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Reward-based Decision Making in Pathological Gambling: the Roles of Risk and Delay
Abstract
Pathological gambling (PG) is a non substance based addiction that shares many behavioral and neural features with substance based addictions. However, in PG behavioral and neural changes are unlikely to be confounded by effects of acute or chronic drug exposure. Changes in reward based decision-making in particular increases in impulsivity are hallmark features of addictions. Here we review studies in PG that applied three reward-related decision tasks: the Iowa Gambling Task, probability discounting and delay discounting. We discuss the findings and focus on the impact of addiction severity and the relation of effects to impulsivity measures. While there is evidence that PGs differ from healthy controls on all three tasks, there is only little support for a further modulation of impairments by addiction severity. Conceptually, delay discounting is related to impulsivity measures and findings in this task show a considerable correlation with e.g. questionnaire-based measures of impulsivity. Taken together, impairments in PG on these three tasks are relatively well replicated, although impairments appear to be largely uncorrelated between tasks. An important next step will be to conceptualize a process-based account of behavioral impairments in PG.
... Behaviorally, gambling disorder is characterized by maladaptive decision-making in a range of laboratory tasks. This includes increased temporal discounting (i.e. an increased preference for smaller-sooner over larger-later rewards) (Alessi & Petry, 2003;Dixon et al., 2003;Holt et al., 2003;MacKillop et al., 2011;Miedl et al., 2012;Wiehler & Peters, 2015), and increased risktaking (Ligneul et al., 2012;Miedl et al., 2012;Wiehler & Peters, 2015). There is also evidence of impairments in feedback-based learning tasks in disordered gambling, such as on the Wisconsin Card Sorting Test (WCST) (Alvarez-Moya et al., 2010;Boog et al., 2014;Goudriaan et al., 2005;Hur et al., 2012;Ledgerwood et al., 2012;Zhou et al., 2016). ...
... Behaviorally, gambling disorder is characterized by maladaptive decision-making in a range of laboratory tasks. This includes increased temporal discounting (i.e. an increased preference for smaller-sooner over larger-later rewards) (Alessi & Petry, 2003;Dixon et al., 2003;Holt et al., 2003;MacKillop et al., 2011;Miedl et al., 2012;Wiehler & Peters, 2015), and increased risktaking (Ligneul et al., 2012;Miedl et al., 2012;Wiehler & Peters, 2015). There is also evidence of impairments in feedback-based learning tasks in disordered gambling, such as on the Wisconsin Card Sorting Test (WCST) (Alvarez-Moya et al., 2010;Boog et al., 2014;Goudriaan et al., 2005;Hur et al., 2012;Ledgerwood et al., 2012;Zhou et al., 2016). ...
... That is, over the course of the experiment, individuals from the gambling group, more than controls, increasingly shifted their focus from accuracy to speed. These findings converge with previous observations of other forms of maladaptive decision-making and action selection in gambling disorder, such as increased motor impulsivity (Chowdhury et al., 2017), higher urgency/reduced premeditation (Kräplin et al., 2014) and higher levels of temporal discounting (MacKillop et al., 2011;Wiehler & Peters, 2015). Attenuated deliberation during decision-making is also reminiscent of previous findings of impaired goal-directed control during RL in disordered gambling (Bruder et al., 2021;Wyckmans et al., 2019). ...
Gambling disorder is associated with deficits in reward-based learning, but the underlying computational mechanisms are still poorly understood. Here, we examined this issue using a stationary reinforcement learning task in combination with computational modeling and functional resonance imaging (fMRI) in individuals that regular participate in gambling (n = 23, seven fulfilled one to three DSM 5 criteria for gambling disorder, sixteen fulfilled four or more) and matched controls (n = 23). As predicted, the gambling group exhibited substantially reduced accuracy, whereas overall response times (RTs) were not reliably different between groups. We then used comprehensive modeling using reinforcement learning drift diffusion models (RLDDMs) in combination with hierarchical Bayesian parameter estimation to shed light on the computational underpinnings of this performance deficit. In both groups, an RLDDM in which both non-decision time and decision threshold (boundary separation) changed over the course of the experiment accounted for the data best. The model showed good parameter and model recovery, and posterior predictive checks revealed that, in both groups, the model accurately reproduced the evolution of accuracies and RTs over time. Modeling revealed that, compared to controls, the learning impairment in the gambling group was linked to a more rapid reduction in decision thresholds over time, and a reduced impact of value-differences on the drift rate. The gambling group also showed shorter non-decision times. FMRI analyses replicated effects of prediction error coding in the ventral striatum and value coding in the ventro-medial prefrontal cortex, but there was no credible evidence for group differences in these effects. Taken together, our findings show that reinforcement learning impairments in disordered gambling are linked to both maladaptive decision threshold adjustments and a reduced consideration of option values in the choice process.
... In light of these similarities, the fifth edition of the "Diagnostic and Statistical Manual of Mental Disorders" categorizes gambling disorder in the category of "Substance-related and Addictive Disorders" (American Psychiatric Association, 2013). In contrast to substance-use-disorders, differences in behavioral and/or neural effects between gamblers and controls are unlikely to be confounded by chronic or acute drug effects Peters & Büchel, 2011;Wiehler & Peters, 2015) . Gambling disorder has thus been termed a "pure addiction" (Mark Dixon, Ghezzi, et al., 2006). ...
... Here we comprehensively examined the contextual modulation of two putatively trans-diagnostic markers implicated in addiction, temporal discounting (Bickel et al., 2019;Lempert et al., 2019) and model-based control (Gillan et al., 2016;Gillan et al., 2020) in a pre-registered study. We studied regular slot machine gamblers, a group previously characterized by high levels of temporal discounting (Wiehler & Peters, 2015) and reduced model-based control (Wyckmans et al., 2019). Posterior distributions of all hyperparameters for the neutral baseline condition. ...
... Dixon et al., 2003;Mark. Dixon, Jacobs, & Sanders, 2006;MacKillop et al., 2011;Miedl et al., 2012;Wiehler & Peters, 2015). This trait-like behavior then appears to be further exacerbated during exposure to gambling-related environments, potentially contributing to the maintenance of maladaptive behavior. ...
Gambling disorder is a behavioral addiction that negatively impacts personal finances, work, relationships and mental health. In this pre-registered study (https://osf.io/5ptz9/) we investigated the impact of real-life gambling environments on two computational markers of addiction, temporal discounting and model-based reinforcement learning. Gambling disorder is associated with increased temporal discounting and reduced model-based learning. Regular gamblers (n = 30, DSM-5 score range 3-9) performed both tasks in a neutral (café) and a gambling-related environment (slot-machine venue) in counterbalanced order. Data were modeled using drift diffusion models for temporal discounting and reinforcement learning via hierarchical Bayesian estimation. Replicating previous findings, gamblers discounted rewards more steeply in the gambling-related context. This effect was positively correlated with gambling related cognitive distortions (pre-registered analysis). In contrast to our pre-registered hypothesis, model-based reinforcement learning was improved in the gambling context. Here we show that temporal discounting and model-based reinforcement learning are modulated in opposite ways by real-life gambling cue exposure. Results challenge aspects of habit theories of addiction, and reveal that laboratory-based computational markers of psychopathology are under substantial contextual control.
... Despite a broad overlap in the neural representation of various decision contexts including delay and risk, discrete areas within cortical (e.g., the prefrontal cortex) and striatal territories seem to encode different dimensions of decisional impulsivity (Dalley & Robbins, 2017;Lopez-Guzman et al., 2019). These discoveries extended behavioral results that indicated dissociable underlying processes of those dimensions (Reynolds et al., 2006;Wiehler & Peters, 2015). Frontostriatal circuits, which have been attributed a crucial role in these processes, are heavily innervated by dopamine (Dalley & Robbins, 2017;Guttman et al., 2018). ...
... Value-based decision-making is a complex cognitive process that requires balancing potential rewards against their potential costs, and incorporates the probability of obtaining them and/or the delay until gratification. Preference for immediately available small rewards over larger but delayed ones (delay discounting) and for probabilistic rewards over smaller but certain ones (risk-seeking), and insensitivity to loss reflect different domains of impulsive decision-making (Green & Myerson, 2004), which characterize psychiatric disorders, such as attention-deficit hyperactivity disorder (ADHD) (Jackson & MacKillop, 2016), gambling disorder (Wiehler & Peters, 2015;Amlung et al., 2017), substance use disorders (Amlung et al., 2017) and bipolar disorders (Chandler et al., 2009;Mason et al., 2012). A central, highly complex role of dopamine has been implicated in these decision-making processes D'Amour-Horvat & Leyton, 2014). ...
... Apart from investigating the impact of L-DOPA on each task, we explored how these tasks are related to one another. Similar to previous studies (Wiehler & Peters, 2015), we observed only subtle correlations between performance on the tasks. Thus, we assume that we studied distinct facets of impulsive choice (Meule et al., 2011;Wiehler & Peters, 2015). ...
Background: The valuation of risks and the speed with which decisions are made and acted upon are important characteristics of everyone’s personality. These characteristics exist along a continuum that ranges from weak to strong expressions of impulsivity. In certain situations it is crucial to decide and react quickly. Yet these qualities can prove disadvantageous if they are expressed excessively and persistently.
Self-reports, such as the Barratt Impulsiveness Scale, inquire long-term patterns of behavior to assess the level of trait impulsivity. Experimental paradigms, on the other hand, quantify specific impulsive facets, which depend rather on the current environment and state of the individual. These paradigms include decision-making tasks that capture impulsive facets such as the attitudes towards delays, risks and losses.
Research indicates that these attitudes are governed by a valuation network of cortical and subcortical brain regions along with several neurotransmitters. Within this intricate network, frontostriatal circuits innervated by dopamine were identified as an important locus of control. Although a wealth of studies have subsequently examined the influence of the dopaminergic system on impulsive choice, the regulatory mechanisms remain largely unclear. This may originate from the interrelations within the valuation network but also from the complexity of the dopaminergic system itself.
Seminal investigations have shown that this complicated interplay may be partly explained by an underlying inverted U-shaped function, which describes an optimal level of dopamine, flanked by increasing impulsivity in the context of sub- and supraoptimal signaling.
Research Question: This work aimed to shed more light on the inverted-U theory by characterizing the contribution of dopaminergic signaling to trait and decisional impulsivity, and by clarifying whether the manipulation of decisional impulsivity through boosting striatal dopamine via L-DOPA depends on baseline signaling.
We hypothesized that individuals with optimal striatal dopaminergic signaling as measured by [18F]DOPA positron emission tomography would feature low trait impulsivity as assessed with the Barratt Impulsiveness Scale. By contrast, individuals with suboptimal signaling were hypothesized to exhibit stronger trait impulsivity corresponding to higher scores on the Barratt Impulsiveness Scale. Assuming an inverted U-shaped function, we predicted that the dopamine precursor L-DOPA would
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reduce impulsive decisions in the latter but overdose individuals with an already optimal signaling and thus make their choice behavior more impulsive.
Materials and Methods: The present studies combined trait and choice measures of impulsivity with the investigation of the dopaminergic system by positron emission tomography and a pharmacological manipulation.
In a double-blind, randomized, placebo-controlled, counter-balanced, repeated measures design, 87 healthy adults completed a computerized decision-making test battery. The battery includes four tasks, each of which captures one distinct dimension of impulsive choice: a delay discounting task quantifies delay discounting, a probability discounting for gains task quantifies risk-seeking for gains, a probability discounting for losses task quantifies risk-seeking for losses and a mixed gambles task quantifies loss aversion. In order to test for baseline-dependent L-DOPA effects on these dimensions, we controlled for trait impulsivity (a suggested proxy for central dopamine) as assessed with the Barratt Impulsiveness Scale (N = 87) and striatal dopamine as measured by [18F]DOPA positron emission tomography (in 60 of the 87 participants).
Results: Our findings highlight the complex role of dopamine in impulsivity and the heterogeneity of its underlying biology.
Participants who scored relatively high on the Barratt Impulsiveness Scale appeared to benefit from L-DOPA, indicated by a decrease in delay discounting, risk-seeking for gains and loss aversion. Participants with low levels of impulsive personality traits as assessed with the Barratt Impulsiveness Scale, on the other hand, exhibited opposite changes in choice preference. Bearing in mind that trait impulsivity may be a behavioral expression of central dopamine, our results suggest an inverted U-shaped function in which impulsive decision-making arises from both sub- and supraoptimal dopaminergic activity.
We found further support for an inverted U-shaped function when accounting for baseline dopamine as measured by [18F]DOPA positron emission tomography. Participants who had higher values on the Barratt Impulsiveness Scale featured low, presumably suboptimal, striatal dopamine signaling. After enhancing and possibly optimizing the basal signaling with L-DOPA, they discounted delays less and tended to less risk-seeking for gains and loss aversion. By contrast, participants with low trait impulsivity as assessed with the Barratt Impulsiveness Scale exhibited higher striatal dopamine,
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probably corresponding to optimal baseline activity as L-DOPA shifted their choice behavior in the opposite direction, thus indicating a dopamine overdose.
The intake of L-DOPA had no influence on risk-seeking for losses, even when differences in trait impulsivity and basal levels of striatal dopamine were considered.
Performance on tasks of the decision-making battery produced only few, weak intercorrelations, which implies that delay discounting, risk-seeking for gains, risk-seeking for losses and loss aversion represent dissociable aspects of choice.
Conclusions: Our results endorse and extend previous findings that indicated an inverted U-shaped influence of dopamine on delay discounting and decisions under risk. Utilizing a battery of largely independent choice tasks, we were able to disentangle the effect of gains and losses on risky decisions. Whereas risk-seeking for gains seemed to depend on baseline dopamine signaling, we found no evidence for dopaminergic neurotransmission affecting risk-seeking for losses.
Consistent with the literature, our data shows that self-reported trait impulsivity and experimentally measured decision-making dimensions are distinct phenomena within the multidimensional construct of impulsivity. Our analyses further revealed that choice measures were differentially related to dopaminergic activity, which suggests that they represent not merely descriptive distinctions but separable psychobiological decision-making processes.
Since the regulation of choice probably spreads across neurotransmitter systems, more research on these systems is warranted. After identifying the precise mechanisms within each system, comprehensive studies of their interplay may ultimately uncover how impulsive decisions arise. Considering a series of studies that related steep delay discounting and excessive risk-seeking to poor health and mental illness, the acquired knowledge may also inform translational research on impulsivity-related maladies.
... In addition to increased temporal discounting and risk-taking (Wiehler and Peters, 2015), gamblers also exhibit cognitive impairments reflected in reduced behavioral flexibility. This includes impaired performance in the Stroop task and increased perseveration following rule changes in the Wisconsin Card Sorting Task (van Timmeren et al., 2018). ...
... We also did not observe correlations between gambling-related control beliefs and exploration behavior or between addiction severity and behavioral and/or fMRI readouts. While this contrasts with some previous findings using different tasks (Reuter et al., 2005;Miedl et al., 2012;van Holst et al., 2012a), overall such effects show considerable variability, both regarding behavior (Wiehler and Peters, 2015) and in reward-related imaging findings (Clark et al., 2019). Our study still included a considerable range of addiction severity (SOGS scores ranged from 3 to 17) suggesting that range restriction is an unlikely explanation for the lack of correlations. ...
... Likely more data are required to reliably estimate these parameters, in particular in clinical samples such as the present one. Impairments in reward-based learning, decision-making and cognitive control are hallmarks of GD (Wiehler and Peters, 2015;Clark et al., 2019). Here, we show using computational modeling that during reinforcement learning in volatile environments, gamblers' behavior is characterized by attenuated directed exploration rather than increased perseveration. ...
