Subjective estimates of uncertainty during gambling and impulsivity after subthalamic deep brain stimulation for Parkinson\u2019s disease

Subthalamic deep brain stimulation (DBS) for Parkinson\u2019s disease (PD) may modulate chronometric and instrumental aspects of choice behaviour, including motor inhibition, decisional slowing, and value sensitivity. However, it is not well known whether subthalamic DBS affects more complex aspects of decision-making, such as the influence of subjective estimates of uncertainty on choices. In this study, 38 participants with PD played a virtual casino prior to subthalamic DBS (whilst \u2018on\u2019 medication) and again, 3-months postoperatively (whilst \u2018on\u2019 stimulation). At the group level, there was a small but statistically significant decrease in impulsivity postoperatively, as quantified by the Barratt Impulsiveness Scale (BIS). The gambling behaviour of participants (bet increases, slot machine switches and double or nothing gambles) was associated with this self-reported measure of impulsivity. However, there was a large variance in outcome amongst participants, and we were interested in whether individual differences in subjective estimates of uncertainty (specifically, volatility) were related to differences in pre- and postoperative impulsivity. To examine these individual differences, we fit a computational model (the Hierarchical Gaussian Filter, HGF), to choices made during slot machine game play as well as a simpler reinforcement learning model based on the Rescorla-Wagner formalism. The HGF was superior in accounting for the behaviour of our participants, suggesting that participants incorporated beliefs about environmental uncertainty when updating their beliefs about gambling outcome and translating these beliefs into action. A specific aspect of subjective uncertainty, the participant\u2019s estimate of the tendency of the slot machine\u2019s winning probability to change (volatility), increased subsequent to DBS. Additionally, the decision temperature of the response model decreased post-operatively, implying greater stochasticity in the belief-to-choice mapping of participants. Model parameter estimates were significantly associated with impulsivity; specifically, increased uncertainty was related to increased postoperative impulsivity. Moreover, changes in these parameter estimates were significantly associated with the maximum post-operative change in impulsivity over a six month follow up period. Our findings suggest that impulsivity in PD patients may be influenced by subjective estimates of uncertainty (environmental volatility) and implicate a role for the subthalamic nucleus in the modulation of outcome certainty. Furthermore, our work outlines a possible approach to characterising those persons who become more impulsive after subthalamic DBS, an intervention in which non-motor outcomes can be highly variable

Slot Machine Use As A Measure Of Decision-Making In Substance Use Disorders

Many of the decision-making tasks involve gambling and gambling paradigms and therefore it is important to understand how gambling relates to decision-making, especially in individuals who use substances. The goal of this study was to investigate how individuals with SUD will perform on a slot machine and relate the slot-machine performance to current lab measures of decision-making. Individuals with and without substance use disorders gambled on a slot machine and completed other decision-making tasks (e.g., IGT, BART, delay discounting). Rewards were manipulated in terms of magnitude (real monetary payout verses no payout) for two reasons. Gambling performance was compared to three common lab measures of decision-making (i.e., IGT, BART, & delay discounting). In addition, measures of substance use and gambling motivation were obtained to relate the slot-machine paradigm to meaningful reasons for engaging in addictive behaviors. There were four main findings in this study. First, all participants tended to bet more tokens per trial on the slot machine when there was no monetary compensation compared to if there was. Second, no group or magnitude differences were found on any of the decision-making tasks (i.e., IGT, BART, and delay discounting). Third, the slot machine and all the decision-making task seems to be relatively independent from each other. Fourth, performance on the slot machine and the decision-making tasks was able to predict using alcohol for positive reinforcement, in particular, for social situations and enhancing positive feelings and experiences. It is important that future research investigates decision making 1) uses multiple measures of decision making to access potentially different aspect of decision-making and 2) flesh out the differences between these tasks and find out what these tasks are able to detect

Factors influencing reward-seeking behaviour in rats and the implications for problem gamblers

Depression and impulsivity have been repeatedly implicated in gambling pathology, but the relationship between these factors is not fully understood. There is evidence of overlapping neural circuitry that may explain the relatedness of these disorders. The following thesis will characterize the neural dysfunction of gambling addiction, depression, and impulsivity, and will argue for the use of animal models to further our understanding of these relationships. Two series of experiments were conducted to examine how these factors influence reward-seeking behaviour. In the first, we will see that depression can lead to compulsive reward-seeking in rats; and in the second, we will present evidence that proves just how motivating gambling-like schedules of reinforcement truly are, and what that means for impulsive problem gamblers.Alberta Gambling Research Institut

