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How Anxiety Impacts the Economic Decision-Making:
Insights from Neuroscience and Cognitive Psychology
Shan Huang
London School of Economics and Political Science, London, United Kingdom
huangshan_sd@163.com
Abstract: Anxiety is a mental disorder that not only impacts the physical and mental well-
being of individuals but also affects cognitive functions, including decision-making processes.
Does anxiety, as a trait instead of a state, disrupt the normal decision-making process? This
paper explores the impact of anxiety as a trait on the normative decision-making framework,
focusing specifically on economic choices that necessitate a balance between potential losses
and gains. A review and discussion of how anxiety affects decision-making will be discussed
in detail from cognitive psychology and neuroscience perspective. The first section examines
key cognitive differences between anxious and non-anxious individuals, highlighting
cognitive biases that hinder decision-making in those with anxiety. Subsequently, we analyze
the neural mechanisms underlying these processes, emphasizing the roles of critical brain
regions such as the amygdala and prefrontal cortex, along with relevant functional
connectivity, to elucidate how cognitive biases affect individuals with anxiety during
economic decision-making. Lastly, the practical implication of the paper will be discussed.
Keywords: anxiety, cognitive bias, economic decision making, neuroeconomics, decision
neuroscience
1. Introduction
Anxiety, characterized by excessive worry, fear, and heightened sensitivity to potential threats, is one
of the pervasive mental disorders affecting the various aspects of people’s daily lives, including
emotional well-being, physical health, social interactions, work performance and so on [1]. Apart
from that, it also influences the executive function and cognitive processes, including the decision-
making process. Many previous studies using behavioural, cognitive and neurobiological methods
have indicated that anxiety impacts the decision-making process [2-4]. Individuals with generalized
anxiety disorder (GAD) show heightened risk aversion and emotional hyper-vigilance. [5,6]. Building
on evidence that anxiety disrupts the ability to balance risk and reward during decision-making [7],
economic decision-making, which requires substantial cognitive effort and involves considerations
of profit, may also be adversely affected by anxiety. This paper aims to explore the cognitive biases
and neural mechanisms that underlie impaired decision-making in anxious individuals, particularly
in economic contexts involving risk and reward.
Economic decision-making, as an intersection between behavioural economics and decision
psychology, has been widely investigated using financial and psychology tools since it is highly
relevant to everyday life. Incorporating neuroscience into economic decision research is useful for
uncovering the underlying rules since even decision behaviours may be identical but associated with
Proceedings of the 3rd International Conference on Social Psychology and Humanity Studies
DOI: 10.54254/2753-7048/91/2025.22780
© 2025 The Authors. This is an open access article distributed under the terms of the Creative Commons Attribution License 4.0
(https://creativecommons.org/licenses/by/4.0/).
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different underlying neural circuitry [8]. Besides, economic decision-making involves a blend of
emotional regulation, reward processing, and risk evaluation, which are key areas that anxiety to exert
significant influence.
Nowadays, some neuroscience techniques, such as electroencephalogram (EEG), positron
emission tomography (PET) and functional magnetic resonance imaging (fMRI), have been applied
to economics constructing a new view of economic decision-making mechanism, which is the area
called neuroeconomics [9]. In Camerer’s paper, the key brain regions related to economics have been
marked clearly as shown in the figure1. Noticeably, the “prefrontal cortex” related to cognitive
control and “amygdala” related to automatic affect is included, which is also related to anxiety
disorder. Previous researches point out that neuroeconomics can work as a bridge to apply in
psychiatry [10,11] since many mental disorders involve deficient cognitive function and result in an
abnormal decision-making process. Hence, the neuroeconomics framework provides new insights
about analyzing the decision-making process, and with better understanding to the decision-making
process related to mental disorder is helpful to relative intervention and treatment.