Gambling disorder (GD) is a behavioral addiction associated with impairments in value-based decision-making and behavioral flexibility and might be linked to changes in the dopamine system. Maximizing long-term rewards requires a flexible tradeoff between the exploitation of known options and the exploration of novel options for information gain. This explorationexploitation trade-off is thought to depend on dopamine neurotransmission. We hypothesized that human gamblers would show a reduction in directed (uncertainty-based) exploration, accompanied by changes in brain activity in a fronto-parietal exploration-related network. Twenty-three frequent, non-treatment seeking gamblers and twenty-three healthy matched controls (all male) performed a four-armed bandit task during functional magnetic resonance imaging (fMRI). Computational modeling using hierarchical Bayesian parameter estimation revealed signatures of directed exploration, random exploration, and perseveration in both groups. Gamblers showed a reduction in directed exploration, whereas random exploration and perseveration were similar between groups. Neuroimaging revealed no evidence for group differences in neural representations of basic task variables (expected value, prediction errors). Our hypothesis of reduced frontal pole (FP) recruitment in gamblers was not supported. Exploratory analyses showed that during directed exploration, gamblers showed reduced parietal cortex and substantia-nigra/ventral-tegmental-area activity. Cross-validated classification analyses revealed that connectivity in an exploration-related network was predictive of group status, suggesting that connectivity patterns might be more predictive of problem gambling than univariate effects. Findings reveal specific reductions of strategic exploration in gamblers that might be linked to altered processing in a fronto-parietal network and/or changes in dopamine neurotransmission implicated in GD.
... Decision-making can be measured through questionnaires (stable measures) or dynamic tasks such as IGT, which can reflect different dimensions of this process [21]. In fact, decision context is a primary variable to understand decision-making in gamblers [22]. Psychometric tests or questionnaires are considered to assess "cold" neurocognitive measures of executive functions (EFs) in adults with a substance use disorder, considering that people respond in an aseptic situation. ...
... This could represent an anomaly that might serve as the starting point for the impulsivity commonly associated with pathological gambling [36,37]. Complementarily, the higher aversion to losses, as measured by the Lottery Choice Task questionnaire, aligns with findings from the existing literature [5,22], and reflect more biased, irrational decisions [38]. Participants with biological addictions also showed loss aversion (lambda = 1.86), but at a level similar to that indicated by the literature in healthy populations, where losses weighed twice as much as gains (lambda = 2) [39]; however, those participants involved in pathological gambling showed a significantly higher level of loss aversion, representing that losses would weigh approximately three times as much as gains (lambda = 3.06). ...
Behavioral and biological addictions can impair decision-making processes, mainly by means of a dysfunction in brain regions associated with reward and frontal areas that may lead to disadvantageous choices. Understanding these differences helps establish appropriate terminology and enhances our ability to recognize, prevent, and treat these disorders effectively. Thus, while behavioral and biological addictions share some common elements, their underlying mechanisms and impact on decision-making vary significantly. Moreover, decision-making can be measured through questionnaires (stable or "cold" measures) or dynamic tasks (hot decisions) such as the Iowa Gambling Task (IGT), which can reflect different dimensions of this process. The aim of this study was to compare decision-making from different perspectives-stable and dynamic measures-in patients with gambling addiction (GA) (n = 42) and patients with biological addictions (BA) (n = 43). Decision-making was assessed using GDMS (Decisional Styles) and the LCT (Loss Aversion), as cold decision-making measures, as well as a hot or situational task called the IGT. The results revealed that GA patients exhibited lower rational style scores compared to BA patients. Additionally, GA patients showed greater loss aversion according to the LCT questionnaire. On the other hand, when analyzing the IGT results, no differences were observed between groups in the overall IG index, learning curves, or the loss aversion parameter. However, GA patients showed higher sensitivity to feedback and less consistency in their decisions. These findings highlight the differences between different types of addictions and highlight the importance of considering the type of measure used to evaluate decision-making.
... Neuropsychological research indicates that impaired cognitive control networks and dysfunctional valuation systems are two core mechanisms involved in GD development and maintenance (Clark, 2010;Goschke, 2014;van Holst, van den Brink, Veltman, & Goudriaan, 2010). There is evidence for impaired performance and aberrant brain activity in tasks requiring inhibitory control (Smith, Mattick, Jamadar, & Iredale, 2014;Verdejo-García, Lawrence, & Clark, 2008) or decision-making in GD (MacKillop et al., 2011;Wiehler & Peters, 2015). However, it remains an open research question whether these neuropsychological processes are generally impaired in GD or particularly in disorder-specific contexts (Goschke, 2014). ...
... However, we adjusted our analyses regarding the education level. Interestingly, we found no group difference in delay discounting after adjusting for education levels even though previous research yielded consistent evidence for higher delay discounting in GD (MacKillop et al., 2011;Wiehler & Peters, 2015). This highlights the importance of taking into account such confounding variables when comparing naturalistic non-randomized groups. ...
... AD patients were recruited from an in-patient detoxification ward. AD detoxification took place on average 42 days before scanning (CI boot95% = [28,60]). PG subjects were recruited via internet advertisement and notices in casinos. ...
... Impaired value-based decision-making is a hallmark of both substance-related disorders and pathological gambling 59,60 . We have further probed the neuro-behavioral factors associated with impaired decision making in both PG and AD focusing on group differences in LA. ...
Diese Dissertation fasst drei wissenschaftliche Arbeiten (Artikel) zusammen, welche sich mit veränderten Entscheidungsprozessen bei substanzgebundenen- und substanzungebundenen Abhängigkeitserkrankungen beschäftigen. In Artikel I wurde beobachtet, dass Probanden mit Alkoholkonsumstörung (AD) und Probanden mit Glücksspielstörung (GD) eine ähnlich reduzierte Verlustaversion gegenüber gesunden Kontrollen (HC) aufweisen. Beide Gruppen zeigten jedoch unterschiedliche neuronale Korrelate dieser reduzierten Verlustaversion: Während AD-Probanden eine unterschiedliche funktionelle Aktivität im dorsal-lateralen-präfrontalen Kortex im Vergleich zu HC aufwiesen, zeigten GD-Probanden eine veränderte funktionelle Konnektivität zwischen Amygdala und orbito-frontalem Kortex (OFC) bzw. medial-präfrontalem Kortex. In den Artikeln II und III wurde untersucht, ob das Verhalten und die neuronale Aktivität bei einer Verlustaversionsaufgabe bei GD-Probanden moduliert wird, wie dies in ähnlichen Studien bei AD-Probanden beobachtet wurde. Tatsächlich konnten GD-Probanden von HC-Probanden auf Grundlage ihrer veränderten Glücksspielannahme während der Präsentation spielbezogener Hinweisreize unterschieden werden. Auf neuronaler Ebene (Artikel III) konnten GD-Probanden von HC-Probanden durch die neuronalen Korrelate der reizinduzierten Veränderungen im Spielverhalten in einem Netzwerk aus Amygdala, Nucleus Accumbens und OFC unterschieden werden. Da in den Studien der Fokus auf Glücksspielabhängigkeit lag, also auf einer Abhängigkeit, welche unabhängig von Substanzmissbrauch existiert, deuten die hier diskutierten Ergebnisse darauf hin, dass verminderte Verlustaversion, sowie erhöhte reizinduzierte Veränderungen im Entscheidungsverhalten – welches beides bekannte Phänomene von Substanzabhängigkeiten sind – nicht durch Substanzmissbrauch zustande kommen. Beide Phänomene scheinen vielmehr erlernte Merkmale oder sogar prädisponierende Faktoren von Abhängigkeitserkrankungen zu sein.
... However, taken together, TSD is likely to influence risk outcomes by affecting risk perceptions. Importantly, different individuals may have different risk perceptions for the BART (Quan et al., 2022;Wiehler & Peters, 2015), whereas the perception of risk aversion is more consistent than the perception of risk appetite. For instance, one study examined the effect of framing on BART performance. ...
Sleep loss impacts a broad range of brain and cognitive functions. However, how sleep deprivation affects risky decision‐making remains inconclusive. This study used functional MRI to examine the impact of one night of total sleep deprivation (TSD) on risky decision‐making behavior and the underlying brain responses in healthy adults. In this study, we analyzed data from N = 56 participants in a strictly controlled 5‐day and 4‐night in‐laboratory study using a modified Balloon Analogue Risk Task. Participants completed two scan sessions in counter‐balanced order, including one scan during rested wakefulness (RW) and another scan after one night of TSD. Results showed no differences in participants' risk‐taking propensity and risk‐induced activation between RW and TSD. However, participants showed significantly reduced neural activity in the anterior cingulate cortex and bilateral insula for loss outcomes, and in bilateral putamen for win outcomes during TSD compared with RW. Moreover, risk‐induced activation in the insula negatively correlated with participants' risk‐taking propensity during RW, while no such correlations were observed after TSD. These findings suggest that sleep loss may impact risky decision‐making by attenuating neural responses to decision outcomes and impairing brain‐behavior associations.
... Recently, IGD has also been designated as an addictive disorder by the World Health Organization in the "Clinical Descriptions and Diagnostic Guidelines for ICD-11 Mental and Behavioral Disorders" (https://icd.who.int/dev11/l-m/en). Impaired value-based decision-making is a feature of both substance-related disorders and pathological gambling (Diekhof, Falkai, & Gruber, 2008;Wiehler & Peters, 2015). Loss aversion is a central facet of value-based decisionmaking (Genauck et al., 2020) and is a concept developed by prospect theory, one of the most classic behavioral models of value-based decision-making, which means that people are more sensitive to the possibility of losing objects or money than the possibility of gaining the same objects or amounts of money (Tom, Fox, Trepel, & Poldrack, 2007). ...
Background and aims:
Impaired value-based decision-making is a feature of substance and behavioral addictions. Loss aversion is a core of value-based decision-making and its alteration plays an important role in addiction. However, few studies explored it in internet gaming disorder patients (IGD).
Methods:
In this study, IGD patients (PIGD) and healthy controls (Con-PIGD) performed the Iowa gambling task (IGT), under functional magnetic resonance imaging (fMRI). We investigated group differences in loss aversion, brain functional networks of node-centric functional connectivity (nFC) and the overlapping community features of edge-centric functional connectivity (eFC) in IGT.
Results:
PIGD performed worse with lower average net score in IGT. The computational model results showed that PIGD significantly reduced loss aversion. There was no group difference in nFC. However, there were significant group differences in the overlapping community features of eFC1. Furthermore, in Con-PIGD, loss aversion was positively correlated with the edge community profile similarity of the edge2 between left IFG and right hippocampus at right caudate. This relationship was suppressed by response consistency3 in PIGD. In addition, reduced loss aversion was negatively correlated with the promoted bottom-to-up neuromodulation from the right hippocampus to the left IFG in PIGD.
Discussion and conclusions:
The reduced loss aversion in value-based decision making and their related edge-centric functional connectivity support that the IGD showed the same value-based decision-making deficit as the substance use and other behavioral addictive disorders. These findings may have important significance for understanding the definition and mechanism of IGD in the future.
... Along with age-related differences, research into decision-making processes has addressed another broad issue (i.e., the fallibility of decision-making mechanisms) among individuals suffering from gambling disorder. A large body of research has demonstrated that gambling severity is one of the most powerful predictors of impaired decision-making (for reviews, see Aram et al., 2019;Ciccarelli et al., 2017;Clark, 2017;Wiehler & Peters, 2015). Although dysfunctional decision-making is a key characteristic of disordered gambling since perturbations in cost-benefit decision-making are something of a prerequisite (Cocker & Winstanley, 2019;p. ...
Several studies have examined age differences in affective decision-making utilizing the Iowa Gambling Task (IGT). However, findings are mixed, with some studies reporting impairments due to aging and others showing no age-related differences. The few studies that have explored personality correlates of IGT performance suggest that underlying personality characteristics may impact performance on the IGT beyond aging. Therefore, the present study investigated the interplay between chronological age, temporal perspective, and gambling-related cognitions in affective decision-making while controlling for gambling severity. Through snowball sampling, 302 adults aged 18–75 years were recruited. They administered the South Oaks Gambling Screen (SOGS), Consideration of Future Consequences scale (CFC-14), Gambling-Related Cognitions Scale (GRCS), and IGT. Regression analysis showed that future orientation and gambling-related cognitions (namely gambling expectancies, illusion of control, and predictive control) predicted IGT performance. Gender, age, education, and gambling severity were not included in the final model. Path analysis showed that gambling expectancies positively impacted the performance, whereas illusion of control and predictive control were detrimental to decision-making. Being oriented toward the future mitigated the negative effects of the two cognitive biases on IGT performance. The present study shows that aging does not affect negatively IGT performance. The quality of performance appears to depend upon individual characteristics, such as future orientation and gambling-related cognitions, irrespective of gambling severity. These findings suggest that individual characteristics should be considered in the clinical evaluation of IGT performance.
... Another typical feature of addiction is the bias towards the reward pursuit of addictive behaviors while ignoring their risks in cognitive decision-making (20). Behavioral studies have found that when performing the delay discounting and gambling tasks, compared with the control group, the addiction group showed an impulsive pursuit of immediate rewards while ignoring the long-term risk of loss (21,22). Similarly, this also happened in Internet game and heroin addicts who prefer rewards and ignore risks when making decisions. ...
Internet game addiction and heroin addiction have many similar clinical manifestations, but whether they share similar neural mechanisms is yet clearly known. Based on MRI data, it was found that the two types of addictions have some damages in the same brain structure and function, and the four addiction-related circuits as cognitive control loop, reward prediction and pleasure loop, motivation drive and salience attribution loop, and learning and memory loop showed widespread and enhanced activation. However, the brain damage area of heroin addiction is biased towards the higher cognitive control circuit and reward circuit, and the scope of damage is wider showing the functional connectivity of the four circuits is reduced, while the brain damage of internet game addiction mainly occurs in relatively low-level memory-learning circuits and motivation circuits, and the scope of damage is also relatively narrow by indicating decreased functional connectivity only occurs between cognitive control and memory-learning circuits. This indicates that the neural mechanisms underlying the two types of addictive behaviors have both similarities and differences. This review compares above-mentioned four circuitry mechanisms between internet game addiction and heroin addiction to highlight the underlying neural similarities between them and provide insights into potential interventional strategies.
... One of these shared features is reward-related decisionmaking, which is known to be an important feature of addictions (5) and is also affected by GD (6). The Iowa gambling task (IGT) is frequently used to study impaired reward-related decisionmaking in humans. ...
Introduction
Gambling disorder (GD) is the first non-substance or behavioral addiction to be included in substance-related and addictive disorders in DSM-5. Since GD is a younger phenomenon relative to alcohol and substance use disorders, little is known about potential unique features in GD and to what extent characteristics are shared with alcohol and substance use disorders. The rat gambling task (rGT) is used to study decision-making in rats. This study aimed to identify individual differences in rGT strategies and explore the stability of these strategies over time. Moreover, motor impulsivity, sexual behavior, and voluntary alcohol intake were examined in rats with different rGT strategies. Finally, the response to naltrexone on performance in rats with different rGT strategies was investigated.
Methods
Male Lister hooded rats (n = 40) underwent repeated testing in the rGT, repeated copulatory behavioral tests, and 7 weeks of voluntary alcohol intake through a modified intermittent two-bottle free-choice paradigm. Finally, rats were treated with naltrexone prior to testing in the rGT.
Results
The results revealed individual choice strategies in the rGT that were stable over time, even after multiple interruptions and other behavioral testing. The rats with a risky choice strategy displayed higher motor impulsivity and voluntary alcohol intake than the other groups. No difference in sexual behavior was found between the different rGT groups. Finally, in all rats irrespectively of rGT strategy, treatment with naltrexone decreased the number of completed trials and premature responses, and increased omissions, which indicates an overall lowered motivation.
Discussion
In conclusion, rats with risky rGT strategies had higher voluntary alcohol intake but not elevated sexual behavior, indicating shared underlying mechanisms between rGT strategies and alcohol intake but not natural rewards in terms of sexual behavior. Finally, naltrexone treatment resulted in an overall lowered motivation in the rGT.
