Post learning sleep improves cognitive-emotional decision-making: evidence for a 'deck B sleep effect' in the Iowa Gambling Task

The Prominent Deck B Phenomenon in Schizophrenia: An Empirical Study on Iowa Gambling Task

Background: The Iowa Gambling Task (IGT) was established to evaluate emotion-based decision-making ability under uncertain circumstances in clinical populations, including schizophrenia (Sz). However, there remains a lack of stable behavioral measures regarding discrimination for decision-making performance in IGT between schizophrenic cases and healthy participants. None of the Sz-IGT studies has specifically verified the prominent deck B (PDB) phenomenon gradually revealed in other populations. Here, we provided a global review and empirical study to verify these Sz-IGT issues. Methods: Seeking reliable and valid behavioral measures, we reviewed 38 studies using IGT to investigate decision-making behavior in Sz groups. The IGT, the Wisconsin Card Sorting Test (WCST), and clinical symptoms evaluations were administered to 61 schizophrenia or schizoaffective cases diagnosed by psychiatrists and 62 demographically matched healthy participants. Results: There were no valid behavioral measures in IGT that could significantly identify the decision-making dysfunction of Sz. However, Sz cases, on average, made more choices from disadvantageous deck B relative to other decks, particularly in the later learning process (block 3-5). Compared to the control group, the Sz group was more impaired on the WCST. The high-gain frequency decks B and D showed significant correlations with WCST but no correlation between clinical symptoms and IGT/WCST. Conclusions: Gain-loss frequency (GLF) has a dominant and stable impact on the decision-making process in both Sz and control groups. PDB phenomenon is essentially challenging to be observed on the ground of the expected value (EV) viewpoint approach on the IGT in both populations. Consequently, caution should be exercised when launching the IGT to assess the decision-making ability of Sz under a clinical scenario.

Recollecting Cross-Cultural Evidences: Are Decision Makers Really Foresighted in Iowa Gambling Task?

The Iowa Gambling Task (IGT) has become a remarkable experimental paradigm of dynamic emotion decision making. In recent years, research has emphasized the "prominent deck B (PDB) phenomenon" among normal (control group) participants, in which they favor "bad" deck B with its high-frequency gain structure-a finding that is incongruent with the original IGT hypothesis concerning foresightedness. Some studies have attributed such performance inconsistencies to cultural differences. In the present review, 86 studies featuring data on individual deck selections were drawn from an initial sample of 958 IGT-related studies published from 1994 to 2017 for further investigation. The PDB phenomenon was found in 67.44% of the studies (58 of 86), and most participants were recorded as having adopted the "gain-stay loss-randomize" strategy to cope with uncertainty. Notably, participants in our sample of studies originated from 16 areas across North America, South America, Europe, Oceania, and Asia, and the findings suggest that the PDB phenomenon may be cross-cultural.

The protective effect of daytime sleep on planning and risk-related decision-making in emerging adults

We assessed the effect of a daytime sleep opportunity on planning and risk-related decision-making in emerging adults using multiple neurobehavioral assessments. A total of 136 healthy emerging adults (20.0 ± 1.5 years), 65% female, performed the Risky-Gains Task and the Tower of London test twice. Between these assessments, they were randomized to either have a sleep opportunity monitored by polysomnography (Sleep group, n = 101) or to stay awake (Wake group, n = 35). During Test 2, in comparison to the Sleep group, the Wake group showed increased sleepiness, worse planning ability and more decrease in reaction times when selecting risky choices. Changes in Tower of London test steps used and Risky-Gains Task response time correlated with the number of central and frontal fast sleep spindles, respectively. These results indicate that among emerging adults who commonly have poor sleep patterns, a daytime sleep opportunity was related to better planning ability, better psychomotor vigilance and stable response speeds in risk-related decision-making. Changes in planning and risk-related decision-making correlated with the number of sleep spindles during the nap, supporting a specific role for sleep in modulating planning and potentially other higher-order cognitive functions.

Deciphering Age Differences in Experience-Based Decision-Making: The Role of Sleep

OBJECTIVE

Recent studies have demonstrated that sleep not only facilitates memory consolidation but also benefits more complex cognitive skills such as decision-making in young adults. Older adults use different decision strategies compared with young adults, which leaves the role of sleep in older adults' decision-making unclear. We investigated the age-by-sleep effect on decision-making.

METHODS

We recruited 67 young adults (ages 18 to 29 years) and 66 older adults (ages 60 to 79 years) and randomly assigned them into the "sleep" or "wake" study condition. They were given a modified Iowa gambling task to perform before and after a 12-hour interval with sleep or wakefulness.

RESULTS

Using the typical model-free analysis, we found that young adults' between-session performance improved greater than that of older adults regardless of the sleep/wake condition. Furthermore, older adults with longer total sleep time showed a greater improvement in the selection of one "good" deck. To further examine the sleep effect on age-related differences in cognitive processes underlying decision-making, we conducted computational modelling. This more fine-grained analysis revealed that sleep improved feedback sensitivity for both young and older adults while it increased loss aversion for older adults but not for young adults.

