Abstract
Bipolar disorder (BD) is associated with impaired decision making, yet few studies have adopted paradigms from behavioral economics to decompose which, if any, aspects of decision making may be impacted. This may be particularly relevant for decision-making processes relevant to known difficulties with emotive dysfunction and corresponding reward dysregulation in BD. Participants with bipolar I disorder (BD; n = 44) and non-psychiatric healthy controls (CTL; n = 28) completed three well-validated behavioral economics decision making tasks via a remote-based survey, including loss aversion and framing effects, that examined sensitivity to probabilities and potential gains and losses in monetary and non-monetary domains. Consistent with past work, we found evidence of moderate loss aversion and framing effects across all participants. No group differences were found in any of the measures of loss aversion or framing effects. We report no group differences between bipolar and non-psychiatric groups with respect to loss aversion and framing effects using a remote-based survey approach. These results provide a framework future studies to explore similar tasks in clinical populations and suggest the context and degree to which decision making is altered in BD may be rooted in a more complex cognitive mechanism that warrants future research.
Highlights
Bipolar Disorder (BD) is a severe psychiatric disorder [1,2] associated with functional disability [3,4], emotion related disturbance [5,6] and high suicide rates [7]
Consistent with goals outlined in a recent review highlighting the link between emotion and rational decision making [16], this preliminary investigation was intended to evaluate how effectively measures from behavioral economics might reflect alterations in decision making that may be driven by emotional dysregulation present in bipolar I disorder (BD)
While several studies report elevated risk-taking behavior in BD populations during a manic episode [20,49], mixed findings are reported in euthymic populations
Summary
Bipolar Disorder (BD) is a severe psychiatric disorder [1,2] associated with functional disability [3,4], emotion related disturbance [5,6] and high suicide rates [7]. Loss aversion and framing effects in bipolar I disorder changes in decision making, the present investigation seeks to understand these changes by linking BD diagnosis and its associated mood symptoms to validated behavioral economics tasks while extending this work into non-monetary domains. The present investigation employed validated behavioral economics tasks measuring loss aversion and framing effects using a remote-based survey among adults with a DSM-IV clinically diagnosed history of bipolar I disorder (BD) compared to non-psychiatric healthy controls (HC). We examined both monetary and non-monetary domains (life versus death scenario) to explore how varying contexts influence framing effects in BD. We predict that increases in current clinical symptoms will correspond with increased likelihood that participants in the BD group will result in deviations from normative decision making
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