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Science 26 October 2007:
Vol. 318. no. 5850, pp. 602 - 606
DOI: 10.1126/science.1142997
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Review

Decision-Making Dysfunctions in Psychiatry—Altered Homeostatic Processing?

Martin P. Paulus

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.

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: mpaulus{at}ucsd.edu

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