CONCLUSION

These findings indicate that sleep promotes learning-based decision-making performance via facilitating value representation, and such modulation is distinct in young compared to older adults.

Impaired emotional memory and decision-making following primary insomnia

Previous studies have indicated that sleep plays an important role in emotional memory and decision-making. However, very little attention has been given to emotional memory and decision-making in patients with primary insomnia (PI). We investigated whether PI influences the accuracy of emotional memory and social decision-making.We examined 25 patients with PI and 20 healthy controls (HC) using an emotional picture memory task and the Iowa Gambling Task (IGT). In the emotional picture memory task, participants completed two testing sessions: an emotional picture evaluation and a delayed recognition phase. During the emotional picture evaluation phase, participants were presented with 48 pictures with different valence (16 positive, 16 neutral, and 16 negative), which they had to evaluate for emotional valence and arousal. During the recognition phase, participants were asked to make a yes/no memory assessment of a set of pictures, which contained the 48 target pictures intermingled with 48 non-target pictures.The performance of the participants with PI was the same as that of the HC in the emotional picture evaluation task. However, the PI group showed worse recognition of the positive and neutral pictures than did the HC group, although recognition of negative pictures was similar in the 2 groups. In the IGT, participants in the PI group more frequently selected cards from the risky decks as the game progressed and selected more disadvantageous cards than did participants in the HC group after the first block.Our findings suggest that insomnia had different effects on memory, depending on the valence of the memory. Specifically, memory performance was impaired for positive and neutral items, but the recognition of negative stimuli seemed to be more resistant to the effects of insomnia. Our results also suggest that decision-making, which is known to be mediated by the ventromedial prefrontal cortex, including decision-making under conditions of uncertainty, may be vulnerable in PI.

Is the Clinical Version of the Iowa Gambling Task Relevant for Assessing Choice Behavior in Cases of Internet Addiction?

Objective: A critical issue in research related to the Iowa gambling task (IGT) is the use of the alternative factors expected value and gain-loss frequency to distinguish between clinical cases and control groups. When the IGT has been used to examine cases of Internet addiction (IA), the literature reveals inconsistencies in the results. However, few studies have utilized the clinical version of IGT (cIGT) to examine IA cases. The present study aims to resolve previous inconsistencies and to examine the validity of the cIGT by comparing performances of controls with cases of Internet gaming disorder (IGD), a subtype of IA defined by the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. Methods: The study recruited 23 participants with clinically diagnosed IGD and 38 age-matched control participants. Based on the basic assumptions of IGT and the gain-loss frequency viewpoint, a dependent variables analysis was carried out. Results: The results showed no statistical difference between the two groups in most performance indices and therefore support the findings of most IGT-IA studies; in particular, expected value and gain-loss frequency did not distinguish between the IGD cases and controls. However, the participants in both groups were influenced by the gain-loss frequency, revealing the existence of the prominent deck B phenomenon. Conclusion: The findings provide two possible interpretations. The first is that choice behavior deficits do not constitute a characteristic feature of individuals who have been diagnosed with IGD/IA. The second is that, as the cIGT was unable to distinguish the choice behavior of the IGD/IA participants from that of controls, the cIGT may not be relevant for assessing IGD based on the indices provided by the expected value and gain-loss frequency perspectives in the standard administration of IGT.

A Simplified Model of Choice Behavior under Uncertainty

The Iowa Gambling Task (IGT) has been standardized as a clinical assessment tool (Bechara, 2007). Nonetheless, numerous research groups have attempted to modify IGT models to optimize parameters for predicting the choice behavior of normal controls and patients. A decade ago, most researchers considered the expected utility (EU) model (Busemeyer and Stout, 2002) to be the optimal model for predicting choice behavior under uncertainty. However, in recent years, studies have demonstrated that models with the prospect utility (PU) function are more effective than the EU models in the IGT (Ahn et al., 2008). Nevertheless, after some preliminary tests based on our behavioral dataset and modeling, it was determined that the Ahn et al. (2008) PU model is not optimal due to some incompatible results. This study aims to modify the Ahn et al. (2008) PU model to a simplified model and used the IGT performance of 145 subjects as the benchmark data for comparison. In our simplified PU model, the best goodness-of-fit was found mostly as the value of α approached zero. More specifically, we retested the key parameters α, λ, and A in the PU model. Notably, the influence of the parameters α, λ, and A has a hierarchical power structure in terms of manipulating the goodness-of-fit in the PU model. Additionally, we found that the parameters λ and A may be ineffective when the parameter α is close to zero in the PU model. The present simplified model demonstrated that decision makers mostly adopted the strategy of gain-stay loss-shift rather than foreseeing the long-term outcome. However, there are other behavioral variables that are not well revealed under these dynamic-uncertainty situations. Therefore, the optimal behavioral models may not have been found yet. In short, the best model for predicting choice behavior under dynamic-uncertainty situations should be further evaluated.