Reward-driven decision-making impairments in schizophrenia
Abstract
The ability to use feedback to guide optimal decision-making is essential for goal-directed behaviour. While impairments in feedback-driven decision-making have been associated with schizophrenia and depression, this has been examined primarily in the context of binary probabilistic choice paradigms. In real-world decision-making, however, individuals must make choices when there are more than two competing options that vary in the frequency and magnitude of potential rewards and losses. Thus, the current study examined win-stay/lose-shift (WSLS) behaviour on the Iowa Gambling Task (IGT) in order to evaluate the influence of immediate rewards and losses in guiding real-world decision-making in patients with schizophrenia and major depressive disorder. Fifty-one patients with schizophrenia, 43 patients with major depressive disorder, and 51 healthy controls completed the IGT, as well as a series of clinical and cognitive measures. WSLS was assessed by quantifying trial-by-trial behaviour following rewards and losses on the IGT. Multivariate analyses of variance revealed that patients with schizophrenia demonstrated intact lose-shift behaviour, but significantly reduced win-stay rates compared to healthy controls. In contrast, no WSLS impairments emerged in the depressed group. Win-stay impairments in the schizophrenia group were significantly related to deficits in motivation and cognition. Patients with schizophrenia exhibit impaired reward-driven decision-making in the context of multiple choices with concurrent rewards and losses, and this appears to be driven by a reduced propensity for advantageous win-stay behaviour. With the importance of reward learning and decision-making in generating goal-directed behaviour, these findings suggest a potential mechanism contributing to the motivation deficits seen in schizophrenia.
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Decision-making and learning impairments are core characteristics of a wide range of psychiatric disorders, including MDD, OCD, and schizophrenia, and are linked to their specific symptoms.
“Decision-making and learning impairments are core characteristics of a wide range of psychiatric disorders — such as major depressive disorder (MDD), obsessive–compulsive disorder (OCD), and schizophrenia — and are linked to their specific symptoms.1–9”
From Investigating disorder-specific and transdiagnostic alterations in model-based and model-free decision-making (2024) · cites this paper as [9]
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- Authors
- Saperia, S., Da Silva, S., Siddiqui, I., Agid, O., Daskalakis, Z. J., Ravindran, A., Voineskos, A. N., Zakzanis, K. K., Remington, G., & Foussias, G.
- Affiliations
- Centre for Addiction and Mental Health (CA)
- University of Toronto (CA)
- Corresponding author
- Saperia, Sarah
- ORCID
- Venue
- Schizophrenia Research
- Publisher
- Elsevier BV
- Published
- 2019-04
- Volume
- 206
- Pages
- 277-283
- ISSN
- 0920-9964 (ISSN-L)
- OpenAlex
- W2901020686
- Cited by
- 41
- References
- 81
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 4 · 2023: 8 · 2022: 4 · 2021: 6 · 2020: 8 · 2019: 2
- FWCI
- 3.15
- Type
- journal article
- Language
- es
- Open access
- closed
- Locations
- Schizophrenia Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ontario Mental Health Foundation
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Keywords
- schizophrenia, major depressive disorder
- MeSH terms
- Adult, Decision Making, Depressive Disorder, Major, Major Depressive Disorder, Female, Humans, Male, Motivation, Psychotic Disorders, Reward, Schizophrenia, Executive Function, Cognitive Dysfunction
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