Hedonistic Differences Between Mechanical Game Players And Table Game Players: An Exploratory Investigation On The Road To A Comprehensive Theory For Gambling

This exploratory research examined relationships between casino play and hedonic factors. The hedonic factors examined were emotion, sensation seeking and impulsivity, absorbing experiences, and analytical characteristics. Differences between slot players and table game players were measured. The subjects were a convenience sampling of 1,010 casino gamblers at a Las Vegas Strip casino catering to out of town visitors. All participants completed a 45- item survey. The constructs were measured using the Mehrabian and Russell (1974) pleasure, arousal, and dominance scale; the Zuckerman Kuhlman sensation seeking and impulsivity scale; the Swanson (1978) absorbing experience scale; and an analytical scale developed by the researchers. Both table game players and slot players derive pleasure from the pursuit of gambling. Table game players are more deeply involved and tend to be more aware of the intricacies of the games than slot players. Table game players are not as impulsive and tend to be more controlled than slot players. The overwhelming majority of table game players and slot players demonstrate discipline in terms of their gambling spending

A comparison of university student and community gamblers: Motivations, impulsivity, and gambling cognitions

Abstract Background and aims The present study tested whether the associations among motivational, cognitive, and personality correlates of problem gambling severity differed across university student gamblers (n = 123) and gamblers in the general adult community (n = 113) Methods The participants completed a survey that included standardized measures of gambling motivation, gambling related cognitions, and impulsivity. The survey also asked participants to report the forms of gambling in which they engaged to test whether gambling involvement (number of different forms of gambling) was related to problem gambling severity. After completing the survey, participants played roulette online to examine whether betting patterns adhered to the gambler's fallacy. Results Gambling involvement was significantly related to problem gambling severity for the community sample but not for the student sample. A logistic regression analysis that tested the involvement, motivation, impulsivity and cognitive correlates showed that money motivation and gambling related cognitions were the only significant independent predictors of gambling severity. Adherence to the gambler's fallacy was stronger for students than for the community sample, and was associated with gambling related cognitions. Discussion The motivational, impulsivity and cognitive, and correlates of problem gambling function similarly in university student gamblers and in gamblers from the general adult community. Interventions for both groups should focus on the financial and cognitive supports of problem gambling

The Gambler’s Fallacy in Problem and Non-Problem Gamblers

Background and aims: Although numerous correlational studies have shown an association between cognitive distortions and problem gambling, only a few behavioral studies have investigated this topic by comparing problem (PGs) and non-problem gamblers (N-PGs). This quasi-experiment investigated the occurrence in both groups of a widespread cognitive distortion, the gambler’s fallacy (GF), using a fictitious roulette game. Moreover, it investigated whether the GF increased the bet amount and whether impulsivity and sensation seeking were associated with the GF. Methods: Two indices of the GF were used: a cognitive index, the probability estimate of each outcome (black/red) after manipulating the final run length (the same outcome occurring four times/once), and a behavioral index, the choice of the outcome on which to bet. A total of 320 (160 PGs and 160 N-PGs) unpaid male volunteers, aged between 18 and 68, participated in this study. Hypotheses: Erroneous probability estimates should mediate the effect of longer runs on the alternation choice (i.e., the choice of an outcome different from the previous one) to support the occurrence of GF. The GF should increase betting. PGs should be more prone than N-PGs to GF. Results: The choice of the outcome depended on both cognitive (erroneous probability estimates) and affective (preference for red) factors. PGs bet more than N-PGs but they were not more prone than N-PGs to incurring GF. Although impulsivity and sensation seeking were more intense in PGs than in N-PGs, they scarcely affected GF. Discussion and conclusions: Overall, our results corroborate the tested model of the GF that links mistaken probability estimates, choice of the outcome on which to bet, and bet amount. However, they are similar to PGs and N-PGs and fail to corroborate the hypothesis that the GF is more evident in PGs

The Relationship between Arousal, Personality, and Perception of Control in a Gambling Task