... Finally, economic rewards have been used particularly in the context of cognitive heuristics, decision making and risk assessment (Kahneman & Tversky, 1979). In addition, impaired decision-making, planning or inhibition have been pointed out earlier in GD (Conversano et al., 2012;Genauck et al., 2017;Wiehler & Peters, 2015) along with special sensitivity to gambling-related stimuli compared to natural rewards (Quester & Romanczuk-Seiferth, 2015). This special sensitivity to addiction-related cues has also been linked to substance addictions (Cummings & Blum, 2000;Robinson & Berridge, 2001;Volkow et al., 2003). ...
Increasing incidence of problem gambling has led to prioritizing the problem from the point of view of public health. Additionally, gambling disorder has been recently classified as a behavioral addiction, with implications for both its diagnosis and treatment. However, the shared neural substrate of addictions, to substances and behavioral, is still discussed. Thus, this systematic review aims to provide up-to-date knowledge from the past five years (2017–2022) concerning the neural correlates of gambling related stimuli (cue-reactivity) on the basis of a previous review (Brevers et al., Cognitive, Affective and Behavioral Neuroscience 18:718–729, 2019). A total of five studies were included in the review. Activation of brain areas related to memory, reward and executive functions could be the underlying mechanism of this behavioral addiction. Specifically, nucleus accumbens and striatum (ventral and dorsal), parahippocampal regions, the right amygdala and several prefrontal cortex regions have systematically been found more active in those subjects exposed to gambling-related cues. Also, the insula could play a pivotal role connecting these three systems in a highly integrated neural network with several implications for reward processing modulation, associative learning and top-down attentional regulation to improve saliency of addiction-related cues. These results are consistent with previous findings on other substance addictions, such as alcohol, tobacco, marijuana or cocaine. The study of neural reactivity to stimuli related to addiction could be useful as a biomarker of the severity of the disorder, the efficacy of the treatment, the risk of relapse, in addition to being an objective criterion to measure the effectiveness of prevention campaigns.
... Decision making under risk occurs on a regular basis in our daily lives. Although certain degree of risk-taking behavior is beneficial and necessary for the survival and evolution of humanity, excessive risk-taking may cause serious social and health issues, such as pathological gambling [1] and substance abuse [2]. Risk-taking behavior was usually investigated via two-alternative choice tasks, where participants were typically required to choose between a probabilistic reward option and a sure reward option [3][4][5][6]. ...
Choices between smaller certain reward and larger riskier reward are referred to as risky decision making. Numerous functional magnetic resonance imaging (fMRI) studies have investigated the neural substrates of risky decision making via conventional univariate analytical approaches , revealing dissociable activation of decisions involving certain rewards and risky rewards. However, it is still unclear how the patterns of brain activity predict the choice that the individual will make. With the help of multi-voxel pattern analyses, which is more sensitive for evaluating information encoded in spatially distributed patterns, we showed that fMRI activity patterns represent viable signatures of certain and risky choice and individual differences. Notably, the regions involved in representation of value and risk and cognitive control play prominent roles in differentiating certain and risky choices as well as individuals with distinct risk preference. These results deepen our understanding of the neural correlates of risky decision making as well as emphasize the important roles of regions involved in representation of value and risk cognitive control in predicting risky decision making and individual differences.
... Thus, discounting is regarded as a trait-like characteristic (Smith & Hantula, 2008). Notably, alterations in temporal discounting are associated with a range of psychiatric disorders, including substance use disorders, gambling disorder, obesity and attention-deficit hyperactivity disorder (Amlung et al., 2016(Amlung et al., , 2019Bickel et al., 2019;Wiehler & Peters, 2015). ...
... Thus, discounting is regarded as a trait-like characteristic (Smith & Hantula, 2008). Notably, alterations in temporal discounting are associated with a range of psychiatric disorders, including substance use disorders, gambling disorder, obesity and attention-deficit hyperactivity disorder (Amlung et al., 2016(Amlung et al., , 2019Bickel et al., 2019;Wiehler & Peters, 2015). ...
Computational psychiatry focuses on identifying core cognitive processes that appear altered across a broad range of psychiatric disorders. Temporal discounting of future rewards and model-based control during reinforcement learning have proven as two promising candidates. Despite its trait-like stability, temporal discounting has been suggested to be at least partly under contextual control. For example, highly arousing cues such as erotic pictures were shown to increase discounting, although overall evidence to date remains somewhat mixed. Whether model-based reinforcement learning is similarly affected by arousing cues is unclear. Here we tested cue-reactivity effects (erotic pictures) on subsequent temporal discounting and model-based reinforcement learning in a within-subjects design in n=39 healthy male participants. Self-reported and physiological arousal (cardiac activity and pupil dilation) were assessed before and during cue exposure. Arousal was increased during exposure of erotic vs. neutral cues both on the subjective and autonomic level. Erotic cue exposure nominally increased discounting as reflected by reduced choices of delayed options. Hierarchical drift diffusion modeling (DDM) linked increased discounting to a shift in the starting point bias of evidence accumulation towards immediate options. Model-based control during reinforcement learning was reduced following erotic cues according to model-agnostic analysis. Notably, DDM linked this effect to attenuated forgetting rates of unchosen options, leaving the model-based control parameter unchanged. Our findings replicate previous work on cue-reactivity effects in temporal discounting and for the first time show similar effects in model-based reinforcement learning. Our results highlight how environmental cues can impact core human decision processes and reveal that comprehensive drift diffusion modeling approaches can yield novel insights in reward-based decision processes.
... See, for example,(Young & Wohl, 2009;Ashrafioun et al., 2013;Wiehler & Peters, 2015;Thomas et al., 2009; Welte et al., 2016; Gong & Zhu, 2019; Estevez et al., 2020)Content courtesy of Springer Nature, terms of use apply. Rights reserved. ...
Gambling can cause significant harms and these can result in a net negative utility from participation, although lower levels of participation have potential benefits and can yield positive net utility. It is therefore important to understand and distinguish between these two stages of gambling behaviour. Currently, economic models have had limited focus on explaining why someone would gamble despite it yielding a negative utility. Here, we present a two-stage model, motivated by empirical literature and intuitive assumptions, that improves on existing economic models by distinguishing between the likelihood of gambling participation and of gambling that yields a negative utility. The model’s predictions are empirically testable, consistent with existing literature, and add new insights. The model’s ability to distinguish between the two stages helps to inform interventions that aim to reduce the prevalence of gambling-related harm while avoiding the need for restrictive approaches that aim to eliminate gambling altogether.
... For example, people with GD frequently choose larger and immediate gains in the Iowa Gambling Task, leading to greater losses over time (Brevers et al., 2013). There is a specific group of disordered gamblers, identified as antisocial impulsivist problem gamblers (Blaszczynski & Nower, 2002), who show increased impulsivity and impaired decision-making abilities (Kräplin et al., 2014;Wiehler & Peters, 2015). ...
Considering the low levels of empathy associated with substance-related addictions and the similarities between gambling disorder (GD) and substance-related addiction, understanding the relationship between empathy and GD may clarify the mechanism of addiction development. This scoping review aimed to evaluate the empirical evidence for the potential protective role of emotional and cognitive empathy against GD development via internalizing and/or externalizing pathways. We followed the preferred reporting items for systematic review and meta-analyses extension for scoping reviews and 11 articles met the inclusion criteria. Although most of the reviewed studies used correlational designs and non-gambling-specific samples, this review highlights (1) significant relationships between both types of empathy and the neural activity of gambling behaviors, and (2) reduced cognitive empathy (i.e., fantasy and perspective taking) and increased emotional empathy (i.e., personal distress) among problem gamblers than their gambling counterparts. Despite the lack of studies directly testing the protective role of empathy against GD, the existing studies (n = 8) nevertheless shed light on the potential protective effects of both types of empathy on GD development. This review identified research gaps, which can be addressed in future studies by discovering the underlying mechanisms (e.g., internalizing and externalizing pathways) of these relationships. Experimental or longitudinal studies in gamblers investigating how different types of empathy are associated with GD via these pathways are called for as their findings have implications for prevention and intervention designs for GD and other addictive disorders.
... It can be as mundane as whether to try a new restaurant or as consequential as whether to wear a face mask amid an infectious disease outbreak. Individual differences in risk-taking are one of the most critical factors in explaining a range of real-life behaviors, such as financial choices (Noussair et al., 2014), alcohol consumption (Abbey et al., 2006), and gambling (Wiehler and Peters, 2015). ...
Human risk tolerance is highly idiosyncratic and individuals often show distinctive preferences when faced with similar risky situations. However, the neural underpinnings of individual differences in risk-taking remain unclear. Here we combined structural and perfusion MRI and examined the associations between brain anatomy and individual risk-taking behavior/risk tolerance in a sample of 115 healthy participants during the Balloon Analogue Risk Task, a well-established sequential risky decision paradigm. Both whole brain and region-of-interest analyses showed that the left cerebellum gray matter volume (GMV) has a strong association with individual risk-taking behavior and risk tolerance, outperforming the previously reported associations with the amygdala and right posterior parietal cortex (PPC) GMV. Left cerebellum GMV also accounted for risk tolerance and risk-taking behavior changes with aging. However, regional cerebral blood flow (CBF) provided no additional predictive power. These findings suggest a novel cerebellar anatomical contribution to individual differences in risk tolerance. Further studies are necessary to elucidate the underestimated important role of cerebellum in risk-taking.
... Several maladaptive behaviours and psychiatric conditions, including impulsivity, substance use disorders and behavioural addictions, have been linked to increased discount rates (see, e.g. Karakula et al., 2016;Steward et al., 2017;Wiehler & Peters, 2015;Yi et al., 2010). Our results suggest that in addition to choices and response times, measures of response vigour may provide information regarding valuation during intertemporal choice. ...
Value-based decision-making is of central interest in cognitive neuroscience and psychology, as well as in the context of neuropsychiatric disorders characterised by decision-making impairments. Studies examining (neuro-)computational mechanisms underlying choice behaviour typically focus on participants’ decisions. However, there is increasing evidence that option valuation might also be reflected in motor response vigour and eye movements, implicit measures of subjective utility.
To examine motor response vigour and visual fixation correlates of option valuation in intertemporal choice, we set up a task where the participants selected an option by pressing a grip force transducer, simultaneously tracking fixation shifts between options. As outlined in our preregistration ( https://osf.io/k6jct ), we used hierarchical Bayesian parameter estimation to model the choices assuming hyperbolic discounting, compared variants of the softmax and drift diffusion model, and assessed the relationship between response vigour and the estimated model parameters.
The behavioural data were best explained by a drift diffusion model specifying a non-linear scaling of the drift rate by the subjective value differences. Replicating previous findings (Green et al., 1997; Wagner et al., 2020), we found a magnitude effect for temporal discounting, such that higher rewards were discounted less. This magnitude effect was further reflected in response vigour, such that stronger forces were exerted in the high vs. the low magnitude condition. Bayesian hierarchical linear regression further revealed higher grip forces, faster response times and a lower number of fixation shifts for trials with higher subjective value differences.
Our data suggest that subjective utility or implicit valuation is reflected in response vigour during intertemporal choice. Taking into account response vigour might thus provide deeper insight into decision-making, reward valuation and maladaptive changes in these processes, e.g. in the context of neuropsychiatric disorders.
... Given that delay and probabilistic discounting are associated with different patterns of activation in brain reward circuitry (Miedl et al., 2012), it is possible that substance-related modulation of mesolimbic dopamine transmission differentially impacts the circuits involved in impulsive choice. Rewardrelated learning also modulates dopamine transmission, and it is possible that learning associated with probabilistic discounting is more relevant in the context of GD, as individuals who gamble are constantly exposed to scenarios that involve making choices about possible rewards in the face of varying outcomes (Wiehler and Peters, 2015). ...
Impulsive reward-related decision-making (RRDM) is robustly associated with gambling disorder (GD), although its role in the development and perpetuation of GD is still being investigated. This project sought to examine the possible roles of impulsive and risky choice, two aspects of RRDM, in the perpetuation of GD. Additionally, the potential moderating role of comorbid substance misuse was considered. A total of 434 participants with symptoms of current GD and symptoms of concurrent substance use disorder (SUD; n = 105), current GD with past SUD ( n = 98), past GD with current SUD ( n = 53), or past GD with past substance use disorder (SUD; n = 92), and 96 healthy controls were recruited through MTurk. Participants completed a randomly adjusting delay discounting (a measure of impulsive choice) and probabilistic discounting (a measure of risky choice) task and self-report questionnaires of gambling participation, GD and SUD symptomology, and trait impulsivity. Although control participants showed significantly greater delay discounting compared to individuals with a current or history of GD, no significant group differences emerged between individuals with current GD or a history of GD. Individuals with current GD showed significantly less probabilistic discounting compared to individuals with a history of GD and control participants showed the greatest rates of probabilistic discounting. These effects remained after controlling for lifetime gambling symptom severity and trait impulsivity. Overall, these findings suggest a potential maintaining role of risky choice in gambling disorder, but do not support a maintaining role for impulsive choice.
... Increased activation of regions encompassing the extended reward pathway in GD subjects (GDs) during high risk choices suggests that the persistence of GD may be due to the increased salience of immediate and greater potential monetary rewards relative to lower monetary rewards or potential future losses (ibidem). There is also considerable evidence that GDs discount delayed rewards steeper than healthy controls (29). Neuroimaging research has shown that GD is associated with a shift in the interplay between a prefrontal-parietal control network and a brain network involved in immediate reward consumption (30), and a generally hypoactive reward system (31). ...
Gambling Disorder (GD) has been recently re-classified in the DSM-5 under the “substance-related and addictive disorders,” in light of its genetic, endophenotypic, and phenotypic resemblances to substance dependence. Diminished control is a core defining concept of psychoactive substance dependence or addiction and has given rise to the concept of “behavioral” addictions, which are syndromes analogous to substance addiction, but with a behavioral focus other than ingestion of a psychoactive substance. The main symptom clusters are represented by loss of control, craving/withdrawal, and neglect of other areas of life, whereas in a Research Domain Criteria (RDoC) perspective, GD patients exhibit deficits in the domain of “Positive valence systems,” particularly in the “Approach motivation” and “Reward learning” constructs, as well as in the “Cognitive systems,” primarily in the “Cognitive control” construct. In the Addictions Neuroclinical Assessment (ANA), three relevant domains for addictions emerge: “Incentive salience,” “Negative Emotionality,” and “Executive Function.” The endocannabinoid system (ECS) may largely modulate these circuits, presenting a promising pharmaceutical avenue for treating addictions. Up to now, research on cannabidiol has shown some efficacy in Attention Deficit/Hyperactivity Disorder (ADHD), whereas in behavioral addictions its role has not been fully elucidated, as well as its precise action on RDoC domains. Herein, we review available evidence on RDoC domains affected in GD and behavioral addictions and summarize insights on the use of cannabidiol in those disorders and its potential mechanisms of action on reward, decisional, and sensorimotor processes.
... Several psychological characteristics of individuals with gambling problems can explain why at-risk gamblers may be more vulnerable to inducements. First, delay discounting is often related to problem gambling and refers to the tendency to devalue gratifications that are delayed in time compared to immediate rewards, regardless of their magnitude (46). In a recent study, delay discounting was found to be associated with chasing (41). ...
Aims
To estimate whether the use of wagering inducements has a significant impact on the gambling behaviors of online gamblers and describe this temporal relation under naturalistic conditions.
Design
This longitudinal observational study is part of the second stage of the Screening for Excessive Gambling Behaviors on the Internet (EDEIN) research program.
Setting
Gambling tracking data from the French national online gambling authority (poker, horse race betting and sports betting) and from the French national lottery operator (lotteries and scratch games).
Participants
A total of 9306 gamblers who played poker, horse race or sports betting and 5682 gamblers who played lotteries and scratch games completed an online survey. The gender ratio was largely male (around 90% for poker, horse race betting and sports betting and 65% for lotteries). Median age ranged from 35 (sports betting) to 53 (horse race betting and lotteries).
