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As an initial starting point it would be useful to briefly define risk and examine what it entails. In this respect, some have defined risk as "An action that jeopardises something of value" (Reber, 1985: 17). From this vantage point, it could be argued that decision making requires individual's evaluation of multiple response options, and subsequent selection of an optimal response selection. In everyday life individuals face a wide range of situations in which they are required to select appropriate responses in order to obtain desired rewards (Clark, Cools, & Robbins, 2004). In turn, reward processing is thought to implicate the ventral tegmental area (VTA), including its dopamine neurons, as well as the amygdala and the prefrontal cortex (PFC [Schultz, 1998]). It is also interesting to notice that neurotransmitters such as serotonin and dopamine play a crucial role in decision making (Rogers, Andrews, Grasby, Brooks & Robbins, 2000). Furthermore, some studies have suggested that the same treatment used for Parkinson's Disease (PD), which involves the increase of dopamine levels, has been shown to significantly modify decision making patterns associated with compulsive gambling, and other impulsive behaviour (Antonini & Cilia, 2009).

It is also well established that optimal decision-making relies on the structural integrity of the prefrontal cortex (Bechara et al, 1997). In addition, it has been demonstrated that glutamate is an important neurotransmitter in the human cortex, given that it modulates dopamine activity in the ventral tegmental area, and thus exerts an impact upon the reward-related effects of dopamine on decision-making (Wolf, Numan, Nestler, Russell, 1999). This view has been corroborated by a number of studies that found GRIN2B to be implicated in phenotypes associated with rewards-related and impulsive behaviour such as smoking initiation (Vinik et al, 2009), alcoholism (Wernicke et al, 2003), pathological gambling (Lee et al, 2009), and obsessive-compulsive disorder (OCD [Arnold et al, 2009]). Moreover, one must also notice that the pathology of disorders such as ADHD is predominantly characterised by abnormal patterns of performance monitoring, a mechanism belonging to the cognitive system which is also vital in successful decision making (Walton et al, 2004; Shiels & Hawk, 2010).

Similarly, a study conducted by Ness, Arning, Stuttgen, Epplen & Beste (2011) found that variations in GRIN2B (N-methyl-D-aspartate receptor 2B subunit) gene may contribute towards risky decision-making with respect to NMDAR (N-methyl-D-aspartate receptor) mechanisms. The ways in which impairments in specific brain regions translate into disadvantageous decision making can be traced to the work of Bechara et al (1994). More specifically, their work has provided some useful insights into understanding the way in which emotions in combination with cognition can guide people's decisions, particularly in instances of risky decision making. Similarly, Sanfey et al (2003) study has helped establishing the fact that decision-making biases can be understood at a neural level.

When it comes to investigating the effects of lesions on decision making, one's analysis would be incomplete without examining the case of Phineas Gage. He suffered a brain injury during work by a tamping iron of 1.25 inches in diameter and 43 inches long, shooting into his face. He appeared to be just as intelligent as before, however he became irresponsible and demonstrated lack of respect for social customs (Wagar & Thagard, 2004). In this way, Phineas Gage has become the most famous and paradigmatic patient with damage to the ventrolateral medial prefrontal cortex (VMPFC). His case provided some useful insights into the neuropsychological correlates of decision-making in general and risky decision-making in particular. It follows that, studies documenting the effects of damage to the VMPFC also include the one conducted by Damasio (1994) who asserted that lesions in this region is characterised by insensitivity to future consequences.

