Gambling Paradigm Research Articles

Altered activation in association with reward-related trial-and-error learning in patients with schizophrenia

In patients with schizophrenia, the ability to learn from reinforcement is known to be impaired. The present fMRI study aimed at investigating the neural correlates of reinforcement-related trial-and-error learning in 19 schizophrenia patients and 20 healthy volunteers. A modified gambling paradigm was applied where each cue indicated a subsequent number which had to be guessed. In order to vary predictability, the cue-number associations were based on different probabilities (50%, 81%, 100%) which the participants were not informed about. Patients' ability to learn contingencies on the basis of feedback and reward was significantly impaired. While in healthy volunteers increasing predictability was associated with decreasing activation in a fronto-parietal network, this decrease was not detectable in patients. Analysis of expectancy-related reinforcement processing yielded a hypoactivation in putamen, dorsal cingulate and superior frontal cortex in patients relative to controls. Present results indicate that both reinforcement-associated processing and reinforcement learning might be impaired in the context of the disorder. They moreover suggest that the activation deficits which patients exhibit in association with the processing of reinforcement might constitute the basis for the learning deficits and their accompanying activation alterations.

Developmental brain alterations in 17 year old boys are related to antenatal maternal anxiety

To assess the association between maternal anxiety during pregnancy and the brain activity of 17 year old adolescents performing two cognitive control tasks. Twenty-three 17 year old boys of mothers whose level of anxiety was measured during pregnancy were investigated using ERP while performing a Go/Nogo paradigm assessing exogenous cognitive control and a Gambling paradigm requiring endogenous cognitive control. No effects of antenatal maternal anxiety were observed in the Go/Nogo paradigm. However, in the Gambling paradigm adolescents of the high anxiety group (n=8) showed a less efficient pattern of decision making compared to the adolescents in the low-average anxiety group (n=15). Moreover, only for this task the ERP data showed an enlarged early frontal P2a component in the high anxiety group. The brain activity of adolescents during an endogenous cognitive control task is associated to the level of anxiety experienced by their mother during pregnancy. This association was not observed during an exogenous cognitive control task. This study indicates that a child's brain functionality is related to its mother's anxiety during pregnancy. Endogenous cognitive control is regarded the cognitive function most affected by the level of antenatal maternal anxiety.

Dissociable processes underlying decisions in the Iowa Gambling Task: a new integrative framework

BackgroundThe Iowa Gambling Task (IGT) is a common paradigm used to study the interactions between emotions and decision making, yet little consensus exists on the cognitive process determining participants' decisions, what affects them, and how these processes interact with each other. A novel conceptual framework is proposed according to which behavior in the IGT reflects a balance between two dissociable processes; a cognitively demanding process that tracks each option's long-term payoff, and a lower-level, automatic process that is primarily sensitive to loss frequency and magnitude.MethodsA behavioral experiment was carried out with a modified version of IGT. In this modified version, participants went through an additional phase of interaction, designed to measure performance without further learning, in which no feedback on individual decisions was given. A secondary distractor task was presented in either the first or the second phase of the experiment. Behavioral measures of performance tracking both payoff and frequency sensitivity in choices were collected throughout the experiment.ResultsConsistent with our framework, the results confirmed that: (a) the two competing cognitive processes can be dissociated; (b) that learning from decision outcomes requires central cognitive resources to estimate long-term payoff; and (c) that the decision phase itself can be carried out during an interfering task once learning has occurred.ConclusionThe experimental results support our novel description of the cognitive processes underlying performance in the Iowa Gambling Task. They also suggest that patients' impairments in this and other gambling paradigms can originate from a number of different causes, including a failure in allocating resources among cognitive strategies. This latter interpretation might be particularly useful in explaining the impairments of patients with ventromedial prefrontal cortex lesions and, by extension, the contribution of this brain region to human decision making.

Brain signatures of monetary loss and gain: Outcome-related potentials in a single outcome gambling task

This study evaluates the event-related potential (ERP) components in a single outcome gambling task that involved monetary losses and gains. The participants were 50 healthy young volunteers (25 males and 25 females). The gambling task involved valence (loss and gain) and amount (50¢ and 10¢) as outcomes. The outcome-related negativity (ORN/N2) and outcome-related positivity (ORP/P3) were analyzed and compared across conditions and gender. Monetary gain (compared to loss) and higher amount (50¢ compared to 10¢) produced higher amplitudes and shorter latencies in both ORN and ORP components. Difference wave plots showed that earlier processing (200–400 ms) is dominated by the valence (loss/gain) while later processing (after 400 ms) is marked by the amount (50¢/10¢). Functional mapping using Low Resolution Electromagnetic Tomography (LORETA) indicated that the ORN separated the loss against gain in both genders, while the ORP activity distinguished the 50¢ against 10¢ in males. This study further strengthens the view that separate brain processes/circuitry may mediate loss and gain. Although there were no gender differences in behavioral and impulsivity scores, ORN and ORP measures for different task conditions had significant correlations with behavioral scores. This gambling paradigm may potentially offer valuable indicators to study outcome processing and impulsivity in normals as well as in clinical populations.

