Reward and Punishment Learning Across Common Forms of Psychopathology

The Iowa Gambling Task (IGT) has been widely used to assess decision-making deficits in clinical populations. Previously used methods do not provide clear evidence whether associations between IGT performance and psychopathology are general across multiple forms of psychopathology or are specific to individual disorders. In this study, we examined IGT performance across anxiety, depression, and substance use disorder. We tested a sample of adults (N=293) on the play-or-pass version of the IGT. We characterized behavior using a hierarchical Bayesian computational model, formalizing parameters underlying task behavior: reward and punishment learning rates, win-frequency sensitivity, and response bias. With the model, we examined unique associations between IGT performance and lifetime diagnostic history of anxiety, depression, and substance use disorder. Anxiety, but not depression or substance use, was associated with higher punishment learning rates, posterior mean β = 0.15, 95% CI [0.01,0.28]. In addition, women showed lower punishment learning rates, posterior mean β = -0.17, 95% CI [-0.30,-0.03], and lower response bias, posterior mean β = -0.30, 95% CI [-0.56,-0.05]. The relation between punishment learning rates and diagnostic history of anxiety was small; however, our findings were consistent with established findings in anxiety derived from self-report. In addition, only main effects of diagnostic status were examined; thus, future research should examine comorbidity between diagnoses on IGT performance. Findings are consistent with research showing that anxiety is associated with punishment avoidance. In addition, our behavioral findings with respect to gender are also consistent with previous research employing the IGT.