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Know the risk, take the win: How executive

functions and probability processing influence
advantageous decision making under risk
conditions
ab a c c
Matthias Brand , Johannes Schiebener , Marie-Theres Pertl & Margarete Delazer
a
General Psychology: Cognition, University of Duisburg-Essen, Duisburg, Germany
b
Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
c
Clinical Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
Published online: 25 Sep 2014.
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To cite this article: Matthias Brand, Johannes Schiebener, Marie-Theres Pertl & Margarete Delazer (2014) Know
the risk, take the win: How executive functions and probability processing influence advantageous decision
making under risk conditions, Journal of Clinical and Experimental Neuropsychology, 36:9, 914-929, DOI:
10.1080/13803395.2014.955783

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 Journal of Clinical and Experimental Neuropsychology, 2014
Vol. 36, No. 9, 914–929, http://dx.doi.org/10.1080/13803395.2014.955783

Know the risk, take the win: How executive functions and
probability processing influence advantageous decision
making under risk conditions
Matthias Brand1,2, Johannes Schiebener1, Marie-Theres Pertl3, and Margarete Delazer3
1
General Psychology: Cognition, University of Duisburg-Essen, Duisburg, Germany
2
Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
3
Clinical Department of Neurology, Innsbruck Medical University, Innsbruck, Austria

(Received 5 March 2014; accepted 13 August 2014)

Downloaded by [New York University] at 20:55 02 June 2015

Recent models on decision making under risk conditions have suggested that numerical abilities are important
ingredients of advantageous decision-making performance, but empirical evidence is still limited. The results of
our first study show that logical reasoning and basic mental calculation capacities predict ratio processing and
that ratio processing predicts decision making under risk. In the second study, logical reasoning together with
executive functions predicted probability processing (numeracy and probability knowledge), and probability
processing predicted decision making under risk. These findings suggest that increasing an individual’s under-
standing of ratios and probabilities should lead to more advantageous decisions under risk conditions.

Keywords: Decision making; Numerical abilities; Executive functions; Mental calculation; Ratio processing.

Neuropsychological studies suggest that patients
with decision-making deficits have a significantly
poorer social outcome and a lower quality of life
than other neurological patients (Bar-On, Tranel,
Denburg, & Bechara, 2003). Understanding the cog-
nitive mechanisms involved in decision making is
thus of major importance for understanding patients’
difficulties and developing intervention methods.
Decision situations differ with respect to the
predictability of their consequences and the expli-
citness of probability-information for a positive or
negative outcome to occur. In decisions under
explicit risk (from now on labeled as “decisions
under risk”), the situation is exactly defined, and
the rules, probabilities, and possible positive or
negative consequences (e.g., gains or losses) are
given explicitly or are calculable. Therefore, the
decision maker can list all possible outcomes with
the related positive and negative consequences and
can contrast the different options against each
other with respect to the expected value. This is a
numerical quantity denoting the mathematical
value of an option by summarizing the probabil-
ities and the heights of potential outcomes in one
number. The expected value is calculated by the
following formula: (gain × winning probability) –
(loss × losing probability) (see e.g., Friedman &
Savage, 1948; Keeney & Raiffa, 1993). In contrast,
in situations of ambiguous risk (from now on
labeled as “decisions under ambiguity”), a decision
maker is not aware of the probabilities of the
various outcomes and/or cannot predict the possi-
ble consequences (e.g., Bechara, Damasio, Tranel,
& Damasio, 1997; Brand, Labudda, &
Markowitsch, 2006). However, the decision
maker can use the feedback of previous decisions
to learn which alternatives lead to more positive
and which to more negative consequences.
In the present study, we focus on decision mak-
ing under risk conditions and on specific cognitive

We thank Ida Gradl, Nina Blume, and Theresa Pfanner for data collection, Elisa Wegmann and Gerrit Stöckigt for helpful
comments on the manuscript, and Mirko Pawlikowski for programming the GDT–Double.
Address correspondence to: Matthias Brand, Department of General Psychology: Cognition, University of Duisburg-Essen,
Forsthausweg 2, 47057 Duisburg, Germany (E-mail: matthias.brand@uni-due.de).

