Application of the somatic marker hypothesis to individual differences in decision making

The comparison of decision-making in ambiguous situations and galvanic skin responses as somatic markers in patients with posterior cortex epilepsy and mesial temporal lobe epilepsy with hippocampal sclerosis

INTRODUCTION

Decision-making behaviors of patients with mesial temporal lobe epilepsy (MTLE) is a subject that has been studied frequently. However, determining the neuropsychological profiles of patients with different types of epilepsy is also important. Our main purpose was to examine the decision-making behaviors of patients with posterior cortex epilepsy (PCE) through the assumptions of somatic marker hypothesis (SMH) and to compare their performances with those of a MTLE group and a control group.

METHOD

Participants comprised of 13 patients with PCE (mean age 30.92 ± 9.99 years); 14 patients with MTLE with hippocampal sclerosis (MTLE-HS) (mean age 25.53 ± 7.40 years) and 15 controls (mean age 24.60 ± 8.45 years). Decision-making performances were assessed with the Iowa gambling test (IGT) and anticipatory skin responses before each choice were recorded. A comprehensive neuropsychological test battery was also given to all participants in order to examine the relationship of decision-making with other cognitive functions.

RESULTS

Anticipatory responses before choosing from disadvantageous decks were significantly larger than choosing from advantageous decks in the PCE group (p = 0.00). No significant difference was found between the PCE and control group's total net scores. IGT total net scores was significantly correlated with Stroop test interference time (p = 0.03).

CONCLUSION

The study reveals that cognitive impairments of patients with PCE are not limited to brain's posterior areas' functions, and provides evidence for the current paradigm which understands epilepsy as a network disorder.

Modeling Skin Conductance Response Time Series during Consecutive Rapid Decision-Making under Concurrent Temporal Pressure and Information Ambiguity

Emergency situations promote risk-taking behaviors associated with anxiety reactivity. A previous study using the Iowa Gambling Task (IGT) has demonstrated that prespecified state anxiety predicts moderate risk-taking (middle-risk/high-return) after salient penalty events under temporal pressure and information ambiguity. Such moderate risk-taking can be used as a behavioral background in the case of fraud damage. We conducted two psychophysiological experiments using the IGT and used a psychophysiological modeling approach to examine how moderate risk-taking under temporal pressure and information ambiguity is associated with automatic physiological responses, such as a skin conductance response (SCR). The first experiment created template SCR functions under concurrent temporal pressure and information ambiguity. The second experiment produced a convolution model using the SCR functions and fitted the model to the SCR time series recorded under temporal pressure and no temporal pressure, respectively. We also collected the participants’ anxiety profiles before the IGT experiment. The first finding indicated that participants with higher state anxiety scores yielded better model fitting (that is, event-related physiological responses) under temporal pressure. The second finding demonstrated that participants with better model fitting made consecutive Deck A selections under temporal pressure more frequently. In summary, a psychophysiological modeling approach is effective for capturing overlapping SCRs and moderate risk-taking under concurrent temporal pressure and information ambiguity is associated with automatic physiological and emotional reactivity.

Normatively Irrelevant Affective Cues Affect Risk-Taking under Uncertainty: Insights from the Iowa Gambling Task (IGT), Skin Conductance Response, and Heart Rate Variability

Being able to distinguish between safe and risky options is paramount in making functional choices. However, deliberate manipulation of decision-makers emotions can lead to risky behaviors. This study aims at understanding how affective reactions driven by normatively irrelevant affective cues can interfere with risk-taking. Good and Bad decks of the Iowa Gambling Task have been manipulated to make them unpleasant through a negative auditory manipulation. Anticipatory skin conductance response (SCR) and heart rate variability (HRV) have been investigated in line with the somatic marker hypothesis. Results showed fewer selections from Good decks when they were negatively manipulated (i.e., Incongruent condition). No effect of the manipulation was detected when Bad decks were negatively manipulated (i.e., Congruent condition). Higher anticipatory SCR was associated with Bad decks in Congruent condition. Slower heart rate was found before selections from Good decks in Control and Congruent condition and from Bad decks in Incongruent condition. Differences in heart rate between Bad and Good decks were also detected in Congruent condition. Results shed light on how normatively irrelevant affective cues can interfere with risk-taking.

Autonomic responses to choice outcomes: Links to task performance and reinforcement-learning parameters

Previous work has shown that autonomic responses to choice feedback can predict subsequent decision-making. In this study, we tested whether skin conductance responses (SCRs) and heart rate (HR) decelerations following the presentation of choice outcomes predict Iowa Gambling Task performance in nonclinical participants (n = 64). We also examined how these signals related to parameters of a reinforcement-learning (RL) model. Feedback SCRs and HR decelerations were greater following outcomes that included losses and choices from the bad decks defined by their negative expected value. In addition, SCRs predicted task performance. A hierarchical Bayesian RL model indicated that greater feedback SCR for the bad decks compared to good decks was associated with stronger loss aversion and a lower learning rate, both of which predicted higher performance. These results suggest that feedback-related SCRs are linked to individual differences in outcome evaluation and learning processes that guide reinforcement-learning.

Sweating the small stuff: A meta-analysis of skin conductance on the Iowa gambling task

To systematically examine the role of anticipatory skin conductance responses (aSCRs) in predicting Iowa Gambling Task (IGT) performance. Secondly, to assess the quality of aSCR evidence for the Somatic Marker Hypothesis (SMH) during the IGT. Finally, to evaluate the reliability of current psychophysiological measurements on the IGT. Electronic databases, journals and reference lists were examined for inclusion. Data were extracted by two reviewers and validated by another reviewer, using a standardised extraction sheet along with a quality assessment. Two meta-analyses of aSCR measures were conducted to test the relationship between overall aSCR and IGT performance, and differences in aSCR between advantageous and disadvantageous decks. Twenty studies were included in this review. Quality assessment revealed that five studies did not measure anticipatory responses, and few stated they followed standard IGT and/or psychophysiological procedures. The first meta-analysis of 15 studies revealed a significant, small-to-medium relationship between aSCR and IGT performance (r= .22). The second meta-analysis of eight studies revealed a significant, small difference in aSCR between the advantageous and disadvantageous decks (r= .10); however, publication bias is likely to be an issue. Meta-analyses revealed aSCR evidence supporting the SMH. However, inconsistencies in the IGT and psychophysiological methods, along with publication bias, cast doubt on these effects. It is recommended that future tests of the SMH use a range of psychophysiological measures, a standardised IGT protocol, and discriminate between advantageous and disadvantageous decks.

