Neuropsychological correlates of decision making in patients with bulimia nervosa.

In addition to the core psychopathology of bulimia nervosa (BN), patients with BN often show impulsive behavior that has been related to decision making deficits in other patient groups, such as individuals with anorexia nervosa and pathological gamblers. However, it remains unclear whether BN patients also show difficulties in decision making. In this study, 14 patients with BN and 14 healthy comparison subjects, matched for age, gender, education, body mass index, and intelligence, were examined with the Game of Dice Task (M. Brand, E. Fujiwara, et al., 2005), a gambling task that has fixed winning probabilities and explicit rules for gains and losses, as well as with a neuropsychological test battery and personality questionnaires. On the task, the patients with BN chose the disadvantageous alternatives more frequently than did the comparison subjects. Performance on the Game of Dice Task was related to executive functioning but not to other neuropsychological functions, personality, or disease-specific variables in the BN group. Thus, in patients with BN, decision making abnormalities and executive reductions can be demonstrated and might be neuropsychological correlates of the patients' dysfunctional everyday-life decision making behavior. Neurocognitive functions should be considered in the treatment of BN. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Anticipatory stress influences decision making under explicit risk conditions.

Recent research has suggested that stress may affect memory, executive functioning, and decision making on the basis of emotional feedback processing. The current study examined whether anticipatory stress affects decision making measured with the Game of Dice Task (GDT), a decision-making task with explicit and stable rules that taps both executive functioning and feedback learning. The authors induced stress in 20 participants by having them anticipate giving a public speech and also examined 20 comparison subjects. The authors assessed the level of stress with questionnaires and endocrine markers (salivary cortisol and alpha-amylase), both revealing that speech anticipation led to increased stress. Results of the GDT showed that participants under stress scored significantly lower than the comparison group and that GDT performance was negatively correlated with the increase of cortisol. Our results indicate that stress can lead to disadvantageous decision making even when explicit and stable information about outcome contingencies is provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Frontal lobe dysfunctions in Korsakoff's syndrome and chronic alcoholism: Continuity or discontinuity?

The effect of long-term heavy alcohol consumption on brain functions is still under debate. The authors investigated a sample of 17 Korsakoff amnesics, 23 alcoholics without Korsakoff's syndrome, and 21 controls with peripheral nerve diseases, matched for intelligence and education. Executive functions were examined for word fluency, the modified Wisconsin Card Sorting Test, an alternate response task, and an "n-back" working memory task. Korsakoff amnesics, but not alcoholics, showed a marked memory impairment. They also scored lower in each of the executive tasks--the alcoholics only in the alternate response task. This task also correlated with the years of the alcohol dependency. First, the authors conclude that Korsakoff's syndrome is associated not only with a memory impairment but also with a global executive deficit. Second, the decline in the ability to alternate between different responses argues for a restricted neurotoxic effect of alcohol on some frontal lobe areas (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Implicit memory for pictures in amnesia: Role of etiology and priming task.

This study examined the performance of patients with Korsakoff and non-Korsakoff amnesia on tests of picture priming. Both groups showed intact priming on a picture-naming task but impaired priming on a fragment-completion task when fragmented pictures were presented at study. When whole pictures were presented at study, patients with non-Korsakoff amnesia showed intact priming, but Korsakoff patients' priming remained impaired. Both groups performed equally poorly on a picture-recognition task. It is concluded that non-Korsakoff patients show intact picture priming when explicit memory does not contaminate fragment-completion performance. Korsakoff patients, in contrast, show a selective impairment in the perceptual processes that mediate picture-fragment completion priming. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The skin conductance response, anticipation, and decision-making.

This paper is concerned with the effective use of the skin conductance response (SCR) in studies involving decision-making. General guidelines for the measurement and quantification of the SCR are briefly described. Cortical and subcortical mechanisms involved in the expression of the SCR are identified in relation to decision-making and related cognitive processes. Finally, literature related to decision-making that utilizes the SCR is reviewed. Specifically, studies involving the Iowa Gambling Task and aversive classical conditioning are drawn upon to determine how the anticipatory SCR relates to the process of decision-making. The roles of conscious and nonconscious cognitive processes in the gambling task and the conditioning paradigm are examined. It is concluded that the SCR is an easily recordable, nonverbal, nonvoluntary, unobtrusive measure of anticipation of significant outcomes, particularly aversive ones, that is related to decision-making. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Executive functions, information sampling, and decision making in narcolepsy with cataplexy.

