Abnormal Exploratory Tendencies in Risk Decision-Making in Gambling Disorder: Evidence from the Balloon Analogue Risk Task.

A cognitive tendency toward high risk-taking is linked to gambling disorder (GD), but the specific behavioral manifestations of risky decision-making in GD are unclear. This study addresses this by analyzing differences in behavior between individuals with GD and healthy controls using the Balloon Analogue Risk Task (BART). Data from 169 adults were analyzed, including 116 with GD (57 severe, 59 mild-to-moderate) and 53 healthy controls. Four metrics were used: (1) total earnings to quantify risk decision-making ability, (2) number of exploded balloons to quantify risk propensity, (3) adjusted average pumps to quantify risk-taking level, and (4) unexploded pumps' standard deviation (SD) to quantify exploratory tendency. Statistical comparisons and correlations among these metrics were examined. Significant differences were found between the GD and control groups in total earnings and the unexploded pumps' SD, with a positive correlation between these measures in the GD group. The unexploded pumps' SD fully mediated the relationship between group membership (GD vs. HC) and total earnings. These patterns were consistent across severe GD groups. While severe GD participants had similar total earnings to the mild-to-moderate group, they exhibited a higher unexploded pumps' SD and showed a significant correlation between total earnings and the unexploded pumps' SD. Individuals with GD demonstrate poorer risk decision-making abilities and higher exploratory tendencies compared to healthy controls. The higher exploratory tendency is a key factor in their disadvantageous decision-making. Severe GD is characterized by a greater exploratory tendency than mild-to-moderate GD. These findings underscore the importance of evaluating exploratory tendencies in risky decision-making and suggest that future GD treatments should target the cognitive neural mechanisms underlying this tendency for more effective diagnostics and therapy.