Similarities and Differences in Decision-Making Impairments between Autism Spectrum Disorder and Schizophrenia.

Long Zhang,Rui Tao,Zhitu Liang,Yun Wu,Yifu Ji,Yi Dong,Kai Wang,Jingsong Chen,Jiulai Tang

doi:10.3389/fnbeh.2015.00259

Abstract

Although individuals with autism spectrum disorders (ASD) and schizophrenia (SCH) share overlapping characteristics and may perform similarly on many cognitive tasks, cognitive dysfunctions common to both disorders do not necessarily share the same underlying mechanisms. Decision-making is currently a major research interest for both ASD and SCH. The aim of the present study was to make direct comparisons of decision-making and disorder-specific underlying neuropsychological mechanisms between the two disorders. Thirty-seven participants with ASD, 46 patients with SCH, and 80 healthy controls (HC) were assessed with the Iowa Gambling Task (IGT), which measures decision-making under ambiguity, and the Game of Dice Task (GDT), which measures decision-making under risk. The results revealed that both the ASD and SCH groups had deficits for both the IGT and the GDT compared with the HC. More importantly, in the IGT, participants with ASD displayed a preference for deck A, indicating that they had more sensitivity to the magnitude of loss than to the frequency of loss, whereas patients with SCH displayed a preference for deck B, indicating that they showed more sensitivity to the frequency of loss than to the magnitude of loss. In the GDT, the impaired performance might be due to the deficits in executive functions in patients with SCH, whereas the impaired performance might be due to the deficits in feedback processing in participants with ASD. These findings demonstrate that there are similar impairments in decision-making tasks between ASD and SCH; however, these two disorders may have different impairment mechanisms.

Highlights

Autism spectrum disorders (ASD) and schizophrenia (SCH) are classified as mutually exclusive diagnoses in the most recent revision of the Diagnostic and Statistical Manual (DSM-5) (APA, 2013), genetic studies have revealed that there is an overlap in genetic risk between the two disorders (Ionita-Laza et al, 2014; McCarthy et al, 2014)
According to the post hoc Bonferroni-corrected comparisons, the SCH group performed significantly worse than the autism spectrum disorders (ASD) and healthy controls (HC) groups in the total errors, perseverative errors, and categories completed, and there were no significant differences between the ASD and HC groups
According to the post hoc Bonferroni-corrected comparisons, the ASD and HC groups performed significantly better on the Trail Making Test (TMT) B and difference score (TMT B − TMT A), and there were no significant differences between the ASD and HC groups

Summary

Introduction

Autism spectrum disorders (ASD) and schizophrenia (SCH) are classified as mutually exclusive diagnoses in the most recent revision of the Diagnostic and Statistical Manual (DSM-5) (APA, 2013), genetic studies have revealed that there is an overlap in genetic risk between the two disorders (Ionita-Laza et al, 2014; McCarthy et al, 2014). A range of impairments in social cognition have been reported in subjects with both ASD and SCH, including impairments in face processing (Sasson et al, 2007; Sachse et al, 2014), theory of mind (Chung et al, 2014), decision-making (Brown et al, 2015; Mussey et al, 2015), and empathy (Lugnegård et al, 2013). Aberrant and maladaptive decision-making has been described as a key concept in understanding several behavioral disturbances in different types of psychiatric and neurological disorders, including ASD and SCH (Brand et al, 2005; Fond et al, 2013; Mussey et al, 2015). As the neural and cognitive mechanisms of decision-making are better understood, there is a greater potential of revolutionizing the nosology, diagnosis, and treatment of these disorders (Lee, 2013)

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