© 2014 Taylor & Francis

 PROBABILITY PROCESSING AND DECISION MAKING
functions that may support advantageous choices.
In particular, we are interested in how numerical
abilities and executive functions support the deci-
sion-making process.
Previous investigations have attributed a major
role to executive functions and logical reasoning
in several instances of decision making depending
on the structure and the complexity of the
decision situation (Brand, Recknor, Grabenhorst,
& Bechara, 2007; Schiebener, Wegmann,
Pawlikowski, & Brand, 2013; Schiebener,
Zamarian, Delazer, & Brand, 2011). Decisions
under risk conditions with explicit and stable rules
have been shown to be correlated with subcompo-
nents of executive functions, such as cognitive flex-
ibility, set-shifting, reasoning, and monitoring (e.g.,
Bazanis et al., 2002; Brand, Fujiwara, et al., 2005;
Downloaded by [New York University] at 20:55 02 June 2015
Brand, Kalbe, et al., 2005; Brand et al., 2004;
Delazer, Sinz, Zamarian, & Benke, 2007; Delazer
et al., 2009; Drechsler, Rizzo, & Steinhausen, 2008;
Euteneuer et al., 2009; Fond et al., 2013; Schiebener
et al., 2011; Zamarian, Sinz, Bonatti, Gamboz, &
Delazer, 2008). Executive functions are needed for
developing strategies or, alternatively, for retrieving
them from long-term memory. After developing or
retrieving strategies from long-term memory, they
have to be compared, evaluated, and selected
(Brand et al., 2006). Categorization and cognitive
flexibility play a major role in the recall and selec-
tion of strategies. Problem solving is essential for
deciding which strategy seems to be the best.
Working memory is required for representing the
features of the current decision situation as well as
for representing the information retrieved from
long-term memory, for combining these aspects,
and for generating or initiating an advantageous
decision strategy. In brief, executive components,
such as categorization and cognitive flexibility,
would trigger and control decision strategies, while
working memory would make relevant information
available (Brand et al., 2006). Furthermore, when
the decision situation provides feedback about the
consequences of decisions consequences, executive
functions are thought to be involved in using this
feedback for monitoring the success of the current
decision-making strategy and for revising the strat-
egy, if necessary. This is called the cognitive feed-
back route in the model suggested by Brand et al.
(2006). However, the model also suggests an emo-
tional route of feedback processing, in which emo-
tional signals learned from processing feedback
may bias towards advantageous decisions options
intuitively (Brand et al., 2006).
Overall, the above summarized model of deci-
sion making under risk conditions, as suggested by
Brand et al. (2006), predicts that advantageous
915
decisions are guided by good executive functions.
Furthermore, Brand et al. (2006) have suggested
an effect of numerical abilities and probability
knowledge on decision making under risk condi-
tions. If the situation provides explicit numerical
information, knowledge about numbers (e.g., that
200 is greater than 100) and probabilities (e.g., that
a winning chance of 50% is higher than a winning
chance of 10%) is activated and combined with the
situational information represented in working
memory. Though it seems theoretically plausible
that numerical abilities have an impact on making
advantageous decisions under risk, empirical evi-
dence is still needed.
Empirical studies in the domain of health care
suggest that people with low numerical abilities
have unfavorable preconditions for making advan-
tageous decisions. They show limited understand-
ing of risks and benefits associated with a specific
medical treatment (Weinfurt et al., 2003), have less
insight into the benefits of cancer screening
(Schwartz, Woloshin, Black, & Welch, 1997),
have less access to treatment options, such as kid-
ney transplantations (Abdel-Kader et al., 2010),
show lower abilities in self-management of chronic
disease (Cavanaugh et al., 2008), and are more
strongly influenced by emotional framing (Peters
et al., 2006; Reyna, Nelson, Han, & Dieckmann,
2009; Zamarian, Benke, Buchler, Wenter, &
Delazer, 2010). Thus, previous studies suggest
that low numerical abilities may significantly influ-
ence decision making in a real-world context.
In everyday decision situations, for example
when comparing price reductions or mortgage
rates, individuals are confronted not only with
basic quantitative measures and simple calculation
problems, but with more complex concepts.
Typically, numerical information provided in the
health context contain concepts such as propor-
tions, probabilities, risks, or survival rates
expressed in frequencies, percentages, or fractions
(Reyna et al., 2009). These concepts pose major
problems to adults with low education, to older
individuals (Delazer, Kemmler, & Benke, 2013),
and to patients with mild cognitive impairment
(Pertl et al., 2014), but also to young and highly
educated adults (Lipkus, Samsa, & Rimer, 2001)
and even to health professionals (Estrada, Barnes,
Collins, & Byrd, 1999; Hoffrage, Lindsey,
Hertwig, & Gigerenzer, 2000; Sheridan &
Pignone, 2002). A typical error in understanding
ratio concepts consists in the so-called denomina-
tor neglect when people focus their attention on the
nominator and neglect the denominator. For
example, they consider only how often an event
may happen without paying attention to the
 916 BRAND ET AL.
overall number of events (Garcia-Retamero,
Galesic, & Gigerenzer, 2010). The denominator
neglect may lead to misinterpretations, biases in
judgment, and in consequence to nonoptimal
decisions.
In sum, executive functions play a major role in
decisions under risk when rules are explicit and
expected outcomes calculable. It may also be
assumed that numerical abilities are relevant in
decisions under risk. However, it is not clear how
numerical abilities and executive functions interact
in order to facilitate advantageous decision mak-
ing. Hypothetically, executive functions not only
have a direct effect on decision making, but facil-
itate numerical abilities in general and processing
probabilities specifically, which in turn promote
advantageous decisions. In fact, previous studies
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reported close relations between numerical abilities
and executive functions whenever tasks require
updating, inhibition, monitoring, or strategy selec-
tion. Brain imaging studies also provide ample
evidence that the prefrontal cortex, which is asso-
ciated with executive functioning, supports arith-
metic processing depending on task demands
(review in Arsalidou & Taylor, 2011). Working
memory is essential in memorizing and retrieving
arithmetic facts from long-term memory as well as
in all more complex arithmetic operations requir-
ing the temporary storage of intermediate results.
Arithmetic processing has been shown to rely on
task management and monitoring abilities
(Mantovan, Delazer, Ermani, & Denes, 1999;
Semenza, Miceli, & Girelli, 1997), on shifting
between different operations, on inhibiting over-
learned associations in calculation (Hodzik &
Lemaire, 2011; Zamarian, Semenza, Domahs,
Benke, & Delazer, 2007), and on flexibility in
adapting numerical strategies to changing demands
(e.g., Hodzik & Lemaire, 2011; Lemaire &
Arnaud, 2008). Executive functions also play an
essential role in conceptual knowledge, which pro-
vides understanding of arithmetic principles and
allows one to make inferences and to relate differ-
ent information involved in arithmetic—for exam-
ple, recognizing that 6 × 17 equals 17 × 6 or that 9
× 8 equals 80 – 8 (Delazer et al., 2004). Finally,
executive functions proved to have an effect on
performance in a numeracy task (Delazer et al.,
2013), where subjects were asked to perform simple
mathematical operations on risk information using
percentages and ratios and to convert numerical
expressions between percentages, proportions, and
probabilities (based on Lipkus et al., 2001).
Overall, several investigations suggest that
executive functions are involved in decision
making under risk conditions and in arithmetic
and number processing. It is reasonable to assume
that also numerical abilities—simple and complex
ones—constitute an important factor for making
advantageous decisions under risk conditions, as
suggested in the model by Brand et al. (2006).
With the current two studies, we aimed at assessing
the potential interaction between executive func-
tions and numerical abilities—in particular, ratio
and probability processing—and decision making
under risk conditions, when explicit information
about the options’ contingencies are numerically
provided. The first study assesses the relations
between basic mental calculation abilities, logical
reasoning, processing of ratios, and decision mak-
ing under risk. Moreover, it tests the hypothesis that
the influence of basic calculation abilities and num-
ber-based logical reasoning, respectively, on deci-
sion making is mediated by the ability to process
ratios. The second study investigates relations
between logical reasoning and executive functions,
higher order probability processing (ratio proces-
sing and complex probability knowledge), and deci-
sions under risk. More specifically, we assume that
the influence of executive functions—logical reason-
ing, set-shifting, and working memory—on deci-
sions under risk is partly mediated by ratio
processing as well as by specific knowledge about
probabilities. Results of these two studies will allow
us to picture important cognitive components of
decision making under risk conditions more
precisely.
In order to test our hypotheses, we developed a
modified version of the Game of Dice Task (GDT;
Brand, Fujiwara, et al., 2005). In the original GDT
participants have to guess which number will
appear in the next throw of a die. They are con-
fronted with different options and can explicitly
evaluate the chance to win and the risk to lose
(for a detailed description see Method section).
The modification to the original GDT was moti-
vated by two limitations of the task. First, contin-
gencies between winning probabilities and
expected values are rather simple and may present
no challenge to mathematically skilled individuals.
Thus, we increased the mathematical complexity of
the task. Second, the original GDT does not allow
differentiating conservative, risk-avoiding behavior
from optimal choices. That means that the most
conservative choice is also the most advantageous
choice, while in real life extremely conservative
decisions are not always the best. The modified
version of the GDT overcomes both disadvan-
tages, but retains the original task’s characteristics.
In brief, the GDT–Double is mathematically more
complex than the original version and allows dis-
tinguishing not only between risky and nonrisky
 PROBABILITY PROCESSING AND DECISION MAKING
TABLE 1
Test batteries of studies 1 and 2
Domain Task
Decision making under risk GDT Double
Basic calculation abilities Mental calculation task
Number-based logical reasoning VESPAR verbal series
Ratio processing Numeracy task
Probability knowledge
questionnaire
Executive functions MCST
TMT–B
Digit span backward
Note. GDT = Game of Dice Task; VESPAR = Verbal and Spatial Reasoning Test; MCST = Modified Card Sorting Test; TMT = Trail
Making Test; x = included in the test battery.
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choices, but also between optimal and conservative
advantageous choices as well as between different
grades of disadvantageous risk taking.
The test batteries of both studies can be found
in Table 1. The tasks were administered in a
pseudorandomized order.
STUDY 1
Method
Subjects
In this study, 190 participants were included.
The participants were recruited by local advertise-
ments. The assessment was done individually in a
quiet setting. Mean age of the sample was 35.91
years (SD = 15.73, range 18–85 years). The sample
included 99 females and 91 males. Mean school
education was 11.88 years (SD = 0.49). None of
the participants had a history of neurological or
psychiatric diseases as determined by a screening
interview. The study was approved by the local
ethics committee.
Instruments
The Game of Dice Task–Double (GDT–
Double). We used a modified version of the
Game of Dice Task (GDT) to assess decision mak-
ing under explicit risk conditions with advanced
requirements on probability processing and mental
calculation abilities. The GDT is a computer-based
task (Brand, Fujiwara, et al., 2005), which has
been used in more than 50 studies on decision
making under risk, so far. The participants’ goal
in the GDT is to maximize the fictitious starting
capital of €1000 within 18 throws of a single virtual
917
Main variable Study 1 Study 2
Mean expected value x x
Correct responses x
Correct responses x x
Correct responses x x
Correct responses x
Nonperseverative errors x
Time needed x
Longest span of x
correctly repeated
digits
die. Prior to each throw, subjects have to guess
which number of the die (1–6) will be thrown.
They can choose one certain number or a combi-
nation of two, three, or four numbers. Each alter-
native is associated with a certain amount of
money dependent upon the winning probability:
€1000 gain/loss for the choice of a single number
(winning probability 16.67%), €500 gain/loss for
two numbers (winning probability 33.33%), €200
gain/loss for three numbers (winning probability
50%), and €100 gain/loss for four numbers (win-
ning probability 66.67%). Participants win the cer-
tain amount of money if their guess was correct
(the number they chose is thrown) and lose the
same amount of money if their guess was not
correct (when another number is thrown). When
choosing an alternative that includes two numbers,
such as the numbers “3” and “4,” the related gain/
loss is €500. In this case, participants win €500 if
either the number “3” or the number “4” is
thrown, and they lose €500 if one of the other
numbers not chosen occurs (the 1, 2, 5, or 6). The
same principle applies for the combinations of
three and four numbers (winning if one of the
numbers chosen is thrown and losing if one of the
numbers not chosen is thrown). Before starting the
game, participants are explicitly briefed about the
rules for winning and losing, and the alternatives
are explained explicitly in a standardized compu-
ter-based manner. The gains and losses linked to
the different alternatives are permanently shown
on the screen; explicit winning probabilities (in
terms of percentages) are not shown or explained.
After the instructions, the participants are asked
whether they understood the task’s rules, and they
have the option to go back to the instructions in
case they have any further questions with respect
to the game’s rules. Subjects are also instructed
 918 BRAND ET AL.

