RISK aversion in Italian forensic and non-forensic patients with schizophrenia spectrum disorders

PLoS One. 2023 Jul 31;18(7):e0289152. doi: 10.1371/journal.pone.0289152. eCollection 2023.

Abstract

Background: Goal-directed decision-making is a central component of the broader reward and motivation system, and requires the ability to dynamically integrate both positive and negative feedback from the environment in order to maximize rewards and minimize losses over time. Altered decision-making processes, in which individuals fail to consider the negative consequences of their decisions on both themselves and others, may play a role in driving antisocial behaviour.

Aim: The main study aim was to investigate possible differences in loss and risk aversion across matched patients, all with a schizophrenia spectrum disorder (SSD), but who varied according to whether they had a history of serious interpersonal violence or not, and a sample of healthy controls with no history of violence.

Results: The sample included 14 forensic and 21 non-forensic patients with SSD, and 41 healthy controls. Among the three decision-making variables under investigation, risk aversion was the only significant predictor of membership of the three groups, with greater risk aversion among non-forensic patients with SSD compared to healthy controls. No differences were observed across groups in loss aversion and choice consistency.

Conclusions: This evidence suggests a new potential treatment target for rehabilitative measures aimed at achieving functional improvements in patients with SSD by selectively leveraging the neuro-cognitive processing of reward.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Affect
  • Antisocial Personality Disorder
  • Decision Making
  • Humans
  • Motivation
  • Reward
  • Schizophrenia*

Grants and funding

The EUropean Study on VIOlence Risk and MEntal Disorders (EU-VIORMED) project has received a grant from European Commission (Grant Number PP-2- 3-2016, November 2017–September 2021) (LI, SA, LC, GC, AD, CF, JH, AM, IM, GN, MP, GR, GR, FT, GDG). This research was partially supported by the “Ricerca Corrente” funding scheme of the Italian Ministry of Health (NC, LI, CF, AM, GM, GDG). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.