Comparison of decision-making styles in individuals with acquired brain injury from different socio-economic strata.
Date
2013-01-07
Authors
Buchanan, Christine
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Decision-making, accepted to be an important part of executive function, is inherent in
all complex human experiences requiring intact brain functioning. Three different types of
decision making have been identified: actor-centred, emotion-based and veridical decisionmaking.
All require goal-setting, planning and execution, which are often impaired after
sustaining an acquired brain injury (ABI). The Cognitive Reserve Hypothesis (CRH) holds that a
larger brain belonging to an individual with a higher IQ and better education will be more
resilient to injury. The principal aim of this study was to investigate performance differences in
neuropsychological tests of decision-making between individuals with ABI from different socioeconomic
status (SES). It was hypothesised that ABI would exacerbate differences in decisionmaking
performance between individuals from a higher SES and those from low SES in terms of
the CRH.
Participants (n=25) had all sustained an ABI. Actor-centred, emotion-based and
veridical decision-making were investigated using the Tinker Toy Test (TTT), the Iowa
Gambling Task (IGT) and the Berg Card Sorting Task (BCST) respectively. Participants were
asked to complete an SES Questionnaire. The independent variables were markers of SES: Race,
Level of Education, Quality of Education, and Quality of Medical Care at time of injury.
Differences in quality of education were significant for the BCST, suggesting that a poor
quality of education has a negative impact on veridical decision-making after ABI. Poor
education (a marker of low SES) does not provide the same buffering effect for insults to the
brain in the event of an ABI as does superior education (a marker of high SES).