More specifically, Damasio (1994) postulated that the VMPFC plays a key role in the production of somatic markers which are responsible for emotional reactions associated with prediction of long-term outcomes of specific responses in given situations or contexts. From this vantage point it would appear that sensory representations for appropriate responses (given a specific context) activate knowledge which is connected with previous emotional experiences. In turn, somatic markers exert an influence in the mechanisms responsible for higher levels of cognitive processes (Damasio, 1994). It is also interesting to notice that there are interconnections between the VMPFC and the amygdala, which play a pivotal role in the formation of memory traces that allow individuals to predict outcomes of a given decision (Wagar & Thagard, 2004). Furthermore, it has also been postulated that the amygdala plays a key role in the process of triggering emotional responses, especially those relating to fear (LeDoux, 2000). It has also been postulated that neural regions such as the insula can also impact decision-making, especially when individuals face uncertainty (Weller et al, 2009). It should be evident that decision-making and risk-taking behaviour is thought to involve a complex interaction between multiple cognitive components (LeDoux, 2000). Furthermore, it is well established that injury to brain regions such as the orbital and ventromedial prefrontal cortex leads to severe alterations in emotional and social behaviour, despite the fact that executive function, perception and language are largely preserved (Malloy, Bihrle, Duffy, & Cimino, 1993; Bechara, Tranel & Damasio, 2000).

In the light of the nature-nurture debate, it would appear that GRIN2B may play a significant role in the process of reward-seeking behaviour which is also involved in the process of risky decision making. However, one must notice the brain is not "naturally hardwired" to seek risky behaviour. Instead, there are instances in which individuals are born with certain genetic traits (i.e. GRIN2B) which make them prone and vulnerable towards engaging in risky decision-making tendencies. Furthermore, one could argue that such deficits in decision-making may become apparent when there is increased sensitivity to rewards or reduced sensitivity punishment.

However, given some relatively recent developments in behavioural genetics, it is particularly difficult to establish the extent to what gene expression is in fact the cause, or the effect of pathological behaviour (see Gottlieb, 2007). More specifically, Coactive and bidirectional relations involving genetic, neural, social, and cultural all exert an impact upon the individuals' behaviour (Gottlieb, 2007). Therefore, even though there is credible evidence favouring a neurobiological account for risky behaviour one must approach such findings with much caution and academic scrutiny, as an association between genes and behaviour may not always imply a causal unidirectional relationship. There is a complex interaction between genes and the environment when it comes to decision-making. Furthermore, individuals develop optimal decision making capacity only after reaching a certain age in upon which their prefrontal cortex is fully developed.

Risk-taking and gambling applied to the present social context

Risky decision-making and its neurobiological underpinnings can be applied to the understanding of pathological gambling. Gambling is essentially a good and useful model for assessing and studying risky decision-making (Clark, Averbeck, Payer, Sescousse, Winstanley & Xue, 2013). It follows that gambling has increasingly started to be recognised in terms of its negative outcomes, especially in the form of pathological gambling. In this respect, pathological gambling has been recognised as a psychiatric disorder in 1980, when it was grouped under the category of 'Impulse Control Disorders' (Petry, 2006). Pathological gambling has been defined as a recurrent and persistent maladaptive gambling behaviour (APA, 1994). More specifically, pathological gambling is characterised by the individual's inability to control gambling, which consequently leads to severe psychosocial consequences, affecting the individual at a personal, financial, and legal level (APA, 1994). It is also interesting to notice that with the expansion of legalized gambling worldwide there have been higher rates of suicide, divorce, and bankruptcy (Lobo et al, 2015). Thus, understanding the social and neurobiological substrates of pathological gambling is of paramount importance. Previous studies have found that pathological gambling is characterised by similar dysfunctions as those of behavioural addiction (Petry, 2010).

