Exploring the association between the Iowa gambling task and community functioning in people with schizophrenia

Background: Decision making (DM) consists of a number of complex processes involving higher-order cognitive functions involved in outcome evaluation. Problems in DM may have significant negative repercussions on community functioning. We hypothesise in individuals with schizophrenia difficulties in community functioning will be associated with DM problems. Subjects and methods: DM performance was assessed using the Iowa Gambling Task (IGT) in 30 individuals with schizophrenia and 32 healthy controls. Participants' choices on the IGT were grouped as: Ambiguous Decisions, where the outcome is uncertain and cannot be predicted (i.e. IGT initial phase), and Risky Decisions, where the outcome can be predicted with an error margin (i.e. IGT final phase). People with schizophrenia were also assessed with measures of community functioning and symptoms. Results: Controls outperformed individuals with schizophrenia in risky decisions. In patients, levels of community functioning positively correlated with DM performance. Symptomatology was not associated with DM proficiency or functioning. Conclusions: DM impairment may represent an important contributor to poor functional outcomes in people with schizophrenia. Interventions targeting decision making and higher order cognitive problems in people with schizophrenia may have a greater impact on functional difficulties.