Measurements
The survey used the Problem Gambling Severity Index (PGSI) to determine the status of the gamblers (at-risk or not). Gambling tracking data included weekly gambling intensity (wagers, deposits), gambling frequency (number of gambling days), proxies of at-risk gambling behaviors (chasing and breadth of involvement), and use of wagering inducements.
Findings
Use of wagering inducements was associated with an increase of gambling intensity (β between -0.06 [-0.08;-0.05] and 0.57 [0.54;0.60]), gambling frequency (β between 0.12 [0.10;0.18] and 0.29 [0.28;0.31]), and at-risk gambling behaviors (odds ratio between 1.32 [1.16;1.50] and 4.82 [4.61;5.05]) at the same week of their use. This effect was stronger for at-risk gambling behaviors and at-risk gamblers.
Conclusions
Wagering inducements may represent a risk factor for developing or exacerbating gambling problems.
... Temporal discounting (TD), the tendency to favour smaller-but-sooner over larger-but-later rewards, is common in humans (Peters & Büchel, 2011) and many animals (Kalenscher & Pennartz, 2008). Alterations in TD are associated with a range of psychiatric conditions and problematic behaviors, including addiction, substance abuse and attention-deficit hyperactivity disorder (Amlung et al., 2019;Bickel et al., 2019;Jackson & McKillop, 2016;Wiehler & Peters, 2015). TD exhibits stability over weeks (r = .91; ...
Humans and many animals devalue future rewards as a function of time (temporal discounting). Increased discounting has been linked to various psychiatric conditions, including substance-use-disorders, behavioral addictions and obesity. Despite its high intra-individual stability, temporal discounting is partly under contextual control. One prominent manipulation that has been linked to increases in discounting is the exposure to highly arousing appetitive cues. However, results from trial-wise cue exposure studies appear highly mixed, and changes in physiological arousal were not adequately controlled. Here we tested the effects of appetitive (erotic), aversive and neutral visual cues on temporal discounting in thirty-five healthy male participants. The contribution of single-trial physiological arousal was assessed using comprehensive monitoring of autonomic activity (pupil size, heart rate, electrodermal activity). Physiological arousal was elevated following aversive and in particular erotic cues. In contrast to our pre-registered hypothesis, if anything, we observed decreased temporal discounting following erotic cue exposure. Aversive cues tended to increase decision noise. Computational modeling revealed that trial-wise arousal only accounted for minor variance over and above aversive and erotic condition effects, arguing against a general effect of physiological arousal on temporal discounting.
... Along with the co-occurrence of mental health disorders (Lorains et al., 2011), several studies have identified poor decision-making among PG's critical factors (Ciccarelli et al., 2017;Labudda et al., 2007;Wiehler & Peters, 2015). Maladaptive decisionmaking patterns, such as the preference for high-risk, high-reward, short-term gains and a less adaptive strategy, have been observed in people with PG (Brevers et al., 2012;Gelskov et al., 2016Kovács et al., 2017. ...
This study aimed to investigate the self-reported measures of concurrent disorders (stress, social anxiety, anxiety, depression and alcohol use) among electronic gaming machine (EGM) gamblers with varying levels of gambling severity and to examine its relationship to decision-making. This cross-sectional study in New Zealand involved an online survey that utilised validated questionnaires to assess self-reported measures of concurrent disorders and the Iowa gambling task (IGT) to analyse decision-making. The study comprised of active EGM gamblers (n = 153) who were divided into two groups: non-problem gambling (NPG, n = 71) and problem gambling (PG, n = 82) based on the cut-off point of the South Oaks Gambling Screen (SOGS). Multiple logistic regression models were performed to analyse co-occurring disorders separately and simultaneously, and a log‐linear model was developed to define the associations between significant variables. The first model showed a strong correlation between gambling severity and measures for depression (p < 0.01), anxiety (p < 0.05), stress (p < 0.05) and alcohol use (p < 0.01), however only depression (p < 0.05) and alcohol use (p < 0.01) remained significant in the second model. Further, no association between social anxiety scores and problem gambling was found in this sample of EGM gamblers in both models. On the IGT, EGM gamblers in the PG group performed significantly worse. Further, the presence of poor decision-making was more pronounced with higher depression scores (p < 0.01) across both NPG and PG groups and higher alcohol use scores (p < 0.05) scores in the PG group. The presence of high levels of co-occurring disorders and its link to poor decision-making are important considerations in the treatment paradigm of EGM problem gamblers.
... Future rewards are discounted in value (Peters and Büchel, 2011) such that humans and many animals prefer smaller-sooner (SS) rewards over larger-but-later (LL) rewards (temporal discounting). Steep discounting of reward value is associated with a range of maladaptive behaviors ranging from substance use disorders (Bickel et al., 2014), attention-deficit hyperactivity disorder , and obesity (Amlung et al., 2016) to behavioral addictions, such as gambling disorder (Wiehler and Peters, 2015). Temporal discounting has thus been suggested to constitute a transdiagnostic process (Amlung et al., 2019;Lempert et al., 2019) with relevance for many psychiatric conditions. ...
The neurotransmitter dopamine is implicated in diverse functions, including reward processing, reinforcement learning and cognitive control. The tendency to discount future rewards over time has long been discussed in the context of potential dopaminergic modulation. Here we examined the effect of a single dose of the D2 receptor antagonist haloperidol (2mg) on temporal discounting in healthy female and male human participants. Our approach extends previous pharmacological studies in two ways. First, we applied combined temporal discounting drift diffusion models to examine choice dynamics. Second, we examined dopaminergic modulation of reward magnitude effects on temporal discounting. Hierarchical Bayesian parameter estimation revealed that the data were best accounted for by a temporal discounting drift diffusion model with non-linear trial-wise drift rate scaling. This model showed good parameter recovery, and posterior predictive checks revealed that it accurately reproduced the relationship between decision conflict and response times in individual participants. We observed reduced temporal discounting and substantially faster non-decision times under haloperidol compared to placebo. Discounting was steeper for low vs. high reward magnitudes, but this effect was largely unaffected by haloperidol. Results were corroborated by model-free analyses and modeling via more standard approaches. We previously reported elevated caudate activation under haloperidol in this sample of participants, supporting the idea that haloperidol elevated dopamine neurotransmission, e.g. by blocking inhibitory feedback via presynaptic D2 auto-receptors. The present results reveal that this is associated with an augmentation of both lower-level (non-decision time) and higher-level (temporal discounting) components of the decision process.
... For example, GD subjects show increased risk taking, higher discounting of delayed rewards (delay discounting), and reduced loss aversion. [6][7][8][9][10] Impaired value-based decision making in addiction may partly be explained, or even further exacerbated, by cues that modulate decision-making processes. The modulating influence of conditioned cues on instrumental behavior (e.g., cue-related increase of vigor with which a behavior is displayed or increase of likelihood of choosing a certain option) has been termed Pavlovian-to-instrumental transfer (PIT). ...
In addiction, there are few human studies on the neural basis of cue‐induced changes in value‐based decision making (Pavlovian‐to‐instrumental transfer, PIT). It is especially unclear whether neural alterations related to PIT are due to the physiological effects of substance abuse or rather related to learning processes and/or other etiological factors related to addiction. We have thus investigated whether neural activation patterns during a PIT task help to distinguish subjects with gambling disorder (GD), a nonsubstance‐based addiction, from healthy controls (HCs). Thirty GD and 30 HC subjects completed an affective decision‐making task in a functional magnetic resonance imaging (fMRI) scanner. Gambling‐associated and other emotional cues were shown in the background during the task. Data collection and feature modeling focused on a network of nucleus accumbens (NAcc), amygdala, and orbitofrontal cortex (OFC) (derived from PIT and substance use disorder [SUD] studies). We built and tested a linear classifier based on these multivariate neural PIT signatures. GD subjects showed stronger PIT than HC subjects. Classification based on neural PIT signatures yielded a significant area under the receiver operating curve (AUC‐ROC) (0.70, p = 0.013). GD subjects showed stronger PIT‐related functional connectivity between NAcc and amygdala elicited by gambling cues, as well as between amygdala and OFC elicited by negative and positive cues. HC and GD subjects were thus distinguishable by PIT‐related neural signatures including amygdala–NAcc–OFC functional connectivity. Neural PIT alterations in addictive disorders might not depend on the physiological effect of a substance of abuse but on related learning processes or even innate neural traits.
... Riguardo ai giocatori problematici, questa "miopia per il futuro" (Bechara, 2003) si traduce anche in una scarsa capacità decisionale in condizioni di incertezza (per una rassegna si veda Wiehler & Peters, 2015). Due recenti studi sul processo decisionale tra gli adolescenti (Ciccarelli et al., 2016; hanno dimostrato che i giovani giocatori d'azzardo ottengono risultati peggiori rispetto ai non giocatori all'Iowa Gambling Task e non mostrano miglioramenti delle prestazioni nel corso del tempo. ...
Riassunto: Il gioco d’azzardo è diventato negli ultimi decenni uno dei comportamenti di dipendenza più frequentemente segnalati tra i giovani. E ciò, sia perché c’è stata una maggiore accettabilità sociale del fenomeno, sia perché si è assistito ad una massiccia e diversificata offerta di gioco d’azzardo legalizzato, soprattutto on line, attraverso le moderne tecnologie digitali, cui i giovani hanno frequente e facile accesso.
Nonostante il gioco d'azzardo adolescenziale sia illegale, i giovani sono coinvolti nel gioco d'azzardo ad un tasso di prevalenza superiore rispetto agli adulti. Inoltre, studi internazionali hanno dimostrato che fino al 12,3% dei giovani soddisfa i criteri per il gioco d'azzardo problematico.
L'obiettivo del presente studio è stato quello di esaminare la relazione tra impulsività e problemi di gioco d'azzardo in adolescenza attraverso un'ampia rassegna dei principali contributi della recente letteratura nazionale e internazionale sui fattori di rischio che incidono sull’insorgenza e il mantenimento del disturbo da gioco d’azzardo tra i giovani.
Abstract: Gambling has become one of the most frequently reported addictive behaviors among young people. And this, both because there has been a greater social acceptability of the phenomenon, and because there has been a massive and diversified offer of legalized gambling, especially online, through modern digital technologies, which young people have frequently and easly access.
In spite of adolescent gambling being an illegal activity, youth engage in gambling with a prevalence rate higher than adults. Moreover, international studies showed that up to 12.3% of youth meet criteria for problem gambling.
The main aim of the present study has been to examine the relationship between impulsivity and problem gambling in adolescence through a wide review of the main contributions in recent national and international literature on risk factors affecting the onset and maintenance of gambling disorder among young people.
... Certaines pathologies influencent le traitement des feedbacks. Par exemple, les participants atteints d'addiction aux jeux d'argent ou de troubles des conduites alimentaires (e.g., anorexie, boulimie), effectuent tout au long de l'Iowa Gambling Task (Bechara et al., 1997) des décisions désavantageuses (Guillaume et al., 2015;Wiehler & Peters, 2015). Ces patients seraient insensibles à la valeur émotionnelle des feedbacks qu'ils reçoivent. ...
Développé en 2015, l’Emotion Imbued Choice (EIC ; Lerner et al., 2015) explique la manière dont les émotions influencent la prise de décision. Selon ce modèle, les émotions incidentes (non reliées à la décision) associées à un haut degré de certitude déclencheraient un traitement plutôt heuristique de l’information tandis que les émotions associées à un haut degré d’incertitude déclencheraient un traitement plutôt délibératif (Tiedens & Linton, 2001), expliquant des différences de performances dans les tâches de prise de décision.L’influence des émotions incidentes a été étudiée dans la prise de décision unique et dans la prise séquentielle de décisions (i.e., séries de décisions). Si l’EIC, fournit un cadre explicatif clair concernant la prise de décision unique, ses prédictions sont moins explicites quant à la prise séquentielle de décisions. Cette dernière présente la particularité que chaque décision est suivie d’un feedback (gain ou perte) ayant une valeur émotionnelle (positive vs. négative). Cette source d’influence émotionnelle intégrée (reliée à la décision) peut modifier les décisions suivantes. Des auteurs ont observé que le déclenchement d’un traitement de l’information plutôt heuristique conduit les participants à prendre des décisions plus avantageuses que le déclenchement d’un traitement de l’information plutôt délibératif (Bagneux et al. 2013 ; voir aussi Bollon & Bagneux, 2013). Toutefois, l’implication du traitement de la valeur émotionnelle des feedbacks dans l’obtention de ce pattern de résultats n’a, à ce jour, pas reçu de confirmation directe.Notre objectif était d’identifier la manière dont les émotions incidentes, en fonction de leur degré de certitude, modulent la prise séquentielle de décisions. Au travers d’une série de sept expériences, nous avons montré comment ces émotions incidentes interagissent avec l’influence émotionnelle intégrée des feedbacks. Ainsi, seul le déclenchement d’un traitement plutôt heuristique conduit les participants à moduler leurs décisions en fonction du type (positifs vs. négatifs) de feedbacks reçus. Ces résultats concernent les tâches de prise séquentielle de décisions ambigües et risquées. La modulation du pattern de prise de décision a été mise en évidence, de manière classique, lors de l’induction d’émotions incidentes négatives et, de manière plus originale, lors de l’induction d’émotions incidentes positives. En second lieu, l’analyse des résultats et de la littérature a mis en évidence la fiabilité médiocre de la mesure du degré de certitude. Une série de six autres études, s’inscrivant dans la méthodologie générale de construction d’échelles, a été réalisée afin d’en recherche les origines. Nous avons montré que cette faible fiabilité était la double conséquence d’une définition incomplète et d’une opérationnalisation imparfaite de la dimension de certitude. À un niveau théorique, nous proposons que l’ensemble de nos résultats supportent la nécessité d’étendre le modèle EIC à la prise séquentielle de décisions. Sur le plan méthodologique, nos résultats justifient l’intérêt de développer un nouvel outil de mesure du degré de certitude.
... Laboratory-based decision-making studies have shown that individuals with GD exhibit decision-making impairments both under risk and ambiguity. They typically perform more poorly than comparison subjects on the IGT (although not always [72]), preferring short-term rewards, even if they are not profitable in the long term, evidencing insensitivity to the future consequences of their gambling behavior [73][74][75][76]. In spite of making more disadvantageous choices, individuals with GD often learn from feedback more slowly than do comparison subjects [77,78]. ...
Purpose of Review
The present review attempts to provide a comprehensive and critical overview of the neurocognitive mechanisms of gambling disorder (GD), problematic pornography use (PPU), and binge-eating disorder (BED), focusing specifically on decision-making processes.
Recent Findings
GD, PPU, and BED have been associated with decision-making impairments both under risk and ambiguity. Features such as intelligence, emotions, social variables, cognitive distortions, comorbidities, or arousal may condition decision-making processes in these individuals.
Summary
Impairments in decision-making seem to be a shared transdiagnostic feature of these disorders. However, there is varying support for the degree to which different features may affect decision-making. Therefore, the study of decision-making processes can provide crucial evidence for understanding addictions and other disorders with addiction-like symptomatology.
... Few studies, if any, have examined cognitive biases with the extended version of the cognitive reflection test and the modified jumping-to-conclusions test in gambling disorders, such that whether performance on these questionnaires and psychological tests are also different from control subjects in patients with gambling disorders remains unclear. In gambling disorders, impaired probability judgments have been reported (Madden et al., 2009;Andrade and Petry, 2012;Linnet et al., 2012;Wiehler and Peters, 2015); this is somewhat consistent with our current study, which demonstrates that impaired probability judgments are also observed in kleptomania and paraphilia patients. In contrast, risk taking has been reported inconsistently in gambling disorders, with some research reporting more risk taking (Ligneul et al., 2013) and other data showing slightly more risk aversion (Branas-Garza et al., 2007). ...
Background:
Accumulating evidence suggests that deficits in decision making and judgment may be involved in several psychiatric disorders, including addiction. Behavioral addiction is a conceptually new psychiatric condition, raising a debate of what criteria would define behavioral addiction, and several impulse control disorders are equivalently considered as behavioral addiction. In this preliminary study with a relatively small sample size, we investigated how decision making and judgment were compromised in behavioral addiction to further characterize this psychiatric condition.
