Oct 13, 2020 16:00:00

Why are people suffering from schizophrenia and drug addiction less likely to make the 'right decision'?

People make 'judgments' in various situations in their daily lives, improve their judgment ability based on their mistakes and advice, and make repeated improvements so that they can make the right decisions for themselves. While many people take this for granted, it seems difficult for

schizophrenic patients and those suffering from drug addiction ( substance use disorder ) to make the right decision, a researcher at the University of Queensland. James Kesby and colleagues explain why.

Why do some people struggle to make'healthy' decisions, day after day?
https://theconversation.com/why-do-some-people-struggle-to-make-healthy-decisions-day-after-day-147666

In everyday situations, it is often difficult to make a clear distinction between 'right decisions' and 'wrong decisions,' but some choices can be expected to have positive consequences for you and your surroundings. According to Kesby, the human brain makes decisions based on four important factors: 'value,' 'motivation,' 'behavior,' and 'strategy.'

When you have two choices, 'A' and 'B' in front of you, you first need to understand which choice is more rewarding and brings more 'value'. And it seems that your personal 'motivation' acts on the rewards that you can earn by making choices, and which choice is preferable.

By understanding the 'behavior' that accompanies subsequent choices and understanding the 'strategy' that maximizes rewards by combining all this information, people can finally make the 'right choice' for themselves. That thing. In addition, by repeating this complex process of selection, you can improve your decision-making ability over time, Kesby explains.

However, people with mental or substance use disorders may have problems with this decision-making process. For example, a 2018

study suggested that patients with schizophrenia find it difficult to understand the relationship between their behavior and the consequences. In other words, patients with schizophrenia choose 'B' for options 'A' and 'B' without knowing the relationship between behavior and outcome, even if they know that 'A' is more valuable than 'B'. It seems that there is a possibility of choosing. Kesby also points out that people with schizophrenia are more likely to adopt strategies that derive results from less information and often jump to conclusions.

A 2011 study suggests that people who suffer from substance use disorders such as stimulants also find it difficult to make the right decisions 'when certain results change.' For example, if the meanings of all the traffic lights are reversed to mean 'advance the red light, stop the green light', many people are confused at first, but eventually accept the change and adjust their actions to the new signal. However, people who depend on stimulants are more likely to proceed at the green light and continue to stop at the red light, even if they are involved in an accident because they proceeded at the green light.

Dopamine , a neurotransmitter in the brain, causes problems in the decision-making process of schizophrenic patients and makes it difficult for stimulant abusers to adapt to changing environments. It seems that it is thought to be.

The human brain contains multiple circuits and neurotransmitters that control different reactions, which interact to perform complex processes. For example, the decision-making process affected by schizophrenia and substance use disorder involves the interrelated striatum of the cerebral cortex and subregions, which perform complex thinking.

It is said that the brain of schizophrenic patients changes the amount of dopamine secreted, which causes hallucinations and delusions. Dopamine plays an important role in making choices, such as predicting rewards, making decisions, and controlling physical behavior. A study by Kesby et al. Suggested that increased dopamine in the striatum could cause problems in the cerebral cortex's ability to integrate information, making decision-making in schizophrenic patients difficult.

Stimulant abuse also promotes excessive dopamine release, making it difficult to adapt to changing environments and change goals, Kesby said. Healthy people can change their habits based on new information taken in by the brain, but drug addiction firmly roots habitual behavior. This makes it difficult for drug addicts to stop taking drugs, even if they are no longer enjoying them.

'Unfortunately, cognitive problems are difficult to treat. There are no drugs for schizophrenia or stimulant addiction that have been shown to definitely improve cognition,' said Kesby. However, cognitive remediation therapy that trains the brain to respond better in certain situations may help people with schizophrenia to restore decision-making ability and visual memory. He said the study hopes to improve the lives of people with mental illness.