that the task contains 18 trials and that they can
continue playing even if they have a negative bal-
ance. After each throw, the gain or loss is indicated
on the screen accompanied by a distinct sound (the
jingle of a cash machine for a gain; a dull tone for
a loss). The current total capital and the number of
the remaining trials are consistently displayed on
the screen.
In this study, we used a modified version of the
GDT. After each choice and before the die is
thrown, the participants are asked whether they
would like to double the gain and the loss. For
example, a participant has chosen one single num-
ber—for example, the “3.” Following his or her
decision, he or she is asked whether the amount of
money that can be won or lost should be doubled
(yes/no answer). If the answer is “yes,” the poten-
Downloaded by [New York University] at 20:55 02 June 2015
GDT, as has been done previously—for example,
the number of riskiest choices (choosing one single
number) and the number of safest choices (choosing
a combination of four numbers). We also analyzed
the mean expected value of all 18 decisions for each
subject. The expected value was calculated by the
formula: (gain × winning probability) – (loss ×
losing probability). The expected values of the dif-
ferent options with and without doubling the gain/
loss can be found in Table 2. Here, it is obvious that
in the GDT–Double, in contrast to the original
GDT, the most conservative behavior (choosing
the four numbers alternative) is not the most advan-
tageous one. The best behavior in the GDT–Double
is to choose the four-number alternative and to
double the potential gains/losses. The riskiest beha-
vior in the GDT–Double is choosing a one-number