ERP correlates of complex human decision making in a gambling paradigm: Detection and resolution of conflict

The present event-related potential study investigated the correlates of decision making in relation to the amount of response conflict. In a gambling paradigm, response conflict was introduced by giving participants the option to either gamble or pass. Second, the odds and gains in each trial were manipulated to make the decision to gamble or pass determined or underdetermined. Underdetermined trials included an extra conflict. The N2 was modulated by the mere presence of conflict. In contrast to both conflict monitoring and inhibition theories for N2, these results suggest that an enhancement in N2 reflects the mere detection of conflicting alternatives. The P3 showed a fronto-central increase in amplitude in trials including two forms of response conflict compared to trials including only one conflict. These findings suggest that P3 reflects part of the conflict resolution processes.

Decision‐making in ADHD: sensitive to frequency but blind to the magnitude of penalty?

Decision-making and reinforcement sensitivity were investigated in 23 children with ADHD and 20 healthy controls using a gambling paradigm. Children were required to choose between three alternatives that carried (A) small rewards and small penalties (advantageous), (B) large rewards and increasing penalties and (C) small rewards and increasing penalties (both disadvantageous). Penalties increased either in frequency or magnitude in two independent conditions. Heart rate (HR) and skin conductance (SC) were measured to examine whether impaired decision-making was accompanied by autonomic abnormalities. Children with ADHD showed a maladaptive response style compared to controls by demonstrating a smaller preference for the advantageous alternative, when penalties increased in magnitude. When penalties increased in frequency, children with ADHD performed like controls. Group differences in decision-making attenuated after the task was administered twice. Compared to controls, performance of children with ADHD in the magnitude condition was accompanied by increased HR acceleration following reward. In this condition, the post-selection SC of children with ADHD was larger for advantageous than for disadvantageous alternatives, in contrast to controls who showed an opposite SC pattern. The current findings suggest that during decision-making, children with ADHD may be sensitive to the frequency but blind to the magnitude of penalty.

Underlying Cognitions in Children's Gambling Behavior: Can they be Modified?

Research examining cognitive perceptions among children has suggested the importance of perceived skill and luck in initiating and maintaining gambling behavior. Using an experimentally manipulated gambling paradigm modifying rates of reinforcement the results suggest, in general, that one can modify these cognitions. More importantly, the results from the gambling task were found to generalize to multiple forms of gambling and were maintained over a relatively short period of time. The modifications of these perceptions appear to be easier for younger children (age 10 vs 12), with differential effects being found for boys and girls. The results are discussed in light of our current prevention initiatives and programs.

Dissociable but inter-related systems of cognitive control and reward during decision making: Evidence from pupillometry and event-related fMRI

Decision making involves the allocation of cognitive resources in response to expectations and feedback. Here we explored how frontal networks respond in a gambling paradigm in which uncertainty was manipulated to increase demands for cognitive control. In one experiment, pupil diameter covaried with uncertainty during decision making and with the degree to which subsequent outcomes violated reward expectations. In a second experiment, fMRI showed that both uncertainty and unexpected outcomes modulated activation in a network of frontal regions. Thus, the frontal network supports multiple phases of the decision-making process including information regarding reward uncertainty and reward outcome. In contrast, striatal activation only tracked reward delivery, suggesting a distinct reward pathway that might, under certain circumstances, oppose the frontal network. These results are consistent with the interpretation that reward signals may bias recruitment of frontal networks that are linked to allocation of cognitive resources.

The Simulated Gambling Paradigm Applied to Young Adults: An Examination of University Students' Performance

Simulated gambling tasks have become popular as sensitive tools for identifying individuals with real-time impairment in decision making. Various clinical samples, especially patients with damage to the ventromedial prefrontal cortex, perform poorly on these tasks. The patients typically persist in choosing risky (disadvantageous) card decks instead of switching to safer (advantageous) decks. In terms of Damasio's (1994) somatic marker hypothesis, the poor performance stems from defective integration of emotional and rational aspects of decision making. Less information is available about performance in healthy populations, particularly young adults. After administering a computerized gambling task to 141 university students, we found that individuals in this population also tend to prefer disadvantageous decks to advantageous decks. The results indicate that performance is governed primarily by the frequency of positive outcomes on a trial-by-trial basis rather than by the accumulation of winnings in the longer term. These findings are discussed in light of the cognitive literature pertaining to the simulated gambling paradigm.

