Executive Functions in Decision Making under Ambiguity and Risk in Healthy Adults: A Scoping Review Adopting the Hot and Cold Executive Functions Perspective

Abstract

Decision making (DM) has a pivotal role in supporting individual autonomy and well-being. It is considered a complex ability exploiting many cognitive functions, among which executive functions (EFs) are crucial. Few studies analyzed the role played by EFs in DM in healthy adults under ambiguity and risk, which are common conditions for most decisions in daily life. This scoping review aims to analyze the relationships between two individual tasks widely used to assess DM under these conditions (Iowa Gambling Task and Game of Dice Task) and EFs. According to the organizing principle that conceptualizes hot and cold EFs, DM under such conditions mainly implies hot EFs, but the relationship with cold EFs is still unclear. Using such an approach, a comprehensive framework is provided, highlighting main findings and identifying possible gaps in the literature. The results suggest different roles played by cold EFs in DM under ambiguity and risk, according to the characteristics of the tasks. The findings can offer guidance to further studies and to design interventions to support DM in healthy adults.

Decision-making under ambiguity and risk and executive functions in Parkinson’s disease patients: A scoping review of the studies investigating the Iowa Gambling Task and the Game of Dice

“…Specifically, hot EFs involve processes connoted by motivation and emotion, such as the incentive value elaboration and the reversal of approach-and-avoidance behaviors, whereas cold EFs underly processes characterized by emotionally neutral situations, involving abilities such as working memory, inhibition, and flexibility (Bechara et al, 1999 ; Chan et al, 2008 ; Salehinejad et al, 2021 ; Zelazo, 2015 ). Although this conceptualization of EFs is not commonly used and only recent works considered it (Colautti et al, 2022 ; Damme et al, 2019 ), it may be useful for a comprehensive and more in-depth analysis of DM processes under ambiguity and risk and the relationship with EFs, considering both the affective aspects involved in reward processing and the cognitive load required by the task.…”

“…Making a decision generally means selecting, at least between two options, the one that can maximize the desirable consequences and minimize the possible costs (Rangel et al, 2008;Kim and Lee, 2011). DM is composed of multiple steps that can be influenced by affective aspects, such as motivation and emotions triggered by the contingent situation, which can affect the decisional process since its earlier steps (Rangel et al, 2008;Ryterska et al, 2014;Schiebener and Brand, 2015;Colautti et al, 2022). The first one is the representation of the decisional problem (identifying relevant information).…”

“…DM implies many cognitive functions (e.g., general cognitive abilities, long-term memory, numerical and probability processing), among which EFs appear to be crucial (Schiebener and Brand, 2015;Colautti et al, 2022). Specifically, decision makers are required to inhibit the drive to be attracted by impulsive choices planning a strategy that allows them to achieve long-term wins rather than making choices characterized by possible higher immediate wins but also long-term higher losses (Colombo et al, 2020).…”

“…These cognitive operations mainly involve flexibility, inhibition, planning, and working memory, which are included in EFs and can be impaired in PD patients. As shown by recent studies focusing on healthy adults (Colautti et al, 2022;Damme et al, 2019), the degree of involvement of EFs in DM depends on some elements, such as the nature of the decisional problem, the kind of information available, the affective components triggered by the situation, and the level of the decision maker's cognitive functioning.…”

“…To better understand such an issue, with the further goal to promote optimal levels of cognitive functioning and wellbeing in PD patients, the present scoping review was designed to delve into the cognitive mechanisms of DM in PD patients, analyzing the relationship between DM under conditions of ambiguity and risk and EFs, which are pivotal in the decisional process (Brand et al, 2006 ; Del Missier et al, 2010 ; Schiebener and Brand, 2015 ; Colautti et al, 2022 ), the underlying neural substrates, and their possible involvement in PD. First, a brief overview of the DM process in PD is reported, followed by an analysis of the underlying neural mechanisms.…”