Previous studies usually explore the abnormal decision-making process from the behavioural and
cognitive perspective, such as decisions under uncertainty, biased attention, and loss aversion. Few
of them explore the neural mechanism underlying the decision-making of anxious people. Besides,
the scope of many papers focuses on nonclinical or mood anxiety, but few of them focus on clinical
anxiety. This paper will narrow down the focus to how anxiety influences the economic decision-
making process through the cognitive and neuroscience lens. Firstly, cognitive differences in
decision-making between anxious and non-anxious people will be reviewed. Three core areas related
to anxiety cognitive bias: adverse events perception and evaluation, increased emotional interference,
and difficulty in decision-making under uncertainty, will be discussed below. Then, the brain region
associated with anxiety-induced abnormal decision-making processes will be discussed to show how
anxiety influences the neural mechanism of decision-making.
Figure 1: The human brain with some economically relevant areas marked
2. Cognitive bias of anxiety
Various studies have explored the behavioural and cognitive differences between anxious people and
non-anxious ones. Here, three key cognitive biases influencing the decision-making of anxious people
will be illustrated below. Some of them overlap and work together, resulting in making the more
conservative and less rational choices for anxiety population.
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2.1. Adverse events perception and evaluation
People with anxiety tend to exhibit abnormal perceptions and evaluations of adverse events, such as
threat, loss and risk. Characterized by enhanced processing of potential future losses, anxiety leads to
attentional biases toward threat-related stimuli [4, 12-14]. Attentional bias specifically refers to 'the
difficulty in disengaging attention from negative stimuli, relative to neutral or positive stimuli' [15].
A study employing the Risk-Taking Behaviors Scale to assess individuals' propensity for engaging
in risky decision-making found that trait anxiety correlates with pessimistic risk appraisals. This
indicates that individuals with anxiety are more likely to perceive the likelihood and severity of
adverse outcomes as heightened [16]. Furthermore, the gambling task, emphasizing the decision-
making under an economic context that involves monetary loss and gains, is useful for inferring how
anxiety potentially impacts the decision-making processes. An experiment utilizing it to compare the
risk aversion tendencies between anxious individuals and healthy controls revealed that risk aversion
is significantly greater in those with pathological anxiety compared to control subjects (mean risk
preference parameter ρ: anxious = 0.564 ± 0.313; control subjects = 0.875 ± 0.537) [17]. Additionally,
evidenced research using the Iowa Gambling Task to test the exaggerated processing of uncertain
negative events among people with GAD reveals that GAD is characterized by enhanced perception
of potential future losses.
Apart from the behavioural evidence, the pessimistic negative outcome perception also can be
explained from the cognitive perspective. According to the Attentional Control Theory (ACT),
anxiety impacts the attentional processes and overall cognitive performance because of the increased
attention to threat-related stimuli [18], which interfere with the normal evaluation of threat and risk.
Besides, unbalanced risk perception can be explained by the prospect theory [19], a neuroeconomic
model explaining risk aversion behaviours under uncertainty. Currently, Attention Bias Modification
(ABM), a cognitive intervention designed to mitigate threat avoidance in anxious individuals, is being
increasingly implemented in therapeutic settings [20].
Anxiety not only influences the perception of negative outcomes but also affects the processing of
positive ones. Individuals with anxiety often exhibit deficient reward processing, characterized by a
diminished response to positive outcomes. We suggest that this reduced sensitivity to rewards may
lead to more conservative economic choices. Consequently, anxiety tends to increase the preference
for low-risk, low-reward options in decision-making [21].
2.2. Increased emotional interference
Emotional interference refers to intense emotional stimuli that can impair cognitive performance [22].
Given that anxiety is a mood disorder [23], the disproportionate influence of emotions on decision-
making is particularly pronounced in individuals with anxiety. The heightened salience of emotions—
especially exaggerated fear and worry—disrupts rational cognitive processes, making it difficult for
individuals to objectively weigh the pros and cons of decisions. Instead, they are more likely to make
biased, emotion-driven choices.