tial gain, but also the potential loss, is doubled alternative and to double the gain/loss. This overall
(e.g., gain/loss €2000). If the answer is “no,” the behavior is best represented by the mean expected
original gain/loss (e.g., €1000) is played for. By value, and therefore this score is the main dependent
using the double option, the expected values of variable, which was used in the structural equation
the alternatives change, with the exception of the models.
three-numbers alternatives (expected value remains
zero, irrespective of doubling or not). The alterna- Mental calculation task. In order to asses basic
tives, winning probabilities, gains/losses, and calculation abilities, participants answered mental
expected values of the alternatives in the GDT– calculation problems, as done in the study by
Double are displayed in Table 2. Delazer et al. (2013). They are asked to solve 16
For analyzing GDT performance, the net score calculation problems altogether (4 addition, 4 sub-
was calculated by subtracting the number of high- traction, 4 multiplication, 4 division problems).
risk choices from the number of low-risk choices. Each problem is presented visually on a separate
Accordingly, a positive net score indicates low risk, page. Response time is maximum 45 s. For each
thus advantageous performance, and a negative net operation, the first problem is simple and has one-
score indicates high risk, thus disadvantageous digit operands for addition, subtraction, and multi-
behavior. This net score has been used in most of plication (for example, 4 + 3; 9 – 3, 6 × 6) and two
the recent studies on GDT performance (e.g., digits and one-digit operands for division (for exam-
Brand, Laier, Pawlikowski, & Markowitsch, 2009; ple 20:4). The following problems are of increasing
Brand et al., 2007; Brand & Schiebener, 2013; difficulty (for example, 48:12; 39:9; 260:13).
Labudda et al., 2009; Pabst, Brand, & Wolf, 2013;
Schiebener et al., 2013; Schiebener et al., 2011). In The Verbal and Spatial Reasoning Test
addition, we also analyzed further variables of the (VESPAR). We used the verbal series subtest of
the VESPAR (Langdon & Warrington, 1995,
TABLE 2 1997) to examine logical reasoning within the num-
GDT–Double options, winning probabilities, gains/losses, and ber domain. This subtest consists of 25 items. In
expected values each item, a line of three numbers is shown on the
left side of the paper. In the right column, four
GDT double Winning Gain/ Expected
options probability (%) loss € value numbers are shown. Participants have to decide
which of the numbers presented on the right side
1 single number 16.67 2000 –1333.33 logically completes the consecutive series of num-
doubled
bers shown on the left side. One example is: 2, 4, 6
1 single number 16.67 1000 –666.67
2 numbers doubled 33.33 1000 –333.33 followed by a blank on the left side and 8, 5, 7, 0
2 numbers 33.33 500 –166.67 on the right side. The correct answer would be “8.”
3 numbers doubled 50 400 0 In contrast to the original version, we used a time
3 numbers 50 200 0 limit of five minutes to complete the task. This was
4 numbers 66.67 100 33.33 done to increase the difficulty of the task, conse-
4 numbers doubled 66.67 200 66.67
quently leading to higher variance in task perfor-
Note. GDT = Game of Dice Task. mance in the sample of brain-healthy participants.
 PROBABILITY PROCESSING AND DECISION MAKING
Numeracy task. The Numeracy Task (Delazer
et al., 2013) includes 12 items similar to Lipkus
et al.’s (2001) expanded numeracy scale (7 items)
and measures ratio processing. Participants are
asked to convert percentages to proportions or to
assess different proportions (“Which of the follow-
ing numbers represents the highest probability to
remain healthy? 80 in 100, 10 in 1000 or 9 in 10?”).
Two items require the addition or subtraction of a
defined percentage, and one item tests the under-
standing of dosage instructions given in a very
short package insert. All 12 items are presented in
a medical context, framed either as positive infor-
mation (e.g., chance of recovery) or as negative
information (e.g., risk of getting a disease).
Answers are open (7 items) or have to be chosen
in a multiple-choice design (5 items; 3 alternatives
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each). Items are presented on the computer screen;
answers are given orally. Response time is limited
to 45 s per item.
Statistical analyses
Statistical standard procedures were carried out
with SPSS 22.0 for Windows (IBM SPSS Statistics,
released 2013). Pearson correlations were calcu-
lated to test for zero-order relationships between
two variables. To control the data for outliers, all
variables were regressed on a random variable. All
correlations with the random variable were very
low, rs < .079, and the regression model with the
main variables (VESPAR verbal series, mental cal-
culation task, numeracy task, and mean expected
value in the GDT–Double as predictors and the
random variable as dependent variable) was not
significant (R2 = .009, p = .789) indicating that
there were no substantially influential outliers in
any of the scores in the sample. Additionally, scat-
terplots between the variables were controlled
visually. Again, no extreme outliers were found.
Therefore, the analyses were performed with all
subjects. The structural equation modeling (SEM)
analysis was computed with MPlus 6 (Muthén &
Muthén, 2011). There were no missing data.
Before testing the full model, the fits of the latent
dimensions were also tested using confirmatory
factor analysis (CFA) in MPlus. For both SEM
and CFA, maximum likelihood parameter estima-
tion was applied.
For the evaluation of model fits, we applied
standard criteria (Hu & Bentler, 1995, 1999).
These are: the standardized root mean square resi-
dual (SRMR; values below .08 indicate good fit
with the data), comparative fit index and Tucker
Lewis index (CFI/TLI; values above .90 indicate a
good fit, values above .95 an excellent fit), and root
919
mean square error of approximation (RMSEA;
“test of close fit”; a value below .08 with a signifi-
cance value below .05 indicates acceptable fit).
Results
Descriptive values and correlations
The descriptive values of the main GDT–Double
variables and the scores in the additional neuropsy-
chological tests administered are shown in Table 3.
The bivariate correlations between the GDT–
Double variables and the neuropsychological test
scores are displayed in Table 4. There were no
effects of gender on GDT–Double performance
(t = 0.229, p = .819). Age was correlated with
GDT–Double performance with a small effect
(r = –.180, p = .013).
The structural equation model
Although the variable “calculation” (total score
of the mental calculation task) was not signifi-
cantly correlated with the mean expected value in
the GDT–Double (but with the net score), we
nevertheless calculated the structural equation
model on manifest dimension, with “VESPAR ver-
bal series sum score” and “mental calculation task
sum score” as predictor variables, “mean expected
value in the GDT–Double” as dependent variable,
and “numeracy task sum score” as mediator.
Given that this model was calculated on manifest
level, the model fit was good, with RMSEA < .001,
CFI = 1.000, TLI = 1.000, and SRMR < .001. The
χ2 test for the baseline model was significant, with
χ2 = 113.56, p < .001. The direct effect from
VESPAR to mean expected value in the GDT–
Double was significant (β = .224, p = .004). Also,
the direct effect from calculation to mean expected
TABLE 3
Study 1: Description of the GDT variables and further neu-
ropsychological test scores
Variable Mean SD
GDT net score 11.14 7.46
GDT 1 single number not doubled 0.45 0.98
GDT 1 single number doubled 0.34 0.99
GDT 4 numbers not doubled 3.16 4.35
GDT 4 numbers doubled 5.06 5.41
GDT Mean expected value –46.26 119.57
Mental calculation task (sum score) 14.93 1.48
VESPAR verbal series (sum score) 17.04 3.31
Numeracy task (sum score) 10.23 1.85
Note. GDT = Game of Dice Task; VESPAR = Verbal and
Spatial Reasoning Test.
 920 BRAND ET AL.
TABLE 4
Study 1: Bivariate correlations between GDT variables and the scores in the additional neuropsychological tests administered
1
GDT
Mean EV 2 3
2 GDT net score .717***
3 GDT 1 single number not doubled –.714*** –.414***
4 GDT 1 single number doubled –.855*** –.756***
5 GDT 4 numbers not doubled .274*** .149*
6 GDT 4 numbers doubled .373*** .160*
7 Mental calculation task .048 .151*
8 VESPAR verbal series .293*** .307***
9 Numeracy task .324*** .272***
Note. GDT = Game of Dice Task; VESPAR = Verbal and Spatial Reasoning Test; EV = expected value. 1: Mean expected value
over the 18 trials of the GDT–Double.
p ≤ .05. **p ≤ .01. ***p ≤ .001.
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value in the GDT–Double was significant (β = –.206,
p = .008). The effects from VESPAR to numeracy
(β = .338, p < .001), the effect from calculation to
numeracy (β = .360, p < .001), and the effect from
numeracy to mean expected value in the GDT–
Double (β = .317, p < .001) were significant. The
indirect effect from VESPAR over numeracy to
mean expected value in the GDT–Double was
significant (β = .107, p = .001). Also, the indirect
effect from calculation over numeracy was signifi-
cant (β = .114, p = .001). Overall, the direct and
indirect effect resulted in a variance explanation of
15.8% (R2 = .158, p = .001) of GDT–Double perfor-
mance (mean expected value).
When gender and age were included as additional
predictors in the model, the model fit indices became
lower, indicating no model fit with the data with
RMSEA = .193, CFI = .889, TLI = .502, and
SRMR = .046. This corresponds with the result
that there were no significant gender effects and
only small correlations between age and GDT–
Double performance on a bivariate level (see results
in the Descriptive Values and Correlations section).
STUDY 2
Method
Subjects
In this study, 130 participants were included.
The participants were recruited by advertisements,
Internet platforms, and e-mail lists. The assessment
was done individually in a laboratory setting.
Mean age of the sample was 28.81 years (SD =
11.19, range 18–66 years). The sample included 85
females and 45 males. Mean school education was
11.25 years (SD = 1.84). None of the participants
4 5 6 7 8
.441***
–.149* –.202**
–.181* –.088 –.288**
–.035 –.026 –.076 .116
–.255*** –.255*** –.121 .184* .421***
–.256*** –.234** .030 .166* .502*** .490***
had a history of neurological or psychiatric dis-
eases as determined by a screening interview. The
study was approved by the local ethics committee.
Instruments
GDT–Double, VESPAR verbal series, and
numeracy task. We used the GDT–Double, the ver-
bal series of the VESPAR, and the numeracy task, as
described in the methods of Study 1. In addition to
these tasks, we used the following instruments.
Modified Card Sorting Test (MCST). The
MCST (Nelson, 1976) assesses categorization,
planning, and monitoring, as well as rule learning
and set-shifting. In this computerized paradigm,
participants are shown a deck of cards displaying
a certain number (1–4) of different shapes (square,
circle, triangle, or star) in a certain color (blue,
red, green, or yellow). The participants are asked
to sort every card that appears on the screen to
one of the four target cards (first line of the
screen) without knowing the current sorting rule,
which can be the number of shapes, the shape
itself, or the color of the shapes. Visual and
acoustic feedback is given to help participants
figure out the correct sorting rule. After six cor-
rectly sorted cards, participants are notified that
the rule has changed, and then they have to find
out the new sorting rule. The main measure of
MCST performance used in this study was the
number of nonperseverative errors (incorrectly
sorted cards not related to a relapse to the pre-
vious sorting rule; fewer errors indicate better
performance).
Trail Making Test–B (TMT–B). The TMT–B
(Reitan, 1958; Reitan & Wolfson, 1995) measures
 PROBABILITY PROCESSING AND DECISION MAKING 921

