ABSTRACT
While an increased impact of cues on decision-making has been associated with substance dependence, it is yet unclear whether this is also a phenotype of non-substance related addictive disorders, such as gambling disorder. To better understand the basic mechanisms of impaired decision-making in addiction, we investigated whether cue-induced changes in decision-making could distinguish gambling disorder (GD) from healthy control (HC) subjects. We expected that cue-induced changes in gamble acceptance and specifically in loss aversion would distinguish GD from HC subjects.
30 GD subjects and 30 matched HC subjects completed a mixed gambles task where gambling and other emotional cues were shown in the background. We used machine learning and classification to carve out the importance of cue-dependency of decision-making and of loss aversion for distinguishing GD from HC subjects.
Cross-validated classification yielded an area under the receiver operating curve (AUC-ROC) of 68.9% (p=0.002). Applying the classifier to an independent sample yielded an AUC-ROC of 65.0% (p=0.047). As expected, the classifier used cue-induced changes in gamble acceptance to distinguish GD from HC. Especially increased gambling during the presentation of gambling cues was characteristic of GD subjects. However, unexpectedly, cue-induced changes in loss aversion were irrelevant for distinguishing GD from HC subjects. To our knowledge, this is the first study to investigate the classificatory power of addiction-relevant behavioral task parameters when distinguishing GD from HC subjects. The results indicate that cue-induced changes in decision-making are a characteristic feature of addictive disorders, independent of a substance of abuse.
Footnotes
Funding Sources: This study was funded by a research grant by the Senatsverwaltung für Gesundheit, Pflege und Gleichstellung, Berlin. A.G. was funded by Deutsche Forschungsgemeinschaft (DFG) HE2597/15-1, HE2597/15-2, and DFG Graduiertenkolleg 1519 “Sensory Computation in Neural Systems”.
Conflict of interest: The authors declare no conflict of interest.
Co-Authors’ email addresses: Milan Andrejevic: milan.andrejevic{at}unimelb.edu.au, Katharina Brehm: kathabrehm{at}gmail.com, Caroline Matthis: matthis{at}ni.tu-berlin.de, Andreas Heinz: andreas.heinz{at}charite.de, André Weinreich: a.weinreich{at}psychologie.hu-berlin.de, Norbert Kathmann: kathmann{at}hu-berlin.de, Nina Romanczuk-Seiferth: nina.seiferth{at}charite.de
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