Reference(s):

1. Main Reference: Tchanturia, K., Liao, P. C., Uher, R., Lawrence, N., Treasure, J., & Campbell, I. C. (2007). An investigation of decision making in anorexia nervosa using the Iowa Gambling Task and skin conductance measurements. J Int Neuropsychol Soc, 13(4), 635-641.
2. Background Reference: Cavedini, P., Zorzi, C., Bassi, T., Gorini, A., Baraldi, C., Ubbiali, A., et al. (2006). Decision-making functioning as a predictor of treatment outcome in anorexia nervosa. Psychiatry Res, 145(2-3), 179-187.

Article(s):

1. Tchanturia An investigation of decision making in AN using the Iowa Gambling Task and skin conductance measurements.pdf
2. Cavedini Decision-making functioning as a predictor of treatment outcome in anorexia nervosa.pdf

Discussion:

We had a good discussion about the Iowa Gambling task, including a review of the task itself and the data presented by Tchanturia et al. We discussed the ways in which a test like the Iowa Gambling Task (IGT), which in this paper was shown to differ in patients and in recovered patients, might be used for prognosis, but is likely not a good task to distinguish between endophenotypes, in that endophenotypic markers distinguish between traits rather than states. Nevertheless, the IGT might help prognosticate for patients. One confound noted was that the currently ill patients were sicker at their worst than the recovered patients, so in fact the IGT in *this* sample might be differing on trait rather than state, at least insofar as the sicker patients might have greater vulernability to more severe illness than their long-recovered peers.

One interesting line of discussion revolved around the lack of personality testing done in the paper, the nature of risk-taking, and why anorexic patients, often thought of as harm avoidant, might do worse on this paradigm. We distinguished between impulsive risk taking, and the ability to ignore noxious stimuli, e.g., hunger, and maintain an undeviating choice despite negative consequences.

Please add your comments below about the discussion or the papers - the above are cursory comments only!

Our next discussion will be on Friday, January 18, at Noon in the Meyer 4 Activity Room. There will be no journal club until March, because of small group teaching.

Thanks to everyone for coming.

Graham