Iowa Gambling Task and Distortion in Perception of Body Image Among Adolescent Women With Eating Disorders

The Iowa gambling task (IGT) is an instrument for the neuropsychological evaluation of cognitive and emotional decision making (DM) processes that was created to test the somatic marker hypothesis (SMH) described by Damasio in 1994. It was initially applied to patients with frontal lobe lesions due to its association with executive functions but was subsequently used on patients with a variety of disorders. Although the DM process is inherently perceptual, few studies have applied the IGT to examine DM processes in patients with eating disorders (EDs), and even fewer have associated the IGT to the perceptual distortion of body image (PDBI) in this population. People diagnosed with ED exhibit heightened control over their somatic responses—for example, they can delay digestion for hours—and DM may be affected in this condition. This study compares the performance of two samples of adolescent women—hospitalized patients with ED, and healthy controls with similar demographic characteristics—on the IGT using body image as a possible factor in the SMH. Seventy-four women with a mean age of 14.97 years (SD = 2.347) participated. To analyze their body self-image, we used the figure-rating scale and compared the results with their body mass index (BMI). Correlations between indices of the IGT and distortion in body image were then explored. The results revealed significant differences between the groups in terms of evolving performance on the partial IGT. Patients with ED performed worse than their healthy counterparts in the last 40 trials and exhibited greater distortions in their body image, especially in terms of overestimation. Indices of these distortions were negatively correlated with the total IGT. These results are compatible with the SMH because they suggest that patients with ED evinced blindness with regard to the future, as described by their authors. In addition, a negative correlation was found between the IGT and PDBI, showing that a more distorted body image was associated with lower IGT, that is, more disadvantageous or riskier decisions were made by the subjects with more distortion.