Methods:
Healthy control subjects (n=31) and patients with kleptomania and paraphilia as behavioral addiction (n=16) were recruited. A battery of questionnaires for assessments of cognitive biases and economic decision making, and a psychological test for assessment of the jumping-to-conclusions bias with functional near-infrared spectroscopy recordings of prefrontal cortical (PFC) activity were conducted.
Results:
Although behavioral addicts exhibited stronger cognitive biases than controls in the questionnaire, such difference was primarily due to lower intelligence in the patients. Behavioral addicts also exhibited higher risk taking in economic decision making, and worse performance indicating compromised probability judgment, along with diminished PFC activity in the right hemisphere.
Conclusions:
Our study suggests that behavioral addiction may involve impairments of probability judgment associated with attenuated PFC activity, which consequently lead to higher risk taking in decision making.
Steep temporal discounting is a hallmark of a range of mental disorders, including substance use disorders and addiction. Episodic cueing during temporal discounting tasks reliably increases the selection of larger-but-later options, but the specific computational mechanisms through which episodic processes impact decision-making have remained elusive. Here, we addressed this issue using hierarchical Baysian computational modeling via temporal discounting drift diffusion models in a pre-registered multi-day study (https://osf.io/rhz2f/). Participants (n=20 males, n=21 females, n=1 non-binary) completed temporal discounting tasks with either future or past cues (compared to control trials), on two separate testing days. Model-agnostic analyses confirmed the prediced increase in larger-later choices following both future and past cueing. Computational modeling revealed that, in addition to reducing the discount rate, both future and past cues reliably increased decision thresholds in a temporal discounting drift diffusion model with non-linear drift rate scaling. Results highlight thatin addition to reducing the discount rate, episodic cueing elicits dynamic control adjustments that serve to counteract the impact of noise in the evidence accumulation process, thereby facilitating selection of options with better long-term value.
Background
Gambling disorder (GD) and bulimic spectrum eating disorders (BSDs) not only share numerous psychopathological, neurobiological, and comorbidity features but also are distinguished by the presence of inappropriate behaviours related to impulsivity and compulsivity. This study aimed to emphasise the differences and similarities in the main impulsivity and compulsivity features between GD and BSD patients, and to analyse the potential influence of sex in these domains.
Methods
Using self-reported and neurocognitive measures, we assessed different impulsive–compulsive components in a sample of 218 female and male patients (59 with BSD and 159 with GD) and 150 healthy controls.
Results
We observed that GD and BSDs exhibited elevated levels of impulsivity and compulsivity in all the dimensions compared to healthy controls. Moreover, these disorders showed differences in several personality traits, such as high novelty seeking in GD, and low persistence and high harm avoidance in BSDs. In addition, patients with BSDs also displayed a trend towards greater impulsive choice than GD patients. Regarding sex effects, GD women presented higher overall impulsivity and compulsivity than GD men. Nevertheless, no sex differences were found in BSDs.
Conclusions
Clinical interventions should consider these deficits to enhance their effectiveness, including adjunctive treatment to target these difficulties. Our findings also provide support to the relevance of sex in GD, which should also be considered in clinical interventions.
When choosing between rewards that differ in temporal proximity (inter-temporal choice), human preferences are typically stable, constituting a clinically-relevant transdiagnostic trait. Here we show in female and male human patients undergoing deep brain stimulation (DBS) of the anterior limb of the internal capsule/nucleus accumbens region for treatment-resistant obsessivecompulsive disorder (OCD), that long-term chronic (but not phasic) DBS disrupts inter-temporal preferences. Hierarchical Bayesian modeling accounting for temporal discounting behavior across multiple time points allowed us to assess both short-term and long-term reliability of inter-temporal choice. In controls, temporal discounting was highly reliable, both long-term (6 months) and short-term (1 week). In contrast, in patients undergoing DBS, short-term reliability was high, but long-term reliability (6 months) was severely disrupted. Control analyses confirmed that this effect was not due to range restriction, the presence of OCD symptoms or group differences in choice stochasticity. Model-agnostic between- and within-subject analyses confirmed this effect. These findings provide initial evidence for long-term modulation of cognitive function via DBS and highlight a potential contribution of the human nucleus accumbens region to inter-temporal preference stability over time.
Significance Statement
Choosing between rewards that differ in temporal proximity is in part a stable trait with relevance for many mental disorders, and depends on prefrontal regions and regions of the dopamine system. Here we show that chronic deep brain stimulation (DBS) of the human anterior limb of the internal capsule/nucleus accumbens region for treatment-resistant obsessive compulsive disorder disrupts the stability of inter-temporal preferences. These findings show that chronic stimulation of one of the brain’s central motivational hubs can disrupt preferences thought to depend on this circuit.
Computational psychiatry focuses on identifying core cognitive processes that appear altered across distinct psychiatric disorders. Temporal discounting of future rewards and model-based control during reinforcement learning have proven as two promising candidates. Despite its trait-like stability, temporal discounting may be at least partly under contextual control. Highly arousing cues were shown to increase discounting, although evidence to date remains somewhat mixed. Whether model-based reinforcement learning is similarly affected by arousing cues remains unclear. Here, we tested cue-reactivity effects (erotic pictures) on subsequent temporal discounting and model-based reinforcement learning in a within-subjects design in n = 39 healthy heterosexual male participants. Self-reported and physiological arousal (cardiac activity and pupil dilation) were assessed before and during cue exposure. Arousal was increased during exposure of erotic versus neutral cues both on the subjective and autonomic level. Erotic cue exposure increased discounting as reflected by more impatient choices. Hierarchical drift diffusion modeling (DDM) linked increased discounting to a shift in the starting point bias of evidence accumulation toward immediate options. Model-based control during reinforcement learning was reduced following erotic cues according to model-agnostic analysis. Notably, DDM linked this effect to attenuated forgetting rates of unchosen options, leaving the model-based control parameter unchanged. Our findings replicate previous work on cue-reactivity effects in temporal discounting and for the first time show similar effects in model-based reinforcement learning in a heterosexual male sample. This highlights how environmental cues can impact core human decision processes and reveal that comprehensive modeling approaches can yield novel insights in reward-based decision processes.
People with mental health problems are more likely to experience problems due to gambling, an intersection of two sources of social disadvantage. However, the mechanisms by which this occurs remain unclear. Analysing if choices while gambling differ for people with mental health problems, and whether these differences involve characteristics linked with gambling harms, can improve this understanding. Evidence on this is limited because most studies rely on survey questions or aggregate data which are either self-reported, unlikely to allow for identification of separate features of gambling options, or do not observe the full set of options people are choosing between. Discrete Choice Experiments can circumvent these issues by observing the gambling environment and individual's gambling choices. This study uses a Discrete Choice Experiment to analyse people's choices while gambling, and if these differ for people with mental health problems. Participants were offered a series of 6 choice sets representing online gambling on horse racing; each presented two hypothetical horse races, both with eight horses, differing in the information they provided. Participants chose which race (if any) and horse they would bet on. The choices were modelled using mixed logit models. People with mental health problems had (i) a lower preference for betting on races with information about horses' recent form and (ii) preferred betting on horses with higher odds. (i) Could indicate that they put less thought into their bet, a sign of gambling as an escape. (ii) Could indicate that they are more risk seeking. These are two gambling characteristics linked with problems due to gambling and are plausible mechanisms by which people with mental health problems may be more likely to develop problems due to gambling.
Computational modeling has become an important tool in neuroscience and psychiatry research to provide insight into the cognitive processes underlying normal and pathological behavior. There are two modeling frameworks, reinforcement learning (RL) and drift diffusion modeling (DDM), that are well-developed in cognitive science, and have begun to be applied to Gambling Disorder. RL models focus on explaining how an agent uses reward to learn about the environment and make decisions based on outcomes. The DDM is a binary choice framework that breaks down decision making into psychologically meaningful components based on choice reaction time analyses. Both approaches have begun to yield insight into aspects of cognition that are important for, but not unique to, gambling, and thus relevant to the development of Gambling Disorder. However, these approaches also oversimplify or neglect various aspects of decision making seen in real-world gambling behavior. Gambling Disorder presents an opportunity for 'bespoke' modeling approaches to consider these neglected components. In this review, we discuss studies that have used RL and DDM frameworks to investigate some of the key cognitive components in gambling and Gambling Disorder. We also include an overview of Bayesian models, a methodology that could be useful for more tailored modeling approaches. We highlight areas in which computational modeling could enable progression in the investigation of the cognitive mechanisms relevant to gambling.
Gambling disorder (GD) is a behavioural addiction characterized by impairments in decision-making, favouring risk- and reward-prone choices. One explanatory factor for this behaviour is a deviation in attentional processes, as increasing evidence indicates that GD patients show an attentional bias toward gambling stimuli. However, previous attentional studies have not directly investigated attention during risky decision-making. 26 patients with GD and 29 healthy matched controls (HC) completed a mixed gambles task combined with eye-tracking to investigate attentional biases for potential gains versus losses during decision-making under risk. Results indicate that compared to HC, GD patients gambled more and were less loss averse. GD patients did not show a direct attentional bias towards gains (or relative to losses). Using a recent (neuro)economics model that considers average attention and trial-wise deviations in average attention, we conducted fine-grained exploratory analyses of the attentional data. Results indicate that the average attention in GD patients moderated the effect of gain value on gambling choices, whereas this was not the case for HC. GD patients with high average attention for gains started gambling at less high gain values. A similar trend-level effect was found for losses, where GD patients with high average attention for losses stopped gambling at lower loss values. This study gives more insight into how attentional processes in GD play a role in gambling behaviour, which could have implications for the development of future treatments focusing on attentional training or for the development of interventions that increase the salience of losses.
Value-based decision-making is of central interest in cognitive neuroscience and psychology, as well as in the context of neuropsychiatric disorders characterised by decision-making impairments. Studies examining (neuro-)computational mechanisms underlying choice behaviour typically focus on participants' decisions. However, there is increasing evidence that option valuation might also be reflected in motor response vigour and eye movements, implicit measures of subjective utility. To examine motor response vigour and visual fixation correlates of option valuation in intertemporal choice, we set up a task where the participants selected an option by pressing a grip force transducer, simultaneously tracking fixation shifts between options. As outlined in our preregistration (https://osf.io/k6jct), we used hierarchical Bayesian parameter estimation to model the choices assuming hyperbolic discounting, compared variants of the softmax and drift diffusion model, and assessed the relationship between response vigour and the estimated model parameters. The behavioural data were best explained by a drift diffusion model specifying a non-linear scaling of the drift rate by the subjective value differences. Replicating previous findings, we found a magnitude effect for temporal discounting, such that higher rewards were discounted less. This magnitude effect was further reflected in motor response vigour, such that stronger forces were exerted in the high vs. the low magnitude condition. Bayesian hierarchical linear regression further revealed higher grip forces, faster response times and a lower number of fixation shifts for trials with higher subjective value differences. An exploratory analysis revealed that subjective value sums across options showed an even more pronounced association with trial-wise grip force amplitudes. Our data suggest that subjective utility or implicit valuation is reflected in motor response vigour and visual fixation patterns during intertemporal choice. Taking into account response vigour might thus provide deeper insight into decision-making, reward valuation and maladaptive changes in these processes, e.g. in the context of neuropsychiatric disorders.
Humans and many animals devalue future rewards as a function of time (temporal discounting). Increased discounting has been linked to various psychiatric conditions, including substance-use-disorders, behavioral addictions, and obesity. Despite its high intra-individual stability, temporal discounting is partly under contextual control. One prominent manipulation that has been linked to increases in discounting is the exposure to highly arousing appetitive cues. However, results from trial-wise cue exposure studies appear highly mixed, and changes in physiological arousal were not adequately controlled. Here we tested the effects of appetitive (erotic), aversive, and neutral visual cues on temporal discounting in 35 healthy male participants. The contribution of single-trial physiological arousal was assessed using comprehensive monitoring of autonomic activity (pupil size, heart rate, electrodermal activity). Physiological arousal was elevated following aversive and in particular erotic cues. In contrast to our pre-registered hypothesis, steepness of temporal discounting was not significantly affected by emotional cues of either valence. Aversive cues tended to increase decision noise. Computational modeling revealed that trial-wise arousal only accounted for minor variance over and above aversive and erotic condition effects, arguing against a general effect of physiological arousal on temporal discounting.
High-performance virtual reality (VR) technology has opened new possibilities for the examination of the reactivity towards addiction-related cues (cue-reactivity) in addiction. In this preregistered study (https://osf.io/4mrta), we investigated the subjective, physiological, and behavioral effects of gambling-related VR environment exposure in participants reporting frequent or pathological gambling (n=31) as well as non-gambling controls (n=29). On two separate days, participants explored two rich and navigable VR-environments (neutral: cafe vs. gambling-related: casino/sports-betting facility), while electrodermal activity and heart rate were continuously measured using remote sensors. Within VR, participants performed a temporal discounting task and a sequential decision-making task designed to assess model-based and model-free contributions to behavior. Replicating previous findings, we found strong evidence for increased temporal discounting and reduced model-based control in participants reporting frequent or pathological gambling. Although VR gambling environment exposure increased subjective craving, there was if anything inconclusive evidence for further behavioral or physiological effects. Instead, VR exposure substantially increased physiological arousal (electrodermal activity), across groups and conditions. VR is a promising tool for the investigation of context effects in addiction, but some caution is warranted since effects of real gambling environments might not generally replicate in VR. Future studies should delineate how factors such as cognitive load and ecological validity could be balanced to create a more naturalistic VR experience.
Gambling disorder is a behavioral addiction that negatively impacts personal finances, work, relationships and mental health. In this pre-registered study (https://osf.io/5ptz9/?view_only=62956a2afcd1495984db4be18c54b50a) we investigated the impact of real-life gambling environments on two computational markers of addiction, temporal discounting and model-based reinforcement learning. Gambling disorder is associated with increased temporal discounting and reduced model-based learning. Regular gamblers (n = 30, DSM-5 score range 3-9) performed both tasks in a neutral (café) and a gambling-related environment (slot-machine venue) in counterbalanced order. Data were modeled using drift diffusion models for temporal discounting and reinforcement learning via hierarchical Bayesian estimation. Replicating previous findings, gamblers discounted rewards more steeply in the gambling-related context. This effect was positively correlated with gambling related cognitive distortions (pre-registered analysis). In contrast to our pre-registered hypothesis, model-based reinforcement learning was improved in the gambling context. Here we show that temporal discounting and model-based reinforcement learning are modulated in opposite ways by real-life gambling cue exposure. Results challenge aspects of habit theories of addiction, and reveal that laboratory-based computational markers of psychopathology are under substantial contextual control.
In recent years the emergence of high-performance virtual reality (VR) technology has opened up new possibilities for the examination of context effects in psychological studies. The opportunity to create ecologically valid stimulation in a highly controlled lab environment is especially relevant for studies of psychiatric disorders, where it can be problematic to confront participants with certain stimuli in real life. However, before VR can be confidently applied widely it is important to establish that commonly used behavioral tasks generate reliable data within a VR surrounding. One field of research that could benefit greatly from VR-applications are studies assessing the reactivity to addiction related cues (cue-reactivity) in participants suffering from gambling disorder. Here we tested the reliability of a commonly used temporal discounting task in a novel VR set-up designed for the concurrent assessment of behavioral and psychophysiological cue-reactivity in gambling disorder. On 2 days, thirty-four healthy non-gambling participants explored two rich and navigable VR-environments (neutral: café vs. gambling-related: casino and sports-betting facility), while their electrodermal activity was measured using remote sensors. In addition, participants completed the temporal discounting task implemented in each VR environment. On a third day, participants performed the task in a standard lab testing context. We then used comprehensive computational modeling using both standard softmax and drift diffusion model (DDM) choice rules to assess the reliability of discounting model parameters assessed in VR. Test–retest reliability estimates were good to excellent for the discount rate log(k), whereas they were poor to moderate for additional DDM parameters. Differences in model parameters between standard lab testing and VR, reflecting reactivity to the different environments, were mostly numerically small and of inconclusive directionality. Finally, while exposure to VR generally increased tonic skin conductance, this effect was not modulated by the neutral versus gambling-related VR-environment. Taken together this proof-of-concept study in non-gambling participants demonstrates that temporal discounting measures obtained in VR are reliable, suggesting that VR is a promising tool for applications in computational psychiatry, including studies on cue-reactivity in addiction.
