Deficit of state-dependent risk attitude modulation in gambling disorder

Abstract

Gambling disorder (GD) is often considered as a problem of trait-like risk preference. However, the symptoms of GD cannot be fully understood by this trait view. In the present study, we hypothesized that GD patients also had problem with a flexible control of risk attitude (state-dependent strategy optimization), and aimed to investigate the mechanisms underlying abnormal risk-taking of GD. To address this issue, we tested GD patients without comorbidity (GD group: n=21) and age-matched healthy control participants (HC group: n=29) in a multi-step gambling task, in which participants needed to clear ‘block quota' (required units to clear a block, 1000–7000 units) in 20 choices, and conducted a task-functional magnetic resonance imaging (fMRI) experiment. Behavioral analysis indeed revealed a less flexible risk-attitude change in the GD group; the GD group failed to avoid risky choice in a specific quota range (low-quota condition), in which risky strategy was not optimal to solve the quota. Accordingly, fMRI analysis highlighted diminished functioning of the dorsolateral prefrontal cortex (dlPFC), which has been heavily implicated in cognitive flexibility. To our knowledge, the present study provided the first empirical evidence of a deficit of state-dependent strategy optimization in GD. Focusing on flexible control of risk attitude under quota may contribute to a better understanding of the psychopathology of GDs.

A Neuroeconomic Theory of Mental Time Travel

“…Again, disruptions of the attentional system will exacerbate these inefficiencies. This idea is consistent with studies showing that pathologic gamblers exhibit disruption of this system (Fujimoto et al, 2017 ). Alternatively, dysfunction of the episodic memory, which is known to be sensitive to reward outcomes, may affect the formation of memories and result in inefficient behavior (Mason et al, 2017 ).…”

Attenuated Directed Exploration during Reinforcement Learning in Gambling Disorder

“…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). State-dependent modulations of risk-attitude have been found impaired in problem gambling (Fujimoto et al, 2017). Similar impairments are observed in reversal learning, where gamblers make more perseveration errors following contingency reversals (de Ruiter et al, 2009;Boog et al, 2014), an effect that has been linked to maladaptive control beliefs about gambling outcomes, which might interfere with decision-making (Lim et al, 2015).…”

Activity of Prefrontal Neurons Predict Future Choices during Gambling

“…The primate cingulate cortex (Pribram et al, 1962) has been linked to error, reward and value-based decision-making (Rushworth et al, 2011), and conflict management (Mansouri et al, 2009) for optimal choice (Kennerley et al, 2006, Botvinick et al, 2004). The difficult question of species homology for prefrontal cortex highlights the importance of discovering distinct neuronal activity patterns to establish better predictive validity for why failing or shifting reward integration mechanisms result in detrimental decision-making across a range of psychiatric conditions (Fujimoto et al, 2017).…”