Research indicates that anxiety is associated with a biased evaluation of emotional information
during decision-making, with neural evidence pointing to a hyperactive emotional system,
particularly the amygdala [24]. The Emotional Stroop task, widely used in cognitive psychology and
neuroscience, assesses how emotional interference affects cognitive performance, particularly in
anxious individuals [25,26]. These studies consistently conclude that emotional interference is
heightened in individuals with high levels of state anxiety. Notably, findings from a study [27] suggest
that attention biased towards emotionally salient stimuli exacerbates emotional interference with
normal cognitive processes. This interference is especially relevant in consumer behavior, where
anxiety can lead to impulsive purchasing decisions [28].
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The dual-system model, proposed by Evans [29], also sheds light on how anxiety interferes with
decision-making through emotional pathways. This model divides the process of decision making
into contributions from system 1 (autonomous and emotional) and system 2 (analytical and deliberate).
Since anxiety is characterised by heightened sensitivity to emotional information [30], individuals
with anxiety are more likely to rely on System 1 (fast, automatic, emotional thinking) when
confronted with intense emotional stimuli. This emotional interference diminishes their ability to
engage in deliberate, rational thinking. Studies utilizing EEG and fMRI techniques have shown that
anxious individuals have impaired working memory compared to those with low anxiety [31,32].
These findings align with previous research [24], which used a dual-system framework to explain
decision-making in anxiety with greater activity in the amygdala-based emotional system and less
activity in the analytic one.
2.3. Difficulty in decision-making under uncertainty
Decision-making under uncertainty is a pervasive topic investigated in neuroeconomics [9,33] since
it is associated with how people balance the distribution of possible outcomes. Key brain regions
implicated in this process include the insular cortex (INS) and the prefrontal cortex (PFC) [34,35].
Individuals with anxiety often find decision-making under uncertainty and ambiguity particularly
challenging due to their heightened sensitivity to potential errors or conflicts. This increased
sensitivity can lead to indecision. Additionally, for anxious individuals, uncertainty can negatively
impact decision-making by diminishing the perceived value of future rewards, leading them to prefer
options with shorter delays in payoff [36].
Other theorists have developed frameworks to explain how anxiety influences decision-making in
uncertain situations. One research [37] propose the Intolerance of Uncertainty theory to explore the
relationship between intolerance of uncertainty and emotional problems. This model posits that
individuals with anxiety have a lower tolerance for uncertainty, making them more prone to distress
in uncertain situations. Taking investment as an example, anxious individuals are likely to forego
greater profits with small uncertainty of risk to obtain smaller gains portfolios. The later similar
research focus on clinical anxiety further illustrates how intolerance of uncertainty contributes to
excessive worry among GAD patients [38]. Another model, the 'uncertainty and anticipation model
of anxiety' (UAMA), proposed by Grupe [39], identifies five processes explaining why uncertainty
about future threats is so disruptive in anxiety. As shown in Figure 2, this model emphasizes that
individuals with anxiety exhibit exaggerated anticipatory responses to uncertainty, driven by the
hyperactivity of the brain's threat detection systems, particularly the amygdala. Specifically, during
the stage of heightened threat attention and hypervigilance (stage b in Figure 2), individuals
experience increased emotional sensitivity to uncertain situations, leading to intensified reactions to
perceived threats. Collectively, these five processes culminate in heightened threat expectancy among
those with anxiety.
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Figure 2: The five stages of altered anticipatory processes in response to uncertainty in anxiety
3. Neural mechanism of decision-making among anxiety
Next, it will analyze from the neuroscience perspective based on the cognitive difference mentioned
above. The studies based on microeconomics have highlighted a network of brain regions including
the striatum, amygdala, vmPFC, insula, and dlPFC are associated with the cognition function for
decision-making, which also the region involves emotion processing [2]. Below, we will analyze and
discuss two key brain regions, the amygdala and prefrontal cortex, as well as their functional
connectivity implicating anxiety, to uncover the neural mechanism related to abnormal decision-
making processes.