Electrophysiological Measurement of Emotion and Somatic State Affecting Ambiguity Decision: Evidences From SCRs, ERPs, and HR

Twenty-three years ago, the Somatic Marker Hypothesis (SMH) proposed by Damasio was introduced to explain the role of emotion in decision-making, and provided a unique neuroanatomical framework for decision-making and its influence by emotion. The core idea of the SMH is that decision-making is a process that is affected by somatic state signals, including those that express themselves in emotion and feeling. In order to verify the SMH, the Iowa Gambling Task (IGT) was originally designed by Bechara et al. and the skin conductance responses (SCRs) was recorded during the IGT. The initial confirmatory results showed that normal subjects would generate anticipatory SCRs when they received reward or punishment, but patients of the VMPFC lesion entirely failed to generate anticipatory SCRs prior to their selection of a card. With the further development of the SMH–related researches, other electrophysiological methods of measuring somatic state was gradually used to test the SMH, including event-related potentials (ERPs), and heart rate (HR). In this mini review article, we summarize the extant electrophysiological research on the SMH and decision-making under ambiguity, propose an integrative perspective for employing different electrophysiological measurement methods, and indicate the application of electrophysiological measurement based on the SMH in daily social decision-making.

Reward sensitivity and electrodermal responses to actions and outcomes in a go/no-go task

Skin conductance response (SCR) is used in psychophysiological research to measure the reactions of the autonomic nervous system to reward and punishment. While there is consistent evidence that SCR increases to both aversive and appetitive stimuli, it remains unclear whether SCR simply represents a general index of arousal to motivationally significant outcomes or may also differentiate action or inhibition of action that lead to such outcomes. Furthermore, individual differences in trait sensitivity to reward and punishment can influence physiological arousal during approach and avoidance behaviors. Yet, their inter-relationships have not been examined. To address these gaps, we employed a reward go/no-go task with ⅔ go and ⅓ no-go trials and an individually titrated go response window. Correct go and no-go responses were rewarded while incorrect responses were penalized. We examined whether SCR varied with outcome (win vs. loss), action (go vs. no-go), and individual differences in reward sensitivity (SR) and sex. The results showed greater SCRs to loss vs. win, to go vs. no-go success, and to go success in positive correlation with SR. Further, SCR mediated the relationship between SR and go success rate. In sex differences, men exhibited greater SCR which was more predictive of go success rate relative to women. In contrast, SCR was more predictive of no-go success rate in women. Thus, SCR varies according to behavioral contingency, outcome, sex, and reward sensitivity. These findings add to the literature by characterizing the individual and behavioral factors that may influence physiological arousal in response to salient events.

Feeling the Insight: Uncovering Somatic Markers of the "aha" Experience

Whether internal insight can be recognized by experiencing (somatic feeling) remains an unexplored problem. This study investigated the issue by examining potential somatic markers of the "aha" experience occurring at the moment of sudden insight. Participants were required to solve a set of compound remote associates (CRA) problems and were simultaneously monitored via electrodermal and cardiovascular recordings. The "aha"-related psychological components and somatic markers were determined by contrasting insightful solutions with non-insightful solutions. Results showed that the "aha" experience was an amalgam entailing positive affects and approached cognition accompanied by a greater mean skin conductance response (mSCR) amplitude and a marginally accelerated heart rate than the "no-aha" one. These results confirm and extend findings of the multidimensionality of the "aha" feeling and offer the first direct evidence of somatic markers, particularly an electrodermal signature of an "aha" feeling, which suggests a sudden insight could likely be experienced by individuals' external soma.

Age of onset of cannabis use and decision making under uncertainty

Objective

Cannabis, like other substances, negatively affects health, inducing respiratory problems and mental and cognitive alterations. Memory and learning disorders, as well as executive dysfunctions, are also neuropsychological disorders associated to cannabis use. Recent evidence reveals that cannabis use during adolescence may disrupt the normal development of the brain. This study is aimed to analyze possible differences between early-onset and late-onset cannabis consumers.

Method

We used a task based on a card game with four decks and different programs of gains/losses. A total of 72 subjects (19 women; 53 men) participated in the study; they were selected through a purposive sampling and divided into three groups: early-onset consumers, late-onset consumers, and control (non-consumers). The task used was the “Cartas” program (computerized version based on the Iowa Gambling Task (IGT)), with two versions: direct and inverse. The computational model “Prospect Valence Learning” (PVL) was applied in order to describe the decision according to four characteristics: utility, loss aversion, recency, and consistency.

Results

The results evidence worst performance in the IGT in the early-onset consumers as compared to late-onset consumers and control. Differences between groups were also found in the PVL computational model parameters, since the process of decision making of the early-onset consumers was more influenced by the magnitude of the gains-losses, and more determined by short-term results without loss aversion.

Conclusions

Early onset cannabis use may involve decision-making problems, and therefore intervention programs are necessary in order to reduce the prevalence and delay the onset of cannabis use among teenagers.

Decision-making, somatic markers and emotion processing in opiate users

RATIONALE

Opiate use is associated with deficits in decision-making. A possible explanation for these deficits is provided by the somatic marker hypothesis, which suggests that substance users may experience abnormal emotional responses during decision-making involving reward and punishment. This in turn may interfere with the brief physiological arousal, i.e. somatic markers that normally occur in anticipation of risky decisions. To date, the applicability of the somatic marker hypothesis to explain decision-making deficits has not been investigated in opiate users.

