Cognitive aspects of adolescent gambling

Abstract

Ranija istraživanja potencijalnih odrednica rizičnog odlučivanja učestalih i problematičnih kockara isticala su središnju ulogu iskrivljenih uvjerenja o kockanju, dok novija psihobiološka perspektiva ističe ulogu potencijalne patofiziologije ventromedijalnog prefrontalnog korteksa. Istraživanja s adolescentima unutar ove perspektive bila su rijetka te nisu koristila mjere napravljene s ciljem testiranja dvoprocesnih teorija rizičnog odlučivanja adolescenata. Stoga je cilj ovog istraživanja bio testirati osnovne pretpostavke dvoprocesnih teorija rizičnog odlučivanja u kontekstu kockanja adolescenata i provjeriti razlikuju li se adolescenti koji različito često kockaju te koji imaju različito izražene psihosocijalne posljedice kockanja u razini sklonosti rizičnom odlučivanju ovisno o vrsti aktiviranog puta donošenja odluke (reaktivni nasuprot racionalnom). Dodatno, provjereno je i mijenjaju li iskrivljena uvjerenja o kockanju odnos učestalosti, odnosno, psihosocijalnih posljedica povezanih s kockanjem, i sklonosti rizičnom odlučivanju ovisno o vrsti aktiviranog puta odlučivanja. Provjereno je i koje vrste informacija adolescenti različite učestalosti kockanja, kao i različite izraženosti psihosocijalnih posljedica kockanja koriste u zadacima reaktivnog, a koje u zadacima racionalnog odlučivanja. Istraživanje je provedeno u srednjim školama na računalima te su u njemu sudjelovali samo mladići s obzirom na nisku prevalenciju učestalog i problematičnog kockanja kod djevojaka. Od ukupnog uzorka od 378 adolescenata prosječne dobi od 17 godina (M = 17,03, SD = 1,296) formirana s dva zasebna uzorka adolescenata s obzirom na njihove rezultate na mjeri učestalosti kockanja (N = 78, podijeljeni u tri skupine (rijetko, povremeno i učestalo kockanje) po 26 adolescenata) i mjerama psihosocijalnih posljedica kockanja (N = 102, podijeljeni u tri skupine (nerizično, rizično i problematično kockanje) po 34 adolescenata). Eksperimentalna paradigma korištena u istraživanju je kraći oblik Kolumbijskog zadatka s karticama koji omogućava ispitivanje dvaju oblika procesiranja informacija pri donošenju rizičnih odluka: „hladnu“ kogniciju (racionalni/namjerni put procesiranja informacija) i „vruću“ kogniciju (reaktivni / afektivni put procesiranja informacija). Putem upitnika, dodatno su izmjerena iracionalna uvjerenja o kockanju te niz kontrolnih varijabli vezanih uz interindividualne razlike u ličnosti (situacijski nespecifična potreba za uzbuđenjem, kognitivna disinhibicija, emocionalna stabilnost te impulzivnost). Pokazalo se kako adolescenti koji često kockaju u zadatku reaktivnog odlučivanja donose rizičnije odluke i od adolescenata koji povremeno i od onih koji rijetko kockaju dok između potonje dvije skupine nije utvrđena razlika u rizičnosti donošenja odluka. U zadatku racionalnog odlučivanja adolescenti koji često kockaju donosili su rizičnije odluke od adolescenata koji rijetko kockaju, ali ne i od adolescenata koji povremeno kockaju, pri čemu između potonje dvije skupine nije utvrđena statistički značajna razlika u rizičnosti odluka. Kod adolescenata različite izraženosti psihosocijalnih posljedica kockanja također je utvrđen sličan interakcijski obrazac. Problematični kockari adolescenti su pri aktivaciji reaktivnog puta odlučivanja također donosili rizičnije odluke i od rizičnih i od neproblematičnih kockara adolescenata. Također, rizični kockari adolescenti su u ovom uvjetu također donosili značajno rizičnije odluke od neproblematičnih vršnjaka. Pri aktivaciji racionalnog puta odlučivanja utvrđen je identičan obrazac razlika: problematični kockari adolescenti donosili su rizičnije odluke i od rizičnih i od neproblematičnih adolescenata, dok su oni iz rizične skupine donosili rizičnije odluke od neproblematičnih adolescenata. Rezultati istraživanja su također pokazali da viša razina iracionalnih uvjerenja o kockanju ne mijenja odnos učestalosti (kao i psihosocijalnih posljedica) kockanja i rizičnosti odluka adolescenata ovisno o vrsti aktiviranog puta odlučivanja. Kada je riječ o vrstama informacija koje adolescenti koriste pri odlučivanju dobiveni rezultati, na poduzorku adolescenata različite učestalosti kockanja, ukazali su da u zadatku reaktivnog odlučivanja adolescenti koji često kockaju isključivo koriste informaciju o vjerojatnosti gubitka, ali ne i informaciju o količini dobitka. Adolescenti koji povremeno kockaju također su koristili informaciju o vjerojatnosti gubitka, ali i informaciju o količini gubitka. Adolescenti koji rijetko kockaju koristili su sve tri vrste informacijskih parametara koja su imali na raspolaganju. U zadatku racionalnog odlučivanja dobiveni su slični nalazi pri čemu su adolescenti koji rijetko kockaju opet koristili sve tri vrste informacija koje imaju na raspolaganju, dok su adolescenti koji povremeno i često kockaju koristili samo informaciju o vjerojatnosti gubitka. Slična situacija je zabilježena je i na poduzorku adolescenata različite izraženosti psihosocijalnih posljedica kockanja. Pri aktivaciji reaktivnog puta odlučivanja jedino su adolescenti s manjom izraženosti psihosocijalnih posljedica kockanja (nerizični) koristili sve tri vrste informacija, dok su oni sa srednjom (rizični) te visokom (problematični) izraženosti psihosocijalnih posljedica koristili samo informaciju o vjerojatnosti gubitka. S druge strane, u zadatku racionalnog odlučivanja opet su jedino nerizični adolescenti koristili