Introduction: Considering the need to provide valid instruments for research and clinical work, the present study aimed to develop and evaluate the psychometric properties
and factor structure of the Persian version of the monetary choice questionnaire.
Methods: In this cross-sectional survey, 400 students were selected through convenience
sampling from all students of Kermanshah universities. The data were collected through
Consideration of Future Consequences scale and Monetary Choice Questionnaire and
were analyzed using statistical methods of Cronbach’s alpha, intra-class and Pearson
correlation tests, and the exploratory factor analysis.
Results: The findings showed that the internal consistency of the scale using Cronbach’s
alpha was 0.89, its split-half reliability was 0.88, and its test-retest reliability was 0.78
for a three week. The exploratory factor analysis results showed that the single-factor
structure and the three-factor structure of the questionnaire were valid.
Conclusion: According to findings, the monetary choice questionnaire has acceptable
validity and reliability, and given the relatively short time it takes to be completed. So, it
can be an appropriate tool for employing in both clinical and research situations.
Increased reactivity to addiction related cues (cue-reactivity) plays a critical role in the maintenance of addiction. Studies assessing cue-reactivity in gambling disorder often suffer from low ecological validity due to the usage of picture stimuli in a neutral lab environment. Here we describe a novel virtual reality (VR) set-up for the concurrent assessment of behavioral and psychophysiological cue-reactivity in gambling disorder. On two days, thirty-four healthy non-gambling participants explored two rich and navigable VR-environments (neutral: cafe vs. gambling-related: casino and sports-betting facility), while their electrodermal activity was measured using remote sensors. In addition, participants completed a temporal discounting task implemented in each VR environment. On a third day, participants performed the task in a standard lab testing context. We then used comprehensive computational modeling using both standard softmax and drift diffusion model (DDM) choice rules to assess the reliability of discounting model parameters assessed in VR. Test-retest reliability estimates were good to excellent for the discount rate log(k), whereas they were poor to moderate for additional DDM parameters. Differences in model parameters between standard lab testing and VR, reflecting reactivity to the different environments, were mostly numerically small and of inconclusive directionality. Finally, while exposure to VR generally increased tonic skin conductance, this effect was not modulated by the neutral vs. gambling-related VR-environment. Taken together this proof-of-concept study in non-gambling participants demonstrates the feasibility assessing both physiological and behavioral cue-reactivity in VR. We show that temporal discounting measures obtained in VR are reliable, suggesting that VR is a promising tool for an ecologically valid assessment of cue-reactivity in gambling disorder.
Decision-making is a complex process essential to daily adaptation in many species. Risk is an inherent aspect of decision-making and it is influenced by gonadal hormones. Testosterone and 17β-estradiol may modulate decision making and impact the mesocorticolimbic dopamine pathway. Here, we explored sex differences, the effect of gonadal hormones and the dopamine agonist amphetamine on risk-based decision making. Intact or gonadectomised (GDX) male and female rats underwent to a probabilistic discounting task. High and low doses of testosterone propionate (1.0 or 0.2 mg) and 17β-estradiol benzoate (0.3 μg) were administered to assess acute effects on risk-based decision making. After 3-days of washout period, intact and GDX rats received high or low (0.5 or 0.125 mg/kg) doses of amphetamine and re-tested in the probabilistic discounting task. Under baseline conditions, males made more risky choices during probability discounting compared to female rats, particularly in the lower probability blocks, but GDX did not influence risky choice. The high, but not the low dose, of testosterone modestly reduced risky decision making in GDX male rats. Conversely, 17β-estradiol had no significant effect on risky choice regardless of GDX status in either sex. Lastly, a higher dose of amphetamine increased risky decision making in both intact males and females, but had no effect in GDX rats. These findings demonstrated sex differences in risk-based decision making, with males showing a stronger bias toward larger, uncertain rewards. GDX status influenced the effects of amphetamine, suggesting different dopaminergic regulation in risk-based choices among males and females.
Gambling disorder is associated with deficits in reward-based learning, but the underlying computational mechanisms are still poorly understood. Here, we examined this issue using a stationary reinforcement learning task in combination with computational modeling and functional resonance imaging (fMRI) in individuals that regular participate in gambling (n=23, seven fulfilled one to three DSM 5 criteria for gambling disorder, sixteen fulfilled four or more) and matched controls (n=23). As predicted, the gambling group exhibited substantially reduced accuracy, whereas overall response times (RTs) were not reliably different between groups. We then used comprehensive modeling using reinforcement learning drift diffusion models (RLDDMs) in combination with hierarchical Bayesian parameter estimation to shed light on the computational underpinnings of this performance deficit. In both groups, an RLDDM in which both non-decision time and decision threshold (boundary separation) changed over the course of the experiment accounted for the data best. The model showed good parameter and model recovery, and posterior predictive checks revealed that, in both groups, accurately reproduced the evolution of both accuracy and RTs over time. Modeling revealed that the learning impairment in the gambling group was attributable to a more rapid reduction in decision thresholds over time, and a reduced effect of value-differences on the drift rate, compared to controls. The gambling group also showed substantially shorter non-decision times. Imaging analyses replicated effects of prediction error coding in the ventral striatum and value coding in the ventro-medial prefrontal cortex, but there was no credible evidence for group differences in these effects. Taken together, our findings show that reinforcement learning impairments in disordered gambling are linked to both maladaptive decision threshold adjustments and a reduced consideration of option values in the choice process.
The purpose of the present study was to revise the Barratt Impulsiveness Scale Version 10 (BIS-10), identify the factor structure of the items among normals, and compare their scores on the revised form (BIS-11) with psychiatric inpatients and prison inmates. The scale was administered to 412 college undergraduates, 248 psychiatric inpatients, and 73 male prison inmates. Exploratory principal components analysis of the items identified six primary factors and three second-order factors. The three second-order factors were labeled Attentional Impulsiveness, Motor Impulsiveness, and Nonplanning Impulsiveness. Two of the three second-order factors identified in the BIS-11 were consistent with those proposed by Barratt (1985), but no cognitive impulsiveness component was identified per se. The results of the present study suggest that the total score of the BIS-11 is an internally consistent measure of impulsiveness and has potential clinical utility for measuring impulsiveness among selected patient and inmate populations.
• The sections in this chapter represent the current understanding of delay discounting as applied to substance abuse. We begin with studies that have compared delay discounting of outcomes in the future (which we refer to here as delay discounting) by substance-abusing populations and nonusing controls. Noteworthy is that much of the literature reviewed used immediate and delayed money outcomes as choice alternatives. Although the substance abuser is not nominally choosing between money outcomes when deciding to consume or not to consume a substance of dependence, the substance abuser is exhibiting a general choice bias favoring immediate reinforcement in lieu of larger, delayed reinforcement. Given the generality of this choice bias across a variety of commodities (including money, drugs, and health) and the relative precision of monetary units, the discounting of money is the prevalent modus operandi in human discounting research on substance abuse and dependence. We also report on the current understanding of probability discounting, a construct thought to have some behavioral overlap with delay discounting (although different neural substrates appear to be involved). We examine the effect of long-term abstinence on delay discounting as well as the utility of delay-discounting measures as predictive tools. Finally, we speculate on more global features of time, incorporating the new construct of past discounting and a developmental perspective on substance abuse and discounting. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
• The sections in this chapter represent the current understanding of delay discounting as applied to substance abuse. We begin with studies that have compared delay discounting of outcomes in the future (which we refer to here as delay discounting) by substance-abusing populations and nonusing controls. Noteworthy is that much of the literature reviewed used immediate and delayed money outcomes as choice alternatives. Although the substance abuser is not nominally choosing between money outcomes when deciding to consume or not to consume a substance of dependence, the substance abuser is exhibiting a general choice bias favoring immediate reinforcement in lieu of larger, delayed reinforcement. Given the generality of this choice bias across a variety of commodities (including money, drugs, and health) and the relative precision of monetary units, the discounting of money is the prevalent modus operandi in human discounting research on substance abuse and dependence. We also report on the current understanding of probability discounting, a construct thought to have some behavioral overlap with delay discounting (although different neural substrates appear to be involved). We examine the effect of long-term abstinence on delay discounting as well as the utility of delay-discounting measures as predictive tools. Finally, we speculate on more global features of time, incorporating the new construct of past discounting and a developmental perspective on substance abuse and discounting. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
There is widespread interest in identifying computational and neurobiological mechanisms that influence the ability to choose long-term benefits over more proximal and readily available rewards in domains such as dietary and economic choice. We present the results of a human fMRI study that examines how neural activity relates to observed individual differences in the discounting of future rewards during an intertemporal monetary choice task. We found that a region of left dorsolateral prefrontal cortex (dlPFC) BA-46 was more active in trials where subjects chose delayed rewards, after controlling for the subjective value of those rewards. We also found that the connectivity from dlPFC BA-46 to a region of ventromedial prefrontal cortex (vmPFC) widely associated with the computation of stimulus values, increased at the time of choice, and especially during trials in which subjects chose delayed rewards. Finally, we found that estimates of effective connectivity between these two regions played a critical role in predicting out-of-sample, between-subject differences in discount rates. Together with previous findings in dietary choice, these results suggest that a common set of computational and neurobiological mechanisms facilitate choices in favor of long-term reward in both settings.
Impulsive behavior such as steep temporal discounting is a hallmark of addiction and is associated with relapse. In pathological gamblers, discounting may be further increased by the presence of gambling-related cues in the environment, but the extent to which the gambling relatedness of task settings affects reward responses in gambling addiction is debated. In the present study, human problem gamblers made choices between immediate rewards and individually tailored larger-but-later rewards while visual gambling-related scenes were presented in the background. N = 17 participants were scanned using fMRI, whereas N = 5 additional participants completed a behavioral version of the task. Postscan craving ratings were acquired for each image, and behavioral and neuroimaging data were analyzed separately for high- and low-craving trials (median split analysis). Discounting was steeper for high versus low craving trials. Neuroimaging revealed a positive correlation with model-based subjective value in midbrain and striatum in low-craving trials that was reversed in high-craving trials. These findings reveal a modulation of striatal reward responses in gamblers by addiction-related cues, and highlight a potentially important mechanism that may contribute to relapse. Cue-induced changes in striatal delayed reward signals may lead to increased discounting of future rewards, which might in turn affect the likelihood of relapse.
Excessive delay discounting (DD) has been related to various maladaptive behaviors and may stem from a myopic focus on immediate gratification. Neuroimaging studies have shown that episodic future thinking (EFT) -vivid mental simulation of future experiences-may reduce DD by promoting consideration of delayed outcomes. However, the EFT manipulations in these experiments may have induced positive affect, which could independently enhance executive functions that facilitate self-regulation. To clarify the mechanism of this effect, 87 participants were randomized to visualize neutral- or positive-valenced events expected to occur in the present or in the future while completing a standardized DD questionnaire. Working memory capacity, inhibitory control, the genotypes of 3 functional dopaminergic polymorphisms (DRD1 rs686, DRD2 rs1800497, and COMT rs4680), as well as an additive dopamine genetic risk score were assessed as potential moderators. The results indicate that EFT reduces DD primarily by shifting the time perspective of intertemporal decision-making, and that this effect is moderated by working memory capacity. In addition, positive episodic thinking may independently attenuate the protective effects of high working memory capacity, high inhibitory control, and lower dopamine genetic risk scores on DD. The current findings dovetail with previous research to suggest that the time perspective and emotional valence of episodic thinking may dynamically shape intertemporal choice, perhaps in part by transiently modulating executive function and dopaminergic neurotransmission. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
Gambling is pertinent to neuroscience research for at least two reasons. First, gambling is a naturalistic and pervasive example of risky decision making, and thus gambling games can provide a paradigm for the investigation of human choice behavior and "irrationality." Second, excessive gambling involvement (i.e., pathological gambling) is currently conceptualized as a behavioral addiction, and research on this condition may provide insights into addictive mechanisms in the absence of exogenous drug effects. This article is a summary of topics covered in a Society for Neuroscience minisymposium, focusing on recent advances in understanding the neural basis of gambling behavior, including translational findings in rodents and nonhuman primates, which have begun to delineate neural circuitry and neurochemistry involved.
The current article focuses on the role of anticipatory time perception in temporal discounting. We propose a perceived-time–based model and demonstrate that 2 aspects of time perception are relevant to hyperbolic discounting. Specifically, our model states that diminishing sensitivity to longer time horizons (i.e., how long individuals perceive short time horizons to be relative to long time horizons) and the level of time contraction overall (i.e., how long or short individuals perceive time horizons to be overall) contribute to the degree of hyperbolic discounting. We estimate individual differences in the degree of diminishing sensitivity to time and the degree of time contraction, and demonstrate that each significantly predicts the degree of hyperbolic discounting. These results empirically confirm two unique aspects of anticipatory time perception in determining individuals’ temporal discounting.
Backgrounds and aims: Pathological gambling, a common psychiatric disorder, has many similarities with substance use disorders. Relapse, an important element in addictive disorders, however, has seldom been studied in pathologi-cal gambling. Hence, in analogy with previous research studies examining the role of self-report and neurocognitive measures on relapse in substance dependent patients, the present pilot study was executed. Methods: Twenty-two pathological gamblers and 31 healthy controls took part in this research. They filled in self-report questionnaires measuring impulsive personality (Barratt Impulsiveness Scale, Sensitivity to Punishment and Sensitivity to Reward Questionnaires) and performed neurocognitive tasks measuring impulsivity, decision-making and attentional bias (Iowa Gambling Task, Delay Discounting Task, Stroop Gambling Task). Twelve months later gambling activity was re-examined. Results: Analyses showed that PGs who relapsed (n = 13) did not differ on self-report and neuro-cognitive measures of impulsivity with PGs who did not relapse (n = 9). However, both groups did differ in age at on-set. Finally, healthy controls and PGs differed in some (Barratt Impulsiveness Scale, Stroop Gambling Task), but not all impulsivity measures (Delay Discounting Task, Iowa Gambling Task, Sensitivity to Punishment and Sensitivity to Reward Questionnaires). Conclusions: One-year relapse in pathological gamblers is not predicted by self-report and or neurocognitive measures of impulsivity and decision-making. The similarities in performances between pathological gamblers and healthy controls illustrate the relative health of the examined pathological gamblers. This last finding supports the idea that subtypes of pathological gamblers exist so that different treatment strategies might be needed.
There is broad agreement that cognitive distortions are an integral component of the development, maintenance, and treatment of pathological gambling. There is no authoritative catalog of the distortions that are observed more frequently in pathological gamblers than in others, but several instruments have been successfully developed that measure various distortions of interest, which are reviewed. All of the prominent instruments include measures of the illusion of control (perceiving more personal control over events than is warranted), and almost all include measures of gambler's fallacy (the belief that after a string of one event, such as a coin landing heads, an alternative event, such as the coin landing tails, becomes more likely). Beyond these two errors, there is scant consensus on relevant errors, and a wide variety has been studied. Meta-analyses were conducted on differences between PGs and non-PGs in scores on six published instruments that were developed to measure distortions in gamblers. All instruments reveal large effects using Hedge's g statistic, suggesting that the impact of distortions on PG is robust. Several subscales, assigned diverse names by scale authors, can be viewed as reflecting common distortions. Those judged to assess gambler's fallacy show evidence of more robust effects sizes than those that assess illusion of control. It is recommended that future research focus more specifically on the impact of particular distortions on gambling disorders. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
Impulsivity is a hallmark of problem gambling. However, impulsivity is not a unitary construct and this study investigated the relationship between problem gambling severity and two facets of impulsivity: impulsive action (impaired ability to withhold a motor response) and impulsive choice (abnormal aversion for the delay of reward).