OBJECTIVES

This study assessed whether decision-making deficits in opiate users were related to abnormal emotional responses and reduced somatic markers.

METHODS

Opiate users enrolled in an opiate substitute treatment program (n = 28) and healthy controls (n = 32) completed the Iowa Gambling Task (IGT) while their skin conductance responses (SCRs) were recorded. Participants' emotional responses to emotion-eliciting videos were also recorded using SCRs and subjective ratings.

RESULTS

Opiate users displayed poorer decision-making on the IGT than did controls. However, there were no differences between the groups in SCRs; both groups displayed stronger SCRs following punishment than following reward, and both groups displayed stronger anticipatory SCRs prior to disadvantageous decisions than advantageous decisions. There were no group differences in objective or subjective measures of emotional responses to the videos.

CONCLUSIONS

The results suggest that deficits in emotional responsiveness are not apparent in opiate users who are receiving pharmacological treatment. Thus, the somatic marker hypothesis does not provide a good explanation for the decision-making deficits in this group.

Selective impairment of decision making under ambiguity in alexithymia

BACKGROUND

Alexithymia is characterised by difficulties identifying and describing emotions. Few studies have investigated how alexithymia influences decision-making under different conditions (ambiguity and risk). This study aimed to examine whether alexithymia contributes to impairment in decision-making.

METHOD

This study included 42 participants with high scores in the Chinese version of Toronto Alexithymia Scale (alexithymia group), and 44 matched subjects with low scores (control group). Decision-making was measured using the Iowa Gambling Task (IGT) and the Game of Dice Task (GDT).

RESULTS

The main findings of this study revealed selective deficits in IGT performance for the alexithymia group, while GDT performance was unimpaired when compared with the control group. In IGT, total netscores were lower for the alexithymia group compared to the control group, particularly with regard to block 5. Moreover, the alexithymia individuals selected significantly more adverse cards than the controls, indicating significant decision-making impairments.

CONCLUSION

Alexithymia selectively influences decision-making under ambiguity.

Frontal-subcortical circuitry in social attachment and relationships: A cross-sectional fMRI ALE meta-analysis

Researchers have explored the concept of attachment in multiple ways, from animal studies examining imprinting to abnormal attachment in psychopathology. However, until recently, few have considered how neural circuitry develops the effective social bonds that are subsequently replicated in relationships across the lifespan. This current cross-sectional study undertook a fMRI Activation Likelihood Estimation (ALE) meta-analyses to examine the neurocircuitry that governs emotional and behavioural functions critical for building effective social relationships in children and adults. Results suggest that dissociable dorsal cognitive ("cool") and ventral - affective ("hot") frontal-subcortical circuits (FSC) work together to govern social relationships, with repeated social consequences leading to potentially adaptive - or maladaptive - relationships that can become routinized in the cerebellum. Implications for forming stable, functional, social bonds are considered, followed by recommendations for those who struggle with cool and hot FSC functioning that can hinder the development of adaptive prosocial relationships.

Go for broke: The role of somatic states when asked to lose in the Iowa Gambling Task

The Somatic Marker Hypothesis (SMH) posits that somatic states develop and guide advantageous decision making by "marking" disadvantageous options (i.e., arousal increases when poor options are considered). This assumption was tested using the standard Iowa Gambling Task (IGT) in which participants win/lose money by selecting among four decks of cards, and an alternative version, identical in both structure and payoffs, but with the aim changed to lose as much money as possible. This "lose" version of the IGT reverses which decks are advantageous/disadvantageous; and so reverses which decks should be marked by somatic responses - which we assessed via skin conductance (SC). Participants learned to pick advantageously in the original (Win) IGT and in the (new) Lose IGT. Using multilevel regression, some variability in anticipatory SC across blocks was found but no consistent effect of anticipatory SC on disadvantageous deck selections. Thus, while we successfully developed a new way to test the central claims of the SMH, we did not find consistent support for the SMH.

Gender differences in two decision-making tasks in a community sample of adolescents

In adolescence, externalized problems such as risk taking and antisocial behavior are more frequent in boys. This suggests that there are differences in the way boys and girls evaluate risk and make decisions during this period. To explore decision making and highlight possible gender differences, 124 adolescents at a junior secondary school completed two decision-making tasks: The Iowa Gambling Task (Bechara, Damasio, Damasio, & Anderson, 1994) and the Rogers Betting Task (Rogers et al., 1999). The results indicate that girls make more advantageous decisions on the Gambling Task and boys take more risks during the Betting Task. These results are discussed in light of the differing development of emotion, cognition, and brain structures in boys and girls.

When parsimony is not enough: considering dual processes and dual levels of influence in sexual decision making

The literature on sexual decision making that has been used to understand behaviors relevant to HIV and STI risk has relied primarily on cognitive antecedents of behavior. In contrast, several prominent models of decision making outside of the sexual behavior literature rely on dual process models, in which both affective and cognitive processing are considered as important precursors to behavior. Moreover, much of the literature on sexual behavior utilizes individual-level traits and characteristics to predict aggregated sexual behavior, despite decision making itself being a situational or event-level process. This article proposes a framework for understanding sexual decision making as the result of dual processes (affective and cognitive) operating at dual level of influence (individual and situational). Finally, this article ends with a discussion of the conceptual and methodological benefits and challenges to its use and future directions for research.