sve tri vrste informacija, dok su rizični i problematični adolescenti koristili informaciju o vjerojatnosti gubitka, ali i o količini gubitka.Introduction: The development of a gambling habit is undeniably one of the most intriguing phenomena within the realm of cognitive psychology and decision-making. This curiosity stems from the paradoxical nature of gambling, succinctly captured by the phrase "The house always wins." This paradox is reflected in the fact that most gamblers are acutely aware that, from an economic standpoint, gambling carries a negative expected value, rendering it a highly risky behavior. Consequently, we're compelled to ask: What cognitive mechanisms drive the risktaking inclinations of frequent gamblers? This inquiry holds particular significance when we consider that persistent gambling can lead to a host of negative psychosocial consequences, potentially meeting the clinical criteria for problem gambling (Tremblay et al., 2010). In this context, it's vital to explore whether individuals who engage in frequent gambling consistently make riskier decisions compared to their non-gambling counterparts. Do they retain the capacity for sound decision-making, and if so, what cognitive mechanisms underlie this capacity? This same line of questioning applies to individuals who have experienced adverse psychosocial consequences due to excessive gambling. Is their ability to make better and less risky decisions potentially more compromised than those who gamble frequently but have not developed clinical symptoms of problem gambling? Traditionally, most studies on the determinants of risky decision-making within the realm of gambling have adopted a classical cognitive perspective. This perspective asserts that gamblers persist in their behavior, making riskier choices, because they hold distorted beliefs about gambling, leading them to overestimate their chances of winning (Ladouceur and Walker, 1996). However, this approach has faced criticism due to inconsistencies in findings. Research has shown that distorted beliefs about gambling do not necessarily correlate with the level of gambling-related problems. Even individuals who are not regular gamblers or only gamble occasionally exhibit the same biases as problem gamblers (Delfabbro, 2004). In addition to the classical cognitive paradigm, some studies have embraced a psycho-biological perspective. They seek to identify differences in various aspects of brain functioning between groups of participants with and without gambling problems. Thus, various neurochemical studies, functional brain imaging studies, and neuropsychological studies were conducted within this perspective. When it comes to neuropsychological studies on risky decision-making in adult problem gamblers, such as the work of Forbush et al. (2008), they have uncovered deficits reminiscent of those found in individuals with damage to the ventromedial prefrontal cortex (vmPFC). These individuals often grapple with real-life challenges in financial decision-making. However, there has been a dearth of neuropsychological studies focused on adolescent samples. One rare study by Ciccarelli et al. (2016) did find that adolescents who made riskier decisions also experienced more pronounced psychosocial consequences related to gambling, along with distorted beliefs about gambling. This suggests that certain dysfunctions in the vmPFC may also serve as significant determinants of risk-taking behavior in adolescents who gamble. Nevertheless, before we hastily conclude that adolescents who gamble frequently or face higher levels of gambling-related problems consistently make irrational and riskier decisions, we should consider the development of theories concerning adolescent risky decision-making. The assumptions made by earlier normative models, which posited that lower rationality and heightened cognitive deficits in adolescents were the primary drivers of their inclination toward risk, have been challenged. Research has demonstrated that, in contrast to adults, adolescents are not inherently less capable of discerning the risk associated with certain behaviors or evaluating their negative consequences (Reyna and Farley, 2006). The perplexing propensity for risky behaviors among adolescents, despite their capacity for rational decision-making, has given rise to the so-called dual-process models of adolescent risky behavior. These models emphasize that age-related differences in risk-taking cannot be solely attributed to the development of analytical ability. Instead, they suggest an imbalance in two information processing systems: the rational/analytical system and the reactive system. This imbalance is linked to the development of two neural regions in adolescence: the prefrontal cortex and the amygdalo-striatal system (Casey et al., 2008). The amygdalo-striatal system matures earlier and governs reactive decision-making, leading to heightened sensitivity to rewards and potentially riskier choices. In contrast, the prefrontal cortex, responsible for rational decisionmaking, matures later, thus inhibiting cognitive control and delaying gratification. In essence, adolescents engage in risky behaviors not because they lack the ability to think rationally, but because they are driven by emotional reactions. Consequently, poorer functional connectivity between the prefrontal cortex and the amygdalo-striatal system also may serve as a significant determinant