Age-related quantitative and qualitative changes in decision making ability

The "frontal aging hypothesis" predicts that brain senescence affects predominantly the prefrontal regions. Preliminary evidence has recently been gathered in favour of an age-related change in a typically frontal process, i.e. decision making, using the Iowa Gambling Task (IGT), but overall findings have been conflicting. Following the traditional scoring method, coupled with a qualitative analysis, in the present study we compared IGT performance of 40 young (mean age: 27.9+/-4.7) and 40 old (mean age: 65.4+/-8.6) healthy adults and of 18 patients affected by frontal lobe dementia of mild severity (mean age: 65.1+/-7.4, mean MMSE score: 24.1+/-3.9). Quantitative findings support the notion that decision making ability declines with age; moreover, it approximates the impairment observed in executive dysfunction due to neurodegeneration. Results of the qualitative analysis did not reach statistical significance for the motivational and learning decision making components considered, but approached significance for the attentional component for elderly versus young normals, suggesting a possible decrease in the ability to maintain sustained attention during complex and prolonged tasks as the putative deficit underlying impaired decision making in normal aging.     

Conscious knowledge influences decision‐making differently in substance abusers with and without co‐morbid antisocial personality disorder

Decision‐making impairment, as measured by the Iowa Gambling Task (IGT), is a consistent finding among individuals with substance use disorder (SUD). We studied how this impairment is influenced by co‐morbid antisocial personality disorder (ASPD) and conscious knowledge of the task. Three groups were investigated: SUD individuals without co‐morbid ASPD (n = 30), SUD individuals with co‐morbid ASPD (n = 16), and healthy controls (n = 17). Both SUD and SUD+ASPD participants had poor overall IGT performance. A block‐by‐block analysis revealed that SUD participants exhibited slow but steady improvement across the IGT, whereas SUD+ASPD participants exhibited initial normal improvement, but dropped off during the last 40 trials. Conscious knowledge of the task was significantly correlated to performance for controls and SUD participants, but not for SUD+ASPD participants. Our findings suggest that decision‐making proceeds differently in SUD and SUD+ASPD individuals due to differences in acquisition and application of conscious knowledge.     

Developmental changes of win-stay and loss-shift strategies in decision making

This study aims to clarify the developmental changes in real-life decision making when strategy is adjusted using both positive and negative feedback, that is, whether strategic adjustment evolves with age. A total of 84 participants divided into three age groups (children, adolescents, and adults) performed the standard version of the Iowa Gambling Task (IGT). Children and adolescents showed a strong bias in favor of disadvantageous choices whereas adults learned to decide advantageously during the course of the task. Interestingly, the results clearly demonstrate that children did not switch differently following gains and losses whereas adolescents and adults switched more often after a loss than after a gain, corresponding to the “loss-shift” and the “win-stay” strategies, respectively. The results also revealed that adults switched less often after losses compared to children and adolescents and, thus, used the loss-stay strategy more often than the 2 youngest groups. These new findings suggest that successful completion of the IGT by adults requires fine feedback monitoring and more frequent use of the win-stay and loss-stay strategic adjustments.     

Decision making cognition in primary progressive aphasia

We sought to investigate the decision making profile of Primary Progressive Aphasia (PPA) by assessing patients diagnosed with this disease (n = 10), patients diagnosed with behavioral variant frontotemporal dementia (bvFTD, n = 35), and matched controls (n = 14) using the Iowa Gambling Task, a widely used test that mimics real-life decision making. Participants were also evaluated with a complete neuropsychological battery. Patients with PPA were unable to adopt an advantageous strategy on the IGT, which resulted in a flat performance, different to that exhibited by both controls (who showed advantageous decision making) and bvFTD patients (who showed risk-appetitive behavior). The decision making profile of PPA patients was not associated with performance on language tasks and did not differ between sub-variants of the disease (namely, semantic dementia and progressive nonfluent aphasia). Investigating decision making in PPA is crucial both from a theoretical perspective, as it can shed light about the way in which language interacts with other cognitive functions, as well as a clinical standpoint, as it could lead to a more objective detection of impairments of decision making deficits in this condition.     

Negative affectivity predicts individual differences in decision making for preschoolers

The authors' goal in conducting this study was to explore the association between temperament and future-oriented decision making. Forty-three preschoolers (mean age = 51 months) were given a child variant of the Iowa Gambling Task (IGT) and asked to choose between a deck with higher immediate rewards and a deck with higher future rewards. Children who were higher on the Extraversion/Surgency factor of the Child Behavior Questionnaire chose more frequently from the higher immediate rewards deck early in the game. The externalizing dimension of Negative Affectivity (anger/frustration, soothability and discomfort) made the greatest contribution to prediction of performance in the last block of the game. Children who were more easily frustrated and had difficulty regulating negative emotions chose more from the deck with higher immediate rewards. There was a significant interaction between the externalizing dimension of Negative Affectivity, the internalizing dimension of Negative Affectivity (sadness and fear) and Extraversion/Surgency on the last block. These results suggest a complex association between IGT performance and temperament in preschoolers.     

