Blunted neuroeconomic loss aversion in schizophrenia.

BACKGROUND: Abnormal social decision-making is prominent in schizophrenia. Antipsychotic medication often improves interpersonal functioning but this action is poorly understood. Neuroeconomic paradigms are an effective method of investigating social decision-making in psychiatric disorders that can be adapted for use with neuroimaging. Using a neuroeconomic approach, it has been shown that healthy humans reproducibly alter their behavior in different contexts, including exhibiting loss aversion: a higher sensitivity to loss outcomes compared to gains of the same magnitude. METHODS: Here, using a novel loss aversion task and fMRI, we tested three hypotheses: controls exhibiting normal behavioral loss aversion show changes in brain activity consistent with previous studies on healthy subjects; behavioral loss aversion is significantly reduced in schizophrenia and associated with abnormal activity in the same brain regions activated in controls during loss aversion behavior; and for the patient group alone, there is a significant correlation between increased psychotic symptoms, blunted loss aversion and abnormal brain activity. These hypotheses were tested in patients with schizophrenia and healthy controls using a loss aversion paradigm and fMRI. RESULTS: The results support the hypotheses, with patients exhibiting significantly blunted behavioral loss aversion compared to controls. Controls showed a robust loss aversion brain activation pattern in the medial temporal lobe, insula and dopaminergic-linked areas, which was blunted in schizophrenia. CONCLUSIONS: Our results are consistent with blunted loss aversion being a reproducible feature of schizophrenia, likely due to abnormal dopaminergic and medial temporal lobe function, suggesting a route by which antipsychotics could influence interpersonal behavior.

Moral licensing, instrumental apology and insincerity aversion: Taking Immanuel Kant to the lab.

Moral licensing, equivalently called "self-licensing", is the instrumental use of a Good Act to cover up a Bad Act. This paper's thesis is that "instrumental apology" i.e., bad-faith apology, is a case of moral licensing. A decision maker may issue an apology (Good Act) after committing a Bad Act, but if the decision maker uses the apology instrumentally, he or she is using the apology to justify the Bad Act. Hence, the apology is insincere. Sincerity is the fine line between a good-faith apology or, more generally, a Good Act, on one hand, and an instrumental apology or, more generally, moral licensing, on the other. In this light, moral licensing should be separated from genuine apology that attains moral equilibrium, which is called in the literature moral "self-regulation' and "conscience accounting." According to Kantian ethics, not just the consequences of an act matter, but also the sincerity with which the act was conducted. This pits Kant against the utilitarian view, which downplays intentions and focuses on consequences. We take Kant to the lab. Participants play a modified ultimatum game, where proposers in some treatments have the option of issuing apology messages and responders have both costly and costless options for rewarding or punishing proposers. We introduce different treatments of the apology message to allow responders to form doubts about the sincerity of the apology messages. Our results support the Kantian position: responders, once they become suspicious of the sincerity of the proposers' apology, exhibit "insincerity aversion" and punish proposers.

Schizophrenia illness severity is associated with reduced loss aversion.

Loss aversion, whereby losses weigh more heavily than equal-sized gains, has been demonstrated in many decision-making settings. Previous research has suggested reduced loss aversion in schizophrenia, but with little evidence of a link between loss aversion and schizophrenia illness severity. In this study, 20 individuals with schizophrenia and 16 control participants, matched by age and sex, played two versions of the Iterated Prisoners' Dilemma, one version with only positive payoffs and another version in which negative payoffs were possible, with the second version being derived from the first by subtracting a constant value from all payoffs. The control group demonstrated significantly lower cooperation rates under negative payoffs, compared with the version with only positive payoffs, indicative of loss aversion. The patient group on average showed no loss aversion response. Moreover, the extent of loss aversion in patients was found to be negatively correlated with schizophrenia illness severity, with less ill patients showing loss aversion more similar to controls. Results were found to be robust to the inclusion of potential confounding factors as covariates within rigorous probit regression analyses. Reduced loss aversion is a feature of schizophrenia and related to illness severity.