The recruitment includes 65 problem gamblers and 35 normal control participants. On the basis of DSM-IV-TR criteria, two groups of gamblers were distinguished: problem gamblers (n = 38) and pathological gamblers (n = 27) with similar durations of gambling practice. Impulsive action was assessed using a response inhibition task (the stop-signal task). Impulsive choice was estimated with the delay-discounting task. Possible confounds (e.g., IQ, mood, ADHD symptoms) were recorded.
Both problem and pathological gamblers discounted reward at a higher rate than their controls, but only pathological gamblers showed abnormally low performance on the most demanding condition of the stop-signal task. None of the potential confounds covaried with these results.
These results suggest that, whereas abnormal impulsive choice characterizes all problem gamblers, pathological gamblers' impairments in impulsive action may represent an important developmental pathway of pathological gambling.
Temporal or delay discounting refers to the phenomenon that the value of a reward is discounted as a function of time to delivery. A range of models have been proposed that approximate the shape of the discount curve describing the relationship between subjective value and time. Recent evidence suggests that more than one free parameter may be required to accurately model human temporal discounting data. Nonetheless, many temporal discounting studies in psychiatry, psychology and neuroeconomics still apply single-parameter models, despite their oftentimes poor fit to single-subject data. Previous comparisons of temporal discounting models have either not taken model complexity into account, or have overlooked particular models. Here we apply model comparison techniques in a large sample of temporal discounting datasets using several discounting models employed in the past. Among the models examined, an exponential-power model from behavioural economics (CS model, Ebert & Prelec 2007) provided the best fit to human laboratory discounting data. Inter-parameter correlations for the winning model were moderate, whereas they were substantial for other dual-parameter models examined. Analyses of previous group and context effects on temporal discounting with the winning model provided additional theoretical insights. The CS model may be a useful tool in future psychiatry, psychology and neuroscience work on inter-temporal choice.
Background
Several lines of evidence implicate orbitofrontal cortex dysfunction in the pathophysiology of obsessive-compulsive disorder (OCD). The purpose of this study was to investigate neuropsychological dysfunction of the orbitofrontal cortex in children with OCD.
Methods
The Iowa Gambling Task (IGT), which reflects orbitofrontal cortex function, and the Wisconsin Card Sorting Test (WCST), which is associated with functioning of the dorsolateral prefrontal cortex, were administered to 22 children with OCD and 22 healthy controls matched for gender, age, and intelligence.
Results
OCD patients displayed poor performance on the IGT. In contrast, performance on the WCST was not impaired in OCD patients compared to controls.
Conclusions
These findings are in line with previous studies demonstrating that OCD in childhood is associated with a dysfunction of orbitofrontal-striatal-thalamic circuitry.
Consumers often make decisions about outcomes and events that occur over time. This research examines consumers' sensitivity to the prospective duration relevant to their decisions and the implications of such sensitivity for intertemporal trade-offs, especially the degree of present bias (i.e., hyperbolic discounting). The authors show that participants' subjective perceptions of prospective duration are not sufficiently sensitive to changes in objective duration and are nonlinear and concave in objective time, consistent with psychophysical principles. More important, this lack of sensitivity can explain hyperbolic discounting. The results replicate standard hyperbolic discounting effects with respect to objective time but show a relatively constant rate of discounting with respect to subjective time perceptions. The results are replicated between subjects (Experiment 1) and within subjects (Experiments 2), with multiple time horizons and multiple descriptors, and with different measurement orders. Furthermore, the authors show that when duration is primed, subjective time perception is altered (Experiment 4) and hyperbolic discounting is reduced (Experiment 3).
Background:
Pathological gambling (PG) is an impulse control disorder characterized by excessive monetary risk seeking in the face of negative consequences. We used tools from the field of behavioral economics to refine our description of risk-taking behavior in pathological gamblers. This theoretical framework allowed us to confront two hypotheses: (1) pathological gamblers distort winning probabilities more than controls; and (2) pathological gamblers merely overweight the whole probability range. Method Eighteen pathological gamblers and 20 matched healthy participants performed a decision-making task involving choices between safe amounts of money and risky gambles. The online adjustment of safe amounts, depending on participants' decisions, allowed us to compute 'certainty equivalents' reflecting the subjective probability weight associated with each gamble. The behavioral data were then fitted with a mathematical function known as the 'probability weighting function', allowing us to disentangle our two hypotheses.
Results:
The results favored the second hypothesis, suggesting that pathological gamblers' behavior reflects economic preferences globally shifted towards risk, rather than excessively distorted probability weighting. A mathematical parameter (elevation parameter) estimated by our fitting procedure was found to correlate with gambling severity among pathological gamblers, and with gambling affinity among controls.
Conclusions:
PG is associated with a specific pattern of economic preferences, characterized by a global (i.e. probability independent) shift towards risky options. The observed correlation with gambling severity suggests that the present 'certainty equivalent' task may be relevant for clinical use.
Dopamine is widely associated with reward, motivation, and reinforcement learning. Research on dopamine has emphasized its contribution to compulsive behaviors, such as addiction and overeating, with less examination of its potential role in behavioral flexibility in normal, non-pathological states. In the study reviewed here, we investigated the effect of increased tonic dopamine in a two-lever homecage operant paradigm where the relative value of the levers was dynamic, requiring the mice to constantly monitor reward outcome and adapt their behavior. The data were fit to a temporal difference learning model that showed that mice with elevated dopamine exhibited less coupling between reward history and behavioral choice. This work suggests a way to integrate motivational and learning theories of dopamine into a single formal model where tonic dopamine regulates the expression of prior reward learning by controlling the degree to which learned reward values bias behavioral choice. Here I place these results in a broader context of dopamine's role in instrumental learning and suggest a novel hypothesis that tonic dopamine regulates thrift, the degree to which an animal needs to exploit its prior reward learning to maximize return on energy expenditure. Our data suggest that increased dopamine decreases thriftiness, facilitating energy expenditure, and permitting greater exploration. Conversely, this implies that decreased dopamine increases thriftiness, favoring the exploitation of prior reward learning, and diminishing exploration. This perspective provides a different window onto the role dopamine may play in behavioral flexibility and its failure, compulsive behavior.
Pathological gambling (PG) is a behavioural addiction associated with elevated impulsivity and suspected dopamine dysregulation. Reduced striatal dopamine D(2)/D(3) receptor availability has been reported in drug addiction, and may constitute a premorbid vulnerability marker for addictive disorders. The aim of the present study was to assess striatal dopamine D(2)/D(3) receptor availability in PG, and its association with trait impulsivity. Males with PG (n=9) and male healthy controls (n=9) underwent [11C]-raclopride positron emission tomography imaging and completed the UPPS-P impulsivity scale. There was no significant difference between groups in striatal dopamine D(2)/D(3) receptor availability, in contrast to previous reports in drug addiction. However, mood-related impulsivity ('Urgency') was negatively correlated with [11C]-raclopride binding potentials in the PG group. The absence of a group difference in striatal dopamine binding implies a distinction between behavioural addictions and drug addictions. Nevertheless, our data indicate heterogeneity in dopamine receptor availability in disordered gambling, such that individuals with high mood-related impulsivity may show differential benefits from dopamine-based medications.
Consumers often make decisions about outcomes and events that occur over time. This research examines consumers’ sensitivity to the prospective duration relevant to their decisions and the implications of such sensitivity for intertemporal trade-offs, especially the degree of present bias (i.e., hyperbolic discounting). The authors show that participants’ subjective perceptions of prospective duration are not sufficiently sensitive to changes in objective duration and are nonlinearand concave in objective time, consistent with psychophysical principles. More important, this lack of sensitivity can explain hyperbolic discounting. The results replicate standard hyperbolic discounting effects with respect to objective time but show a relatively constant rate ofdiscounting with respect to subjective time perceptions. The results are replicated between subjects (Experiment 1) and within subjects (Experiments 2), with multiple time horizons and multiple descriptors, and with different measurement orders. Furthermore, the authors showthat when duration is primed, subjective time perception is altered (Experiment 4) and hyperbolic discounting is reduced (Experiment 3).
We review 74 experiments with no, low, or high performance-based financial incentives. The modal result has no effect on mean performance (though variance is usually reduced by higher payment). Higher incentive does improve performance often, typically judgment tasks that are responsive to better effort. Incentives also reduce presentation effects (e.g., generosity and risk-seeking). Incentive effects are comparable to effects of other variables, particularly cognitive capital and task production demands, and interact with those variables, so a narrow-minded focus on incentives alone is misguided. We also note that no replicated study has made rationality violations disappear purely by raising incentives.
Sleep deprivation (SD) has detrimental effects on cognition, but the affected psychological processes and underlying neural mechanisms are still essentially unclear. Here we combined functional magnetic resonance imaging and computational modeling to examine how SD alters neural representation of specific choice variables (subjective value and decision conflict) during reward-related decision making. Twenty-two human subjects underwent two functional neuroimaging sessions in counterbalanced order, once during rested wakefulness and once after 24 h of SD. Behaviorally, SD attenuated conflict-dependent slowing of response times, which was reflected in an attenuated conflict-induced decrease in drift rates in the drift diffusion model. Furthermore, SD increased overall choice stochasticity during risky choice. Model-based functional neuroimaging revealed attenuated parametric subjective value signals in the midbrain, parietal cortex, and ventromedial prefrontal cortex after SD. Conflict-related midbrain signals showed a similar downregulation. Findings are discussed with respect to changes in dopaminergic signaling associated with the sleep-deprived state.
The present project utilized the Five Factor Model of personality (FFM; McCrae & Costa, 1990) to clarify the multi-faceted nature of impulsivity. The NEO-PI-R and a number of commonly used impulsivity measures were administered to over 400 young adults. Exploratory factor analyses identified four distinct personality facets associated with impulsive-like behavior which were labeled urgency, (lack of) premeditation, (lack of) perseverance, and sensation seeking. Each of these traits was marked by a different facet of the FFM. Following the initial factor identification, scales to measure each of the personality facets were created and combined to form the UPPS Impulsive Behavior scale. Implications for the understanding of impulsive behavior and the FFM are discussed, as are future applications of the UPPS impulsive behavior scale.
The neural basis of excessive delay discounting and reduced risk sensitivity of pathological gamblers with a particular focus on subjective neural reward representations has not been previously examined.
To examine how pathological gamblers represent subjective reward value at a neural level and how this is affected by gambling severity.
Model-based functional magnetic resonance imaging study with patients and control subjects.
Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf.
Participants were recruited from the local community by advertisement and through self-help groups. A sample of 16 pathological gamblers (according to the DSM-IV definition) was matched by age, sex, smoking status, income, educational level, and handedness to 16 healthy controls.
Pathological gamblers showed increased discounting of delayed rewards and a trend toward decreased discounting of probabilistic rewards compared with matched controls. At the neural level, a significant group × condition interaction indicated that reward representations in the gamblers were modulated in a condition-specific manner, such that they exhibited increased (delay discounting) and decreased (probability discounting) neural value correlations in the reward system. In addition, throughout the reward system, neuronal value signals for delayed rewards were negatively correlated with gambling severity.
The results extend previous reports of a generally hypoactive reward system in pathological gamblers by showing that, even when subjective reward valuation is accounted for, gamblers still show altered reward representations. Furthermore, results point toward a gradual degradation of mesolimbic reward representations for delayed rewards during the course of pathological gambling.
Pathological gambling (PG) has recently been considered as a "behavioral" or nonsubstance addiction. A comparison of the characteristics of PG and substance use disorders (SUDs) has clinical ramifications and could help advance future research on these conditions. Specific relationships with impulsivity and compulsivity may be central to understanding PG and SUDs.
This review was conducted to compare and contrast research findings in PG and SUDs pertaining to neurocognitive tasks, brain function, and neurochemistry, with a focus on impulsivity and compulsivity.
Multiple similarities were found between PG and SUDs, including poor performance on neurocognitive tasks, specifically with respect to impulsive choice and response tendencies and compulsive features (e.g., response perseveration and action with diminished relationship to goals or reward). Findings suggest dysfunction involving similar brain regions, including the ventromedial prefrontal cortex and striatum and similar neurotransmitter systems, including dopaminergic and serotonergic. Unique features exist which may in part reflect influences of acute or chronic exposures to specific substances.
Both similarities and differences exist between PG and SUDs. Understanding these similarities more precisely may facilitate treatment development across addictions, whereas understanding differences may provide insight into treatment development for specific disorders. Individual differences in features of impulsivity and compulsivity may represent important endophenotypic targets for prevention and treatment strategies.
Neuroimaging studies of decision-making have generally related neural activity to objective measures (such as reward magnitude, probability or delay), despite choice preferences being subjective. However, economic theories posit that decision-makers behave as though different options have different subjective values. Here we use functional magnetic resonance imaging to show that neural activity in several brain regions—particularly the ventral striatum, medial prefrontal cortex and posterior cingulate cortex—tracks the revealed subjective value of delayed monetary rewards. This similarity provides unambiguous evidence that the subjective value of potential rewards is explicitly represented in the human brain.
The difficulties inherent in obtaining consistent and adequate diagnoses for the purposes of research and therapy have been pointed out by a number of authors. Pasamanick12 in a recent article viewed the low interclinician agreement on diagnosis as an indictment of the present state of psychiatry and called for "the development of objective, measurable and verifiable criteria of classification based not on personal or parochial considerations, but on behavioral and other objectively measurable manifestations."Attempts by other investigators to subject clinical observations and judgments to objective measurement have resulted in a wide variety of psychiatric rating scales.4,15 These have been well summarized in a review article by Lorr11 on "Rating Scales and Check Lists for the Evaluation of Psychopathology." In the area of psychological testing, a variety of paper-and-pencil tests have been devised for the purpose of measuring specific
This study evaluated delay discounting functions of substance abusing problem gamblers, substance abusing non-problem gamblers, and non-problem gambling/non-substance abusing controls. Subjects chose between hypothetical monetary amounts available after various delays or immediately. In one condition, a USUS$1000 reward was delayed at intervals ranging from 6 h to 25 years. At each delay interval, the immediately available rewards varied from USUS$1 to USUS$999 until choices reflected indifference between the smaller immediate and larger delayed rewards. In a second condition, the delayed reward was USUS$100, and immediate rewards varied from USUS$0.10 to USUS$99.90. In all three groups, hyperbolic discounting functions provided a good fit of the data, and the smaller reward was discounted at a higher rate than the larger reward. Substance abusers discounted delayed rewards at significantly higher rates than non-substance abusing controls, and problem gambling substance abusers discounted delayed rewards at higher rates than their non-problem gambling substance abusing counterparts. Discounting rates were not associated with types or recency of drug use. These results provide further evidence of more rapid discounting of delayed rewards in substance abusers, and especially among substance abusers with a comorbid gambling problem. Rapid discounting of delayed rewards may be a feature central to impulse control and addictive disorders.
To analyse problem gamblers' decision making under conditions of risk and ambiguity, investigated underlying psychological factors associated with their choice behaviour and examine whether decision making differed in strategic (e.g., sports betting) and non-strategic (e.g., electronic gaming machine) problem gamblers.
Cross-sectional study.
Out-patient treatment centres and university testing facilities in Victoria, Australia.
39 problem gamblers and 41 age-, gender- and estimated-IQ-matched controls.
Decision making tasks included the Iowa Gambling Task (IGT) and a Loss Aversion Task. The Prospect Valence Learning (PVL) model was used to provide an explanation of cognitive, motivational and response style factors involved in IGT performance.