The effect of cognitive behavior therapy on decision making in adolescents who self-harm: a pilot study

Research shows poor decision making in adolescents who self-harm and a positive correlation between decision-making abilities and duration since last self-harm episode. This exploratory study investigated whether decision making in self-harming adolescents could be improved through treatment with a novel cognitive behavior therapy (CBT). It also investigated whether improvement in decision making following treatment was linked to self-harm cessation. Adolescent self-harmers receiving CBT (n = 24) or no treatment (n = 9) and healthy controls (n = 22) were longitudinally compared on the Iowa gambling task (IGT). Significant IGT improvements were only observed for adolescents who self-harm following CBT. CBT may benefit adolescent self-harmers and generate decision-making improvements.     

Altered behavioral and neural responsiveness to counterfactual gains in the elderly

Counterfactual information processing refers to the consideration of events that did not occur in comparison to those actually experienced, in order to determine optimal actions, and can be formulated as computational learning signals, referred to as fictive prediction errors. Decision making and the neural circuitry for counterfactual processing are altered in healthy elderly adults. This experiment investigated age differences in neural systems for decision making with knowledge of counterfactual outcomes. Two groups of healthy adult participants, young (N = 30; ages 19–30 years) and elderly (N = 19; ages 65–80 years), were scanned with fMRI during 240 trials of a strategic sequential investment task in which a particular strategy of differentially weighting counterfactual gains and losses during valuation is associated with more optimal performance. Elderly participants earned significantly less than young adults, differently weighted counterfactual consequences and exploited task knowledge, and exhibited altered activity in a fronto-striatal circuit while making choices, compared to young adults. The degree to which task knowledge was exploited was positively correlated with modulation of neural activity by expected value in the vmPFC for young adults, but not in the elderly. These findings demonstrate that elderly participants’ poor task performance may be related to different counterfactual processing.     

Decision-making capacity in elderly, terminally ill patients with cancer

Despite the importance and complexity of evaluating decision-making capacity at the end of life, little research has focused on terminally ill patients' decision-making ability. The purpose of this study was to explore the decision-making capacity of elderly, terminally ill patients and the psychological and physical factors that affect decision making. Decision-making capacity and cognitive abilities were assessed using four measures: the Hopkins Competency Assessment Kit, the Bechara Gambling Task, the Concept Assessment Kit, and the Mini Mental Status Exam. In addition, symptoms of depression, level of physical functioning, and extent of physical symptoms were evaluated in order to identify correlates of decision-making ability. Two samples were compared: elderly, terminally ill patients with cancer (n = 43) and elderly, physically healthy adults living in supportive community residence (n = 35). Results revealed significantly poorer decision-making abilities among the terminal ill sample compared with healthy comparisons, but no association between demographic variables (e.g., age, race, or education) or clinical variables (depression or physical symptoms) and decision making. Implications for evaluating decision-making capacity are addressed.     

Hormonal changes after competition predict sex‐differentiated decision‐making

Recent neuroendocrinology research has pointed out that testosterone (T) and cortisol (C) changes after social interactions can predict risk‐taking behavior in decision‐making, depending on the sex of participants. However, previous research has focused on the effects of the changes in only one hormone, rather than the interaction between them, even though C can suppress T activity. Our aim was to test, in men and women, the role of T changes moderated by C changes after competition in decision‐making. Thus, 48 males and 46 females completed the Iowa Gambling Task (IGT) after a laboratory competition or a noncompetitive task (control task). Saliva samples were collected before and after the competition/control task. IGT was employed to measure risk‐taking decision‐making, considering the degree of uncertainty. Our results showed sex‐differentiated effects of T and C changes on risk‐taking behavior. On the one hand, men from both task groups (Competition/Control) who had higher C and T changes after competition showed more risk‐taking decision‐making (higher IG Risk). On the other hand, women from the competitive task who had high C and T showed conservative decision‐making. Therefore, these results show sex‐differentiated decision‐making profiles, which would help to understand how men and women behave after experiencing a competitive social context.     

