title: 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 predictors. Performance on the IGT-ABCD for decisions made under risk was predicted 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 predictors 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 predict decision making.
authors: Department of Psychiatry, Pathological Gambling Unit, Bellvitge University Hospital, Barcelona, Spain.
authors: Cristian
authors: C
authors: Ochoa
authors: Eva M
authors: EM
authors: Alvarez-Moya
authors: Eva
authors: E
authors: Penelo
authors: M Neus
authors: MN
authors: Aymami
authors: Mónica
authors: M
authors: Gómez-Peña
authors: Fernando
authors: F
authors: Fernández-Aranda
authors: Roser
authors: R
authors: Granero
authors: Julio
authors: J
authors: Vallejo-Ruiloba
authors: José Manuel
authors: JM
authors: Menchón
authors: Natalia S
authors: NS
authors: Lawrence
authors: Susana
authors: S
authors: Jiménez-Murcia
mesh_terms: D000328:Adult; D003657:Decision Making; D056344:Executive Function; D005260:Female; D005715:Gambling / Q000523:psychology*; D006801:Humans; D007175:Impulsive Behavior / Q000523:psychology*; D008297:Male; D009483:Neuropsychological Tests; D011678:Punishment / Q000523:psychology; D012201:Reward; D012309:Risk-Taking