Sex differences in risk-based decision making in adolescents with conduct disorder

Justina Sidlauskaite,Luke Clark,Harriet Cornwell,Edmund J S Sonuga-Barke,Karen González-Madruga,Graeme Fairchild,Roberta Riccelli,Areti Smaragdi,Ignazio Puzzo,Molly Batchelor

doi:10.1007/s00787-017-1024-9

Abstract

Altered decision making processes and excessive risk-seeking behaviours are key features of conduct disorder (CD). Previous studies have provided compelling evidence of abnormally increased preference for risky options, higher sensitivity to rewards, as well as blunted responsiveness to aversive outcomes in adolescents with CD. However, most studies published to date have focused on males only; thus, it is not known whether females with CD show similar alterations in decision making. The current study investigated potential sex differences in decision making and risk-seeking behaviours in adolescents with CD. Forty-nine adolescents with CD (23 females) and 51 control subjects (27 females), aged 11-18 years, performed a computerised task assessing decision making under risk—the Risky Choice Task. Participants made a series of decisions between two gamble options that varied in terms of their expected values and probability of gains and losses. This enabled the participants’ risk preferences to be determined. Taking the sample as a whole, adolescents with CD exhibited increased risk-seeking behaviours compared to healthy controls. However, we found a trend towards a sex-by-group interaction, suggesting that these effects may vary by sex. Follow-up analyses showed that males with CD made significantly more risky choices than their typically developing counterparts, while females with CD did not differ from typically developing females in their risk-seeking behaviours. Our results provide preliminary evidence that sex may moderate the relationship between CD and alterations in risk attitudes and reward processing, indicating that there may be sex differences in the developmental pathways and neuropsychological deficits that lead to CD.

Highlights

Decision making plays a pivotal role in everyday functioning
Our results provide preliminary evidence that sex may moderate the relationship between conduct disorder (CD) and alterations in risk attitudes and reward processing, indicating that there may be sex differences in the developmental pathways and neuropsychological deficits that lead to CD
Given the previously identified sex differences in risky decision making in normative populations, and our currently limited understanding of the neuropsychological profile associated with CD in females, the present study examined the potential role of sex as a moderator of decision making in CD

Summary

Introduction

Decision making plays a pivotal role in everyday functioning. From a neuropsychological perspective, decision making encompasses a variety of distinct processes [1], and is an important determinant of an individual’s successes and failures in life [2]. Efficient decision making requires constant updating of value representations and the evaluation of potential outcomes, for instance, estimates of the magnitude of potential gains and losses and the respective probabilities of their delivery are integrated to yield the expected value of that choice [3]. This implies that the option with the highest expected value should always be chosen, decision making in human participants is strongly influenced by psychological factors affecting subjective value assignment [4, 5]. There are individual differences—some individuals are more prone to risk-seeking behaviours, while others may be significantly risk averse [6]

Methods

Results

Discussion

Conclusion