3.1. Amygdala: heightened emotional processing
The amygdala, an almond-shaped structure in the temporal lobe, is central to processing emotions
[40], particularly automatic affective responses such as fear and anxiety. In anxious individuals, the
amygdala tends to be hyperactive [41, 42], leading to heightened sensitivity to potential threats. Also,
“amygdala damage is associated with impairment in decision-making” [43] suggests the amygdala
did play a role in the decision-making process [44, 45]. In short, the heightened emotional processing
of the amygdala related to anxiety disorder generates a potential influence on the decision-making
process [2].
The abnormal amygdala activity can account for the salience-averse event perception and
evaluation among anxious people. The heightened activity of the amygdala can result in an
exaggerated perception of risk, making anxious individuals more likely to avoid negative outcomes,
such as risk and loss during economic decisions. It has been supported by some fMRI studies. For
instance, a study by [46] examined whether the amygdala is involved in the computational processes
underlying loss aversion in a monetary gambling context. Participants with amygdala lesions
exhibited a marked absence of loss aversion during the task. The findings reveal that the amygdala
plays a necessary role in shaping everyday financial decisions by contributing to monetary loss
aversion, as it inhibits actions that may lead to harmful outcomes. Another fMRI study focuses on the
functional dissociation within the human amygdala with aversive information processing indicating
a similar result [47]. Investigating the sub-regions of the amygdala suggests that highly anxious
individuals show increased activity in the basolateral amygdala (BLA) for aversive cues, which may
explain why people with high anxiety tend to be risk aversion or threat avoidance.
Furthermore, the emotional interference affected by abnormal activity in amygdala influences the
economic decision-making among anxious individuals. Generally, the heightened activation of the
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amygdala and reduced regulatory control from the PFC can lead to decisions that are more
emotionally driven rather than rational. Etkin team’s research [41] using fMRI have demonstrated
that individuals with anxiety show increased amygdala activation when exposed to emotional stimuli,
such as images of fearful faces. This hyperactive activity leads to an exaggerated response to
emotionally salient information and interferes with decision-making further step by prioritizing
emotional responses over logical or rational considerations. Also, the bed nucleus of the stria-
terminalis, located in the ventral basal forebrain and often considered part of the "extended
amygdala," seems to contribute to the emotional distress (such as a prolonged state of arousal and
heightened vigilance) typically seen in individuals with anxiety [48]. The sustained hyperarousal state
causes individuals to be very cautious and deliberate when deciding on economic or financial choices
that involve deep considerations. Hence, the emotional interference caused by anxiety distorts rational
thinking during the economic decision-making process.
Apart from the influence on risk perception and emotional interference, difficulty in making
decisions under anxiety is also associated with elevated amygdala activity. Researchers proposed the
UMMA model also explains from the neuro perspective, they found that maladaptive responses to
uncertainty in anxiety involved the amygdala [39]. They suggest that amygdala responses under
conditions of uncertainty are elevated. Besides, another study draws a similar conclusion, it shows
that even without any adverse outcome following, the unpredictability or uncertainty itself can elicit
increased amygdala activity and induce anxious behaviour among human subjects [49]
In sum, anxious people experience difficulty in making decisions under uncertainty due to the
hyperactive activity in the amygdala, resulting in risk-aversion bias and less rational decision-making.
For the economic decision context which involves the monetary gains and loss, I propose that the
elevated amygdala activity plays a crucial role in distorting the normal decision-making processing.
3.2. Prefrontal cortex: impaired executive function
The PFC is primarily responsible for cognitive control and higher-order executive functions [50],
including planning, impulse regulation, and evaluating long-term consequences. Same as the
amygdala, the prefrontal cortex (PFC) is a key brain region affecting both anxiety [51] and decision-
making [43, 52]. It facilitates the balance between immediate rewards and future benefits. Specifically,
the ventromedial prefrontal cortex (vmPFC) is involved in reward evaluation, while the dorsolateral
prefrontal cortex (dlPFC) exerts control, enabling individuals to prioritize long-term gains over
immediate temptations in decision-making [53].
