Ambiguity aversion in schizophrenia: An fMRI study of decision-making under risk and ambiguity

Junya Fujino, Kimito Hirose, Shisei Tei, Ryosaku Kawada, Kosuke Tsurumi, Noriko Matsukawa, Jun Miyata, Genichi Sugihara, Yujiro Yoshihara, Takashi Ideno, Toshihiko Aso, Kazuhisa Takemura, Hidenao Fukuyama, Toshiya Murai, Hidehiko Takahashi*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

20 Citations (Scopus)


When making decisions in everyday life, we often have to choose between uncertain outcomes. Economic studies have demonstrated that healthy people tend to prefer options with known probabilities (risk) than those with unknown probabilities (ambiguity), which is referred to as “ambiguity aversion.” However, it remains unclear how patients with schizophrenia behave under ambiguity, despite growing evidence of their altered decision-making under uncertainty. In this study, combining economic tools and functional magnetic resonance imaging (fMRI), we assessed the attitudes toward risk/ambiguity and investigated the neural correlates during decision-making under risk/ambiguity in schizophrenia. Although no significant difference in attitudes under risk was observed, patients with schizophrenia chose ambiguity significantly more often than the healthy controls. Attitudes under risk and ambiguity did not correlate across patients with schizophrenia. Furthermore, unlike in the healthy controls, activation of the left lateral orbitofrontal cortex was not increased during decision-making under ambiguity compared to under risk in schizophrenia. These results suggest that ambiguity aversion, a well-established subjective bias, is attenuated in patients with schizophrenia, highlighting the need to distinguish between risk and ambiguity when assessing decision-making under these situations. Our findings, comprising important clinical implications, contribute to improved understanding of the mechanisms underlying altered decision-making in patients with schizophrenia.

Original languageEnglish
Pages (from-to)94-101
Number of pages8
JournalSchizophrenia Research
Issue number1-3
Publication statusPublished - 2016 Dec 1


  • Ambiguity
  • Decision-making
  • Functional magnetic resonance imaging
  • Orbitofrontal cortex
  • Risk
  • Schizophrenia

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry


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