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J Affect Disord. 2010 Jul;124(1-2):207-10. doi: 10.1016/j.jad.2009.11.013. Epub 2009 Dec 9.

Impaired flexible decision-making in Major Depressive Disorder.

Author information

1
Department of Psychology, Swansea University, United Kingdom. matteo.cella@kcl.ac.uk

Abstract

BACKGROUND:

Depression is associated with dysfunctional affective states, neuropsychological impairment and altered sensitivity to reward and punishment. These impairments can influence complex decision-making in changing environments.

METHODS:

The contingency shifting variant Iowa Gambling Task (IGT) was used to assess flexible decision-making performance in a group of medicated unipolar Major Depressive Disorder (MDD) patients (n=19) and a group of healthy control volunteers (n=20). The task comprised the standard IGT followed by a contingency-shift phase where decks progressively changed reward and punishment schedule.

RESULTS:

Patients with MDD showed impaired performance compared to controls during both the standard and the contingency-shift phases of the IGT. Analysis of the contingency-shift phase demonstrated that individuals with depression had difficulties perceiving when a previously bad contingency became good.

LIMITATIONS:

The present findings have several limitations including small sample size, the possible confounding role of medication and absence of other neuropsychological tests (i.e., executive function).

CONCLUSION:

Depressed patients show impaired decision-making behaviour in static and dynamic environments. Altered sensitivity to reward and punishment is proposed as the mechanism responsible for the lack of advantageous choices and poor adjustment to a changing environment.

PMID:
20004023
DOI:
10.1016/j.jad.2009.11.013
[Indexed for MEDLINE]
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