Firstly, the PFC's reduced cognitive control is evident in its less efficient regulation of emotional
responses from the amygdala [2]. Since economic decision-making usually involves the considered
balancing loss and gains, the reduced regulatory control can lead to heightened emotional reactivity
and an exaggerated tendency to make impulse choices, which finally leads to poorer decision-making.
Consequently, the impaired impulse control of the PFC prevents it from properly regulating the
emotional interference aroused by anxiety.
Besides, a previous paper review of the relationship between anxiety and decision-making
concludes that anxiety impairs part of the prefrontal cortex-dependent cognitive function and reduces
its ability to modulate these prepotent tendencies [2]. The impairment of the PFC may shape or
influence cognitive processes since it is related to various cognitive executive functions. For instance,
attention control involves the lateral PFC circuitry, and evidence suggests there is reduced lateral PFC
activity among people with heightened anxiety [30]. Hence, anxious individuals find it hard to remove
their attention from threat-related stimuli, which drives their cognition to make risk-aversion
decisions. Also, anxiety not only attention control but also working memory. During a visuospatial
task that requires memory, people with anxiety display reduced PFC activation during tasks since
anxiety taxes cognitive resources by loading emotional processing circuits [54]. Thus, it can be
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inferred here that emotional distractions impact the executive cognitive functions that require mental
effort. And people with high anxiety may be lost in indecision.
Furthermore, the papers using fMRI and transcranial magnetic stimulation (TMS) respectively
demonstrate dlPFC related to risk aversion, the increased dlPFC activity decreases the risky
preference [55], while disruption of it increases the tendency to make risky choices [56]. The paper
suggests that dlPFC of the anxiety population inhibits their risk-seeking predisposition mediated by
the orbitofrontal cortex. It emphasizes the risk aversion tendency during the decision-making process
mediated by dlPFC among anxious people.
3.3. Alter functional connectivity
A singular brain region cannot adequately explain the complexity of anxiety-related processes, as
abnormal brain activity involves interactions among multiple key structures. For example, as
discussed earlier, trait and clinical anxiety are associated with reduced prefrontal engagement.
Expanding on this,Sehlmeyer et al. [57] explored how anxiety affects the interplay between various
brain regions from a fear control perspective. Given that both the amygdala and PFC are involved in
the fear response or control of fear, their study demonstrated that elevated levels of trait anxiety are
linked to increased amygdala activation and decreased recruitment of the dorsal anterior cingulate
cortex (dACC) during fear extinction. The influence of both the hyper-responsitivity of the amygdala
and the deficient cognitive control in anxious subjects reflect an increased resistance to extinct fear
responses and may potentially reinforce the vulnerability of anxiety disorders.
Functional connectivity studies capture the complexity of brain interactions, providing a more
comprehensive, dynamic, and network-based understanding of how anxiety affects decision-making.
As shown in figure 3, a ROI analysis based on the fMRI experiment explores how the amygdala and
vmPFC functional connectivity are impacted by anxiety. The result indicates the functional
connectivity between the amygdala and vmPFC was significantly positively correlated with trait
anxiety (r = 0.61, p < 0.01) [24]. Also, Bishop’s study [51] highlights that anxiety alters the balance
of activity within the amygdala-prefrontal circuitry, leading to a bias toward threat-related responses.
The findings suggest that anxiety plays a central role in influencing both the representation of a
stimulus's emotional salience and the top-down control of attentional processes. Therefore, it can be
inferred that when the anxious population face economic or financial decisions, such as investment
or gambling, their impulse or less rational choices are driven by a distorted top-down cognitive
process.