The somatic marker theory in the context of addiction: contributions to understanding development and maintenance

Recent theoretical accounts of addiction have acknowledged that addiction to substances and behaviors share inherent similarities (eg, insensitivity to future consequences and self-regulatory deficits). This recognition is corroborated by inquiries into the neurobiological correlates of addiction, which has indicated that different manifestations of addictive pathology share common neural mechanisms. This review of the literature will explore the feasibility of the somatic marker hypothesis as a unifying explanatory framework of the decision-making deficits that are believed to be involved in addiction development and maintenance. The somatic marker hypothesis provides a neuroanatomical and cognitive framework of decision making, which posits that decisional processes are biased toward long-term prospects by emotional marker signals engendered by a neuronal architecture comprising both cortical and subcortical circuits. Addicts display markedly impulsive and compulsive behavioral patterns that might be understood as manifestations of decision-making processes that fail to take into account the long-term consequences of actions. Evidence demonstrates that substance dependence, pathological gambling, and Internet addiction are characterized by structural and functional abnormalities in neural regions, as outlined by the somatic marker hypothesis. Furthermore, both substance dependents and behavioral addicts show similar impairments on a measure of decision making that is sensitive to somatic marker functioning. The decision-making deficits that characterize addiction might exist a priori to addiction development; however, they may be worsened by ingestion of substances with neurotoxic properties. It is concluded that the somatic marker model of addiction contributes a plausible account of the underlying neurobiology of decision-making deficits in addictive disorders that is supported by the current neuroimaging and behavioral evidence. Implications for future research are outlined.

Avoidant decision making in social anxiety: the interaction of angry faces and emotional responses

Recent research indicates that angry facial expressions are preferentially processed and may facilitate automatic avoidance response, especially in socially anxious individuals. However, few studies have examined whether this bias also expresses itself in more complex cognitive processes and behavior such as decision making. We recently introduced a variation of the Iowa Gambling Task which allowed us to document the influence of task-irrelevant emotional cues on rational decision making. The present study used a modified gambling task to investigate the impact of angry facial expressions on decision making in 38 individuals with a wide range of social anxiety. Participants were to find out which choices were (dis-) advantageous to maximize overall gain. To create a decision conflict between approach of reward and avoidance of fear-relevant angry faces, advantageous choices were associated with angry facial expressions, whereas disadvantageous choices were associated with happy facial expressions. Results indicated that higher social avoidance predicted less advantageous decisions in the beginning of the task, i.e., when contingencies were still uncertain. Interactions with specific skin conductance responses further clarified that this initial avoidance only occurred in combination with elevated responses before choosing an angry facial expressions. In addition, an interaction between high trait anxiety and elevated responses to early losses predicted faster learning of an advantageous strategy. These effects were independent of intelligence, general risky decision-making, self-reported state anxiety, and depression. Thus, socially avoidant individuals who respond emotionally to angry facial expressions are more likely to show avoidance of these faces under uncertainty. This novel laboratory paradigm may be an appropriate analog for central features of social anxiety.

Emotion-based learning: insights from the Iowa Gambling Task

Interest in the cognitive and/or emotional basis of complex decision-making, and the related phenomenon of emotion-based learning, has been heavily influenced by the Iowa Gambling Task. A number of psychological variables have been investigated as potentially important in understanding emotion-based learning. This paper reviews the extent to which humans are explicitly aware of how we make such decisions; the biasing influence of pre-existing emotional labels; and the extent to which emotion-based systems are anatomically and functionally independent of episodic memory. Review of literature suggests that (i) an aspect of conscious awareness does appear to be readily achieved during the IGT, but as a relatively unfocused emotion-based "gut-feeling," akin to intuition; (ii) Several studies have manipulated the affective pre-loading of IGT tasks, and make it clear that such labeling has a substantial influence on performance, an experimental manipulation similar to the phenomenon of prejudice. (iii) Finally, it appears that complex emotion-based learning can remain intact despite profound amnesia, at least in some neurological patients, a finding with a range of potentially important clinical implications: in the management of dementia; in explaining infantile amnesia; and in understanding of the possible mechanisms of psychotherapy.

Learning on the IGT follows emergence of knowledge but not differential somatic activity

The importance of unconscious autonomic activity vs. knowledge in influencing behavior on the Iowa Gambling Task (IGT) has been the subject of debate. The task's developers, Bechara and colleagues, have claimed that behavior on the IGT is influenced by somatic activity and that this activity precedes the emergence of knowledge about the task contingencies sufficient to guide behavior. Since then others have claimed that this knowledge emerges much earlier on the task. However, it has yet to be established whether somatic activity which differentiates between advantageous and disadvantageous choices on the IGT is found before this point. This study describes an experiment to determine whether knowledge sufficient to guide behavior precedes differential autonomic activity or vice versa. This experiment used a computerized version of the IGT, knowledge probes after every 10 trials and skin conductance recording to measure somatic activity. Whereas in previous reports the majority of participants end the task with full conceptual knowledge of the IGT contingencies we found little evidence in support of this conclusion. However, full conceptual knowledge was not critical for advantageous deck selection to occur and most participants had knowledge sufficient to guide behavior after approximately 40 trials. We did not find anticipatory physiological activity sufficient to differentiate between deck types in the period prior to acquiring this knowledge. However, post-punishment physiological activity was found to be larger for the disadvantageous decks in the pre-knowledge period, but only for participants who displayed knowledge. Post-reward physiological activity distinguished between the advantageous and disadvantageous decks across the whole experiment but, again, only in participants who displayed knowledge and then only in later trials following their display of knowledge.

Learning on the IGT follows emergence of knowledge but not differential somatic activity

The importance of unconscious autonomic activity vs. knowledge in influencing behavior on the Iowa Gambling Task (IGT) has been the subject of debate. The task's developers, Bechara and colleagues, have claimed that behavior on the IGT is influenced by somatic activity and that this activity precedes the emergence of knowledge about the task contingencies sufficient to guide behavior. Since then others have claimed that this knowledge emerges much earlier on the task. However, it has yet to be established whether somatic activity which differentiates between advantageous and disadvantageous choices on the IGT is found before this point. This study describes an experiment to determine whether knowledge sufficient to guide behavior precedes differential autonomic activity or vice versa. This experiment used a computerized version of the IGT, knowledge probes after every 10 trials and skin conductance recording to measure somatic activity. Whereas in previous reports the majority of participants end the task with full conceptual knowledge of the IGT contingencies we found little evidence in support of this conclusion. However, full conceptual knowledge was not critical for advantageous deck selection to occur and most participants had knowledge sufficient to guide behavior after approximately 40 trials. We did not find anticipatory physiological activity sufficient to differentiate between deck types in the period prior to acquiring this knowledge. However, post-punishment physiological activity was found to be larger for the disadvantageous decks in the pre-knowledge period, but only for participants who displayed knowledge. Post-reward physiological activity distinguished between the advantageous and disadvantageous decks across the whole experiment but, again, only in participants who displayed knowledge and then only in later trials following their display of knowledge.

