Background

Behavioral flexibility –the ability to dynamically readjust our behavior in response to reward contingency changes– is often investigated using probabilistic reversal learning tasks (PRLT). Poor PRLT performance has been proposed as a proxy for compulsivity, and theorized to be related to perseverative gambling. Previous attempts to measure inflexibility with the PRLT in patients with gambling disorder have, however, used a variety of indices that may conflate inflexibility with more general aspects of performance in the task.

Methods

Trial-by-trial PRLT acquisition and reacquisition curves in 84 treatment-seeking patients with gambling disorder and 64 controls (non-gamblers and non-problem recreational gamblers) were analyzed to distinguish between (a) variability in acquisition learning, and (b) reacquisition learning in reversed contingency phases. Complementarily, stay/switch responses throughout the task were analyzed to identify (c) premature switching, and (d) sensitivity to accumulated negative feedback.

Results and interpretation

Even after controlling for differences in acquisition learning, patients were slower to readjust their behavior in reversed contingency phases, and were more prone to maintain their decisions despite accumulated negative feedback. Inflexibility in patients with gambling disorder is thus a robust phenomenon that could predate gambling escalation, or result from massive exposure to gambling activities.

中文翻译：

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赌博疾病中的决策灵活性。

背景

经常使用概率逆向学习任务（PRLT）来研究行为灵活性（动态地调整我们的行为以响应奖励偶然性变化的能力）。已提出将PRLT表现不佳作为强制性的代名词，并认为与持久性赌博有关。然而，先前尝试用赌博性疾病来衡量PRLT的不灵活性的尝试已经使用了多种指标，这些指标可能会将不灵活性与工作中更一般的表现结合起来。

方法

分析了84位寻求赌博治疗的患者和64位对照者（非赌徒和非问题娱乐性赌徒）的逐项PRLT采集和重新采集曲线，以区分（a）采集学习的差异和（b）逆向应变阶段的重购学习。作为补充，对整个任务中的停留/切换响应进行了分析，以确定（c）过早切换，以及（d）对累积的负反馈的敏感性。

结果与解释

即使在控制了习得学习的差异之后，患者在逆向权变阶段重新调整其行为的速度也较慢，并且尽管积累了负面反馈，但仍更倾向于维持其决策。因此，患有赌博疾病的患者缺乏适应能力是一种强有力的现象，可能早于赌博升级，或者是由于大量暴露于赌博活动而导致的。