Figure 3: The amydala-prefrontal circuitry on trait anxiety
Figure 4 depict the abnormalities in the neural circuitry associated with decision bias among
anxious people, based on the UAMA model proposed by Grupe[36]. It emphasize the dynamic
process of how amygdala, dorsomedial prefrontal cortex (dmPFC), orbitofrontal cortex (OFC),
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ventral striatum (VS) and anterior insula (AI) work together result of the heightened reactivity to
uncertainty for anxiety people. Specifically, as shown in the figure 4. step (b), hyper-vigilance and
heightened threat perception in anxiety are the result of interactions between the amygdala, OFC),
and VS. And as indicates in step (e)the responses to uncertainty are linked to dysfunction in the
anterior insula, which is associated with an elevated intolerance of uncertainty and further contributes
to amygdala hyperactivity. Together, these findings illustrate the complex processes by which various
brain circuits and cognitive functions are impacted by anxiety.
Figure 4: Neural regions and circuitry implicated in the UAMA
4. Discussion and conclusion
Grupe [36] notes that anxiety and its associated disorders have not traditionally been examined
through the lens of decision-making. As a result, much of the evidence discussed in this paper
addresses through the lens of decision-making or anxiety independently to infer how anxiety impact
decision-making processing, due to the scarcity of explicit research connecting the two.
This paper firstly explores the cognitive biases that individuals with anxiety may exhibit during
the decision-making process, particularly within an economic context. It presents three key biases
closely associated with anxiety, supported by both behavioral and cognitive evidence. The cognitive
biases discussed here pertain to value, risk, and uncertainty—key components that must be considered
in economic decision-making. First, anxious individuals often exhibit heightened attention to
potential negative outcomes, leading them to avoid risk. As a result, they may be more inclined to
purchase insurance or select less risky options to ensure security in their decisions. Additionally, due
to increased emotional interference, individuals with anxiety are more prone to making less rational
decisions, such as engaging in impulsive buying. Lastly, anxiety can exacerbate indecision,
particularly when faced with uncertainty, making it difficult for them to arrive at clear decisions.
The following section examines how anxiety shapes the decision-making process from a
neuroscience perspective. Generally, anxiety is associated with heightened amygdala activity and
reduced PFC activity, alongside increased functional connectivity with heightened trait anxiety. The
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impaired cognitive control and heightened emotional responses help explain the cognitive biases
observed in individuals with anxiety.
Therefore, the paper implies the cognitive characteristics and neural mechanisms underlying the
economic decision-making processes with anxiety. Understanding these mechanisms has significant
practical implications for decision-making, especially for economic decisions which involve putting
into cognitive efforts. Some tailored suggestions and interventions can be provided for anxious people
to help them make rational decisions. For example, recognizing that anxious individuals may be more
risk-averse in high-stress financial contexts, emotional regulation and more balanced choices should
be provided to anxious individuals. Or, giving them a second chance to double-check their choices
before making the payment to mitigate the impulsive consumption.
Some limitations are admitted here, firstly, the investigations of the amygdala and PFC are not
covered in detail, and even though some sub-regions of PFC are mentioned in the paper, the analysis
is not deep and comprehensive. And the potential impact from neurotransmitters is not mentioned
here. Secondly, instead of attention and memory, some other cognitive functions that are relevant to
decision-making are understudies. In addition, there is a lack of contextual variability in economic
decisions. Therefore, future research should delve deeper into the interplay between anxiety and
decision-making across different economic and cognitive contexts, such as long-term financial
planning or high-risk investment environments. Additionally, further investigation into the role of
specific subregions within the prefrontal cortex, such as the mlPFC and dACC, in regulating decision-
making under anxiety could provide more nuanced insights. Lastly, even though the paper stand from
a neuroeconomics perspective, other areas, for example computational psychiatry, can be integrated
to provide insights about mental disorder impact the decision-making process. For example, calculate
the probability of how likely people will choose the preference for risk in an economic decision based
on the prediction errors in ventral stratum related to gains and loss will be interesting and meaningful.
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