Delayed transition from ambiguous to risky decision making in alcohol dependence during Iowa Gambling Task

It has been demonstrated that alcohol-dependent patients exhibit decision-making deficits, particularly, hypersensitivity to reward and executive dysfunction. Yet, how the impaired motivational process and executive dysfunction in the patients affect decisions under ambiguity and risk with different degrees of uncertainty is little known. To investigate the neuropsychological origin of the impaired decision making under uncertainty in alcohol dependence, we administered the Iowa Gambling Task (IGT), Game of Dice Task (GDT) and Wisconsin Card Sorting Test (WCST) to 23 alcohol-dependent patients and 21 healthy subjects, and calculated the correlations between the task performances. We found that the patients showed poor performance in all three tasks compared with the healthy subjects. Moreover, correlations between performances on the GDT and the later trials of the IGT were delayed in alcohol-dependent patients when compared with healthy subjects. There is also a significant correlation between performances of earlier trials of the IGT and the WCST in the patients. These findings suggest that executive dysfunction in alcohol-dependent patients hampers appropriate estimation of probability distributions of possible alternatives, leading to a delayed transition from ambiguous to risky conditions in the Iowa Gambling Task.