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Decision-Making Dysfunctions in Psychiatry—Altered Homeostatic Processing?

Martin P. Paulus
Science • 26 Oct 2007 • Vol 318, Issue 5850 • pp. 602-606 • DOI: 10.1126/science.1142997
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Abstract

Decision-making consists of selecting an action from a set of available options. This results in an outcome that changes the state of the decision-maker. Therefore, decision-making is part of a homeostatic process. Individuals with psychiatric disorders show altered decision-making. They select options that are either non-optimal or nonhomeostatic. These dysfunctional patterns of decision-making in individuals with psychiatric disorders may fundamentally relate to problems with homeostatic regulation. These may manifest themselves in (i) how the length of time between decisions and their outcomes influences subsequent decision-making, (ii) how gain and loss feedback are integrated to determine the optimal decision, (iii) how individuals adapt their decision strategies to match the specific context, or (iv) how seemingly maladaptive responses result from an attempt to establish an unstable homeostatic balance.
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I would like to acknowledge the help of E. Arce, D. Leland, S. Matthews, M. Wittmann, and A. Simmons during the preparation of the manuscript. This research was supported by grants from the National Institute on Drug Abuse (R01DA016663 and R01DA018307) and a U.S. Department of Veterans Affairs merit grant.

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Science
Volume 318 | Issue 5850
26 October 2007

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Martin P. Paulus
Department of Psychiatry, University of California at San Diego, 8950 Villa La Jolla Drive, La Jolla, CA 92037–0985, USA; and Veterans Affairs Health Care System San Diego, 3350 La Jolla Village Drive, San Diego, CA 92161, USA. E-mail: [email protected]
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