speed of processing with a focus on inhibitory
control and cognitive flexibility/set-shifting. We
used the paper-and-pencil task, in which the parti-
cipants are confronted with a sheet showing
encircled numbers (1–13) and letters (A–L). They
are instructed to connect numbers and letters alter-
nating in numerical, respectively alphabetical
order, starting with 1, proceeding to A, followed
by 2, B, and so on, and ending with 13. The time
needed to fulfill the task was used as main measure
(shorter times indicate better performances).
Digit span backward. Working memory was
assessed with the subtest Digit Span Backward
from the German version (Härting et al., 2000) of
the Wechsler Memory Scale–Revised (Wechsler,
1987). In this subtest, digits are read out and
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variables. To control the data for outliers, all vari-
ables were regressed with a random variable. All
correlations with the random variable were very
low, rs < .096, and the regression model with the
main variables (VESPAR verbal series, MCST non-
perseverative errors, TMT–B, digit span backward,
numeracy task sum score, sum score of the probabil-
ity knowledge questionnaire, and mean expected
value in the GDT–Double as predictors and the ran-
dom variable as dependent variable) was not signifi-
cant (R2 = .075, p = .205), indicating that there were
no substantially influential outliers in any of the
scales in the sample. Additionally scatterplots
between the variables were controlled visually.
Again, no extreme outliers were found. Therefore,
the analyses were performed with all subjects.
The SEM analysis was computed with MPlus 6

have to be repeated by the participant in the
reverse order. The number of digits that have to
be repeated will increase after two consecutive
trials, if at least one trial has been performed cor-
rectly. Here we used the longest span of correctly
repeated digits as the main measure.
(Muthén & Muthén, 2011) using the same methods
and criteria as those described for study 1. There
were no missing data.
Results

Probability knowledge questionnaire. The prob- Descriptive values and correlations

ability knowledge questionnaire consists of eight
items assessing the knowledge and understanding The descriptive values of the main GDT–Double
of probabilities. All items are multiple-choice ques- variables and the scores in the additional neuropsy-
tions with four alternatives. The items are pre- chological tests administered are shown in Table 5.
sented on paper, and participants have to mark The bivariate correlations between the GDT–
the correct answer. Participants are instructed Double variables and the neuropsychological test
that they had to answer questions about probabil- scores are displayed in Table 6. There were no effects
ities. They are also informed that there are easier of gender on GDT–Double performance (t = 0.667,
questions as well as more difficult ones. p = .506). Age was not significantly correlated with
Furthermore, they are told that there is an overall GDT–Double performance, and again the correla-
time limit for answering the questionnaire (eight tion had a small effect, only (r = –.161, p = .068).
minutes). The participants are provided with a
calculator as well as an extra paper for auxiliary TABLE 5
calculation. For example, participants are asked Study 2: Description of the GDT variables and further neu-
what the chances are of heads coming up twice if ropsychological test scores
a fair coin is flipped twice: 0, .333, .5, or .25. Or: A Variable Mean SD
bowl is filled with 5 white and 5 black balls and
one by one the balls are drawn from the bowl, GDT net score 7.45 11.45
without putting them back in. On the first four GDT 1 single number not doubled 1.38 3.45
GDT 1 single number doubled 0.51 1.55
occasions a black ball was drawn from the bowl.
GDT 4 numbers not doubled 3.06 4.65
What is the possibility that a black ball is drawn on GDT 4 numbers doubled 3.46 4.33
the fifth draw? .024, .167, .004, .5. Performance in GDT mean expected value –112.07 205.80
the questionnaire was scored by the number of VESPAR verbal series (sum score) 18.11 2.88
correct answers (total score 0–8). MCST nonperseverative errors 5.68 4.87
TMT–B 64.65 22.25
Digit span backward 4.72 1.24
Statistical analyses Numeracy task (sum score) 9.45 2.05
Probability knowledge questionnaire 5.68 2.31
Statistical standard procedures were carried out (sum score)
with SPSS 22.0 for Windows (IBM SPSS Statistics, Note. GDT = Game of Dice Task; VESPAR = Verbal and
released 2013). Pearson correlations were calculated Spatial Reasoning Test; MCST = Modified Card Sorting Test;
to test for zero-order relationships between two TMT = Trail Making Test.
 922 BRAND ET AL.

