Risk/reward decision-making in schizophrenia: a preliminary examination of the influence of tobacco smoking and relationship to Wisconsin Card Sorting Task performance

Schizophr Res. 2009 May;110(1-3):156-64. doi: 10.1016/j.schres.2009.01.012. Epub 2009 Mar 9.

Abstract

Background: Individuals with schizophrenia show deficits in cognitive functioning, as evidenced by deficits on neurocognitive tasks such as the Wisconsin Card Sorting Task (WCST). Studies of risk/reward decision-making in individuals with schizophrenia have yielded mixed results, and few studies have examined systematically the relationship between these domains and their relationship with clinical factors.

Method: Thirty-two smokers with schizophrenia, ten non-smokers with schizophrenia, nine non-psychiatric non-smokers and ten non-psychiatric smokers were administered computerized versions of the Iowa Gambling Task (IGT) and the WCST. Smokers were allowed to smoke adlibitum during designated breaks in order to prevent deprivation.

Results: Subjects with schizophrenia performed significantly worse than non-psychiatric controls on both the IGT and the WCST, and performance on these tasks was significantly correlated across subject groups. Among women with schizophrenia, smokers performed significantly better than non-smokers on the IGT.

Conclusions: Individuals with schizophrenia perform worse than controls on the IGT, suggesting impairments in risk/reward decision-making. Correlations between IGT and WCST performance suggest a shared element underlying task performance, such as a deficit in set-shifting or perseverance. Further research is needed to establish the relationship between cigarette smoking and IGT performance in schizophrenia.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cognition Disorders / drug therapy
  • Cognition Disorders / etiology*
  • Decision Making / drug effects
  • Decision Making / physiology*
  • Disruptive, Impulse Control, and Conduct Disorders / etiology
  • Female
  • Gambling
  • Humans
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Psychiatric Status Rating Scales
  • Reward*
  • Risk
  • Schizophrenia / complications*
  • Schizophrenic Psychology*
  • Sex Factors
  • Smoking / physiopathology*
  • Young Adult