Schizophrenic Patients May Not Feel Regret

"You Won't Regret Reading This"

Researchers are interested in the way in which regret affects decision-making processes such as the thought process of a person who is gambling or a person’s simple, daily decision-making tasks. While the Orbitofrontal Cortex (OFC) and Ventral Striatium (VS) are already known to encode expected outcomes during decision-making tasks, Gregory B. Bissonette, Daniel W. Bryden, and Matthew R. Roesch used a Restaurant Row experiment to test which areas of the brain are activated when a rat is faced with a possible missed opportunity, rather than an expected result. They were successful in deciphering neural encodings in the OFC and VS at the exact moment at which a rat had realized that it had missed an opportunity and found that the OFC and VS were responsible for the "regret" that the rat exhibited. Therefore, people who have damaged or lesioned OFCs may show poor social and individual decision-making skills, along with atypical emotional responses to the effects of their decisions.

It has been theorized that some schizophrenic patients, like OFC lesion patients, may be unable to feel regret due to their inability to assign appropriate value to the effects of their decisions. In a study completed by Marion Larquet, GiorgioCoricelli, Gaelle Opolcynski, and Florence Thibaut, a gambling task was used to bring the previously rejected information on the outcomes of alternative choices into subjects’ future evaluations. In this way, they were allowed to study situations that would, or should, elicit feelings of regret in most people. They found differences between subjects with lesions in their OFC (OFCL) and schizophrenic subjects, along with differences between the types of schizophrenic subjects, which are characterized by the type of symptoms they exhibit (positive or negative symptoms). After analysis, they concluded that their data suggest a possible OFC dysfunction in a subset of schizophrenia patients rather than schizophrenic patients as a whole. However, in general, schizophrenic patients do exhibit more risk seeking behaviour than healthy controls. Since the gambling task did not rely on impairments that any of the schizophrenic subjects exhibited, such as working memory or loading information, it can be concluded that schizophrenic patients with positive symptoms react similarly to OFCL patients when faced with a decision-making task. Their inability to integrate cognitive and emotional aspects of the task is impaired which suggests that, like OFCL patients, schizophrenic patients with positive symptoms are unable to learn from poor decisions and were unable to feel regret.

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             Not only does this study further elucidate the maladaptive behaviour of people with Schizophrenia by clarifying another feature of this behaviour, but it also allows researchers to use studies such as the Restaurant Row experiment to progress the research of human beings. Moving forward, researchers may be able to advance their understanding of the mechanisms by which regret occurs, and possibly, uncover a way to repair the regions of the brain that cause regret to disappear in OFCL and schizophrenic patients.

References:

Bissonette, B., Gregory, Bryden, W., Daniel, Roesch, R., Matthew. "You Won't Regret Reading This" Nature Neuroscience

https://dornsife.usc.edu/assets/sites/472/docs/Larquet_Coricelli_Schizophrenia_Research_2010.pdf