{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T13:28:57Z","timestamp":1764077337641,"version":"3.40.5"},"reference-count":39,"publisher":"Cambridge University Press (CUP)","issue":"15","license":[{"start":{"date-parts":[[2021,3,18]],"date-time":"2021-03-18T00:00:00Z","timestamp":1616025600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0033291721000386_sec_a1\"><jats:title>Background<\/jats:title><jats:p>Neurobehavioral decision profiles have often been neglected in chronic diseases despite their direct impact on major public health issues such as treatment adherence. This remains a major concern in diabetes, despite intensive efforts and public awareness initiatives regarding its complications. We hypothesized that high rates of low adherence are related to risk-taking profiles associated with decision-making phenotypes. If this hypothesis is correct, it should be possible to define these endophenotypes independently based both on dynamic measures of metabolic control (HbA1C) and multidimensional behavioral profiles.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291721000386_sec_a2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>In this study, 91 participants with early-stage type 1 diabetes fulfilled a battery of self-reported real-world risk behaviors and they performed an experimental task, the Balloon Analogue Risk Task (BART).<\/jats:p><\/jats:sec><jats:sec id=\"S0033291721000386_sec_a3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p><jats:italic>K<\/jats:italic>-means and two-step cluster analysis suggest a two-cluster solution providing information of distinct decision profiles (concerning multiple domains of risk-taking behavior) which almost perfectly match the biological partition, based on the division between stable or improving metabolic control (MC,<jats:italic>N<\/jats:italic>= 49)<jats:italic>v.<\/jats:italic>unstably high or deteriorating states (NoMC,<jats:italic>N<\/jats:italic>= 42). This surprising dichotomy of behavioral phenotypes predicted by the dynamics of HbA1C was further corroborated by standard statistical testing. Finally, the BART game enabled to identify groups differences in feedback learning and consequent behavioral choices under ambiguity, showing distinct group choice behavioral patterns.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291721000386_sec_a4\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>These findings suggest that distinct biobehavioral endophenotypes can be related to the success of metabolic control. These findings also have strong implications for programs to improve patient adherence, directly addressing risk-taking profiles.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0033291721000386","type":"journal-article","created":{"date-parts":[[2021,3,18]],"date-time":"2021-03-18T03:59:47Z","timestamp":1616039987000},"page":"3616-3624","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":5,"title":["Successful metabolic control in diabetes type 1 depends on individual neuroeconomic and health risk-taking decision endophenotypes: a new target in personalized care"],"prefix":"10.1017","volume":"52","author":[{"given":"Helena","family":"Jorge","sequence":"first","affiliation":[]},{"given":"Isabel C.","family":"Duarte","sequence":"additional","affiliation":[]},{"given":"B\u00e1rbara R.","family":"Correia","sequence":"additional","affiliation":[]},{"given":"Lu\u00edsa","family":"Barros","sequence":"additional","affiliation":[]},{"given":"Ana Paula","family":"Relvas","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4364-6373","authenticated-orcid":false,"given":"Miguel","family":"Castelo-Branco","sequence":"additional","affiliation":[]}],"member":"56","published-online":{"date-parts":[[2021,3,18]]},"reference":[{"key":"S0033291721000386_ref31","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2009.01.002"},{"key":"S0033291721000386_ref35","doi-asserted-by":"publisher","DOI":"10.1002\/1098-108X(198602)5:2<295::AID-EAT2260050209>3.0.CO;2-T"},{"volume-title":"An\u00e1lise estat\u00edstica: Com utiliza\u00e7\u00e3o do SPSS [statistical analysis: Using SPSS]","year":"2007","author":"Maroco","key":"S0033291721000386_ref22"},{"volume-title":"Escala de intelig\u00eancia de Wechsler para adultos-terceira edi\u00e7\u00e3o (WAIS-III [WAIS- Wechsler adult intelligence scale (3rd. ed.)]","year":"2008","author":"Wechsler","key":"S0033291721000386_ref39"},{"key":"S0033291721000386_ref5","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2018.00264"},{"volume-title":"Matrizes progressivas coloridas de Raven, CPM-P [Raven Progressive Matrices]","year":"2009","author":"Raven","key":"S0033291721000386_ref25"},{"key":"S0033291721000386_ref34","doi-asserted-by":"publisher","DOI":"10.1057\/s41599-020-0446-z"},{"key":"S0033291721000386_ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2015.06.006"},{"key":"S0033291721000386_ref37","doi-asserted-by":"publisher","DOI":"10.14195\/978-989-26-0839-6_1"},{"key":"S0033291721000386_ref16","doi-asserted-by":"publisher","DOI":"10.1177\/014107680309600402"},{"key":"S0033291721000386_ref29","doi-asserted-by":"publisher","DOI":"10.1002\/wcs.73"},{"key":"S0033291721000386_ref8","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1098\/rstb.1996.0125","article-title":"The