Bipolar (BD) and schizophrenia (SZ) are two mental health conditions that share many symptoms related to psychosis. However, both of these conditions also differ in unique ways. One such way that BD and SZ differ is in the neurological processing of incentive discrimination. Using the Iowa Gambling Task (IGT), a test used to identify various decision making processes in people with a spectrum of mental health issues including addiction, Paolo Brambilla of the Inter-University Centre for Behavioral Neuroscience at the University of Udine in Italy recently discovered some distinctions between how people with BD and people with SZ respond to reward-punishment tasks.
In his study, Brambilla compared the performance of 70 clients in remission from BD, 70 clients in remission from SZ, and 140 nonpsychotic participants. He found that three categories of motivational processing and performance emerged as clearly different between the groups. The participants with SZ had low expectancy learning scores and had higher inconsistencies in responses when compared to the nonpsychotic or BD participants. The BD participants demonstrated significant focus on reward-punishment outcomes in relation to either the SZ or nonpsychotic participants. Brambilla noted that even though all of the psychotic participants were on medication at the time of the experiment, the results were analyzed with that consideration.
Brambilla pointed out that other factors, including presence of manic or depressive symptoms, could influence the outcome of the results, especially for the BD participants. The diminished expectancy learning found among the SZ participants was not a surprising finding, as many studies have shown that people with SZ have difficulty considering past events when making current decisions. Thus, prior outcomes to poor decisions are usually not recalled when clients with SZ are faced with new choices. Clearly, these results show that cognitive processes are impacted by schizophrenia and bipolar in unique and independent ways. Brambilla added, “Our results point to dissociable processes underlying abnormal incentive decision making in BD and SZ that could potentially be mapped to different neural circuits.”
Brambilla, P., et al. (2013). Increased salience of gains versus decreased associative learning differentiate bipolar disorder from schizophrenia during incentive decision making. Psychological Medicine 43.3 (2013): 571-80. ProQuest. Web.
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