Differences in Cold and Hot Decision-Making between Gambling and Other Addictions

Behavioral and biological addictions can impair decision-making processes, mainly by means of a dysfunction in brain regions associated with reward and frontal areas that may lead to disadvantageous choices. Understanding these differences helps establish appropriate terminology and enhances our ability to recognize, prevent, and treat these disorders effectively. Thus, while behavioral and biological addictions share some common elements, their underlying mechanisms and impact on decision-making vary significantly. Moreover, decision-making can be measured through questionnaires (stable or "cold" measures) or dynamic tasks (hot decisions) such as the Iowa Gambling Task (IGT), which can reflect different dimensions of this process. The aim of this study was to compare decision-making from different perspectives-stable and dynamic measures-in patients with gambling addiction (GA) (n = 42) and patients with biological addictions (BA) (n = 43). Decision-making was assessed using GDMS (Decisional Styles) and the LCT (Loss Aversion), as cold decision-making measures, as well as a hot or situational task called the IGT (Iowa Gambling Task). The results revealed that GA patients exhibited lower rational style scores compared to BA patients. Additionally, GA patients showed greater loss aversion according to the LCT questionnaire. On the other hand, when analyzing the IGT results, no differences were observed between groups in the overall IG index, learning curves, or the loss aversion parameter. However, GA patients showed higher sensitivity to feedback and less consistency in their decisions. These findings highlight the differences between different types of addictions and highlight the importance of considering the type of measure used to evaluate decision-making.