Thesis title: “Changing decision by changing the emotion”: the role of emotions in decision-making processes by using a Virtual Reality scenario
Introduction. In the last few years, research on decision-making has provided a considerable amount of evidence about the importance of affective states when individuals make decisions. Emotions, in fact, support and have different effects on the decision-making process during its different stages, from the problem assessing to judging the results of choices (Mellers, Schwartz et al., 1997). Different emotional states can help the decision maker in different ways, guiding the acquisition of information, facilitating the evaluation of information, and finally orienting the choice. The state of mood experienced by individuals, even when it is not related to the decision (i.e., incidental to the choice), exerts important effects on the decision-making process. Several studies have shown that latent emotional states can modify goals, attitudes, risk perception and, in particular, have investigated how emotions of different valence, positive or negative, influence decision-making (Lerner, & Keltner, 2000; Paulus, & Angela, 2012). The interplay of mood in the sphere of cognition makes the study of the interaction between cognitive and emotional aspects of decision-making socially relevant. The study of affect and decision-making has gained particular relevance due to the connection to avoidance and risk-taking behaviour. The literature has highlighted the primary role of affect in decision-making processes and subsequent risk behaviour; indeed, several theories have been developed to explain the influence of affective states on the development and maintenance of addictions (Baker et al., 2004; Hudgens-Haney et al., 2013). However, it is currently unclear in which direction positive and negative emotions influence decision-making and risk-taking. However, both affective states and emotional competence play a key role in the development and maintenance of addiction disorders (Bechara, 2003; Bechara, 2004; Barrault et al., 2017, 2019). Method. Three different studies addressed some research questions on emotions, decision-making, and gambling disorder in different ways. The first study proposed a meta-analysis of activation likelihood estimation (ALE), providing an extensive review of the current neuropsychological and neuroimaging literature on gambling disorder (GD) and alcohol use disorder (AUD). We performed a meta-analysis on fMRI studies assessing executive functions (e.g., decision-making, delay discounting, inhibitory response) in individuals with AUD and GD to summarise previous findings on the neural correlates of the two conditions in terms of activation and/or deactivation of brain areas dedicated to executive control and provide new evidence of common and distinct neural mechanisms in these two conditions. The second study is exploratory in nature and focuses on recovery communities by investigating the presence of exclusive factors in individuals with “pure” GD, including several clinical variables (e.g., impulsivity, mood, and performance in cognitive tasks), with the aim of understanding whether these differences play a role in the specific vulnerability to GD, configuring a specific subtype of gambler. The third study proposes the use of Virtual Reality as a reliable technology to provoke craving and physiological reactions and to influence affective states, attention, cognition, and brain activity (Bouchard et al., 2017; Mazza et al., 2021). Specifically, through the use of a mood induction procedure (MIP) and a virtual reality gambling scenario, we aim at investigating which of the seemingly contradictory conceptualisations reported in the literature on the influence of negative and positive mood (e.g., motivation or an information processing factor) can explain engagement in risky behaviour in healthy individuals. Results. The meta-analysis detected interesting findings about the direction of functional alterations in individuals with AUD and GD that have not been previously described. The GD was mainly associated with higher activation of the fronto-striatal circuit (including the basal ganglia, middle frontal gyrus and anterior cingulate cortex). In contrast, AUD was associated with higher activation of the occipital cortex and of the superior portion of putamen as well as with deactivation of the fronto-striatal network (including the middle frontal gyrus, middle cingulate cortex, and inferior portion of the putamen). Thus, GD seems to be associated with an activation of the reward network, whereas AUD seems to be associated with both deactivation and activation of different nodes of this circuit. The second study highlighted specific traits of the gambling disorder, which can be observed independently of comorbidity with other substances. Results support the crucial role played by emotions and affective states in both the development and maintenance of gambling disorder, furthermore, a new task (i.e.,Gambling Affective Task) aimed at inducing a specific affective state (i.e., positive, or negative) showed that, following positive priming, participants had longer reaction times despite negative and neutral priming. This finding is in line with previous studies (Arndt et al., 2018) that investigated reaction times in relation to positive and negative emotional activators, suggesting that the activation of positive emotions could be considered as a protective factor as it would lengthen and delay the game’s conduct. The results of the third study showed that group of negative mood induction made riskier choices than the group of positive and neutral mood induction and also, the positive mood group showed longer reaction times after a risky bet. These results, in addition to being in line with those reported by the gamblers’ group in the second study during performance on the gambling affective task (i.e., longer response time after a positive priming picture), appear to be in line with both the “Affect regulation” theory by Hill (2015) and with Isen and colleagues (1983,1987) in which they showed that positive moods result in a risk-averse behaviour especially in gambling and lottery tasks. Neurophysiological results showed that specific ERPs of the EEG (i.e., P300 and RewP) are more sensitive to winning and near-miss than to losses, confirming recent studies that have collected and analysed behavioural data. Furthermore, the results highlighted the importance of implementing a new ecological study paradigm using virtual reality for both the mood induction procedure (MIP) and the virtual gambling scenario. Conclusions. The findings agree with the primary role of the affect on decision-making processes and the subsequent engagement in a risky behaviour. The present studies also provided several and innovative elements including an in-depth study of the topic of incidental mood and decision making with important implications for daily life in both control subjects and pathological gamblers; the development of an innovative study methodology through virtual reality for the study of psychophysiological processes during decision making under risky conditions, in order to overcome the methodological limitations that characterize studies in the literature on this topic; the development of an innovative mood induction procedure (MIP) administered through virtual reality with the simultaneous use of multiple techniques capable of eliciting affective state; and lastly, the development of an innovative gambling virtual scenario VR with the aim of studying the effect of near-misses outcome.