ii Loss Aversion in Major Depressive Disorder Public
Dunlop, Boadie W (2012)
Abstract
iv
Abstract
Loss Aversion in Major Depressive Disorder
Major depressive disorder (MDD) is a common, disabling condition.
Poor decision-making
contributes to the physical morbidity, role dysfunction and suicide
risk in MDD patients, but little research has attempted to
objectively measure decision-making in
MDD. "Loss aversion" is a behavioral economic measure of the degree
to which individuals
demonstrate greater sensitivity to the possibility of losing
objects or money than to the
possibility of gaining the same objects or amounts of money. This
study aimed to identify
whether loss aversion differed between patients with MDD and
healthy controls (HC). Subjects completed a three-hour process of
evaluation and testing in order to
"earn" $100. One week later, they completed a decision-making task
during a
functional magnetic resonance imaging scan. The decision-making
task involved presenting
120 trials of risky decisions which participants chose to accept or
reject. Each risky decision
represented an equal chance of adding to or losing some of their
$100 endowment.
The amount to be won or lost varied from trial to trial.
Twenty-four HC and 19 MDD participants completed
the study. Two methods for calculation of loss aversion were
employed. In the subject-level
analysis, mean loss aversion for the two groups differed
significantly (HC: 1.64 ± 0.78,
MDD: 1.19 ± 0.49, p=.032). However, after removal of 2
outliers, the difference was no
longer significant (HC: 1.53 ± 0.55, MDD: 1.25 ± 0.41,
p=.085). In the representative agent
analysis, mean loss aversion was nearly identical between the
groups. Regression analyses suggested impulsivity was associated
with greater loss aversion, and that
there was an interaction between risk-taking and mood state. These
results suggest that at a group level,
there are no meaningful differences in loss aversion between MDD
and HC subjects.
However, MDD occurring in a person with low impulsivity but high
risk-taking may reduce
sensitivity to loss, thereby contributing to poor
decision-making.
v
Loss Aversion in Major Depressive Disorder
MD, Mayo Medical School, 1997
BA, Washington University, 1990
Advisor: Gregory S. Berns, MD, PhD
A thesis submitted to the Faculty of the James T. Laney School of
Graduate Studies of
Emory University in partial fulfillment of the requirements for the
degree of
Master of Science in Clinical Research
in Medicine
2012
Table of Contents
vii
TABLE OF CONTENTS
Page
Introduction
1
Methods 7
Results
17
Discussion
19
References
21
Table
1
25
Table
2
26
Table
3
27
Table
4
28
Table
5
29
Figure
1 30
Figure
2 31
Figure
3 32
Figure
4 33
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