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Impulsive Decisions Associated With Slate of Psychiatric Disorders

September 05, 2019
Michael Amlung, PhD

With the exception of anorexia nervosa, people across a slate of psychiatric disorders tend to choose smaller, immediate rewards instead of larger, delayed rewards—a type of impulsive decision-making deemed “delay discounting.” Researchers reported the findings online in JAMA Psychiatry.

“The revelation that delay discounting is one of these transdiagnostic processes will have a significant effect on the future of psychiatric diagnosis and treatment,” said study lead author Michael Amlung, PhD, of McMaster University, Hamilton, Ontario, Canada.

The finding stemmed from a meta-analysis of data from 43 studies across 8 diagnostic categories.

A preference for delay discounting was present in people with depression, bipolar disorder, schizophrenia, borderline personality disorder, bulimia nervosa, and binge-eating disorder, compared with control subjects, researchers reported.

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People with bipolar disorder, borderline personality disorder, and schizophrenia showed the most delay discounting. Those with anorexia nervosa, on the other hand, showed the opposite: a preference for delayed rewards rather than immediate rewards. Data for patients with posttraumatic stress disorder was limited and should be a priority area for future research, researchers noted.

“Examining factors that cut across psychiatric disorders, such as delay discounting, helps to illuminate commonalities and distinguishing characteristics among disorders that then guide further research on treatment and prevention,” said study coauthor Randi McCabe, PhD, of McMaster University.

“The more we understand the nature of psychiatric illness,” she added, “the better we are equipped to provide effective treatment strategies.”

—Jolynn Tumolo


Amlung M, Marsden E, Holshausen K, et al. Delay discounting as a transdiagnostic process in psychiatric disorders: a meta-analysis. JAMA Psychiatry. 2019 August 28;[Epub ahead of print].

Study finds many psychiatric disorders have heightened impulsivity [press release]. Ontario, Canada: McMaster University; August 28, 2019.

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