Inverse association between dopaminergic neurotransmission and Iowa Gambling Task performance in pathological gamblers and healthy controls

Linnet, J., Møller, A., Peterson, E., Gjedde, A. & Doudet, D. (2011). Inverse association between dopaminergic neurotransmission and Iowa Gambling Task performance in pathological gamblers and healthy controls. Scandinavian Journal of Psychology 52, 28–34. The dopamine system is believed to affect gambling behavior in pathological gambling. Particularly, dopamine release in the ventral striatum appears to affect decision‐making in the disorder. This study investigated dopamine release in the ventral striatum in relation to gambling performance on the Iowa Gambling Task (IGT) in 16 Pathological Gamblers (PG) and 14 Healthy Controls (HC). We used Positron Emission Tomography (PET) to measure the binding potential of [¹¹C] raclopride to dopamine D2/3 receptors during a baseline and gambling condition. We hypothesized that decreased raclopride binding potentials in the ventral striatum during gambling (indicating dopamine release) would be associated with higher IGT performance in Healthy Controls, but lower IGT performance in Pathological Gamblers. The results showed that Pathological Gamblers with dopamine release in the ventral striatum had significantly lower IGT performance than Healthy Controls. Furthermore, dopamine release was associated with significantly higher IGT performance in Healthy Controls and significantly lower IGT performance in Pathological Gamblers. The results suggest that dopamine release is involved both in adaptive and maladaptive decision‐making. These findings may contribute to a better understanding of dopaminergic dysfunctions in pathological gambling and substance related addictions.     

Construct Validity of the Iowa Gambling Task

The Iowa Gambling Task (IGT) was created to assess real-world decision making in a laboratory setting and has been applied to various clinical populations (i.e., substance abuse, schizophrenia, pathological gamblers) outside those with orbitofrontal cortex damage, for whom it was originally developed. The current review provides a critical examination of lesion, functional neuroimaging, developmental, and clinical studies in order to examine the construct validity of the IGT. The preponderance of evidence provides support for the use of the IGT to detect decision making deficits in clinical populations, in the context of a more comprehensive evaluation. The review includes a discussion of three critical issues affecting the validity of the IGT, as it has recently become available as a clinical instrument: the lack of a concise definition as to what aspect of decision making the IGT measures, the lack of data regarding reliability of the IGT, and the influence of personality and state mood on IGT performance.     

越老越风险规避吗？——年龄对冲动性预测决策行为的调节效应

年老化伴随着风险承担倾向的改变,而决策行为受冲动性的影响是否受到年龄的调节尚不清楚。研究采用两种不同类型的决策任务以及Barratt冲动性量表,考察老年人风险承担在自我报告和决策行为上的改变。结果显示老年人在剑桥博弈任务中更加风险寻求而在模拟充气球任务中更加风险规避。同时冲动性可以显著预测模拟充气球的行为,且该预测受到年龄的调节。研究结果提示,老年人并不是单一的更加风险规避或者风险寻求,而是与任务特异性相关。同时,冲动性可以较好的预测年轻人的决策行为,而对老年人的决策行为没有预测作用。     

Imagery Interference Diminishes in Older Adults: Age-Related Differences in the Magnitude of the Perky Effect

Studies have documented the negative effects of mental imagery on perception (also known as the Perky effect) in younger adults, but imagery-interference effects in older adults have never been assessed. Two experiments examined this issue directly. Experiment 1 demonstrated that visual mental images diminish visual acuity in younger adults (mean age = 19.0) but not older adults (mean age = 73.6). Experiment 2 obtained parallel results, showing that visual imagery interfered with performance on a visual detection task in younger (mean age = 18.7) but not older adults (mean age = 66.7). Processes underlying age-related differences in imagery-interference effects are discussed and implications of these results for changes in cognitive performance in older adults are considered.     

奖惩频率对3～5岁幼儿完成博弈任务的影响

通过对情感决策的常用研究工具——标准爱荷华博弈任务进行了得失总量不变而频率改变的修改,并使之适合于年幼的3～5岁儿童,可以比较幼儿在不同奖惩频率任务中的表现,从而考察奖惩频率对幼儿情感决策的影响。对120名3～5岁幼儿在四种不同类型的任务中的表现进行分析后,所得实验结果如下:(1)儿童对惩罚和奖励频率的变化比较敏感:正向博弈任务中,"有利纸牌不变,不利纸牌的惩罚总量不变,只增加不利纸牌的惩罚频率"可以使3～5岁儿童完成博弈任务的成绩有显著提高;逆向博弈任务中,"不利纸牌不变,有利纸牌的奖惩总量不变,而有利纸牌奖励频率的增加"能促使4～5岁幼儿更多更快地做出正确选择。(2)幼儿的情感决策能力在3～4岁时期发展迅速,而在4～5岁时仍然有较快发展。     

Propensity for risk taking and trait impulsivity in the Iowa Gambling Task

The Iowa Gambling Task (IGT) is sensitive to decision making impairments in several clinical groups with frontal impairment. However the complexity of the IGT, particularly in terms of its learning requirements, makes it difficult to know whether disadvantageous (risky) selections in this task reflect deliberate risk taking or a failure to recognise risk. To determine whether propensity for risk taking contributes to IGT performance, we correlated IGT selections with a measure of propensity for risk taking from the Balloon Analogue Risk Task (BART), taking into account potential moderating effects of IGT learning requirements, and trait impulsivity, which is associated with learning difficulties. We found that IGT and BART performance were related, but only in the later stages of the IGT, and only in participants with low trait impulsivity. This finding suggests that IGT performance may reflect different underlying processes in individuals with low and high trait impulsivity. In individuals with low trait impulsivity, it appears that risky selections in the IGT reflect in part, propensity for risk seeking, but only after the development of explicit knowledge of IGT risks after a period of learning.     

