title: Clinical and genetic correlates of decision making in anorexia nervosa.
abstract: BACKGROUND
  Decision-making (DM) abilities have been found to be impaired in anorexia nervosa (AN), but few data are available about the characteristics and correlates of this cognitive function. The aim of the present study was to provide data on DM functioning in AN using both veridical and adaptive paradigms. While in veridical DM tasks, the individual's ability to predict a true/false response is measured, adaptive DM is the ability to consider both internal and external demands in order to make a good choice, in the absence of a single true "correct" answer.
  
  
  METHODS
  The participants were 189 women, of whom 91 were eating-disordered patients with a lifetime diagnosis of anorexia nervosa, and 98 were healthy women. All the participants underwent clinical, neuropsychological, and genetic assessment. The cognitive evaluation included a set of neuropsychological tasks and two decision-making tests: The Iowa Gambling Task and the Cognitive Bias Task.
  
  
  RESULTS
  Anorexia nervosa patients showed significantly poorer performances on both decision-making tasks than healthy women. The Cognitive Bias Task revealed that anorexia nervosa patients employed significantly more context-independent decision-making strategies, which were independent from diagnostic subtype, handedness, education, and psychopathology. In the whole sample (patients and controls), Cognitive Bias Task performance was independently predicted by lifetime anorexia nervosa diagnosis, body mass index at assessment, and 5-HTTLPR genotype.
  
  
  CONCLUSIONS
  Patients displayed poor decision-making functioning in both veridical and adaptive situations. The difficulties detected in anorexia nervosa individuals may affect not only the ability to consider the future outcomes of their actions (leading to "myopia for the future"), but also the capacity to update and review one's own mindset according to new environmental stimuli.
authors.affiliation: a Department of Neurosciences: DNS ; University of Padova , Padua , Italy.|c Cognitive Neuroscience Center, University of Padova , Padua , Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Tenconi
authors.affiliation: a Department of Neurosciences: DNS ; University of Padova , Padua , Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Degortes
authors.affiliation: b Clinical Genetics Unit, Department of Woman and Child Health , University of Padova , Padua , Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Clementi
authors.affiliation: a Department of Neurosciences: DNS ; University of Padova , Padua , Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Collantoni
authors.affiliation: b Clinical Genetics Unit, Department of Woman and Child Health , University of Padova , Padua , Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Pinato
authors.affiliation: b Clinical Genetics Unit, Department of Woman and Child Health , University of Padova , Padua , Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Forzan
authors.affiliation: b Clinical Genetics Unit, Department of Woman and Child Health , University of Padova , Padua , Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Cassina
authors.affiliation: a Department of Neurosciences: DNS ; University of Padova , Padua , Italy.|c Cognitive Neuroscience Center, University of Padova , Padua , Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Santonastaso
authors.affiliation: a Department of Neurosciences: DNS ; University of Padova , Padua , Italy.|c Cognitive Neuroscience Center, University of Padova , Padua , Italy.|d CIRMAN-MEC, Centro Interdipartimentale di Ricerca sulla Modellistica delle Alterazioni Nueropsichiche in Medicina Clinica , University of Padova , Padua , Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Favaro
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000856:Anorexia Nervosa / Q000150:complications* / Q000235:genetics*; D015992:Body Mass Index; D001835:Body Weight; D002394:Catechol O-Methyltransferase / Q000235:genetics; D003072:Cognition Disorders / Q000209:etiology* / Q000235:genetics; D003657:Decision Making / Q000502:physiology*; D004522:Educational Status; D005260:Female; D007839:Functional Laterality; D005717:Games, Experimental; D014644:Genetic Variation / Q000235:genetics*; D005838:Genotype; D006801:Humans; D007558:Italy; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D050486:Serotonin Plasma Membrane Transport Proteins / Q000235:genetics*; D055815:Young Adult
chemical_list: C493230:SLC6A4 protein, human; D050486:Serotonin Plasma Membrane Transport Proteins; C588010:COMT protein, human; D002394:Catechol O-Methyltransferase
keywords: Eating disorders; anorexia nervosa; genetics; neuropsychological test.; serotonin transporter