Disruption of Right Prefrontal Cortex by Low-Frequency Repetitive Transcranial Magnetic Stimulation Induces Risk-Taking Behavior

Decisions require careful weighing of the risks and benefits associated with a choice. Some people need to be offered large rewards to balance even minimal risks, whereas others take great risks in the hope for an only minimal benefit. We show here that risk-taking is a modifiable behavior that depends on right hemisphere prefrontal activity. We used low-frequency, repetitive transcranial magnetic stimulation to transiently disrupt left or right dorsolateral prefrontal cortex (DLPFC) function before applying a well known gambling paradigm that provides a measure of decision-making under risk. Individuals displayed significantly riskier decision-making after disruption of the right, but not the left, DLPFC. Our findings suggest that the right DLPFC plays a crucial role in the suppression of superficially seductive options. This confirms the asymmetric role of the prefrontal cortex in decision-making and reveals that this fundamental human capacity can be manipulated in normal subjects through cortical stimulation. The ability to modify risk-taking behavior may be translated into therapeutic interventions for disorders such as drug abuse or pathological gambling.

Do patients with inflammatory bowel disease want genetic testing?

Inflammatory bowel disease (IBD) is a complex genetic disorder characterized by nonmendelian inheritance, incomplete penetrance, and disease susceptibility but not disease certainty. Genotype and phenotype associations are described, but the level of interest of patients with IBD in genetic testing for themselves or at-risk family members remains unknown. Thus, the goal of this study was to assess the interest of patients with IBD in genetic testing and their willingness to accept the uncertainty inherent in complex genetics. Consecutive outpatients with IBD were recruited to complete a 57-item self-administered survey. The survey included a layperson explanation of the limits of IBD genetics. A 5-point Likert scale was used to determine willingness to undergo genetic testing to determine diagnosis, prognosis, and treatment; to help their family; and to advance medical knowledge. The IBD Questionnaire, a validated measure of the health status attitudes of patients with IBD, was used. To determine limits of patient interest in testing family members, the standard reference gamble paradigm was used. Patients were presented with situations for the genetic test with various levels of certainty in 10% decrements starting with 100%. They indicated the lowest degree of certainty that they would accept to test their family member. One hundred fourteen patients (mean age 38.4 years; 48.2% women) completed the survey. Of these 114, 71.9% (82) had Crohn's disease. Among the patients who answered questions on self-willingness, 76.8% (86 of 112) would undergo testing for diagnostic confirmation, 81.3% (91 of 112) for prognostic value, 88.4% (99 of 112) for therapeutic decision making, and 85.0% (96 of 113) for advancement of medical knowledge. We found that 28.1% of patients (32 of 114) had a first-degree relative with IBD. Those patients with a first-degree relative with IBD were more willing to undergo genetic testing than those without a first-degree relative with IBD (raw score on self-willingness 4.62 vs 4.36; P=0.026). There was no significant association between patients' health status and their willingness to undergo genetic testing (IBD Questionnaire score and raw score on self-willingness; Spearman's correlation coefficient -0.06; P=0.51). We also found that 88.6% of patients (93 of 105) indicated an interest in testing family members if the test provided absolute certainty of future disease. The average lowest level of certainty these patients were willing to accept was 42.2%. Despite the complexity of IBD genetics, most patients with IBD are interested in testing and willing to accept a variable degree of uncertainty about the results. An important minority of patients does not wish to be tested. Future work should better identify the reasons for these different attitudes. This information should be factored into plans for widespread clinical testing.

An fMRI study of reward-related probability learning

The human striatum has been implicated in processing reward-related information. More recently, activity in the striatum, particularly the caudate nucleus, has been observed when a contingency between behavior and reward exists, suggesting a role for the caudate in reinforcement-based learning. Using a gambling paradigm, in which affective feedback (reward and punishment) followed simple, random guesses on a trial by trial basis, we sought to investigate the role of the caudate nucleus as reward-related learning progressed. Participants were instructed to make a guess regarding the value of a presented card (if the value of the card was higher or lower than 5). They were told that five different cues would be presented prior to making a guess, and that each cue indicated the probability that the card would be high or low. The goal was to learn the contingencies and maximize the reward attained. Accuracy, as measured by participant's choices, improved throughout the experiment for cues that strongly predicted reward, while no change was observed for unpredictable cues. Event-related fMRI revealed that activity in the caudate nucleus was more robust during the early phases of learning, irrespective of contingencies, suggesting involvement of this region during the initial stages of trial and error learning. Further, the reward feedback signal in the caudate nucleus for well-learned cues decreased as learning progressed, suggesting an evolving adaptation of reward feedback expectancy as a behavior–outcome contingency becomes more predictable.