Objective: Narcolepsy with cataplexy (NC) affects neurotransmitter systems regulating emotions and cognitive functions. This study aimed to assess executive functions, information sampling, reward processing, and decision making in NC. Method: Twenty-one NC patients and 58 healthy participants performed an extensive neuropsychological test battery. Results: NC patients scored as controls in executive function tasks assessing set shifting, reversal learning, working memory, and planning. Group differences appeared in a task measuring information sampling and reward sensitivity. NC patients gathered less information, tolerated a higher level of uncertainty, and were less influenced by reward contingencies than controls. NC patients also showed reduced learning in decision making and had significantly lower scores than controls in the fifth block of the IOWA gambling task. No correlations were found with measures of sleepiness. Conclusions: NC patients may achieve high performance in several neuropsychological domains, including executive functions. Specific differences between NC patients and controls highlight the importance of the hypocretin system in reward processing and decision making and are in line with previous neuroimaging and neurophysiological studies. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Implicit and Explicit Memory in Children With Congenital and Acquired Brain Disorder.

Implicit and explicit memory were examined in 8- to 15-year-old children with myelomeningocele and shunted hydrocephalus, severe traumatic brain injuries, or orthopedic injuries. Each group included between 22 and 29 children. Children completed a fragmented picture identification task to assess perceptual priming and a semantic decision-making task to assess conceptual priming. Each task also assessed procedural learning as well as explicit recall and recognition. All 3 groups showed significant perceptual and semantic priming of similar magnitude. In contrast, both brain-disordered groups displayed poorer explicit memory than did the comparison group. No group showed significant procedural learning on either task. Age and IQ were stronger predictors of explicit recall than of implicit memory. The findings indicate that implicit memory is relatively intact in many children with congenital and acquired brain disorders, despite deficits in explicit memory, and support the existence of separate memory systems in children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impaired Decision Making Related to Working Memory Deficits in Individuals With Substance Addictions.

This study examined whether individuals with substance dependence (ISDs) show impairments in working memory and whether there is a relationship between their impairments in decision making as measured by the gambling task (GT) paradigm and working memory as measured by a delayed nonmatching to sample (DNMS) task. Using the GT, 11% of healthy control participants and 61% of ISDs opted for choices with high immediate gains in spite of higher future losses. For the ISDs and controls with equal GT impairments, the ISDs performed significantly lower than controls on the DNMS task. The nonimpaired ISDs on the GT also performed significantly worse than matched controls on the DNMS task. The DNMS task deficit in ISDs was across all delay times, suggesting the deficit may lie in the "executive" process of working memory, which supports earlier findings (E. M. Martin et al., 2003). The authors suggest that the prefrontal cortex hosts multiple distinct mechanisms of decision making and inhibitory control and that ISDs may be affected in any one or combination of them. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Temporal and spatial context memory in patients with focal frontal, temporal lobe, and diencephalic lesions

Patients with focal frontal, temporal lobe, or diencephalic lesions were investigated on measures of temporal (recency) and spatial (position) context memory, after manipulating exposure times to match recognition memory for targets (pictorial stimuli) as closely as possible. Patients with diencephalic lesions from an alcoholic Korsakoff syndrome showed significant impairment on the temporal context (recency) task, as did patients with frontal lesions penetrating the dorsolateral frontal cortex, according to MRI (and PET) evidence. Patients with temporal lobe lesions showed only a moderate (non-significant) impairment on this task, and patients with medial frontal lesions, or large frontal lesions not penetrating the dorsolateral cortical margins, performed as well as healthy controls at this task. On the spatial context memory task, patients with lesions in the temporal lobes showed significant impairment, and patients with right temporal lesions performed significantly worse than patients with left temporal lesions. Patients with diencephalic lesions showed only a modest (non-significant) impairment on this task, and the frontal lobe group performed normally. When a group of patients with temporal lobe lesions resulting from herpes encephalitis were examined separately, an identical pattern of results was obtained, the herpes group being significantly impaired on spatial memory and showing a trend towards impairment for temporal context memory. There were strong correlations between anterograde memory quotients and context memory performance (despite the use of an exposure time titration procedure) and a weak association in the frontal group with one frontal/executive task [corrected] (card-sorting perservations). It is predicted that correlations between temporal context memory and frontal/executive tasks will be greater in samples of patients all of whom have frontal lesions invading the dorsolateral cortical margin.     

