Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-10-31T23:53:42.508Z Has data issue: false hasContentIssue false

Decision-making deficits in normal elderly persons associated with executive personality disturbances

Published online by Cambridge University Press:  02 August 2013

Christopher M. Nguyen
Affiliation:
Department of Neurology, Division of Cognitive Neuroscience, University of Iowa College of Medicine, Iowa, USA Counseling Psychology Program, Department of Psychological and Quantitative Foundations, University of Iowa College of Education, Iowa, USA
Joseph Barrash
Affiliation:
Department of Neurology, Division of Cognitive Neuroscience, University of Iowa College of Medicine, Iowa, USA Department of Psychology, University of Iowa, Iowa, USA
Anna L. Koenigs
Affiliation:
Department of Neurology, Division of Cognitive Neuroscience, University of Iowa College of Medicine, Iowa, USA
Antoine Bechara
Affiliation:
Department of Psychology, University of Southern California, California, USA
Daniel Tranel
Affiliation:
Department of Neurology, Division of Cognitive Neuroscience, University of Iowa College of Medicine, Iowa, USA Department of Psychology, University of Iowa, Iowa, USA
Natalie L. Denburg*
Affiliation:
Department of Neurology, Division of Cognitive Neuroscience, University of Iowa College of Medicine, Iowa, USA
*
Correspondence should be addressed to: Natalie L. Denburg, Department of Neurology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242-1053, USA. Phone: +1-319-356-7619; Fax: +1-319-384-7199. Email: natalie-denburg@uiowa.edu.

Abstract

Background:

The problems that some community-dwelling elderly persons develop in real-world decision-making may have disastrous consequences for their health and financial well-being. Investigations across the adult life span have identified personality as an important individual differences variable that is related to decision-making ability. The aim of this study was to investigate the relationship between personality characteristics, as rated by an informant, and complex decision-making performance among elderly persons. It was hypothesized that deficits in decision-making would be associated with personality characteristics reflecting weak executive functioning (Lack of Planning, Poor Judgment, Lack of Persistence, Perseveration, Lack of Initiative, Impulsivity, and Indecisiveness).

Methods:

Fifty-eight elderly persons participated. Their health and cognitive status were deemed intact via comprehensive neuropsychological evaluation. The Iowa Scales of Personality, completed by an informant, was used to assess personality characteristics, and the Iowa Gambling Task, completed by the participant, was used to assess complex decision-making abilities.

Results:

Longstanding disturbances in executive personality characteristics were found to be associated with poor decision-making, and these disturbances remained predictive of poor decision-making even after taking into consideration demographic, neuropsychological, and mood factors. Acquired personality disturbances did not add significantly to prediction after longstanding disturbances were taken into account. Disturbances in other dimensions of personality were not significantly associated with poor decision-making.

Conclusions:

Our study suggests that attentiveness to the personality correlates of difficulties with aspects of executive functioning over the adult years could enhance the ability to identify older individuals at risk for problems with real-world decision-making.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Barrash, J., Anderson, S. W. and Tranel, D. (1996). The Iowa Rating Scales of Personality Change: Psychometric properties. Iowa City, Iowa: University of Iowa Carver College of Medicine, Department of Neurology.Google Scholar
Barrash, J., Anderson, S. W., Hathaway-Nepple, J., Jones, R. D. and Tranel, D. (1997). The Iowa Scales of Personality Change. Iowa City: University of Iowa, Department of Neurology.Google Scholar
Barrash, J., Cross, S. and Manzel, K. (1999). The validity of Boston Naming Test short forms. Journal of the International Neuropsychological Society, 5, 118.Google Scholar
Barrash, J., Tranel, D. and Anderson, S. W. (2000). Acquired personality disturbance associated with bilateral damage to the ventromedial prefrontal region. Developmental Neuropsychology, 18, 355381.CrossRefGoogle Scholar
Barrash, J., Asp, E., Markon, K., Manzel, K., Anderson, S. W. and Tranel, D. (2011). Dimensions of personality disturbance after focal brain damage: investigation with the Iowa Scales of Personality Change. Journal of Clinical and Experimental Neuropsychology., 33, 833852.CrossRefGoogle ScholarPubMed
Bechara, A. (2007). Iowa Gambling Task (IGT) Professional Manual. Lutz: Psychological Assessment Resources.Google Scholar
Brand, M., Recknor, E., Grabenhorst, R. and Bechara, A. (2007). Decisions under ambiguity and decisions under risk: correlations with executive functions and comparisons of two different gambling tasks with implicit and explicit rules. Journal of Clinical and Experimental Neuropsychology, 29, 8699.CrossRefGoogle ScholarPubMed
Cabeza, R., Nyberg, L. and Park, D. C. (2005). Cognitive Neuroscience of Aging: Linking Cognitive and Cerebral Aging. New York: Oxford University Press.Google Scholar
Carver, C. and White, T. (1994). Behavioral inhibition, behavioral activation, and affective responses to impending reward and punishment: the BIS/BAS scales. Journal of Personality and Social Psychology, 67, 319333.CrossRefGoogle Scholar
Costa, P. T. Jr. and McCrae, R. R. (1992). Revised NEO Personality Inventory-Revised (NEO PI-R) and NEO Five-Factor Inventory (NEO-FFI) Professional Manual. Lutz, FL: Psychological Assessment Resources.Google Scholar
Davis, C., Patte, K., Tweed, S. and Curtis, C. (2007). Personality traits associated with decision-making deficits. Personality and Individual Differences, 42, 279290.CrossRefGoogle Scholar
Denburg, N. L. and Barrash, J. (2007). Iowa Scales of Personality Change: Adaptation for healthy adults. Iowa City, Iowa: University of Iowa Carver College of Medicine, Department of Neurology.Google Scholar
Denburg, N. L., Tranel, D. and Bechara, A. (2005). The ability to decide advantageously declines prematurely in some normal older persons. Neuropsychologia, 43, 10991106.CrossRefGoogle ScholarPubMed
Denburg, N. L., Recknor, E. C., Bechara, A. and Tranel, D. (2006). Psychophysiological anticipation of positive outcomes promotes advantageous decision-making in normal older persons. International Journal of Psychophysiology, 61, 1925.CrossRefGoogle ScholarPubMed
Denburg, N. L.et al. (2007). The orbitofrontal cortex, real-world decision making, and normal aging. Annals of the New York Academy of Sciences, 1121, 480498.CrossRefGoogle ScholarPubMed
Denburg, N. L.et al. (2009). Poor decision making among older adults is related to elevated levels of neuroticism. Annals of Behavioral Medicine, 37, 164172.CrossRefGoogle ScholarPubMed
Franken, I. H. A., van Strien, J. W., Nijs, I. and Murus, P. (2008). Impulsivity is associated with behavioral decision-making deficits. Psychiatry Research, 158, 155163.CrossRefGoogle ScholarPubMed
Gläscher, J.et al. (2012). Lesion mapping of cognitive control and value-based decision-making in the prefrontal cortex. Proceedings of the National Academy of Sciences, 109, 1468114686.CrossRefGoogle ScholarPubMed
He, W., Sengupta, M., Velkoff, V. A. and DeBarros, K. A. (2005). 65+ in the United States: 2005. U.S. Census Bureau, Current Population Reports, P23209. Washington, DC: U.S. Government Printing Office.Google Scholar
Investor Protection Trust. (2010). IPT Elder Investment Fraud Survey. Available at: http://www.investorprotection.org/learn/research/?fa=eiffeSurvey.Google Scholar
Lezak, M. D., Howieson, D. B., Bigler, E. D. and Tranel, D. (2012). Neuropsychological Assessment, 5th edn. New York: Oxford University Press.Google Scholar
Rogers, R. D., Tunbridge, E. M., Bhagwagar, Z., Drevets, W., Sahakian, B. J. and Carter, C. S. (2003). Tryptophan depletion alters the decision-making of healthy volunteers through altered processing of reward cues. Neuropsychopharmacology, 28, 153162.CrossRefGoogle ScholarPubMed
Suhr, J. and Hammers, D. (2010). Who fails the Iowa Gambling Task (IGT)? Personality, neuropsychological, and near-infrared spectroscopy findings in healthy young controls. Archives of Clinical Neuropsychology, 25, 293302.CrossRefGoogle ScholarPubMed
Tranel, D., Anderson, S. W. and Benton, A. (1994). Development of the concept of “executive function” and its relationship to the frontal lobes. In Boller, F. and Grafman, J. (eds.), Handbook of Neuropsychology (Vol. 8, pp. 125148). Amsterdam: Elsevier.Google Scholar
Tranel, D., Benton, A. and Olson, K. (1997). A 10-year longitudinal study of cognitive changes in elderly persons. Developmental Neuropsychology, 13, 8796.CrossRefGoogle Scholar
Toplak, M. E., Sorge, G. B., Benoit, A., West, R. F. and Stanovich, K. E. (2010). Decision-making and cognitive abilities: a review of associations between Iowa Gambling Task performance, executive functions, and intelligence. Clinical Psychology Review, 30, 562581.CrossRefGoogle ScholarPubMed
U.S. Census Bureau. (2010). National Population Projections (Data file). Available at: http://www.census.gov/population/www/projections/natdet-D1A.html.Google Scholar
Whiteside, S. P. and Lynam, D. R. (2001). The Five Factor model and impulsivity: using a structural model of personality to understand impulsivity. Personality and Individual Differences, 30, 669689.CrossRefGoogle Scholar
Zermatten, A., Van der Linden, M., d’Acremont, M., Jermann, F. and Bechara, A. (2005). Impulsivity and decision making. Journal of Nervous and Mental Disease, 193, 647650.CrossRefGoogle ScholarPubMed