Decision-making under risk in patients with antisocial personality disorder

Abstract

Objective To investigate decision making under risk in patients with antisocial personality disorder(ASPD). Methods The game of dice task (GDT) was a commonly used measure of decision making under risk. 31 ASPD patients and 33 healthy controls (HC) were investigated by GDT with explicit probability. Results ASPD patients performed poorly in the entire task.ASPD selected more risky options (ASPD: 10.06±5.26, HC: 5.42±3.29, t=4.201, P<0.01) compared with healthy controls. The most frequent choice made by ASPD patients was two numbers.Accordingly, the most frequent choice made by HC group was three numbers(one number: the median of ASPD patients was 1(1-8), the median of HC was 1(0-2.5), Z=-2.295, P=0.022); three numbers: ASPD: 4.77±4.23; HC: 6.79±3.43; t=-2.100, P=0.04; four numbers: ASPD: 3.06±3.53; HC: 5.82±3.41; t=3.176, P=0.002). The frequency of choosing the risky options had correlation with the rate of using negative feedback(r=-0.613, P<0.01), impulsiveness(r=0.481, P=0.006) and the results of Stroop test(r=0.566, P<0.01). Conclusion Main results reveal that patients with ASPD make risky decisions significantly more often than the HC. Moreover, they show lack of capacity to advantageously utilize feedback, and correlation with executive function, impulsiveness, and negative feedback. Key words: Antisocial personality disorder; Decision making; Cognitive; Executive function