Knowledge of New English vocabulary in amnesia: an examination of premorbidly acquired semantic memory

To assess if amnesics have intact remote memory for general semantic information, we examined memory for vocabulary words with known dates of entry into the language between 1955 and 1989. Amnesics of mixed etiology with acute onset performed normally on both a recall and a recognition task. Korsakoff patients, in contrast, were impaired on both tasks and demonstrated a gradient such that their knowledge of words acquired during more recent time periods was worse than that of words acquired during more remote time periods. The improvement in performance associated with recognition testing was larger for Korsakoff patients than for control subjects and correlated significantly with a composite measure of frontal dysfunction. These findings suggest a deficit in the controlled search and retrieval of semantic information in Korsakoff patients. The implications of the differential performance of Korsakoff and mixed etiology amnesics for explanations of temporally graded retrograde amnesia are discussed.     

Examining the neural correlates of choice behavior in a gambling task using steady state topography.

The present study investigated the behavioral and neuropsychological characteristics of decision-making behavior during a gambling task as well as how these characteristics may relate to the Somatic Marker Hypothesis and the Frequency of Gain model. The applicability to intertemporal choice was also discussed. Patterns of card selection during a computerized interpretation of the Iowa Gambling Task were assessed for 10 men and 10 women. Steady State Topography was employed to assess cortical processing throughout this task. Results supported the hypothesis that patterns of card selection were in line with both theories. As hypothesized, these 2 patterns of card selection were also associated with distinct patterns of cortical activity, suggesting that intertemporal choice may involve the recruitment of right dorsolateral prefrontal cortex for somatic labeling, left fusiform gyrus for object representations, and the left dorsolateral prefrontal cortex for an analysis of the associated frequency of gain or loss. It is suggested that processes contributing to intertemporal choice may include inhibition of negatively valenced options, guiding decisions away from those options, as well as computations favoring frequently rewarded options. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The restless mind.

This article reviews the hypothesis that mind wandering can be integrated into executive models of attention. Evidence suggests that mind wandering shares many similarities with traditional notions of executive control. When mind wandering occurs, the executive components of attention appear to shift away from the primary task, leading to failures in task performance and superficial representations of the external environment. One challenge for incorporating mind wandering into standard executive models is that it often occurs in the absence of explicit intention--a hallmark of controlled processing. However, mind wandering, like other goal-related processes, can be engaged without explicit awareness; thus, mind wandering can be seen as a goal-driven process, albeit one that is not directed toward the primary task. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of environmental support on implicit and explicit memory in younger and older adults.

Addressed (1) whether there are age differences on an implicit word-stem-completion task and (2) whether age differences on both implicit and explicit memory would decrease with increased environmental support. A total of 287 Ss were presented with words in an incidental learning task with structural or semantic processing. Following 2 filler tasks, Ss received an implicit or an explicit word-stem-completion task. The number of letters in the stem varied from 2 to 4. Results yielded an Age?×?Memory Task dissociation such that there were large age differences on the explicit task and no age difference on the implicit task, regardless of whether Ss aware of the memory test were included or excluded. There was no evidence that environmental support improved older adults' performance more than that of younger adults on either memory task. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A contribution of cognitive decision models to clinical assessment: Decomposing performance on the Bechara gambling task.

The Bechara simulated gambling task is a popular method of examining decision-making deficits exhibited by people with brain damage, psychopathology, antisocial personality, or drug abuse problems. However, performance on this task is confounded by complex interdependencies between cognitive, motivational, and response processes, making it difficult to sort out and identify the specific processes responsible for the observed behavioral deficits. The authors compare 3 competing cognitive decision models of the Bechara task in terms of their ability to explain the performance deficits observed in Huntington's disease patients as compared with healthy populations and people with Parkinson's disease. The parameters of the best fitting model are used to decompose the observed performance deficit of the Huntington patients into cognitive, motivational, and response sources. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Implicit false memory in the DRM paradigm: Effects of amnesia, encoding instructions, and encoding duration.

Recent studies with the Deese/Roediger–McDermott (Deese 1959; Roediger & McDermott, 1995) paradigm have revealed that amnesic patients do not only show impaired veridical memory, but also diminished false memory for semantically related lure words. Due to the typically used explicit retrieval instructions, however, this finding may reflect problems at encoding, at recollection, or both. Therefore, the present experiments examined implicit as well as explicit false memory in patients suffering from Korsakoff’s syndrome and controls. In Experiment 1, encoding instructions either focused on remembering individual list words, or on discovering semantic relationships among the words. In Experiment 2, different presentation durations were used. Results emphasize the distinction between automatic and intentional retrieval: Korsakoff patients’ veridical and false memory scores were diminished when explicit recollection was required, but not when memory was tested implicitly. Encoding manipulations only significantly affected veridical memory: Priming was reduced with thematic encoding, and explicit retrieval was facilitated when given more study time. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evidence for deficits on different components of theory of mind in Huntington's disease.

