Decision-making (in)flexibility in gambling disorder

Perandrés-Gómez, Ana; Navas, Juan F.; van Timmeren, Tim; Perales López, José César

doi:https://doi.org/10.1016/j.addbeh.2020.106534

Artículo principal (1.785Mo)

Identificadores

URI: https://hdl.handle.net/10481/87606

DOI: https://doi.org/10.1016/j.addbeh.2020.106534

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Materia

Gambling disorder

Reversal learning

Reward-based learning

Instrumental learning

Decision-making under ambiguity

Compulsivity

Date

2021-01

Referencia bibliográfica

Perandrés-Gómez, A., Navas, J. F., van Timmeren, T., & Perales, J. C. (2021). Decision-making (in) flexibility in gambling disorder. Addictive Behaviors, 112, 106534.

Patrocinador

This work was supported by grants from the Spanish Government (PSI2017-85488-P: Ministerio de Economía y Competitividad, Secretaría de Estado de Investigación, Desarrollo e Innovación, Convocatoria 2017 de Proyectos I+ D de Excelencia, Spain, co-funded by the Fondo Europeo de Desarrollo Regional, FEDER, European Commission; and PSI2013-45055: Ministerio de Economía y Competitividad, Secretaría de Estado de Invetigación, Desarrollo e Innovación, Convocatoria 2013 de Proyectos I+ D de Excelencia). Additionally, JFN was supported by a grant from the Spanish Government (PSI2017-85159-P. Ministerio de Ciencia, Innovación y Universidades). Funding agencies had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication.

Résumé

Background: Behavioral flexibility –the ability to dynamically readjust our behavior in response to reward contingency changes– is often investigated using probabilistic reversal learning tasks (PRLT). Poor PRLT performance has been proposed as a proxy for compulsivity, and theorized to be related to perseverative gambling. Previous attempts to measure inflexibility with the PRLT in patients with gambling disorder have, however, used a variety of indices that may conflate inflexibility with more general aspects of performance in the task. Methods: Trial-by-trial PRLT acquisition and reacquisition curves in 84 treatment-seeking patients with gambling disorder and 64 controls (non-gamblers and non-problem recreational gamblers) were analyzed to distinguish between (a) variability in acquisition learning, and (b) reacquisition learning in reversed contingency phases. Complementarily, stay/switch responses throughout the task were analyzed to identify (c) premature switching, and (d) sensitivity to accumulated negative feedback. Results and interpretation: Even after controlling for differences in acquisition learning, patients were slower to readjust their behavior in reversed contingency phases, and were more prone to maintain their decisions despite accumulated negative feedback. Inflexibility in patients with gambling disorder is thus a robust phenomenon that could predate gambling escalation, or result from massive exposure to gambling activities.

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