Alcoholic Ss were not significantly different from controls on any of the measures. As expected, brain-damaged Ss had significantly more total errors, longer reaction times, and higher impulsivity scores than controls. Differences in errors appeared to be due to difficulty in maintaining the perceptual and motor set rather than in set shifting. The importance of investigating disruptions in set maintenance in the performance of brain-damaged Ss is emphasized. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Normal aging affects decisions under ambiguity, but not decisions under risk.

Old adults have to face many situations that require important decisions. In the present investigation, the authors examined the effects of aging on both decisions under ambiguity and decisions under risk. To this purpose, healthy young and old adults completed the Iowa Gambling Task (IGT) and the Probability-Associated Gambling task (PAG task). Old adults performed the PAG task as well as young adults, demonstrating ability to make decisions when full information about the problem situation, the options' probabilities and the associated gains and losses was given. Differently, old adults showed poor performance on the IGT relative to young adults, indicating difficulty in making advantageous decisions under ambiguous conditions. Indeed, in the IGT, participants are not aware of the rules for gains and losses and have to learn about the utility of their selections through experience. Results of our analyses point to the contribution of executive functions to all types of decisions. Our findings have also practical implications, suggesting that old people can make advantageous decisions when complete information about the decision situation is available. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sleepiness, alertness and performance during a laboratory simulation of an acute shift of the wake-sleep cycle

Monitoring the presence of sleepiness on the job and its effects on performance is of primary importance for improving schedule systems of shiftworkers. Shiftworkers, often involved in night-time operations and irregular work schedules, frequently complain of nocturnal sleepiness especially in conditions of abrupt shift of the wake-sleep cycle. In this study, the authors evaluated the effects of a laboratory simulation of acute night-shift changes on sleepiness, vigilance and performance, using Maintenance of Wakefulness Test, Multiple Sleep Latency Test and three pencil and paper tests: Digit Symbol Substitution Test, 'Deux Barrages' Test and a 3-Letter Cancellation Task. All of the tests were administered four times at 2-hourly intervals during the night after daytime sleep. Results showed that the ability to maintain wakefulness and to perform simple visuo-attentive tasks is substantially spared during the night. On the other hand, sleep tendency and performance on a more complex and monotonous task (Letter Cancellation Task) reveal, respectively, increasing sleepiness and degrading performance.