O Iowa Gambling Task: uma revisão crítica

O Iowa Gambling Task (IGT) é uma tarefa amplamente utilizada na avaliação da capacidade de tomada de decisão. Neste artigo, procede-se à revisão da literatura, comparando-se as versões do IGT, as diferentes medidas de avaliação do desempenho e as alterações introduzidas nos procedimentos, nomeadamente no feedback, na aleatorização espacial dos baralhos, no número de ensaios e de cartas por baralho, nas instruções, na remuneração e na manipulação das recompensas e punições. Desta análise, conclui-se que as diversas versões da tarefa, as alterações nos procedimentos de aplicação e as diferentes medidas utilizadas na avaliação têm impacto no desempenho, prejudicam a comparação entre estudos e as generalizações dos resultados. Finalmente, apresentam-se sugestões para uma maior adequação dos procedimentos.

Enhanced cardiac perception is associated with increased susceptibility to framing effects

Previous studies suggest in line with dual process models that interoceptive skills affect controlled decisions via automatic or implicit processing. The "framing effect" is considered to capture implicit effects of task-irrelevant emotional stimuli on decision-making. We hypothesized that cardiac awareness, as a measure of interoceptive skills, is positively associated with susceptibility to the framing effect. Forty volunteers performed a risky-choice framing task in which the effect of loss versus gain frames on decisions based on identical information was assessed. The results show a positive association between cardiac awareness and the framing effect, accounting for 24% of the variance in the framing effect. These findings demonstrate that good interoceptive skills are linked to poorer performance in risky choices based on ambivalent information when implicit bias is induced by task-irrelevant emotional information. These findings support a dual process perspective on decision-making and suggest that interoceptive skills mediate effects of implicit bias on decisions.

The somatic marker affecting decisional processes in obsessive-compulsive disorder

INTRODUCTION

Patients with obsessive-compulsive disorder (OCD) demonstrate impairment in decisional processes in which both cognition and emotion play a crucial role.

METHODS

We investigated the connection between decision-making performances and choice-related skin conductance responses (SCRs), to identify a somatic marker impairment affecting decisional processes in these patients. We explored SCRs during the Iowa Gambling Task in 20 OCD and 18 control, measuring anticipatory and posticipatory psychophysiological reactions according to card choices and to the outcomes of each selection.

RESULTS

Most patients exhibited weaker SCRs compared to HC, although there weren't substantial differences in magnitude between the two groups. In contrast with HC, patients with OCD showed no significant differences of SCRs activation according to card selections; they chose cards from neither favourable nor unfavourable decks.

CONCLUSIONS

The main finding of the study were the evidence of a dysfunctional biological marker in OCD subjects, affecting decision-making process. Dysfunctional patterns of SCRs could partially explain OCDs' impairment in this ability. Decision-making deficits in OCDs could be influenced in part by the lack of somatic differences in discriminating between advantageous and disadvantageous behaviour. These findings could lead to a more complete understanding of OCD.

Personality and Skin Conductance Responses to Reward and Punishment

For several years now, the somatic aspect of emotions has been regarded as a major factor in the decision-making process. A large body of literature has investigated this issue, within the somatic marker hypothesis perspective, using the classical Iowa Gambling Task (IGT). Many studies reported an influence of clinical and differential factors, including personality, on IGT performance. On the other hand, personality appears to modulate the emotional responses as a function of valence (i.e., responses to rewards vs. punishments). The present study investigated whether the influence of personality on the decision-making process might be mediated by differential emotional responsiveness. Skin conductance levels were recorded in 32 subjects while performing the IGT. The results showed that novelty seeking (NS) modulated the skin conductance responses to feedback, and both NS and harm avoidance (HA) influenced anticipative response development. We also found that NS tended to modulate the final score, beyond the influence of beneficial anticipative autonomic responses. The present data partially support the hypothesis that personality-related differential emotional responsiveness may modulate somatic marker development in a decision-making situation. On the other hand, personality influence on the performance was not entirely explained by these emotional differences.

Impaired decision making in oppositional defiant disorder related to altered psychophysiological responses to reinforcement

BACKGROUND

When making decisions, children with oppositional defiant disorder (ODD) are thought to focus on reward and ignore penalty. This is suggested to be associated with a state of low psychophysiological arousal.

METHODS

This study investigates decision making in 18 children with oppositional defiant disorder and 24 typically developing control subjects. Children were required to choose between three alternatives that carried either frequent small rewards and occasional small penalties (advantageous), frequent large rewards and increasing penalties (seductive), or frequent small rewards and increasing penalties (disadvantageous). Penalties in the seductive and disadvantageous alternatives increased either in frequency or magnitude in two conditions. Heart rate (HR) and skin conductance responses to reinforcement were obtained.

RESULTS

In the magnitude condition, children with ODD showed an increased preference for the seductive alternative (carrying large rewards); this was not observed in the frequency condition. Children with ODD, compared with typically developing children, displayed greater HR reactivity to reward (more HR deceleration) and smaller HR reactivity to penalty. Correlation analyses showed that decreased HR responses to penalty were related to an increased preference for large rewards. No group differences were observed in skin conductance responses to reward or penalty.

CONCLUSIONS

The findings suggest that an increased preference for large rewards in children with ODD is related to a reduced cardiac reactivity to aversive stimuli. This confirms notions of impaired decision making and altered reinforcement sensitivity in children with ODD and adds to the literature linking altered autonomic control to antisocial behavior.

