Decisions and learning processes are under metacognitive control, where confidence in one's actions guides future behaviour. Indeed, studies have shown that being more confident results in less action updating and learning, and vice versa. This coupling between action and confidence can be disrupted, as has been found in individuals with high compulsivity symptoms. Patients with Gambling Disorder (GD) have been shown to exhibit both higher confidence and deficits in learning.
In this study, we tested the hypotheses that patients with GD display increased confidence, reduced action updating and lower learning rates. Additionally, we investigated whether the action-confidence coupling was distorted in patients with GD. To address this, 27 patients with GD and 30 control participants performed a predictive inference task designed to assess action and confidence dynamics during learning under volatility. Action-updating, confidence and their coupling were assessed and computational modeling estimated parameters for learning rates, error sensitivity, and sensitivity to environmental changes.
Contrary to our expectations, results revealed no significant group differences in action updating or confidence levels. Nevertheless, GD patients exhibited a weakened coupling between confidence and action, as well as lower learning rates.
Discussion and conclusions
This suggests that patients with GD may underutilize confidence when steering future behavioral choices. Ultimately, these findings point to a disruption of metacognitive control in GD, without a general overconfidence bias in neutral, non-incentivized volatile learning contexts.
Dysfunction of the striatum, a brain region part of the mesolimbic reward system, is a key characteristic of addictive disorders, but neuroimaging studies have reported conflicting findings. An integrative model of addiction points to the presence or absence of addiction-related cues as an explanation for hyper- or hypoactivation, respectively, of the striatum.
To test this model directly, we investigated striatal activation during monetary reward anticipation in the presence versus absence of addiction-related cues using functional MRI. Across two studies, we compared 46 alcohol use disorder (AUD) patients with 30 matched healthy controls; and 24 gambling disorder (GD) patients with 22 matched healthy controls.
During monetary reward anticipation, hypoactivation of the reward system was seen in AUD individuals compared to HCs. Additionally, a behavioral interaction was seen where gambling cues made participants, across groups, respond faster for bigger, but slower for smaller rewards. However, no striatal differences were seen in response to addiction-related cues between AUD or GD patients and their matched controls. Finally, despite substantial individual differences in neural activity to cue-reactivity and reward anticipation, these measures did not correlate, suggesting that they contribute independently to addiction aetiology.
Discussion and Conclusions
Our findings replicate previous findings of blunted striatal activity during monetary reward anticipation in alcohol use disorder but do not support the idea that addiction-related cues explain striatal dysfunction as suggested by the model.
People with Gambling Disorder (GD) often make risky decisions and experience cognitive distortions about gambling. Moreover, people with GD have been shown to be overly confident in their decisions, especially when money can be won. Here we investigated if and how the act of making a risky choice with varying monetary stakes impacts confidence differently in patients with GD (n = 27) relative to healthy controls (HCs) (n = 30).
We used data from our previous mixed-gamble study, in which participants were given the choice of a certain option or a 50/50 gamble with potential gains or losses, after which they rated their confidence.
While HCs were more confident when making certain than risky choices, GD patients were specifically more confident when making risky choices than certain choices. Notably, relative to HCs, confidence of patients with GD decreased more strongly with higher gain values when making a certain choice, suggesting a stronger fear of missing out or “anticipated regret” of missing out on potential gains when rejecting the risky choice.
The current findings highlight the potential relevance of confidence and “regret” as cognitive mechanisms feeding into excessive risk-taking as seen in GD. Moreover, this study adds to the limited previous work investigating how confidence is affected in value-based risky contexts.
Open science refers to a set of practices that aim to make scientific research more transparent, accessible, and reproducible, including pre-registration of study protocols, sharing of data and materials, the use of transparent research methods, and open access publishing. In this commentary, we describe and evaluate the current state of open science practices in behavioral addiction research. We highlight the specific value of open science practices for the field; discuss recent field-specific meta-scientific reviews that show the adoption of such practices remains in its infancy; address the challenges to engaging with open science; and make recommendations for how researchers, journals, and scientific institutions can work to overcome these challenges and promote high-quality, transparently reported behavioral addiction research. By collaboratively promoting open science practices, the field can create a more sustainable and productive research environment that benefits both the scientific community and society as a whole.