Neural predictive error signal correlates with depressive illness severity in a game paradigm

Considerable experimental evidence supports the existence of predictive error signals in various brain regions during associative learning in animals and humans. These regions include the prefrontal cortex, temporal lobe, cerebellum and monoamine systems. Various quantitative theories have been developed to describe behaviour during learning, including Rescorla–Wagner, Temporal Difference and Kalman filter models. These theories may also account for neural error signals. Reviews of imaging studies of depressive illness have consistently implicated the prefrontal and temporal lobes as having abnormal function, and sometimes structure, whilst the monoamine systems are directly influenced by antidepressant medication. It was hypothesised that such abnormalities may be associated with a dysfunction of associative learning that would be reflected by different predictive error signals in depressed patients when compared with healthy controls. This was tested with 30 subjects, 15 with a major depressive illness, using a gambling paradigm and fMRI. Consistent with the hypothesis, depressed patients differed from controls in having an increased error signal. Additionally, for some brain regions, the magnitude of the error signal correlated with Hamilton depression rating of illness severity. Structural equation modelling was used to investigate hypothesised change in effective connectivity between prespecified regions of interest in the limbic and paralimbic system. Again, differences were found that in some cases correlated with illness severity. These results are discussed in the context of quantitative theories of brain function, clinical features of depressive illness and treatments.

Beyond the gambling paradigm: internal controllability in decision-making.

Much research within decision-making has used the standard gambling paradigm, where decision outcomes depend only on chance. Many real life decisions, however, imply personal control over decision outcomes. This paper addressed the question of how internal controllability influences decision-making. Internal controllability is assumed (i) to enhance unrealistic optimism and (ii) to result in a better cost:benefit ratio. Both tendencies support each other and predict an enhanced attractiveness for internal and controllable choice options. Participants read a scenario and made a decision afterwards. Results supported the prediction: decision-makers take the option they can personally control. This finding widens the narrow perspective inherent in much previous research based on the gambling paradigm.

Consequences of Regret Aversion 2: Additional Evidence for Effects of Feedback on Decision Making

We discuss the effects of anticipated and experienced regret on decision making under uncertainty. In previous research, using the standard, context-free, gamble paradigm, we found that decision makers anticipate the regret they can experience as a result of post-decisional feedback on forgone outcomes (Zeelenberg, Beattie, van der Pligt, & de Vries, 1996). In the present research we move away from the gamble paradigm, on to richer contexts. In Experiments 1 and 2, involving investment decision making and decision making in the ultimatum game, it is shown that the expectation of feedback on forgone outcomes influences decision making and can promote more risk seeking behavior. Experiment 3 focused on effects of retrospective regret and shows that actual feedback on foregone outcomes influences the experience of regret and subsequent decision making. The results of these studies support our earlier work on regret aversion.

A Reverse Outcome Bias: The Influence of Multiple Reference Points on the Evaluation of Outcomes and Decisions

Two experiments examined the influence of multiple reference points on the evaluation of outcomes and decisions that lead to those outcomes. Norm theory is applied as a conceptual framework for understanding the conditions under which alternative norms may be evoked by the decision context and how they are subsequently used as reference points in the evaluation process. Of primary interest, in these studies, was how an outcome is evaluated when two reference points, the status quo and an evoked alternative, provide conflicting information about the "goodness" of the outcome (the outcome is good from the perspective of one reference point and bad from the perspective of the other). A gambling paradigm, based on regret theory, is employed to address these questions. We find that an alternative outcome is more likely to be evoked as a reference point when: (1) it is certain that another choice would have led to the alternative outcome; (2) a social comparison other receives the alternative outcome; and (3) the alternative outcome is in a different evaluative domain than the outcome received (i.e., is negative when the outcome received is positive). When these conditions hold, and the alternative outcome is used as a reference point for evaluation, the evaluations which result are quite counterintuitive: winners are rated as more regretful over their choices than losers are considered to be less satisfied with their outcomes than losers, and are rated as having made poorer quality decision than losers, who made the same choice! The latter finding represents a complete reversal of the outcome bias often observed in judgments of decisions made under uncertainty.

Decision making in a schizophrenic population.

Over the past decade, competence to make decisions has become a prominent topic in forensic psychology. We employed a gambling paradigm to measure ability to weigh risks, benefits, and probabilities in an internally consistent manner. Decision-making behavior of chronic, involuntarily committed schizophrenic inpatients was compared to outpatient schizophrenics and first-degree relatives of the patients. We found significant differences between inpatients and non-mentally-ill relatives, and between inpatient and outpatient schizophrenics. When WAIS-R Vocabulary subtest score was statistically controlled,no significant differences between any of the groups remained. Vocabulary x group interactions revealed that Vocabulary subtest predicted decision-making behavior for outpatients and controls, but not inpatients. Severity of psychiatric symptoms and number of prior hospitalizations predicted decision-making behavior for inpatient schizophrenics. Results suggest that competence assessments that rely primarily on verbal abilities may be inadequate to assess competence in acutely ill psychiatric patients.