TABLE 6
Study 2: Bivariate correlations between GDT variables and the scores in the additional neuropsychological tests administered

1
GDT
Mean EV 2 3 4 5 6 7 8 9 10 11

2 GDT net score .852***

3 GDT 1 single number –.732*** –.646***
not doubled
4 GDT 1 single number –.712*** –.682*** .173*
doubled
5 GDT 4 numbers not .351*** .190* –.182* –.209*
doubled
6 GDT 4 numbers doubled .352*** .227** –.245** –.057 –.179*
7 VESPAR verbal series .275** .176* –.278** –.085 .049 .111
8 MCST nonperseverative –.201* –.131 .158 .086 .065 –.179* –.369***
errors
9 TMT–B –.203* –.166 .117 .190* –.077 –.017 –.380*** .232**
10 Digit span backward .070 .069 .028 –.149 –.016 .112 .147 .016 –.124
11 Numeracy task .430*** .382*** –.377*** –.207* .072 .285** .579*** –.241** –.198* .144
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12 Probability knowledge .357*** .319*** –.282** –.242** –.011 .233** .460*** –.280** –.332*** .192* .579***
questionnaire

Note. GDT = Game of Dice Task; VESPAR = Verbal and Spatial Reasoning Test; MCST = Modified Card Sorting Test; TMT =
Trail Making Test; EV = expected value. 1: Mean expected value over the 18 trials of the GDT–Double.
p ≤ .05. **p ≤ .01. ***p ≤ .001.

Latent dimensions of the proposed model in TABLE 7

confirmatory factor analysis Study 2: Coefficients of the manifest variables’ loadings on
the latent dimensions, tested with CFA in MPlus
In order to systematically test the proposed the-
Latent dimension Manifest variables β SE
oretical model, we first tested whether the latent
dimensions (executive functions and probability Executive VESPAR verbal series .870*** .074
processing) are acceptably represented by the functions
manifest variables. Therefore, CFA was performed MCST nonperseverative –.424*** .084
with these two latent dimensions. Overall, the CFA errors
TMT–B –.437*** .084
model had a good fit with the data. The RMSEA Digit span backward .183* .096
was .062, the CFI was .974, the TLI was .951, and Probability Numeracy task .820*** .062
the SRMR was .039. processing
The latent dimension “executive functions” was Probability knowledge .706*** .065
represented well by the scores in the four manifest questionnaire
variables. The only exception was “digit span Notes. VESPAR = Verbal and Spatial Reasoning Test;
backward,” although the loading was still signifi- MCST = Modified Card Sorting Test; TMT = Trail Making
cant. The second latent dimension “probability Test; CFA = confirmatory factor analysis.
*p ≤ .05. ***p ≤ .001.
processing” was also well represented by the scores
of the two manifest variables. Overall, the CFA
indicates that the latent dimensions are acceptably SRMR was .037. The χ2 test was not significant, χ2 =
represented by the manifest variables. All factor 14.06, p = .297. The χ2 test for the baseline model was
loadings and standard errors are shown in Table 7. significant with χ2 = 199.17, p < .001. In summary,
the data fit well with the proposed theoretical model.
Overall, 28.2% of the variance in the variable “mean
The full structural equation model
expected value in the GDT–Double” was signifi-
The proposed theoretical model with the mean cantly explained by the full SEM (R2 = .282, p =
expected value of the GDT–Double as dependent .003). The model and all direct and indirect effects
variable (on manifest level) and the predictor “execu- are shown in Figure 1.
tive functions” as latent variable and the mediator When adding gender and age as additional predic-
“probability processing” also as latent variable tors to the model, the model fit indices become
yielded a good fit with the data. The RMSEA was lower, indicating no model fit with the data with
.036, the CFI was .988, the TLI was .980, and the RMSEA = .105, CFI = .837, TLI = .762, and
 PROBABILITY PROCESSING AND DECISION MAKING 923
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Figure 1. Results of the structural equation model including factor loadings of the latent dimensions, β-weights, p-values, and residuals
(*p ≤ .05, ***p < .001). GDT = Game of Dice Task; VESPAR = Verbal and Spatial Reasoning Test; MCST = Modified Card Sorting
Test; TMT = Trail Making Test; EV = expected value.

SRMR = .103. Again, this corresponds with the result

that there were no significant gender effects and no
significant correlations between age and GDT–
Double performance on a bivariate level (see results
in Descriptive Values and Correlations section).

