Is decision-making impairment an endophenotype of Anorexia Nervosa?
Introduction Patients with anorexia nervosa (AN) show impaired decision-making ability, but it is still unclear if this is a trait marker, i.e. a stable endophenotype of AN, or a state parameter, i.e. being explained by present symptoms and associated comorbidity. Objectives We aimed to determine...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2022-06-01
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| Series: | European Psychiatry |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933822004035/type/journal_article |
| _version_ | 1827754171709784064 |
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| author | L. Di Lodovico M. Lachatre J. Marcheselli A. Versini N. Ramoz P. Gorwood |
| author_facet | L. Di Lodovico M. Lachatre J. Marcheselli A. Versini N. Ramoz P. Gorwood |
| author_sort | L. Di Lodovico |
| collection | DOAJ |
| description |
Introduction
Patients with anorexia nervosa (AN) show impaired decision-making ability, but it is still unclear if this is a trait marker, i.e. a stable endophenotype of AN, or a state parameter, i.e. being explained by present symptoms and associated comorbidity.
Objectives
We aimed to determine whether decision-making impairment is an endophenotype of AN. We hypothesized that decision-making alteration would not respect the criteria of an endophenotype, and that these alterations would have a relationship with illness severity.
Methods
Ninety-one patients with acute AN (A-AN), 90 unaffected relatives (UR), 23 patients remitted from AN (R-AN) and 204 healthy controls (HC) underwent the Iowa Gambling Task (IGT) and psychometric assessments. Prospective Valence Learning model (PVL) was employed to distinguish the cognitive dimensions underlying the decision-making process. Performance at the IGT was compared between the four groups and then analysed according to clinical and psychometric variables.
Results
Patients with A-AN scored worse than UR and HC at the IGT (p<.01). PVL-feedback sensitivity parameter was lower in patients with R-AN and A-AN than in the two other groups (p<.01) and PVL-loss aversion parameter was lower in A-AN than in UR and R-AN (p<.01). Decision-making style, in particular learning and loss aversion parameters, accounted for a significant part of variance of psychopathology in patients with AN (p<.01).
Conclusions
Impaired decision-making represents a state-associated, cognitive hallmark of AN. The aggravation of reward modulation along with illness progression may explain the persistence of symptoms despite their consequences on health. Reversal of decision-making impairment should not be limited by inherited vulnerability.
Disclosure
No significant relationships.
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| first_indexed | 2024-03-11T07:45:28Z |
| format | Article |
| id | doaj.art-9483486494da48ecb13cafa1f3ad0336 |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T07:45:28Z |
| publishDate | 2022-06-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-9483486494da48ecb13cafa1f3ad03362023-11-17T05:07:39ZengCambridge University PressEuropean Psychiatry0924-93381778-35852022-06-0165S150S15010.1192/j.eurpsy.2022.403Is decision-making impairment an endophenotype of Anorexia Nervosa?L. Di Lodovico0M. Lachatre1J. Marcheselli2A. Versini3N. Ramoz4P. Gorwood5GHU Paris Psychiatrie, Clinique Des Maladies Mentales Et De L’encéphale, Paris, FranceLMD/IPSL, Ecole Polytechnique, Institut Polytechnique De Paris, Ens, Psl Université Sorbonne Université, Cnrs, Palaiseau, FranceInternational School for Advanced Studies (SISSA), Chemistry, Trieste, ItalyGHU Paris Psychiatrie, Clinique Des Maladies Mentales Et De L’encéphale, Paris, FranceUniversité de Paris, Ipnp, Inserm U1266, Paris, FranceGHU Paris Psychiatrie, Clinique Des Maladies Mentales Et De L’encéphale, Paris, France Introduction Patients with anorexia nervosa (AN) show impaired decision-making ability, but it is still unclear if this is a trait marker, i.e. a stable endophenotype of AN, or a state parameter, i.e. being explained by present symptoms and associated comorbidity. Objectives We aimed to determine whether decision-making impairment is an endophenotype of AN. We hypothesized that decision-making alteration would not respect the criteria of an endophenotype, and that these alterations would have a relationship with illness severity. Methods Ninety-one patients with acute AN (A-AN), 90 unaffected relatives (UR), 23 patients remitted from AN (R-AN) and 204 healthy controls (HC) underwent the Iowa Gambling Task (IGT) and psychometric assessments. Prospective Valence Learning model (PVL) was employed to distinguish the cognitive dimensions underlying the decision-making process. Performance at the IGT was compared between the four groups and then analysed according to clinical and psychometric variables. Results Patients with A-AN scored worse than UR and HC at the IGT (p<.01). PVL-feedback sensitivity parameter was lower in patients with R-AN and A-AN than in the two other groups (p<.01) and PVL-loss aversion parameter was lower in A-AN than in UR and R-AN (p<.01). Decision-making style, in particular learning and loss aversion parameters, accounted for a significant part of variance of psychopathology in patients with AN (p<.01). Conclusions Impaired decision-making represents a state-associated, cognitive hallmark of AN. The aggravation of reward modulation along with illness progression may explain the persistence of symptoms despite their consequences on health. Reversal of decision-making impairment should not be limited by inherited vulnerability. Disclosure No significant relationships. https://www.cambridge.org/core/product/identifier/S0924933822004035/type/journal_articleendophenotypedecision makingiowa gambling taskAnorexia nervosa |
| spellingShingle | L. Di Lodovico M. Lachatre J. Marcheselli A. Versini N. Ramoz P. Gorwood Is decision-making impairment an endophenotype of Anorexia Nervosa? European Psychiatry endophenotype decision making iowa gambling task Anorexia nervosa |
| title | Is decision-making impairment an endophenotype of Anorexia Nervosa? |
| title_full | Is decision-making impairment an endophenotype of Anorexia Nervosa? |
| title_fullStr | Is decision-making impairment an endophenotype of Anorexia Nervosa? |
| title_full_unstemmed | Is decision-making impairment an endophenotype of Anorexia Nervosa? |
| title_short | Is decision-making impairment an endophenotype of Anorexia Nervosa? |
| title_sort | is decision making impairment an endophenotype of anorexia nervosa |
| topic | endophenotype decision making iowa gambling task Anorexia nervosa |
| url | https://www.cambridge.org/core/product/identifier/S0924933822004035/type/journal_article |
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