Decision Making and Executive Function in Male Adolescents with Early-Onset or Adolescence-Onset Conduct Disorder and Control Subjects

作者：Fairchild Graeme^*; van Goozen Stephanie H M; Stollery Sarah J; Aitken Michael R F; Savage Justin; Moore Simon C; Goodyer Ian M

来源：Biological Psychiatry, 2009, 66(2): 162-168.

DOI：10.1016/j.biopsych.2009.02.024

• Conduct disorder
• decision making
• developmental taxonomic theory
• executive function
• reward
• risk
• stress

Background: Although conduct disorder (CD) is associated with an increased susceptibility to substance use disorders, little is known about decision-making processes or reward mechanisms in CD. This study investigated decision making under varying motivational conditions in CD.
Methods: Performances on the Risky Choice Task (RCT) and the Wisconsin Card Sorting Test (WCST) were assessed in 156 adolescents (84 control subjects, 34 with adolescence-onset CD, and 38 with early-onset CD). The RCT was performed twice,once under normal motivational conditions and once under conditions of increased motivation and psychosocial stress.
Results: Increased motivation and stress led to more cautious decision making and changes in framing effects on the RCT in all groups, although such effects were least pronounced in the early-onset CD group. Participants from both CD subgroups selected the risky choice more frequently than control subjects. Under normal motivational conditions, early-onset CD participants chose the risky choice more frequently in trials occurring after small gains, relative to control subjects and adolescence-onset CID participants. Following adjustment for IQ differences, the groups did not differ significantly in terms of WCST performance.
Conclusions: Differences in decision making between control subjects and individuals with CD suggest that the balance between sensitivity to reward and punishment is shifted in this disorder, particularly the early-onset form. Our data on modulation of decision making according to previous outcomes suggest altered reward mechanisms in early-onset CID. The WCST data suggest that impairments in global executive function do not underlie altered decision making in CD.

• 出版日期2009-7-15