Blunted neuroeconomic loss aversion in schizophrenia

James Currie, Gordon D Waiter, Blair Johnston, Nick Feltovich, J Douglas Steele

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish
Article number147957
Number of pages8
JournalBrain Research
Early online date30 May 2022
Publication statusPublished - 15 Aug 2022

Bibliographical note

We thank all participants for their time and effort in taking part in this study and radiographers for their invaluable work in the MRI procedures.


  • Antipsychotic Agents/pharmacology
  • Brain
  • Brain Mapping
  • Humans
  • Magnetic Resonance Imaging
  • Neuroimaging
  • Schizophrenia/diagnosis


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