Impact of childhood trauma and cognitive emotion regulation strategies on risk-aversive and loss-aversive patterns of decision-making in patients with depression

Introduction: Although poor decision-making ultimately impairs quality of life in depression, few studies describe the clinical characteristics of patients suffering from dysfunctional decision-making. This study aims to delineate the effect of childhood trauma and other personality factors on risk-aversive and loss-aversive patterns of decision-making in patients with depression.

Methods: A total of 50 depressive patients completed surveys for the measurement of sociodemographic factors, trauma loads and other clinical characteristics, including depression, anxiety, and strategies for emotion regulation. Risk aversion and loss aversion were quantified using probability discounting task and a 50:50 gamble on monetary decision-making task under specified risks. Stepwise multiple regression analysis was performed to determine the factors, predicting risk aversion or loss aversion in depression.

Results: Childhood trauma was the most prominent factor predicting loss aversion in patients with depressive disorders. Overall maladaptive emotion regulation strategies were associated with risk aversion.

Conclusion: Childhood trauma and specific strategies of emotion regulation contribute to risk or loss aversion in patients with depression. These findings may provide useful insight into elaborative evaluation and interventions to improve decision-making and quality of life in patients with depression.