Emotion, decision-making and substance dependence: a somatic-marker model of addiction

Similar to patients with orbitofrontal cortex lesions, substance dependent individuals (SDI) show signs of impairments in decision-making, characterised by a tendency to choose the immediate reward at the expense of severe negative future consequences. The somatic-marker hypothesis proposes that decision-making depends in many important ways on neural substrates that regulate homeostasis, emotion and feeling. According to this model, there should be a link between abnormalities in experiencing emotions in SDI, and their severe impairments in decision-making in real-life. Growing evidence from neuroscientific studies suggests that core aspects of substance addiction may be explained in terms of abnormal emotional guidance of decision-making. Behavioural studies have revealed emotional processing and decision-making deficits in SDI. Combined neuropsychological and physiological assessment has demonstrated that the poorer decision-making of SDI is associated with altered reactions to reward and punishing events. Imaging studies have shown that impaired decision-making in addiction is associated with abnormal functioning of a distributed neural network critical for the processing of emotional information, including the ventromedial cortex, the amygdala, the striatum, the anterior cingulate cortex, and the insular/somato-sensory cortices, as well as non-specific neurotransmitter systems that modulate activities of neural processes involved in decision-making. The aim of this paper is to review this growing evidence, and to examine the extent of which these studies support a somatic-marker model of addiction.

Dissociation of decisions in ambiguous and risky situations in obsessive-compulsive disorder

Patients with obsessive-compulsive disorder (OCD) often show deficits in everyday decision-making, a phenomenon which is leading to a growing research interest in neuropsychological aspects of decision-making in OCD. Previous investigations of OCD patients demonstrated deficits in the Iowa Gambling Task (IGT), a decision-making task with implicit rules. Results were interpreted as reflecting orbitofrontal cortex dysfunctions observed in OCD. The aim of the present study is to investigate OCD patients' performance on the Game of Dice Task (GDT), a decision-making task with explicit and stable rules. For this purpose, 23 patients with OCD and 22 healthy comparison subjects were examined with the GDT and the IGT as well as with tests of executive functioning. While patients performed worse than comparison subjects on the IGT, they were unimpaired on the GDT and executive functioning tasks. Results further emphasize dysfunctions of the orbitofrontal cortex, but indicate intact functioning of the dorsolateral prefrontal cortex in patients with OCD.

Right ventromedial and dorsolateral prefrontal cortices mediate adaptive decisions under ambiguity by integrating choice utility and outcome evaluation

The Iowa gambling task (IGT) is one of the most influential behavioral paradigms in reward-related decision making and has been, most notably, associated with ventromedial prefrontal cortex function. However, performance in the IGT relies on a complex set of cognitive subprocesses, in particular integrating information about the outcome of choices into a continuously updated decision strategy under ambiguous conditions. The complexity of the task has made it difficult for neuroimaging studies to disentangle the underlying neurocognitive processes. In this study, we used functional magnetic resonance imaging in combination with a novel adaptation of the task, which allowed us to examine separately activation associated with the moment of decision or the evaluation of decision outcomes. Importantly, using whole-brain regression analyses with individual performance, in combination with the choice/outcome history of individual subjects, we aimed to identify the neural overlap between areas that are involved in the evaluation of outcomes and in the progressive discrimination of the relative value of available choice options, thus mapping the two fundamental cognitive processes that lead to adaptive decision making. We show that activation in right ventromedial and dorsolateral prefrontal cortex was predictive of adaptive performance, in both discriminating disadvantageous from advantageous decisions and confirming negative decision outcomes. We propose that these two prefrontal areas mediate shifting away from disadvantageous choices through their sensitivity to accumulating negative outcomes. These findings provide functional evidence of the underlying processes by which these prefrontal subregions drive adaptive choice in the task, namely through contingency-sensitive outcome evaluation.

Anticipatory emotions in decision tasks: covert markers of value or attentional processes?

Anticipatory emotions precede behavioral outcomes and provide a means to infer interactions between emotional and cognitive processes. A number of theories hold that anticipatory emotions serve as inputs to the decision process and code the value or risk associated with a stimulus. We argue that current data do not unequivocally support this theory. We present an alternative theory whereby anticipatory emotions reflect the outcome of a decision process and serve to ready the subject for new information when making an uncertain response. We test these two accounts, which we refer to as emotions-as-input and emotions-as-outcome, in a task that allows risky stimuli to be dissociated from uncertain responses. We find that emotions are associated with responses as opposed to stimuli. This finding is contrary to the emotions-as-input perspective as it shows that emotions arise from decision processes.

Skin conductance responses during decisions in ambiguous and risky situations in obsessive-compulsive disorder

INTRODUCTION

Patients with obsessive-compulsive disorder (OCD) often have difficulties in everyday decision making. In addition, recent research suggests that patients have reduced performance on the Iowa Gambling Task, a laboratory decision-making task with implicit rules that taps emotional feedback processing. Disadvantageous decision making is accompanied by reduced skin conductance responses (SCRs) generated during task performance.

METHODS

The current study investigates behavioural and SCR data during the Iowa Gambling Task (IGT) and additionally the Game of Dice Task (GDT), a decision-making task with explicit and stable rules. We examined 14 patients with OCD and 15 comparison subjects performing the two decision-making tasks while recording accompanying SCR.

RESULTS

Patients showed difficulties on the Iowa Gambling Task but not the Game of Dice Task. This was also confirmed by the SCR results. In the Iowa Gambling Task differences in SCR patterns for patients and comparison subjects were observed, whereas SCRs during the Game of Dice Task did not differ between groups.

CONCLUSIONS

Behavioural and SCR data indicate that patients with OCD have difficulties in decisions under implicit but not under explicit risk conditions.

Brain maps of Iowa gambling task

Background

Somatic Marker Hypothesis (SMH), based on clinical observations, delineates neuronal networks for interpreting consciousness generation and decision-making. The Iowa gambling task (IGT) was designed to verify the SMH. However, more and more behavioral and brain imaging studies had reported incongruent results that pinpointed a need to re-evaluate the central representations of SMH. The current study used event-related fMRI (functional Magnetic Resonance Imaging) to examine neural correlates of anticipation vs. outcome, wins vs. losses, and differential decks' contingencies of IGT.