Similarly, substance addiction and pathological addiction have been found to share similar performance in neuropsychological tasks, as well as similar brain regions (Leeman & Potenza, 2011). Furthermore, one should also note that research has found that there are similar deficits between pathological gambling and substance addiction in assessments of reflection impulsivity (Lawrence, Luty, Bogdan, Sahakian, Clark, 2009) and inhibitory response (Goudriaan, Oosterlaan, de Beurs & van den Brink, 2006). More specifically, when administering the Iowa Gambling task as means of assessing decision making mediated by the prefrontal cortex (PFC) individuals exhibit the aforementioned behavioural deficits. The same pattern emerges when one compares the two groups (i.e. pathological gamblers and substance addicted individuals) in terms of their inherent genetic traits. In this respect, previous studies have found that as much as 74% of the overlap between pathological gambling and alcohol addiction in men are accounted for by genetic factors (Slutske, Eisen, True, Lyons, Goldberg, Tsuang, 2000). Moreover, twin studies (see Eisen et al, 2001; Slutske, Zhu, Meier, Martin, 2010) provided strong supportive evidence for important role played by genetic factors (50-60%) of vulnerability for developing pathological gambling.

However, one should also take into account that risk perception also plays an important role in gambling in general, and pathological gambling in particular. For instance, it is thought that individuals' perception of possible impacts (i.e. positive or negative) of engaging in particular activities determines to some extent one's willingness to take part in gambling activities in the first place (Brunborg et al., 2012). In addition, when engaging in behaviour such as gambling people assess the potential for gains and losses on an ongoing basis, and subsequently use this information to decide to increase, reduce, and continuing with their gambling activity. It follows that the one can also gain useful insights into individuals' gambling habits by studying the extent to what they are more sensitive to losses than to gains.

This phenomenon could be explained in terms the ways in which people experience "loss aversion" when for example they are faced with a gambling offer of a 50-50 chance of losing or winning a bet. It is thought that loss aversion and its underpinning value computations may constitute a key feature of neural activity in the amygdala and ventral striatum (DeMartino et al, 2010). It is also interesting to notice that recent work has demonstrated that pathological gamblers show impaired processing of loss information (Brevers et al., 2012), as well as inability to process loss aversive signals (Brunborg et al., 2012).

Gamblers also have the general tendency of overestimating small probabilities and underestimate high probabilities. More specifically, it is thought that this subjective distortion is a reflection of neural activity of the dorsolateral prefrontal cortex and the ventral striatum (Hsu, Krajbich, Zhao, Camerer, 2009). In turn, from a behavioural standpoint, the overestimation of small probabilities may underlie the perception of gambles such as the lottery as being attractive (Trepel, Fox & Poldrack, 2005). Furthermore, it is also interesting to notice that previous studies have found that measures such as the Gambling Related Cognitions Scale (GRCS) clearly indicate that pathological gamblers have an overall propensity towards erroneous beliefs (Raylu & Oei, 2004). So to this extent one could argue that behavioural and neuropsychological evidence has consistently demonstrated that there is an association between pathological gambling and risky-decision making. However, it is particularly difficult to understand what are the mechanisms underlying risky-decision making. More specifically, current evidence is by no means conclusive, especially when it attributes risky-behaviour and pathological gambling. This is due to the fact that both directions of causality, as well as its causal association are not immediately apparent. Moreover, gene may be a necessary condition for risky decision making, however, not a sufficient one.


Despite their serious consequences, it is well established that risk taking is very prevalent in today's society. It should be evident that damage to the ventrolateral medial prefrontal cortex leads to impairment in the ability to predict the future consequences of one's own actions. One must also acknowledge that understanding decision-making is challenging given that future outcomes are not always predictable. However, when it comes to gambling and risky decision making, research over the past decade seems to suggest that there are multiple similarities between substance abuse and pathological disorders, including a neurobiological overlap. Nonetheless, there is no evidence to suggest that the average individual is 'hardwired' for risky behaviour, but this may in exceptional circumstances be a product of genotype expression and exposure to a socio-environmental and cultural context which promotes gambling. Thus, it is sensible to approach this issue from a multidisciplinary angle and include social, cultural, neurobiological, behavioural and cognitive approaches in one's analysis. Finally, it is hoped that the present paper will act as a catalyst for future debate concerning the neuropsychological basis for human decision-making.


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Author:Teixeira, Mirian
Publication:Journal of Social and Psychological Sciences
Article Type:Report
Date:Jan 1, 2018

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