Increased salience of gains versus decreased associative learning differentiate bipolar disorder from schizophrenia during incentive decision making


Background Abnormalities in incentive decision making, typically assessed using the Iowa Gambling Task (IGT), have been reported in both schizophrenia (SZ) and bipolar disorder (BD). We applied the Expectancy-Valence (E-V) model to determine whether motivational, cognitive and response selection component processes of IGT performance are differentially affected in SZ and BD. Method Performance on the IGT was assessed in 280 individuals comprising 70 remitted patients with SZ, 70 remitted patients with BD and 140 age-, sex-and IQ-matched healthy individuals. Based on the E-V model, we extracted three parameters, 'attention to gains or loses', 'expectancy learning' and 'response consistency', that respectively reflect motivational, cognitive and response selection influences on IGT performance. Results Both patient groups underperformed in the IGT compared to healthy individuals. However, the source of these deficits was diagnosis specific. Associative learning underlying the representation of expectancies was disrupted in SZ whereas BD was associated with increased incentive salience of gains. These findings were not attributable to non-specific effects of sex, IQ, psychopathology or medication. Conclusions Our results point to dissociable processes underlying abnormal incentive decision making in BD and SZ that could potentially be mapped to different neural circuits.

Publication DOI:
Divisions: College of Health & Life Sciences > School of Biosciences
College of Health & Life Sciences > Clinical and Systems Neuroscience
Additional Information: Copyright © Cambridge University Press 2012
Uncontrolled Keywords: Bipolar disorder,schizophrenia,salience,reward,motivation,gambling,expectancy–valence,decision making
Publication ISSN: 1469-8978
Full Text Link: http://journals ... ine&aid=8826741
Related URLs: http://www.scop ... tnerID=8YFLogxK (Scopus URL)
PURE Output Type: Article
Published Date: 2013-03
Published Online Date: 2012-06-12
Authors: Brambilla, P.
Perlini, C.
Bellani, M.
Balestrieri, M.
Tomelleri, L.
Ferro, A.
Cerruti, S.
Marinelli, V.
Rambaldelli, G.
Tansella, M.
Christodoulou, T.
Jogia, J. (ORCID Profile 0000-0003-1799-1245)
Dima, D.
Frangou, S.



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