Results

Behavioral results showed a prominent effect of frequency in driving choices. The insula and basal ganglia were activated during the anticipation phase while the inferior parietal lobule was activated during the outcome phase. The activation of medial prefrontal cortex was especially targeted during the high punishment contingencies. The data suggest that under uncertainty the normal decision makers can become myopic.

Conclusion

The insula and basal ganglia might play a vital role in long-term guidance of decision-making. Inferior parietal lobule might participate in evaluating the consequence and medial prefrontal cortex may service the function of error monitoring.

Immediate gain is long-term loss: Are there foresighted decision makers in the Iowa Gambling Task?

BACKGROUND

The Somatic Marker Hypothesis suggests that normal subjects are "foreseeable" and ventromedial prefrontal patients are "myopic" in making decisions, as the behavior shown in the Iowa Gambling Task. The present study questions previous findings because of the existing confounding between long-term outcome (expected value, EV) and gain-loss frequency variables in the Iowa Gambling Task (IGT). A newly and symmetrically designed gamble, namely the Soochow Gambling Task (SGT), with a high-contrast EV between bad (A, B) and good (C, D) decks, is conducted to clarify the issue about IGT confounding. Based on the prediction of EV (a basic assumption of IGT), participants should prefer to choose good decks C and D rather than bad decks A and B in SGT. In contrast, according to the prediction of gain-loss frequency, subjects should prefer the decks A and B because they possessed relatively the high-frequency gain.

METHODS

The present experiment was performed by 48 participants (24 males and 24 females). Most subjects are college students recruited from different schools. Each subject played the computer version SGT first and completed a questionnaire for identifying their final preference. The IGT experimental procedure was mostly followed to assure a similar condition of decision uncertainty.

RESULTS

The SGT experiment demonstrated that the prediction of gain-loss frequency is confirmed. Most subjects preferred to choose the bad decks A and B than good decks C and D. The learning curve and questionnaire data indicate that subjects can not "hunch" the EV throughout the game. Further analysis of the effect of previous choice demonstrated that immediate gain increases the probability to stay at the same deck.

CONCLUSION

SGT provides a balanced structure to clarify the confounding inside IGT and demonstrates that gain-loss frequency rather than EV guides decision makers in these high-ambiguity gambles. Additionally, the choice behavior is mostly following the "gain-stay, lose-randomize" strategy to cope with the uncertain situation. As demonstrated in SGT, immediate gain can bring about a long-term loss under uncertainty. This empirical result may explain some shortsighted behaviors in real life.

Does Autonomic Arousal Distinguish Good and Bad Decisions?

The somatic marker hypothesis (SMH) proposes that physiological feedback to the brain influences cognitive appraisal and human decisions, however, the strength of evidence in support of the SMH is equivocal. We examined the validity of the SMH by measuring physiological arousal in a population of healthy individuals playing the Iowa Gambling Task (IGT), which is a computerized card game designed to assess real-life decisions. We also examined the influence of reinforcer type on IGT performance and physiological reactivity. Skin conductance level (SCL) reactivity was measured in 41 participants performing the IGT using either facsimile or real money. Participants were categorized as normal (i.e., nonimpaired) or impaired on the basis of their IGT performance, and differences in performance and physiological reactivity between groups were examined. No differences in SCL were found between normal and impaired groups. However, greater SCL rises were borderline significant when anticipating choices from bad decks compared with good decks, and a significantly greater SCL rise followed a reward from a bad deck. The effect of reinforcer type also revealed marginally greater performance when using facsimile money. This was corroborated physiologically by Deck × Reinforcer Type interactions, showing a marginally significant tendency for a greater SCL rise when anticipating a choice from a bad deck using facsimile but not real money, and a significantly greater SCL rise following a reward from a bad deck when using facsimile but not real money. Findings constrain the SMH, suggesting that autonomic activity may discriminate between good and bad decks (i.e., good vs. bad decision-making) by reflecting the magnitude of gains and losses, but is independent of long-term consequences and does not discriminate between overall good and bad performance (i.e., normal vs. impaired decision-makers).

Development of decision making in school-aged children and adolescents: evidence from heart rate and skin conductance analysis

Age differences in decision making indicate that children fail to anticipate outcomes of their decisions. Using heart rate and skin conductance analyses, we tested whether developmental changes in decision making are associated with (a) a failure to process outcomes of decisions, or (b) a failure to anticipate future outcomes of decisions. Children aged 8-10, 12-14, and 16-18 years performed the Hungry Donkey task, a child version of the Iowa Gambling Task, while heart rate and skin conductance activity were continuously recorded. Children aged 16-18 learned to make advantageous choices over task blocks faster than the two younger age groups. Age differences were present for anticipation-related autonomic activity but not outcome-related autonomic activity. The results are interpreted vis-à-vis models of prefrontal cortex maturation.

Is deck C an advantageous deck in the Iowa Gambling Task?

BACKGROUND

Dunn et al. performed a critical review identifying some problems in the Somatic Marker Hypothesis (SMH). Most of the arguments presented by Dunn focused on the insufficiencies for replication of skin conductance responses and somatic brain loops, but the study did not carefully reassess the core-task of SMH. In a related study, Lin and Chiu et al. identified a serious problem, namely the "prominent deck B phenomenon" in the original IGT. Building on this observation, Lin and Chiu also posited that deck C rather than deck A was preferred by normal decision makers due to good gain-loss frequency rather than good final-outcome. To verify this hypothesis, a modified IGT was designed that possessed high contrast of gain-loss value in each trial, with the aim of achieving a balance between decks A and C in terms of gain-loss frequency. Based on the basic assumption of IGT, participants should prefer deck C to deck A based on consideration of final-outcome. In contrast, based on the prediction of gain-loss frequency, participants should have roughly equal preferences for decks A and C.

METHODS

This investigation recruited 48 college students (24 males and 24 females) as participants. Two-stage IGT with high-contrast gain-loss value was launched to examine the deck C argument. Each participant completed the modified IGT twice and immediately afterwards was administered a questionnaire to assess their consciousness and final preferences following the game.