of the proclivity for risk-taking in frequent or problematic adolescent gamblers. To test these assumptions rigorously, we require neuropsychological tasks capable of robustly activating both systems. With this objective in mind, Figner et al. (2009) developed the Colombian card task, featuring two parallel versions. The critical distinction lies in the type of cognition each version engages: "cold" cognition for rational decision-making, which strongly activates the prefrontal cortex, and "hot" cognition for reactive decision-making, which strongly activates the amygdalo-striatal system. Utilizing this measure allows us to gain a more comprehensive understanding of adolescent risky decision-making. In both versions of the task, we can assess not only the degree of risk propensity but also determine which of the three available information parameters (loss probability, gain amount, and loss amount) adolescents, on average, prioritize or overlook when making risky decisions. Surprisingly, despite its potential, this measure has not yet been applied in studies investigating the cognitive aspects of adolescent gambling. Its adoption could enhance our comprehension of the irrationality observed in adolescent gamblers, especially when considering variations in decision-making quality among adolescents with different gambling frequencies and varying levels of gamblingrelated problems. Importantly, adolescents who have experienced a range of psychosocial consequences due to excessive gambling might exhibit further impairments in decisionmaking. According to dual-process theories, we could hypothesize that adolescents who gamble more frequently or face higher levels of gambling-related problems possess heightened reward sensitivity. Consequently, they should exhibit riskier decision-making when the reactive pathway is activated. Moreover, employing this task enables us to delve deeper into the role of distorted gambling beliefs during the activation of both decision-making pathways. Clark (2010) suggests that these distorted beliefs likely originate at the neural level and may become more pronounced during reactive decision-making situations. This could potentially exacerbate the inclination toward risky decisions, particularly among adolescents who gamble more frequently or have experienced more significant psychosocial consequences due to gambling. Lastly, by leveraging this task, we can explore which information adolescents rely on when making risky decisions, contingent on their gambling frequency and gambling-related problems. Figner et al. (2009) found that, unlike adults, adolescents only consider information about loss probability and gain amount when making reactive decisions. In contrast, in rational decision-making scenarios, they take into account all three available information parameters. Consequently, it would be intriguing to investigate whether these findings hold true when comparing adolescents with differing levels of gambling frequency and gambling-related problems. It is plausible that adolescents who gamble more frequently or face higher levels of gambling-related problems possess heightened reward sensitivity, potentially limiting their use of all available information during reactive decision-making. The aim and the research methodology: The primary aim of this research was to examine the assumptions of dual-process theories concerning risky decision-making in adolescents. We sought to explore potential distinctions among adolescents based on their varying levels of gambling frequency and the extent of their gambling-related problems. Specifically, we wanted to investigate whether these differences influenced their propensity for risky decision-making depending on the type of decisionmaking pathway activated. Furthermore, we aimed to determine if these effects were contingent on the presence of distorted beliefs about gambling. We also set out to understand which types of available information adolescents with varying levels of gambling frequency and gambling-related problems relied on during reactive and rational decision-making. Our study involved a total of 378 adolescent boys, with an average age of 17 years (M = 17.03, SD = 1.296). The inclusion of girls was limited due to the infrequent occurrence of gambling among them. To effectively analyze the data, we divided the participants into two distinct subsamples: one consisting of adolescents with different gambling-related problems and the other comprising adolescents with varying gambling frequencies. For the sub-sample of adolescents with different gambling-related problems, we rigorously classified individuals who met the criteria for problematic gambling (demonstrating a high degree of psychosocial consequences resulting from gambling) and risky gambling (exhibiting a moderate level of psychosocial consequences due to gambling) on both the South Oaks Gambling Screen (SOGS-RA; Winters et al., 1993) and the Canadian Adolescent Gambling Inventory (CAGI; Tremblay et al., 2010). We identified a total of 34 such adolescents in each of the two groups. To maintain balance, we also included 34 adolescents in the non-risky category (displaying a low level of psychosocial consequences related to gambling) using a random selection method. This led to a total of 102 adolescents in this sub-sample. To avoid any overlap between the effects of gambling-related problems and gambling frequency, we included only those