Overall, problem gamblers performed more poorly than controls on both the IGT (p = 0.04) and the Loss Aversion Task (p = 0.01), and their IGT decisions were associated with heightened attention to gains (p = 0.003) and less consistency (p = 0.002). Strategic problem gamblers did not differ from matched controls on either decision making task, but non-strategic problem gamblers performed worse on both the IGT (p = 0.006) and the Loss Aversion task (p = 0.02). Furthermore, we found differences in the PVL model parameters underlying strategic and non-strategic problem gamblers' choices on the IGT.
Problem gamblers demonstrated poor decision making under conditions of risk and ambiguity. Strategic (e.g., sports betting, poker) and non-strategic (e.g., electronic gaming machines) problem gamblers differed in decision making and the underlying psychological processes associated with their decisions.
Dysfunctional decision-making in individuals with pathological gambling (PGs) may result from dominating reward-driven processes, indicated by higher impulsivity. In the current study we examined (1) if PGs show specific decision-making impairments related to dominating reward-driven processes rather than to strategic planning deficits and (2) whether these impairments are related to impulsivity. Nineteen PGs according to DSM-IV and 19 matched control subjects undertook the Cambridge Gambling Task (CGT) to assess decision-making. The delay discounting paradigm (DDP) as well as the UPPS Impulsive Behavior Scale (measuring urgency, premeditation, perseverance and sensation seeking) were administered as multidimensional measures of impulsivity. Results revealed that (1) PGs exhibited higher risk seeking and an immediate reward focus in the CGT and, in contrast, comparable strategic planning to the control group. (2) Decision-making impairments were related to more severe delay discounting and, specifically, to increased urgency and less premeditation. Our findings suggest (1) the necessity to disentangle decision-making components in order to improve etiological models of PGs, and (2) that urgency and premeditation are specifically related to disadvantageous decision-making and should be tackled in intervention strategies focusing on emotion tolerance and control strategies.
Humans have the ability to engage in prospective imagery to anticipate the future consequences of present behaviors (Suddendorf & Busby, 2005), but we often let our desire for immediate gratification lead us to devalue larger future consequences in favor of smaller immediate rewards. Discounting large future rewards in favor of smaller immediate rewards is known as delay discounting and increases with greater temporal distance between the rewards (Bickel & Marsch, 2001). One approach to reducing delay discounting is episodic future thinking (Atance & O'Neill, 2001). Episodic future thinking engages the episodic memory in prospectively experiencing future events (Atance & O'Neill, 2001; Schacter, Addis, & Buckner, 2007) and activates brain regions involved in prospective thinking (Benoit, Gilbert, & Burgess, 2011; Schacter et al., 2007). Episodic future thinking during intertemporal decision making reduces delay discounting, with the vividness of prospective imagery predicting the degree of the reduction (Peters & Buchel, 2010).
The inability to delay gratification is related to obesity (Davis, Patte, Curtis, & Reid, 2010; Francis & Susman, 2009; Weller, Cook, Avsar, & Cox, 2008). Delay discounting predicts intake of energy-dense convenience foods in obese women (Appelhans et al., 2012), and poor impulse control predicts a lack of success in weight loss (Best et al., 2012). To determine episodic future thinking's effect on impulsive behavior, we assessed whether episodic future thinking, compared with engagement in a control imagery task, reduced impulsivity and energy intake in overweight and obese individuals.
A variety of cognitive and emotional processes influence the decision-making deficits observed in pathological gambling (PG). This study investigated the role of immediate/delayed sensitivity to reward and punishment, executive functions, impulsivity and explicit knowledge in relation to decision-making performance on the original Iowa Gambling Task (IGT-ABCD) and a variant (IGT-EFGH).
We assessed 131 consecutive patients with a diagnosis of PG by using executive functioning and decision-making tasks, self-report measures of impulsivity and explicit knowledge.
The majority of pathological gamblers (PGs) showed deficits in decision-making, characterized mainly by myopia for the future. Decisions made under risk showed different predictors. Performance on the IGT-ABCD for decisions made under risk was predicted by medium and high levels of explicit knowledge of the task, as well as by scores on the Disorderliness subscale and the degree of Stroop interference. By contrast, IGT-EFGH results were only associated with self-report impulsivity measures.
Decision making in PG involves distinct patterns of deficits, and the predictors differ depending on the reinforcement schedule. Decisions made under risk on the IGT-ABCD are associated with explicit knowledge, executive functions and impulsivity traits related to conscious awareness and control processes. On the IGT-EFGH, however, only impulsivity traits predict decision making. (Am J Addict 2013;22:492-499).
People vary widely in how much they discount delayed rewards, yet little is known about the sources of these differences. Here we demonstrate that neural activity in ventromedial prefrontal cortex (VMPFC) and ventral striatum (VS) when human subjects are asked to merely think about the future-specifically, to judge the subjective length of future time intervals-predicts delay discounting. High discounters showed lower activity for longer time delays, while low discounters showed the opposite pattern. Our results demonstrate that the correlation between VMPFC and VS activity and discounting occurs even in the absence of choices about future rewards, and does not depend on a person explicitly evaluating future outcomes or judging their self-relevance. This suggests a link between discounting and basic processes involved in thinking about the future, such as temporal perception. Our results also suggest that reducing impatience requires not suppression of VMPFC and VS activity altogether, but rather modulation of how these regions respond to the present versus the future.
Discounting tasks were used to evaluate whether gambling and non-gambling college students (categorized based on their scores on the South Oaks Gambling Screen) differed in the degree to which they discounted delayed and probabilistic rewards. Hyperbola-like functions provided equally good descriptions of discounting in both groups. Both groups discounted large delayed amounts less steeply than small delayed amounts, whereas both groups discounted large probabilistic amounts more steeply than small probabilistic amounts. Gamblers discounted probabilistic rewards less steeply than non-gamblers, suggesting that gamblers are impulsive in the sense that they are less affected by risk than non-gamblers. However, gamblers did not discount delayed rewards more steeply than non-gamblers. The results argue against the view that impulsivity is a general trait that includes both an inability to delay gratification and a tendency to take risks.
LEYTON, M., Vezina, P. Striatal Ups and Downs: Their Roles in Vulnerability to Addictions in Humans. NEUROSCI BIOBEHAV REV XX(X) XXX-XXX, 2013. Susceptibility to addictive behaviors has been related to both increases and decreases in striatal function. Both profiles have been reported in humans as well as in animal models. Yet, the mechanisms underlying these opposing effects and the manner in which they relate to the behavioral development and expression of addiction remain unclear. In the present review of human studies, we describe a number of factors that could influence whether striatal hyper- or hypo-function is observed and propose a model that integrates the influence of these opposite responses on the expression of addiction related behaviors. Central to this model is the role played by the presence versus absence of addiction related cues and their ability to regulate responding to abused drugs and other rewards. Striatal function and incentive motivational states are increased in the presence of these cues and decreased in their absence. Alternations between these states might account for the progressive narrowing of interests as addictions develop and point to relevant processes to target in treatment.
a b s t r a c t There is an established link between risk-seeking behavior and problem gambling but it remains unclear whether problem gamblers are specifically attracted to the uncertainty of risky situations. We examined the relation between problem gambling severity and probabilistic discounting of monetary gains and losses among gamblers. Fifty-nine regular gamblers completed two discounting tasks in which they made choices between small, certain outcomes and larger, probabilistic outcomes. Contrary to our hypotheses, results showed that problem gambling severity did not relate to either type of discounting which is inconsistent with the idea that problem gamblers have a general tendency towards more risky choices relative to non-problem gamblers. Participants also completed the Gambling Expectancy Questionnaire (GEQ) that assesses affect-regulation expectancies of gambling. Based on responses to the GEQ, partici-pants were subtyped into one of three groups and degree of discounting was compared across groups. Participants subtyped as having strong expectations that gambling augments positive mood made signif-icantly riskier choices on both discounting tasks versus those subtyped as having strong expectations that gambling relieves negative mood and those subtyped as having neither expectation. This finding suggests that viewing gambling as a way to enhance positive mood may be related to the risk-taking element of gambling.
Behavioral economics examines conditions that influence the consumption of commodities and provides several concepts that may be instrumental in understanding drug dependence. One such concept of significance is that of how delayed reinforcers are discounted by drug dependent individuals. Discounting of delayed reinforcers refers to the observation that the value of a delayed reinforcer is discounted (reduced in value or considered to be worth less) compared to the value of an immediate reinforcer. This paper examines how delay discounting may provide an explanation of both impulsivity and loss of control exhibited by the drug dependent. In so doing, the paper reviews economic models of delay discounting, the empirical literature on the discounting of delayed reinforcers by the drug dependent and the scientific literature on personality assessments of impulsivity among drug-dependent individuals. Finally, future directions for the study of discounting are discussed, including the study of loss of control and loss aversion among drug-dependent individuals, the relationship of discounting to both the behavioral economic measure of elasticity as well as to outcomes observed in clinical settings, and the relationship between impulsivity and psychological disorders other than drug dependence.
The aim of the present study was to examine the relationship between problem gambling severity and decision-making situations that vary in two degrees of uncertainty (probability of outcome is known: decision-making under risk; probability of outcome is unknown: decision-making under ambiguity). For this purpose, we recruited 65 gamblers differing in problem gambling severity and 35 normal controls. Decision-making under ambiguity was assessed with the Iowa Gambling Task (IGT) and the Card Playing Task (CPT). Decision-making under risk was assessed with the Coin Flipping Task (CFT) and the Cups Task. In addition, we included an examination of two working memory components (verbal storage and dual tasking). Results show that problem gamblers performed worse than normal controls on both ambiguous and risky decision-making. Higher problem gambling severity scores were associated with poorer performance on ambiguous decision-making tasks (IGT and CPT) but not decision-making under risk. Additionally, we found that dual task performance correlated positively with decision-making under risk (CFT and Cups tasks) but not with decision-making under ambiguity (IGT and CPT). These results suggest that impairments in decision-making under uncertain conditions of problem gamblers may represent an important neurocognitive mechanism in the maintenance of their problem gambling.
Tobacco use disproportionately affects lower socioeconomic status (SES) groups. Current explanations as to why lower SES groups respond less robustly to tobacco control efforts and tobacco dependence treatment do not fully account for this disparity. The identification of factors that predict relapse in this population might help to clarify these differences. Good candidates for novel prognostic factors include the constellation of behaviors associated with executive function including self-control/impulsiveness, the propensity to delay reward, and consideration and planning of future events. This study examined the ability of several measures of executive function and other key clinical, psychological, and cognitive factors to predict abstinence for highly dependent lower SES participants enrolled in intensive cognitive-behavioral treatment for tobacco dependence. Consistent with predictions, increased discounting and impulsiveness, an external locus of control as well as greater levels of nicotine dependence, stress, and smoking for negative affect reduction predicted relapse. These findings suggest that these novel factors are clinically relevant in predicting treatment outcomes and suggest new targets for therapeutic assessment and treatment approaches.
Although delay discounting, the attenuation of the value of future rewards, is a robust finding, the mechanism of discounting is not known. We propose a potential mechanism for delay discounting such that discounting emerges from a search process that is trying to determine what rewards will be available in the future. In this theory, the delay dependence of the discounting of future expected rewards arises from three assumptions. First, that the evaluation of outcomes involves a search process. Second, that the value is assigned to an outcome proportionally to how easy it is to find. Third, that outcomes that are less delayed are typically easier for the search process to find. By relaxing this third assumption (e.g. by assuming that episodically-cued outcomes are easier to find), our model suggests that it is possible to dissociate discounting from delay. Our theory thereby explains the empirical result that discounting is slower to episodically-imagined outcomes, because these outcomes are easier for the search process to find. Additionally, the theory explains why improving cognitive resources such as working memory slows discounting, by improving searches and thereby making rewards easier to find. The three assumptions outlined here are likely to be instantiated during deliberative decision-making, but are unlikely in habitual decision-making. We model two simple implementations of this theory and show that they unify empirical results about the role of cognitive function in delay discounting, and make new neural, behavioral, and pharmacological predictions.
A total of 1320 Ss (559 males and 761 females) completed the I6 Impulsiveness Questionnaire. Reliabilities, scale intercorrelations, means and standard deviations as well as age means are given after some item changes from the original I5 Questionnaire. The resulting I7 Impulsiveness Questionnaire is reproduced in the Appendix, together with the scoring key. A further 589 Ss (383 males and 206 females) completed the new I7, together with the EPQ and intercorrelations of the seven factors obtained are given (i.e. Psychoticism, Extraversion, Neuroticism, Lie score, impulsiveness Venturesomeness and Empathy). A table of means and standard deviations for this second sample of Ss is also given for the sake of completeness.
The phenomenon of `chasing' has been identified as one of the central characteristics of the behavior of pathological gamblers [American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th ed., DSM IV). Washington, DC: APA]. It consists of more frequent involvement, increased persistence and elevated monetary risk in an effort to recoup money that has been lost. The present research makes a distinction between within- and between-session chasing, and attempts to examine the determinants of within-session chasing in a reasonably valid laboratory analogue. Male college students who gambled (N=248) were given US$10 and an opportunity to gamble. They could: (1) decline to gamble and keep their US$10 (nonplayers); (2) gamble and win even more money by quitting at a more optimal time (nonchasers); or (3) gamble longer than they should, resulting in the loss of all available money (chasers). Zuckerman's impulsivity factor (from the ZKPQ) discriminated chasers from nonchasers. Breen and Zuckerman's Gambling Beliefs and Attitudes Survey (GABS) discriminated players from nonplayers. A sensation-seeking explanation of within-session chasing was not supported. The results are discussed in terms of the impact of impulsivity on within-session chasing. It is suggested that the GABS may serve as a general measure of `affinity' to gambling, and could be useful in examining the process of between-session chasing, that is, returning on another day to `get even'.
Certain clinical aspects of patients with Obsessive-Compulsive Disorder (OCD) appear similar to those of patients with damage to the ventromedial sector of the prefrontal cortex. The hypothesis for the involvement of the frontal region in OCD is also supported by neuropsychological findings. Building on this evidence, we assessed the performance of a group of 34 OCD patients on a measure indexing with orbitofrontal cortex functioning and compared it with the performance of two other subject groups, one consisting of 34 healthy control subjects and the other 16 patients with panic disorder. All study subjects performed a neuropsychological task, which is sensitive to frontal lobe dysfunction and simulating real-life decision-making. Significant differences were found between the neuropsychological profiles of the OCD and of other groups, pointing to a possible specificity of decision-making deficit in OCD. Comparison of the performance of the OCD patients grouped according to response to antiobsessive drug treatment showed that poor neuropsychological task performance predicted poor outcome of pharmacological treatment. Task behavior did not correlate with severity of illness or demographic characteristics of the subjects. Results support the role of the ventromedial prefrontal cortex in OCD.
Mesocorticolimbic neurocircuitry and impulsivity have both been implicated in pathological gambling (PG) and in reward processing. However, the neural underpinnings of specific phases of reward and loss processing in PG and their relationships to impulsivity remain only partially understood. The present functional magnetic resonance imaging study examined brain activity associated with different phases of reward and loss processing in PG. Given an inverse relationship between ventral striatal recruitment during anticipation of monetary rewards and impulsivity in alcohol dependence, the current study explored whether a similar association might also be present in PG.
Fourteen adults with PG and 14 control comparison participants performed the Monetary Incentive Delay Task to identify brain activation changes associated with reward/loss prospect, reward/loss anticipation, and reward/loss notification. Impulsivity was assessed separately using the Barratt Impulsiveness Scale.
Relative to the control comparison group, the PG group exhibited significantly reduced activity in the ventromedial prefrontal cortex, insula, and ventral striatum during several phases, including the prospect and anticipation phases of both gains and losses. Activity in the ventral striatum correlated inversely with levels of impulsivity in PG participants, consistent with prior findings in alcohol dependence.
Relatively decreased activity in corticostriatal neurocircuitry during multiple phases of reward processing suggests consistent alterations in neurocircuitry underlying incentive valuation and loss prediction. Together with findings in alcohol dependence, these results suggest that impulsive tendencies in addictions may be reflected in diminished ventral striatal activations to reward anticipation and may represent targets for treatment development in addictions.
