Decision-making and ‘gut feeling’ in males with anorexia nervosa

Abstract

Objective: To examine decision-making in males with anorexia nervosa (AN) and establish if performance is associated with skin conductance responses (SCRs).

Method: Decision-making was assessed in 39 participants [11 males with AN and 28 healthy males] using the Iowa gambling task (IGT). SCRs were recorded during the performance of the IGT.

Results: The male AN group performed significantly worse than healthy controls (HCs) in the IGT. However, their SCRs were similar to the HC group's SCRs, and IGT performance was not correlated with an established somatic measure (SCR).

Discussion: Impaired performance in the IGT in male patients with AN is not associated with diminished somatic responses and clinical severity. Taken with other data, this shows that impaired decision-making is present in both male and female patients with AN. As impaired decision-making is also present in other psychiatric groups, it could be either a non-specific predisposing factor or a consequence of psychiatric morbidity. Nonetheless, this understanding may help to facilitate the development of improved interventions, for example, cognitive rehabilitation programmes, and may also be of benefit for predicting treatment outcome.

Keywords:

• decision making
• executive functions
• neuropsychology
• anorexia
• male
• Iowa Gambling Task

Acknowledgements

This work was funded by the BIAL foundation (grant number 57/10 and 61/04) and by the NIHR Biomedical Research Centre for Mental Health, South London, and Maudsley NHS Foundation Trust and Institute of Psychiatry, King's College London.