Decision-making under ambiguity in patients with social anxiety disorder

Abstract

INTRODUCTION: The study aimed to compare the decision-making functions of patients with social anxiety disorder (SAD) under ambiguity with healthy controls METHODS: Seventy-nine patients with SAD (47 with generalized subtype, and 32 with nongeneralized subtype) were included in the study. The healthy control group consisted of 72 individuals who were matched with the patient group in terms of age, sex, and education. Sociodemographic Data Form, Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Liebowitz Social Anxiety Scale (LSAS), Barratt Impulsiveness Scale-Short Form (BIS-15), and Iowa Gambling Test (IGT) were administered to all participants RESULTS: The decision-making performance of patients with SAD was similar to healthy control group. In SAD subtypes, the generalized type performed poorly in the IGT compared with the nongeneralized subtype type. Participants with nongeneralized subtype increased their performance by choosing more advantageous decks after the first 20 card selections and showed a learning effect. Those with generalized type showed a learning effect only in block 5 and continued to choose from disadvantageous cards in the other blocks DISCUSSION AND CONCLUSION: Patients with SAD preferred advantageous decks like healthy control group and learned to avoid disadvantageous decks. The decision-making performance of the generalized type was impaired. The generalized subtype made choices that won in the short run but lost in the long run and did not benefit from feedback. We believe that this separation in decision-making processes among SAD subtypes will contribute to a better understanding of the types.

Keywords

• social anxiety disorder
• ambiguity
• decision-making
• generalized subtype
• nongeneralized subtype