ADDITIONAL ANALYSES WITH THE

COMBINED SAMPLES OF STUDY 1 AND
STUDY 2

In order to better understand task performance in

the GDT–Double and to address the additional
goal of the studies—namely, to differentiate
between conservative and optimal performance in
the GDT–Double, we combined the two samples,
Figure 2. Relative proportion of the choices made in the GDT–
resulting in a total sample of n = 320 subjects (mean Double in the whole sample (n = 320, subjects from both studies
age = 33.02, SD = 14.47 years, 136 males). The combined). GDT = Game of Dice Task.
relative proportions of choosing the eight different
options provided in the GDT–Double (one number,
two numbers, three numbers, and four numbers,
each with the option to double the potential gain/ The GDT–Double mean net score in the total sam-
loss) are shown in Figure 2. Altogether, 42% of the ple was 9.64 (SD = 9.45), and the mean expected
choices in the GDT–Double represent safe choices value was –72.99 (SD = 163.23). There were no
with a positive expected value (choosing the four effects of gender (t = 0.853, p = .394) and no
numbers combination with or without doubling). correlations between GDT–Double performance
Among the risky choices with a negative expected and age (r = –.101, p = .073).
value (23% of all choices), the majority of decisions
were made for the alternative of two numbers
without doubling. Only 2% of all choices represent DISCUSSION
very risky and disadvantageous decisions (one sin-
gle number and doubling the potential gain/loss) The present study aimed at investigating the role of
with the lowest expected value of –1333.33. executive functions and numerical abilities in
 924 BRAND ET AL.
decision making under explicit risk conditions.
Two studies were performed, the first focusing on
the effect of calculation abilities, logical reasoning,
and ratio processing on decision making, the sec-
ond on the impact of executive functions and prob-
ability processing—that is, ratio processing and
probability knowledge. A further aim was to assess
healthy individuals’ decision performance in a
modified version of the GDT allowing the fine-
grained differentiation between optimal, conserva-
tive, and risky choices.
First, results show that number-based logical
reasoning and basic mental calculation capacities
predict ratio processing and that ratio processing
predicts decision making under risk. Secondly,
number-based logical reasoning together with
other executive functions predicts probability pro-
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cessing, and probability processing predicts deci-
sion making under risk. It should be noticed that
the amounts of variance explanation of decision-
making performance were moderate in both stu-
dies (15.8% and 28.2%). These moderate variance
explanations indicate that there are also further
factors influencing decision-making performance.
Nevertheless, it makes sense that executive func-
tions, basic calculation capacities, and number-
based logical reasoning contribute to decision-
making behavior in the GDT to a considerable
extent and in a systematic manner.
In sum, the results of the two studies converge
on the view that in decision making with explicit
information about probabilities and possible out-
comes, the ability to process complex probability
information acts as a mediator for the relationship
between more basic cognitive functions and deci-
sion-making performance.
Calculation abilities predicted performance in
the numeracy task assessing the understanding
and manipulation of ratio concepts such as percen-
tages and proportions. The calculation task given
in the present study includes simple arithmetic
facts (such as 6 × 6), but also more complex multi-
digit problems that had to be performed mentally
(such as 32 × 4). Answering these calculation pro-
blems requires the retrieval of arithmetic fact
knowledge from long-term memory as well as the
execution of mental calculation procedures or stra-
tegies (Dehaene & Cohen, 1995; Delazer, 2003;
McCloskey, Caramazza, & Basili, 1985). The
more complex numeracy task (the mediator)
requires a basic understanding of ratio concepts,
including proportions, risks, and percentages, as
well as the knowledge of when and how to perform
arithmetic operations on these ratio concepts.
Though the task probes a higher level of mathe-
matical understanding, basic calculation abilities
are a prerequisite to perform accurately.
However, low scores in the numeracy task are not
simply attributable to calculation difficulties, but
more often reflect systematic misunderstandings of
ratio concepts or of the decimal system. For exam-
ple, in previous studies subjects often had difficul-
ties to convert a frequency measure (4 out of 1000)
into a percentage (“0.4 percent”), typically failing
by a power of 10 (“4 percent”; Delazer et al., 2013;
Pertl et al., 2014). Others showed the typical
denominator neglect (Garcia-Retamero et al.,
2010) and were unable to identify the largest of
three different risks expressed as ratios (Delazer
et al., 2013; Lipkus et al., 2001). These results are
in line with previous studies (Reyna & Brainerd,
2007; Reyna et al., 2009) showing that ratio con-
cepts such as fraction, percentages, and propor-
tions are especially difficult to understand and
pose difficulties not only to students, but also to
adults. As suggested by results of the present study,
people with high arithmetic competence in per-
forming mental calculation had also higher scores
in the numeracy task requiring the understanding
of ratio concepts. This effect may be partly attrib-
uted to calculation performance itself, as basic
calculation is required in the numeracy task, but
also to the fact that people with higher calculation
abilities have more insight into ratio concepts.
High competence in the numeracy task assessing
ratio processing predicted better decision making
in a situation with exactly defined options, prob-
abilities, and related consequences. Individuals
who have good understanding of ratio concepts
as well as the competence to perform arithmetic
operations on these concepts frequently chose
advantageous alternatives in the GDT–Double.
These results are consistent with the theoretical
model of decision making under risk proposed by
Brand et al. (2006). This model assumes that basic
knowledge about numbers and probabilities is a
fundamental ingredient of making advantageous
decisions in situations that explicitly provide
numerical information in terms of the amount of
potential gains and losses and/or in terms of (impli-
cit or explicit) information about probabilities. The
present study is the first that supports this theore-
tical assumption in an empirical study on
the GDT.
Calculation abilities, as measured in study 1,
showed not only an indirect positive effect on deci-
sion making mediated by ratio processing.
Surprisingly, there was also a direct negative effect.
Individuals performing well in mental calculation,
but not in ratio processing, performed poorly in the
decision task. Seemingly, calculation abilities had a
paradoxical effect on decision making when they
 PROBABILITY PROCESSING AND DECISION MAKING
were not accompanied by sufficient understanding of
ratio concepts. We suggest future studies, to investi-
gate whether this may be explained by the effect that
people with good calculation skills, but poor
understanding of ratios, focus only on parts of the
given information (for example, on the different
gains) without insight into the contingencies of
advantageous choices. Future studies may also find
a possible explanation for the paradoxical effect
when investigating the role of different types and
difficulties of calculation processes on decision
making. In the mental calculation task used in the
current study there were easier and harder arithmetic
problems. The easier ones may be solved by arith-
metic facts knowledge, while the harder ones require
more complex calculations. One may assume that
arithmetic facts knowledge and complex calculation
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abilities contribute differently to decision making
under risk, which may explain the paradoxical
findings.
A further result of the first study was that num-
ber-based logical reasoning directly predicts per-
formance on the GDT–Double, but that this
effect is partially mediated by the individuals’ abil-
ity to understand ratios. The result of the direct
effect of logical thinking fits well with a sum of
previous investigations (Brand et al., 2009). Also,
the relationship between logical thinking and
understanding ratios is consistent with previous
findings. The interesting point of our current
results is the partial mediation effect. This means
that logical thinking by itself, controlled for the
mediation over ratio processing, explains variance
in GDT–Double performance. What does this
result tell us? We argue that independent from the
ability to process ratios, logical thinking can
increase the probability of individuals categorizing
the decision options on the basis of the numerical
information. The second study yielded clear evi-
dence that logical reasoning together with other
executive functions predicts probability processing,
and probability processing predicts decision mak-
ing under risk. In previous studies, the impact of
executive functions on making advantageous deci-
sions under risk conditions has been intensively
addressed. Different executive subcomponents,
such as categorization, cognitive flexibility, logical
reasoning, strategy application, and monitoring,
have been found to correlate on a bivariate level
with performance in the GDT in various patient
populations—for example, Morbus Parkinson