adolescents who did not meet the criteria for risky or problematic gambling on the aforementioned instruments. We then sorted them based on the frequency of their gambling, utilizing the Gambling Activities Questionnaire (Ricijaš et al., 2016). We identified 26 adolescents who fell into the occasional and frequent gambling categories. Additionally, we included 26 adolescents with infrequent gambling frequency through random selection, given their larger representation in the overall sample. Consequently, this sub-sample comprised a total of 78 adolescents. Our research took place in secondary schools and student dormitories within the areas of the City of Zagreb, Karlovac, and Varaždin Counties. We employed a convenient sampling procedure, and students participated in small groups (1-4 students) within separate rooms during regular school hours. This was coordinated with the school's professional staff or dormitory personnel. Before the measurement process, each student drew a unique short code consisting of a random sequence of numbers and letters (6 characters). This code was used to match the data collected from various measures, including questionnaires and experimental tasks, as all respondents completed all the measures. The experimental task used in our study was a shortened version of the Columbia Card Task (CCT; Figner et al., 2009). This task allowed us to assess two forms of information processing during decision-making: "cold" cognition (involving rational and intentional information processing) and "hot" cognition (involving reactive and affective information processing). To mitigate the transfer effect, we interspersed part of the questionnaire measures between the two experimental tasks, as participants needed to complete both versions of the task, with the experimental conditions rotated among them. In addition to measures of gambling frequency and gambling-related problems, we used the Gambling Belief Scale (Ricijaš et al., 2011) to gauge irrational beliefs about gambling. We also incorporated control measures for inter-individual personality differences, including the Need for Arousal Questionnaire (Figner et al., 2009) to assess situationally non-specific need for arousal, the disinhibition subscale of the Sensation Seeking Scale (SSS - form V; Zuckerman et al., 1978) to measure cognitive disinhibition, the Barratt Impulsiveness Scale-Version 11 (BIS-11; Patton et al., 1995), and the emotional stability subscale of the IPIP 50S questionnaire (Mlačić and Goldberg, 2007). All data were collected using laptops, with experimental tasks conducted in a specialized local programming environment designed for experiments (Psychopy). Questionnaire measures were administered via the Google Forms platform. On average, each data collection session with a single respondent lasted approximately 45 minutes. Results: The findings revealed that adolescents who frequently engage in gambling tend to make riskier decisions compared to those who gamble occasionally and those who rarely gamble, particularly when the reactive decision-making process is at play. However, there was no discernible difference between the latter two groups in this context. In contrast, when it comes to rational decision-making, the three aforementioned groups didn't exhibit an equal propensity for making risky decisions. Specifically, adolescents who frequently gamble, even when the rational decision-making pathway was activated, made riskier choices compared to those who rarely gamble. However, they did not differ significantly from adolescents who gamble occasionally. Moreover, no significant distinction was observed between the latter two groups either. A similar trend was also identified among adolescents with varying levels of gamblingrelated problems. Problematic gamblers tended to make riskier decisions than both risky and non-problem adolescent gamblers when the reactive decision-making pathway was engaged. Additionally, in this condition, risky adolescent gamblers also made significantly riskier decisions compared to their non-problem peers. The pattern of differences remained consistent during the activation of the rational decision-making pathway: problematic adolescent gamblers made riskier decisions than both risky and non-problematic adolescents, while risky gamblers made riskier decisions than non-problematic ones. The results further indicated that there was no interaction effect between irrational beliefs about gambling, the activated decision pathway, and gambling frequency, or gambling-related problems on the degree of risk propensity. In other words, a higher level of irrational beliefs about gambling did not lead to an increase in the riskiness of decisions made by adolescents who gamble frequently or those with higher levels of gambling-related problems in the context of reactive decision-making. Regarding the types of information adolescents employ when making decisions, the results from a sub-sample of adolescents with varying gambling frequencies showed that, during the reactive decision-making task, adolescents who frequently gamble primarily relied on information related to loss probability, while neglecting information about the gain amount. Adolescents who gambled occasionally also considered information about the loss probability but additionally factored in information about the loss amount, while disregarding information about the gain amount. Conversely, adolescent