RESULTS

The experimental results supported the predictions regarding gain-loss frequency participants choose the deck C with nearly identical frequency to deck A, despite deck C having a better final outcome than deck A. The "sunken deck C" phenomenon is clearly identified in this version of IGT which achieves a balance in gain-loss frequency. Moreover, the "sunken deck C" phenomenon not only appears during the first stage, but also during the second stage of IGT. In addition, questionnaires indicated that normal decision makers disliked deck C at the consciousness (explicit) levels.

CONCLUSION

In the modified version of IGT, deck C was no longer preferred by normal decision makers, despite having a better long-term outcome than deck A. This study identified two problems in the original IGT. First, the gain-loss frequency between decks A and C is pseudo-balanced. Second, the covered phenomenon leads to most IGT related studies misinterpreting the effect of gain-loss frequency in situations involving long-term outcomes, and even leads to overstatement of the foresight of normal decision makers.

Is deck B a disadvantageous deck in the Iowa Gambling Task?

Background

The Iowa gambling task is a popular test for examining monetary decision behavior under uncertainty. According to Dunn et al. review article, the difficult-to-explain phenomenon of "prominent deck B" was revealed, namely that normal decision makers prefer bad final-outcome deck B to good final-outcome decks C or D. This phenomenon was demonstrated especially clearly by Wilder et al. and Toplak et al. The "prominent deck B" phenomenon is inconsistent with the basic assumption in the IGT; however, most IGT-related studies utilized the "summation" of bad decks A and B when presenting their data, thereby avoiding the problems associated with deck B.

Methods

To verify the "prominent deck B" phenomenon, this study launched a two-stage simple version IGT, namely, an AACC and BBDD version, which possesses a balanced gain-loss structure between advantageous and disadvantageous decks and facilitates monitoring of participant preferences after the first 100 trials.

Results

The experimental results suggested that the "prominent deck B" phenomenon exists in the IGT. Moreover, participants cannot suppress their preference for deck B under the uncertain condition, even during the second stage of the game. Although this result is incongruent with the basic assumption in IGT, an increasing number of studies are finding similar results. The results of the AACC and BBDD versions can be congruent with the decision literatures in terms of gain-loss frequency.

Conclusion

Based on the experimental findings, participants can apply the "gain-stay, loss-shift" strategy to overcome situations involving uncertainty. This investigation found that the largest loss in the IGT did not inspire decision makers to avoid choosing bad deck B.

The Simulated Gambling Paradigm Applied to Young Adults: An Examination of University Students' Performance

Simulated gambling tasks have become popular as sensitive tools for identifying individuals with real-time impairment in decision making. Various clinical samples, especially patients with damage to the ventromedial prefrontal cortex, perform poorly on these tasks. The patients typically persist in choosing risky (disadvantageous) card decks instead of switching to safer (advantageous) decks. In terms of Damasio's (1994) somatic marker hypothesis, the poor performance stems from defective integration of emotional and rational aspects of decision making. Less information is available about performance in healthy populations, particularly young adults. After administering a computerized gambling task to 141 university students, we found that individuals in this population also tend to prefer disadvantageous decks to advantageous decks. The results indicate that performance is governed primarily by the frequency of positive outcomes on a trial-by-trial basis rather than by the accumulation of winnings in the longer term. These findings are discussed in light of the cognitive literature pertaining to the simulated gambling paradigm.

Role of the amygdala in decisions under ambiguity and decisions under risk: evidence from patients with Urbach-Wiethe disease

Various neuropsychological studies have shown that decision-making deficits can occur in a wide range of patients with brain damage or dysfunctions. Decisions under ambiguity, as measured with the Iowa Gambling Task, primarily depend on the integrity of the ventromedial prefrontal cortex and the amygdala, as well as on further brain regions such as the somatosensory cortex. However, little is known about the specific role of these structures in decisions under risk measured with tasks that offer explicit rules for gains and losses and winning probabilities, for example, the Game of Dice Task. We aimed to investigate the potential role of the amygdala for decisions under risk. For this purpose, we examined three patients with Urbach-Wiethe disease--a rare syndrome associated with selective bilateral mineralisation of the amygdalae. Neuropsychological performance was assessed with the Iowa Gambling Task (decisions under ambiguity), the Game of Dice Task (decisions under risk), and an extensive neuropsychological test battery focussing on executive functions. Furthermore, previous studies found relationships between generating skin conductance responses and deciding advantageously in the Iowa Gambling Task. Accordingly, we recorded skin conductance responses during both decision tasks as a measure of emotional reactivity. Results indicate that patients with selective amygdala damage have lower scores in both decisions under ambiguity and decisions under risk. Decisions under risk are especially compromised in patients who also demonstrate deficits in executive functioning. In both gambling tasks, patients showed reduced skin conductance responses compared to healthy comparison subjects. The results suggest that deciding advantageously under risk conditions involves both the use of feedback from previous trials, as required by decisions under ambiguity, and in addition, executive functions.

Decision making and set shifting impairments are associated with distinct symptom dimensions in obsessive-compulsive disorder

Obsessive-compulsive disorder (OCD) is clinically heterogeneous. The authors examined how specific OCD symptom dimensions were related to neuropsychological functions using multiple regression analyses. A total of 39 OCD patients and 40 controls completed the Iowa Gambling Task (IGT; A. Bechara, A. R. Damasio, H. Damasio, & S. W. Anderson, 1994), which is a test of decision making, and the Wisconsin Card Sorting Test (R. K. Heaton, 1981), which is a test of set shifting. OCD patients and controls showed comparable decision making. However, patients with prominent hoarding symptoms showed impaired decision making on the IGT as well as reduced skin conductance responses. OCD patients had poorer set shifting abilities than controls, and symmetry/ordering symptoms were negatively associated with set shifting. These results help explain previous inconsistent findings in neuropsychological research in OCD and support recent neuroimaging data showing dissociable neural mechanisms involved in mediating the different OCD symptom dimensions.