The role of anxiety in decision-making

Over the past decade, many studies have shown that individuals with reduced sensitivity for risk due to traumatic brain injury in orbital parts of the prefrontal cortex tend to ignore the long term outcomes of their behavioral actions (the same holds true for individuals with socio-/psychopathy). Instead, these individuals merely base decisions on anticipated immediate gains, similar to impulsive choice in children. The Iowa gambling task has been designed specifically to measure this behavioral tendency. We used this task to investigate a state opposite to that of impulsiveness and carelessness, namely enhanced anxiety and risk intolerance. We expected beneficial effects on decision-making, especially since high anxiety in both healthy populations and patients with anxiety disorders has been linked with enhanced activation of orbitofrontal cortex. Our most important finding is that intolerance towards uncertainty is indeed positively correlated with overall performance on the Iowa gambling task in a sample of adults as well as with anxiety in a sample of children. Results illustrate the protective functions of anxiety and risk aversion, and their positive long-term effects on decision-making. These motives seem to enable individuals to better consider future consequences of their actions, and to switch from previously reinforced behaviors to alternative behaviors when contingencies change