The somatic marker hypothesis posits that physiological arousal is partially responsible for decision-making behavior. Arousal, measured by skin conductance responses (SCR), increases before deck choice in the Iowa Gambling Task (IGT). These markers co-vary with performance -- pathological gamblers lack these markers and perform poorly. Personality also modulates IGT behavior – high-novelty-seeking (NS) individuals tend to perform worse. In the IGT, participants decide which deck to select, creating a potential confound between personality, performance, and arousal. For example, high-NS individuals select the bad decks more often, potentially causing habituation and a muted SCR. The first goal of this research was to replicate the finding that personality modulates arousal in a task which removes these confounds. Participants selected a series of cards from two decks. Each card was either a win or loss. Real money was used. To remove the potential confound between choice and outcome, all participants experienced the same outcomes regardless of choice. SCR was measured during the task. Personality characteristics previously shown to modulate gambling behavior, such as sensation seeking (SS), were measured. Arousal may also occur during other phases of gambling, for example, before or after the outcome is revealed. To date, few studies have examined the relationship between arousal in these different phases. The second goal was to determine this relationship. The phases of gambling (pre-choice, anticipation, and outcome) were temporally separated to allow for precise SCR measurement in each phase. The final goal was to determine the relationship between perceived control and physiological arousal. An \u27illusion of control\u27, e.g., pulling the lever on a slot machine, promotes gambling, especially in pathological gamblers. Little work has addressed the relationship between personality, control, and arousal. In different sessions, participants either selected the next card or the next card was selected for them. SS decreased arousal during all three gambling phases. The perception of control decreased arousal during the pre-choice phase only. This latter effect was strongest for low-SS individuals. The ramifications of this study are clear: identifying how physiological responses vary with personality opens up avenues for potential treatment of problem gambling

The need for a behavioural analysis of behavioural addictions

This review discusses research on behavioural addictions (i.e. associative learning, conditioning), with reference to contemporary models of substance addiction and ongoing controversies in the behavioural addictions literature. The role of behaviour has been well explored in substance addictions and gambling but this focus is often absent in other candidate behavioural addictions. In contrast, the standard approach to behavioural addictions has been to look at individual differences, psychopathologies and biases, often translating from pathological gambling indicators. An associative model presently captures the core elements of behavioural addiction included in the DSM (gambling) and identified for further consideration (internet gaming). Importantly, gambling has a schedule of reinforcement that shows similarities and differences from other addictions. While this is more likely than not applicable to internet gaming, it is less clear whether it is so for a number of candidate behavioural addictions. Adopting an associative perspective, this paper translates from gambling to video gaming, in light of the existing debates on this matter and the nature of the distinction between these behaviours. Finally, a framework for applying an associative model to behavioural addictions is outlined, and it's application toward treatment

Heterogeneity in Disordered Gambling: Decision-Making and Impulsivity in Gamblers Grouped by Preferred Form.

Background: Previous research has indicated that disordered gamblers display deficits in impulsivity and risky decision-making, compared to healthy control groups. However, disordered gamblers are not a homogenous group, and differences in performance on neurocognitive tasks may be related to the form of gambling in which an individual chooses to engage. The present study used neurocognitive tasks and questionnaire measures to ascertain group differences in gamblers grouped by preferred form of gambling. Method: Treatment-seeking pathological gamblers from the National Problem Gambling Clinic, London (n = 101), completed a neurocognitive assessment comprising the Cambridge gamble task (CGT), the stop-signal task (SST), a probabilistic reversal learning task (PRL), and the Kirby Monetary Choice Questionnaire, as well as questionnaire measures of gambling severity, impulsivity, depression, and anxiety. Analyses compared gamblers who favored fixed-odds betting terminals (FOBTs) (the modal form) to gamblers who preferred other forms of gambling (non-FOBT). Results: The FOBT group showed impaired decision-making under risk on the CGT compared to the non-FOBT group, choosing the likely option less on more uncertain decisions. The FOBT group made fewer perseverative errors on the PRL task, had lower depression and anxiety scores, and were less likely to have a family history of problem gambling than the non-FOBT group. Discussion: Decision-making and cognitive flexibility differences between gamblers grouped by gambling type supports preferred form as an important source of heterogeneity in gambling disorder. Decision-making strategies and risk attitudes should be considered when approaching cognition-focused treatment strategies, allowing interventions to be targeted at specific cognitive deficits