somatic marker hypothesis and the possible functions of the prefrontal cortex","volume":"351","author":"Damasio","year":"1996","journal-title":"Philosophical Transactions of the Royal Society London B"},{"key":"S0033291721000386_ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2012.03.002"},{"key":"S0033291721000386_ref27","unstructured":"Silva, J. P. (2012). Risk profiling and the DOSPERT Scale: An approach using prospect theory. Unpublished master thesis, University of Lisbon. Retrieved from https:\/\/www.repository.utl.pt\/bitstream\/10400.5\/10351\/1\/DM-RJCPS-2012.pdf"},{"key":"S0033291721000386_ref15","doi-asserted-by":"publisher","DOI":"10.1101\/sqb.2014.79.024778"},{"key":"S0033291721000386_ref36","first-page":"59","article-title":"Estilo alimentar: Adapta\u00e7\u00e3o e valida\u00e7\u00e3o do question\u00e1rio holand\u00eas do comportamento alimentar. [Eating style: adaptation and validation of the Dutch eating behavior questionnaire]","volume":"8","author":"Viana","year":"2003","journal-title":"Psicologia: Teoria, Investiga\u00e7\u00e3o e Pr\u00e1tica"},{"key":"S0033291721000386_ref32","doi-asserted-by":"publisher","DOI":"10.3389\/fnbeh.2014.00076"},{"key":"S0033291721000386_ref13","doi-asserted-by":"publisher","DOI":"10.5812\/ijem.3505"},{"key":"S0033291721000386_ref12","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-16433-y"},{"key":"S0033291721000386_ref28","first-page":"141","volume-title":"Avalia\u00e7\u00e3o psicol\u00f3gica: Instrumentos validados para a popula\u00e7\u00e3o portuguesa [Psychological assessment: Instruments validated for portuguese population]","volume":"2","author":"Sim\u00f5es","year":"2004"},{"key":"S0033291721000386_ref9","doi-asserted-by":"publisher","DOI":"10.1111\/j.1745-6916.2006.00007.x"},{"key":"S0033291721000386_ref30","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.26.2.390"},{"key":"S0033291721000386_ref38","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-018-04631-9"},{"key":"S0033291721000386_ref19","doi-asserted-by":"publisher","DOI":"10.2466\/pr0.2000.86.3.858"},{"key":"S0033291721000386_ref33","doi-asserted-by":"publisher","DOI":"10.1111\/1467-6427.12022"},{"key":"S0033291721000386_ref18","first-page":"118","article-title":"Further evidence of a dissociation between decision-making under ambiguity and decision-making under risk in obsessive-compulsive disorder","volume":"1","author":"Kim","year":"2015","journal-title":"Journal of Affective Disorder"},{"key":"S0033291721000386_ref2","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1017\/S1930297500000334","article-title":"A domain-specific risk-taking (DOSPERT) scale for adult populations","volume":"1","author":"Blais","year":"2006","journal-title":"Judgment and Decision-making"},{"key":"S0033291721000386_ref7","unstructured":"Cruz, A. R. , & Barbosa, F. (2012). European Portuguese Version of BIS-11 for research. Retrieved from http:\/\/www.impulsivity.org\/measurement\/BIS11_Portuguese"},{"key":"S0033291721000386_ref17","doi-asserted-by":"publisher","DOI":"10.2466\/pr0.2000.87.3f.1057"},{"key":"S0033291721000386_ref3","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0210880"},{"key":"S0033291721000386_ref10","unstructured":"Fernandes, D. (2014). Estudos de valida\u00e7\u00e3o da escala de impulsividade BIS-11 de Barratt para uma amostra da popula\u00e7\u00e3o portuguesa. [Validation studies of Barratt Impulsivity Scale BIS-11-for Portuguese population]. Unpublished master thesis, University of Coimbra. Retrieved from https:\/\/estudogeral.sib.uc.pt\/bitstream\/10316\/28357\/3\/TESE%20%20Daniela%20Fernandes.pdf"},{"key":"S0033291721000386_ref6","doi-asserted-by":"publisher","DOI":"10.1348\/135910705X25697"},{"key":"S0033291721000386_ref1","doi-asserted-by":"publisher","DOI":"10.1126\/science.275.5304.1293"},{"key":"S0033291721000386_ref24","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1017\/S1930297500005076","article-title":"Why are gainers more risk seeking?","volume":"8","author":"Peng","year":"2013","journal-title":"Judgment and Decision-making"},{"key":"S0033291721000386_ref4","first-page":"187","article-title":"Um estudo intercultural da personalidade: Compara\u00e7\u00e3o de adultos portugueses e ingleses no EPQ","volume":"25","author":"Castro-Fonseca","year":"1991","journal-title":"Revista Portuguesa de Pedagogia"},{"key":"S0033291721000386_ref26","doi-asserted-by":"publisher","DOI":"10.1007\/BF00400236"},{"key":"S0033291721000386_ref20","first-page":"75","article-title":"Evaluation of a behavioral measure of risk-taking: The balloon analogue risk task (BART)","volume":"8","author":"Lejuez","year":"2002","journal-title":"Journal of Experimental Psychology"},{"key":"S0033291721000386_ref11","doi-asserted-by":"publisher","DOI":"10.1080\/13803395.2011.589374"},{"key":"S0033291721000386_ref14","first-page":"35","volume-title":"Diabetes. 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