Cited by 41Schizophrenia research and treatmentNeural and Behavioral Psychology StudiesNeurotransmitter Receptor Influence on Behavior

Reward-driven decision-making impairments in schizophrenia

Saperia, Sarah, Da Silva, Susana, Siddiqui, Ishraq, Agid, Ofer, Daskalakis, Z. Jeff, Ravindran, Arun, Voineskos, Aristotle N., Zakzanis, Konstantine K. +2 more·2019·Schizophrenia Research

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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Crossref · 10.1016/j.schres.2018.11.004

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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”

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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
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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