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Decision-making deficits in pathological gambling: The role of executive functions, explicit knowledge and impulsivity in relation to decisions made under ambiguity and risk

Abstract:

Background 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). Methods 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. Results The majority of pathological gamblers (PGs) showed deficits in decision-making, characterized mainly by myopia for the future. Decisions made under risk showed different pbkp_redictors. Performance on the IGT-ABCD for decisions made under risk was pbkp_redicted 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. Conclusions Decision making in PG involves distinct patterns of deficits, and the pbkp_redictors 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 pbkp_redict decision making. (Am J Addict 2013;22:492-499) Copyright © American Academy of Addiction Psychiatry.