Objective: The main aim of this study was to investigate the effects of Huntington's disease (HD) on cognitive and affective Theory of Mind (ToM) abilities. The relation of ToM performance and executive functions was also examined. Method: Eighteen HD patients, early in the course of the disease, and 18 healthy volunteers matched for age and educational levels, were given two tasks: a nonverbal cognitive ToM task assessing attribution of intentions to others and a revised version of the 'Reading the Mind in the Eyes' test, which is an affective ToM task assessing the understanding of other people's mental states from their eyes. Participants were also given various executive tests. Results: The two ToM tasks revealed a significant impairment of ToM abilities in HD patients. Executive functioning was impaired in the HD group and ToM performance on the attribution of intentions task was dependent on several executive processes. Conclusions: Our results are consistent with the idea that both cognitive and affective aspects of ToM could be impaired in HD patients, indicating that cortico-subcortical circuits are underlying higher social functions such as ToM. The results are also consistent with the idea that only a few executive mechanisms regulate the ToM abilities we tested in this work. They also provide a basis for the understanding of the disorganized behavior and the breakdown of interpersonal relationships in daily life after HD. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Test-retest characteristics of the Balloon Analogue Risk Task (BART).

The Balloon Analogue Risk Task (BART) is a computerized decision-making task that provides a test of behavioral risk taking. The task is increasingly used in laboratory settings and in the field with young adults and adolescents. However, there are currently no published data about the test-retest characteristics of the task when it is administered on separate days. The current paper addresses this gap. Risky behavior on the BART (adjusted average pumps) showed acceptable test-retest reliability across days (r = +.77, p     

The nature of the memory deficit in Korsakoff's psychosis.

Compared the performance of 10 alcoholics with Korsakoff's psychosis (mean age, 51.5 yrs) with that of 10 alcoholics without Korsakoff's psychosis (mean age, 47.9 yrs) on a probe-recognition task. Results are consistent with the view that Korsakoff patients have a greater susceptibility to proactive inhibition than do non-Korsakoff patients. A signal detection analysis of the results suggests that this might be reflected in lower initial registration strength for recent items. Ss' scores on the Wechsler Memory Scale also indicate that Korsakoff Ss did most poorly on tasks demanding the greatest use of information processing involving long-term memory (e.g., paired-associate learning). Results are discussed in terms of current theories of amnesia. (French summary) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impairment in risk-sensitive decision-making in older suicide attempters with depression.

Suicidal behavior is a potentially lethal complication of late-life depression. In younger adults, suicide has been linked to abnormal decision-making ability. Given that there are substantial age-related decreases in decision-making ability, and that older adults experience environmental stressors that require effective decision-making, we reasoned that impaired decision-making may be particularly relevant to suicidal behavior in the elderly. We thus compared performance on a probabilistic decision-making task that does not involve working memory (“Cambridge Gamble Task”) in four groups of older adults: (1) individuals with major depression and a history of suicide attempt (n = 25), (2) individuals with major depression with active suicidal ideation but no suicide attempt (n = 13), (3) individuals with major depression without suicidality (n = 35), and (4) nondepressed control subjects (n = 22). There was a significant effect of group on quality of decision-making, whereby the suicide attempters exhibited poorer ability to choose the likely outcome, compared with the nonsuicidal depressed and nondepressed comparison subjects. There were no group differences in betting behavior. The suicide attempters differed in several aspects of social problem-solving on a self-report scale. Quality of decision-making was negatively correlated with the score on the impulsive/careless problem-solving subscale. These data suggest that older suicide attempters have a deficit in risk-sensitive decision-making, extending observations in younger adults. More specifically, older suicide attempters seem to neglect outcome probability and make poor choices. These impairments may precipitate and perpetuate suicidal crisis in depressed elders. Identification of decision-making impairment in suicidal elders may help with designing effective interventions. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Individual differences in executive functions are almost entirely genetic in origin.

Recent psychological and neuropsychological research suggests that executive functions--the cognitive control processes that regulate thought and action--are multifaceted and that different types of executive functions are correlated but separable. The present multivariate twin study of 3 executive functions (inhibiting dominant responses, updating working memory representations, and shifting between task sets), measured as latent variables, examined why people vary in these executive control abilities and why these abilities are correlated but separable from a behavioral genetic perspective. Results indicated that executive functions are correlated because they are influenced by a highly heritable (99%) common factor that goes beyond general intelligence or perceptual speed, and they are separable because of additional genetic influences unique to particular executive functions. This combination of general and specific genetic influences places executive functions among the most heritable psychological traits. These results highlight the potential of genetic approaches for uncovering the biological underpinnings of executive functions and suggest a need for examining multiple types of executive functions to distinguish different levels of genetic influences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)