title: Further evidence of a dissociation between decision-making under ambiguity and decision-making under risk in obsessive-compulsive disorder.
abstract: BACKGROUND
  Deficits in decision-making have been suggested as a key concept in understanding the symptoms of obsessive-compulsive disorder (OCD). However, evidence in the extant literature remains inconclusive on whether patients with OCD show inferior performance on laboratory decision-making tasks. The aims of the present study were therefore to (1) assess decision-making under ambiguity and under risk in patients with OCD and (2) study the influence of neuropsychological and clinical variables on decision-making in OCD.
  
  
  METHODS
  The sample consisted of 65 patients with OCD and 58 controls. The Iowa gambling task (IGT) and the game of dice task (GDT) were used to examine decision-making under ambiguity and decision-making under risk, respectively. In addition, reversal learning and executive function were assessed in terms of their relationship with decision-making tasks.
  
  
  RESULTS
  Patients with OCD showed impairment in the IGT, but not in the GDT. Reversal learning was neither impaired nor correlated with IGT performance. Among the clinical variables, illness severity and depression were associated with IGT scores. Executive function was impaired, but no significant relationship was found between executive function and GDT performance in OCD patients.
  
  
  CONCLUSIONS
  Almost all OCD patients were on medication when they performed decision-making tasks.
  
  
  CONCLUSIONS
  Patients with OCD are impaired in decision-making under ambiguity, but not under risk. These findings demonstrate that decision-making processes are dissociated in OCD.
authors.affiliation: Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Hae Won
authors.initials: HW
authors.lastname: Kim
authors.affiliation: Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Jee In
authors.initials: JI
authors.lastname: Kang
authors.affiliation: Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Kee
authors.initials: K
authors.lastname: Namkoong
authors.affiliation: Department of Adolescent Psychiatry, National Center for Child and Adolescent Psychiatry, Seoul National Hospital, Seoul, South Korea.
authors.forename: Kyungun
authors.initials: K
authors.lastname: Jhung
authors.affiliation: Department of Psychiatry, Seoul Bukbu Hospital, Seoul, South Korea.
authors.forename: Ra Yeon
authors.initials: RY
authors.lastname: Ha
authors.affiliation: Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea. Electronic address: kimsejoo@yuhs.ac.
authors.forename: Se Joo
authors.initials: SJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003657:Decision Making; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D009771:Obsessive-Compulsive Disorder / Q000523:psychology*; D012309:Risk-Taking; D035501:Uncertainty; D055815:Young Adult
keywords: Decision-making; Game of dice task; Iowa gambling task; Obsessive–compulsive disorder