Impulsive decision-making: Learning to gamble wisely?

A decade ago, Bechara et al. [Bechara, A., Damasio, A. R., Damasio, H., & Anderson, S. W. (1994). Insensitivity to future consequences following damage to human prefrontal cortex. Cognition, 50, 7–15] published a paper in Cognition, introducing a Gambling Task which was designed to mimic everyday decision-making. Since then, the task has been computerized, its decision-making components have been scrutinized, and it has been employed in various patient groups, such as pathological gamblers, substance abusers, and so forth. Time and again it has been shown that while normal controls perform well on the task, it is the various target populations under scrutiny who exhibit poor performance. Yet, as we show in this paper, a total of 46% of normal individuals exhibited poor performance on the task, indicating a lack of learning. We argue that while so much importance has been placed on contrasting patients with controls, perhaps the real emphasis should lie in distinguishing among different individual profiles of performance on the task, irrespective of clinical classification. Our basic recommendation is to look at the individual data, pool when you can, and only then to contrast groups.