Affect can have a significant influence on decision-making processes and subsequent choice. One particularly relevant type of negative affect is anxiety, which serves to enhance responses to threatening stimuli or situations. In its exaggerated form, it can lead to psychiatric disorders, with detrimental consequences for quality of life, including the ability to make choices. This study investigated, for the first time, how pathological anxiety affects risk-taking behavior. In this study, 20 anxious participants meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for either generalized anxiety disorder (n = 10) and for panic attack disorder (n = 10), as well as 20 matched nonanxious controls, performed a gambling task. To investigate the tendency toward either a risk-seeking or a risk-averse behavior, we employed a task that did not allow for learning from outcomes. Anxious participants made significantly fewer risky choices than matched nonanxious participants. Specifically, they become risk-avoidant after gains. Moreover, anxious participants not only were less happy after gains but were also less sad after losses, and they also evinced less desire to change their choices after losses than did nonanxious participants. Importantly, whereas the desire to switch choice was followed by actual choice switch for all participants, happiness directly predicted subsequent risky choices, particularly in the nonanxious participants. Further analyses revealed that the anxious participants' risk-avoidance behavior was independent of different types of anxiety disorder (panic attack disorder and generalized anxiety disorder) as well as of the effects of psychotropic drugs treatment. This study demonstrates a specific role for anxiety in individual decision making. In particular, hypersensitivity to potential threats and pessimistic evaluation of future events reduced risk-taking behavior.

Adjustment Disorder is a condition strongly tied to acute and chronic stress. Despite clinical suggestion of a large prevalence in the general population and the high frequency of its diagnosis in the clinical settings, there has been relatively little research reported and, consequently, very few hints about its treatments.

The aim of this study was to use the Eating Attitudes Test-26 (EAT-26) as a screening instrument on a specific population with a marked prevalence of binge eating disorder (BED) and eating disorder not otherwise specified (EDNOS). The EAT-26 questionnaire was used in order to identify the high-risk subjects for referral to clinical evaluation. EAT-26 was administered to 845 subjects who, for the first time, came to the Nutritional Medicine Service looking for a diet between January 1999 and December 2002. From this initial sample, subsequently, 250 subjects were randomly selected and administered a semistructured clinical interview for DSM-IV (SCID I, version 2.0). Discriminant analysis provided a cutoff value of EAT-26=11. Logistic regression analysis indicated high Dieting (D) or Bulimia (B) subscale scores as a risk factor of EDNOS or bulimia nervosa (BN) cases, respectively; on the other hand, a high Oral Control (O) subscale score represented a protecting factor for BED cases. Our study tried to assess the usefulness of EAT-26 as a screening instrument for obese patients attending a Medical Nutritional Service. Results from this study suggest that a cutoff score of 11, lower than that indicated in the literature, improves the diagnostic accuracy of the EAT-26 in a high-risk setting regarding sensibility level (68.1%) and leading to a reduction of the false negative rate (31.9%).

Although the pathogenesis of bipolar disorder is still not completely understood, there is evidence from imaging studies that abnormalities in inter-hemispheric communication may play a major role in the pathophysiology of bipolar disorder. In the present review, we discuss the most consistent findings from diffusion imaging studies exploring corpus callosum integrity in bipolar disorder.