Cella, Dymond, Cooper, 2010

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APA Citation: 

Cella, M., Dymond, S., & Cooper, A. (2010). Impaired flexible decision-making in major depressive disorder. Journal of Affective Disorders, 124, 207-210.

Publication Topic: 
Behavior Analysis: Empirical
Publication Type: 
Depression, Decision-making, reward sensitivity, IGT, MDD, flexibility

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.