(Brand et al., 2004; Euteneuer et al., 2009),
Alzheimer’s disease (Delazer et al., 2007), temporal
lobe epilepsy (Labudda et al., 2009), Korsakoff’s
syndrome (Brand, Fujiwara, et al., 2005), patholo-
gical gambling (Brand, Kalbe, et al., 2005), opiate
925
dependency (Brand, Roth-Bauer, Driessen, &
Markowitsch, 2008), schizophrenia (Fond et al.,
2013), and other groups (see Gleichgerrcht,
Ibanez, Roca, Torralva, & Manes, 2010). More
interestingly, executive functions have also been
found as important moderators for the relationship
between different individual characteristics and
decision making in the GDT. One example is the
moderating effect of executive functions (e.g., mea-
sured by the MCST) on the relationship between
age and decision making (Brand & Schiebener,
2013). It has been reported that only those older
adults with reduced executive functions show risky
decision making in the GDT, while those older
individuals with good executive functions perform
as well as young subjects on the GDT. This result
is also emphasized by the nonsignificant correla-
tion between GDT–Double performance and age
in the current study (whole sample). Additionally,
gender did not directly affect decision making in
the GDT–Double. This is also consistent with pre-
vious studies with even larger samples, in which no
effects of gender were found (e.g., Brand &
Schiebener, 2013). Another example is the interac-
tion between executive functions and the applica-
tion of a certain decision strategy (Brand, Heinze,
Labudda, & Markowitsch, 2008). Subjects with
good executive functions (measured by the
MCST) perform well on the GDT regardless of
whether they use an intuitive or a calculative strat-
egy, while subjects with lower executive function-
ing perform well only if they use a calculative
strategy. Lastly, the study by Schiebener et al.
(2011) demonstrated that executive functions (also
measured by the MCST) interact with probability
processing in predicting GDT performance. As
suggested by those results, good probability hand-
ling may compensate for the effects of weak execu-
tive functions in decisions under risk. Although the
study by Schiebener et al. (2011) contributes to a
better understanding of executive functions and
probability processing in making advantageous
decisions, it has two important limitations and
confounds: First, probability processing was
assessed by another gambling task, the
Probability Associated Gambling Task (Zamarian
et al., 2008), without assessing the participants’
explicit knowledge about probabilities or the abil-
ity to process and calculate probabilities correctly.
Secondly, the study by Schiebener et al. (2011) did
not analyze potential processes that may lie behind
the relationships between executive functions,
probability processing, and decision making.
These two limitations were explicitly addressed by
our current study 2. Using structural equation
model on latent dimension for both the predictor
 926 BRAND ET AL.
(executive functions) and the hypothesized media-
tor (probability processing), we report that the
effect of executive functions on GDT performance
(in the GDT–Double version) is mediated by the
ability to process complex probabilities correctly.
The present results provide insight into the relation
between executive functions, probability proces-
sing, and performance on the GDT–Double.
They suggest that the interpretation of simple
bivariate correlations indicating a direct relation-
ship between executive functions and performance
on the GDT–Double may lead to an incomplete
and misrepresentative picture.
Bringing together the model of decision making
under risk (Brand et al., 2006) and the results of
the current study, we may hypothesize the cogni-
tive processes in decision making under explicit
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risk conditions as follows. The person inspects the
information provided (e.g., number of options,
possible gains, possible losses), extracts essential
pieces of information, and keeps them in working
memory. Arithmetic fact knowledge, calculation
procedures, and strategies are employed to calcu-
late the probabilities, related consequences, and
expected values of each of the available alterna-
tives. In order to perform these operations cor-
rectly, an individual needs understanding of
probabilities as well as the knowledge of how to
perform arithmetic operations on them. Logical
reasoning and other executive functions, such as
categorization, cognitive flexibility, and monitor-
ing, are important for extracting relevant informa-
tion (e.g., the gain in the single die option is
€1000), retrieving knowledge about probabilities
from long-term memory (e.g., the chance of gues-
sing a single die throw is 1/6), combining these
pieces of information into a mathematical problem
representation, selecting appropriate calculation
procedures and strategies to work on this problem
(e.g., multiply the possible gain with the chance to
win and subtract the possible loss multiplied by the
risk to lose), and comparing different options.
Executive functions are needed to retrieve knowl-
edge from long-term memory, to select procedures
and strategies, and to organize and monitor the
single procedural steps, as well as to shift between
different problem situations. They are also needed
in order to inhibit seemingly attractive, but risky
choices. In particular, the present study adds evi-
dence on the interaction of executive functions and
numerical abilities in decisions under risk.
The present results are also compatible with the
Lipkus and Peters (2009) model of numeracy in
decision making in a real-world context. Highly
numerate individuals pay higher attention to num-
bers and show better computational abilities and a
better comprehension of numbers as well as ratio
concepts. They are more likely to manipulate num-
bers and to derive meaning from numerical infor-
mation, thus influencing decisions. Importantly,
the model by Lipkus and Peters (2009) assumes
that the deliberate analytical mode is completed
by intuitive processing, the two systems interacting
and informing each other. Intuitive processing
would also include basic approximate processing,
which constitutes the basis for more advanced
numerical operations (Lipkus & Peters, 2009).
Differentiating between a deliberative and an intui-
tive system has a long tradition in psychological
decision-making research (Epstein, Pacini, Denes-
Raj, & Heier, 1996; Kahneman, 2003; Reyna,
2004; Stanovich & West, 2000; Tversky &
Kahneman, 1983). Consistent with those dual-pro-
cess approaches, the neuropsychological model by
Brand et al. (2006) also suggests that decision mak-
ing under risk can be done by an executive/calcula-
tion path, but also by an emotionally driven
feedback-based path. The model suggests that deci-
ders perform optimally when they rely on both
pathways—that is, when they use the executive/
calculation path for selecting an advantageous
strategy and at the same time profit from feedback
for monitoring its efficacy.
The results of the current studies support parti-
cularly the view that the deliberative/cognitive path
to process ratios is guided primarily by executive
functions and that these cognitive processes result
in advantageous decisions in situations that offer
explicit numerical information about the expected
outcome.
An additional aim of the present research was to
assess whether healthy subjects decide advanta-
geously in the modified version of the GDT. In
the original GDT, the most conservative choice is
also the most advantageous choice. That means
that advantageous choices may either reflect opti-
mal decision making or derive from risk aversive
behavior (see also discussion in Sinz, Zamarian,
Benke, Wenning, & Delazer, 2008). The GDT–
Double overcomes this weakness by the possibility
to double the stakes after each choice, but is iden-
tical to the original GDT in all other aspects. As
shown by the present results, healthy individuals
chose the advantageous alternative (combination
of 4 dices) in 42% of the cases. These advantageous
decisions may be further differentiated into conser-
vative, risk-avoiding choices (41% of all advanta-
geous choices) and optimal choices (59%). The
present results suggest that healthy individuals
show optimal decisions in a high proportion of
instances. So obviously, choosing a combination
of four numbers in the original GDT may reflect
 PROBABILITY PROCESSING AND DECISION MAKING
both optimal decision making and risk-avoiding
behavior and does not necessarily indicate conser-
vative behavior. Moreover, the results suggest that
the distinction between optimal and conservative
behavior as provided by the GDT–Double
enhances the diagnostic validity of the original
GDT. While the modified version proved to be
useful in the assessment of healthy individuals
with relatively high education, its application in
neuropsychological research remains to be
investigated.
CONCLUSION
Decision making under risk conditions with expli-
cit numerical information about the consequences
and the probabilities is affected by the decider’s
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level of executive functions and numerical abilities.
Number-based logical thinking influences decision
making under risk directly, but this effect is also
mediated by the ability to process ratios. Logical
reasoning in combination with other executive
functions also affects more complex probability
processing, which then affects decision making
under risk. These findings suggest that increasing
an individual’s understanding of ratios and prob-
abilities should lead to more advantageous deci-
sions under risk conditions.
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