Aging and decision‐making competence: an analysis of comprehension and consistency skills in older versus younger adults considering health‐plan options

Older adults need to maintain strong decision‐making capabilities as they age. However, we know little about how age‐related physical and psychological changes affect older adults' judgment and decision processes. This paper reports the results of research comparing older versus younger adults' performance on evaluation and choice tasks about health‐plan options. In particular, comprehension and consistency in judgments (across separate versus joint evaluation contexts) were examined. Results indicated that increasing age was related to greater comprehension errors and inconsistent preferences, even when covariates (education, income, gender, self‐perceived skill and health, decision style, and attitude toward delegation) were taken into account. Discussion of the results emphasizes difficulties in interpreting the meaning of age differences in performance on decision tasks and the need for research that ascertains the seriousness of the consequences of age differences in real‐life tasks. The implications for providing decision‐aiding interventions for older adults are highlighted. Copyright © 2002 John Wiley & Sons, Ltd.     

Age-related changes in decision making: comparing informed and noninformed situations

Advantageous decision making progressively develops into early adulthood, most specifically in complex and motivationally salient decision situations in which direct feedback on gains and losses is provided (Figner & Weber, 2011). However, the factors that underlie this developmental improvement in decision making are still not well understood. The current study therefore investigates 2 potential factors, long-term memory and working memory, by assigning a large developmental sample (7-29 years of age) to a condition with either high or low demands on long-term and working memory. The first condition featured an age-adapted version of the Iowa Gambling Task (IGT; Bechara, Damasio, Damasio, & Anderson, 1994; i.e., a noninformed situation), whereas the second condition provided an external store where explicit information on gains, losses, and probabilities per choice option was presented (i.e., an informed situation). Consistent with previous developmental IGT studies, children up to age 12 did not learn to prefer advantageous options in the noninformed condition. In contrast, all age groups learned to prefer the advantageous options in the informed conditions, although a slight developmental increase in advantageous decision making remained. These results indicate that lowering dependence on long-term and working memory improves children's advantageous decision making. The results additionally suggest that other factors, like inhibitory control processes, may play an additional role in the development of advantageous decision making.     

Alexithymia, Cumulative Feedback, and Differential Response Patterns on the Iowa Gambling Task

ABSTRACT Although the role of emotional processing is central to contemporary models of risky decision making, to date the role of trait emotional understanding has not been explored experimentally in this context. The current experiment ( N =326) explores the role of alexithymia with respect to performance on the standard Iowa Gambling Task (IGT) and a version where cumulative financial feedback is obscured. Standard learning on the IGT was observed for those low in alexithymia. Those high in alexithymia learned to avoid disadvantageous decks over the first half of the task. However, over the later trials they showed a change in performance, shifting from advantageous to disadvantageous and back to advantageous decks again (termed an "explore-learn-change-return" strategy). It is argued that this is due to an inability to fully consolidate earlier learning and reduced sensitivity to losses. The absence of cumulative feedback independently resulted in reduced performance.     

Comparison of deck- and trial-based approaches to advantageous decision making on the Iowa Gambling Task

We compared the original deck-based model of advantageous decision making assessed with the Iowa Gambling Task (IGT) with a trial-based approach across behavioral and physiological outcomes in 33 younger adults (15 men, 18 women; 22.2 ± 3.7 years of age). One administration of the IGT with simultaneous measurement of skin conductance responses (SCRs) was performed and the two methods applied: (a) the original approach of subtracting disadvantageous picks of Decks A and B from advantageous picks of Decks C and D and (b) a trial-based approach focused on the financial outcome for each deck leading up to the trial in question. When directly compared, the deck-based approach resulted in a more advantageous behavioral profile than did the trial-based approach. Analysis of SCR data revealed no significant differences between methods for physiological measurements of SCR fluctuations or anticipatory responses to disadvantageous picks. Post hoc investigation of the trial-based method revealed Deck B contributed to both advantageous and disadvantageous decision making for the majority of participants. When divided by blocks of 20, the number of advantageous to disadvantageous choices reversed as the task progressed despite the total number of picks from Deck B remaining high. SCR fluctuations for Deck B, although not significantly different from the other decks, did show a sharp decline after the first block of 20 and remained below levels for Decks C and D toward the end of the task, suggesting that participants may have gained knowledge of the frequency of loss for this deck.