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The opposite effect of trait and state anxiety on IOWA gambling task

Article in Learning & Perception · December 2009

DOI: 10.1556/LP.1.2009.2.110

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 Learning & Perception 1 (2009) 2, pp. 279–295
DOI: 10.1556/LP.1.2009.2.7

THE OPPOSITE EFFECT OF TRAIT AND STATE ANXIETY

ON IOWA GAMBLING TASK

P. PAJKOSSY1*, L. DEZSÕ2 and Z. ZOLTAY PAPRIKA3

1
Department of Cognitive Science, Budapest University of Technology and Economics,
Budapest, Hungary
2
Department of Economics, University of Szeged, Szeged, Hungary
3
Department of Decision Sciences, Corvinus University of Budapest, Budapest, Hungary

The impact of state/trait anxiety and worry on decision-making was investigated applying a computer-
ized gambling task (Iowa Gambling Task). Besides, using two measures of knowledge about the
task-contingencies, we examined the role of declarative knowledge in successful performance on the
task and we tested whether the amount of declarative knowledge is related to anxiety. Results showed
that trait anxiety has a negative impact, while state anxiety and worry have a positive impact on perfor-
mance on the Iowa Gambling Task. Furthermore, responses on post-experiment survey suggest that
those who perform better on the Iowa Gambling Task are more likely to form and report correct declara-
tive knowledge about the task-rules. This ability, however, was not associated with anxiety.

Keywords: Iowa Gambling Task, anxiety, worry, emotions in decision-making, explicit/implicit

learning

1. INTRODUCTION

Since emotions exert influence on decision-making their impact has been a continuous re-
search agenda for behavior decision-making studies. Although in most philosophical tradi-
tions and in psychological research, emotions were mainly cited for their adverse effects, re-
cent research in decision sciences suggests a more positive impact of emotions on deci-
sion-making.

* Corresponding author: Péter Pajkossy, Department of Cognitive Science, Budapest University of Technology and
Economics, Stoczek u. 2, H-1111 Budapest, Hungary; E-mail: ppajkossy@cogsci.bme.hu

1789-3186/$20.00 © 2011 Akadémiai Kiadó, Budapest

280 P. Pajkossy, L. Dezsõ and Z. Zoltay Paprika

1.1. The somatic marker theory

One of the most prominent approaches concerning the impact of emotions on decision-mak-
ing is the Somatic Marker Hypothesis (SMH) proposed by Antonio Damasio (1994, 1996):
this theory postulates that human decision-making is also subserved by dispositional informa-
tion stored in the emotion circuitry of the brain, thus it is not only drawing upon high-level
cognitive operations on propositional information. The circuitry stores somatosensory pat-
terns of several emotional states, the so-called “somatic markers”, and these somatic markers
can be associated with many stimuli/responses/situations during the life of the individual.
When facing a decision, somatic markers associated with response options are activated, and
unconsciously (that is without conscious awareness) influence the decision-making by
roughly signaling the value of the given response option. This assistance is particularly sup-
portive for decisions under uncertainty, in which the computational demands are high, and the
signals of the somatic markers can reduce the size of the problem space. On of the presumed
neural location of this emotional circuitry is the ventromedial part of the prefrontal cortex
(henceforward vmPFC), which is responsible for recording “linkages between factual knowl-
edge and bioregulatory states” (Damasio, 1996, p. 1414).
The evidence on which SMH is based mainly comes from experimental results applying
the Iowa Gambling Task (henceforward IGT), which was designed to model real-life decision
making under uncertainty (Bechara et al., 1994). In the IGT subjects are endowed with a cer-
tain amount of (virtual) money and are presented with 4 decks of cards (A, B, C and D). They
have to select one card from one of the decks in every round. Selecting any of the decks is re-
warded (that is subjects receive money). However, according to a preset probability distribu-
tion some selections are also punished (that is, subjects lose money). The subjects are in-
structed to collect as much money as possible throughout the game, which consists of 100
rounds (the number of the rounds is previously not revealed to the subjects). The four decks
differ in their reward–punishment schedules: decks A and B are associated with larger re-
wards than decks C and D. However, due to large and frequent punishments, permanently
choosing decks A and/or B leads to losses, even to the loss of the whole initial endowment. On
the contrary, when subjects choose from decks C and/or D, rewards surpass punishments. Al-
though this pattern is hidden, healthy subjects figure it out that on the long run decks C and D
are advantageous, due to the smaller punishments involved. The typical behavior on the task
is a progressive shift from disadvantageous (“bad”) decks (A and B) to advantageous
(“good”) decks (C and D). Since the reward–punishment schedule is hidden, it was suggested
by Bechara et al. (1994) that this shift is not due to explicit knowledge. This proposal is bol-
stered by experimental results showing that only a part of the subjects can correctly formulate
explicit knowledge on the reward–punishment schedule, and this acknowledgement mainly
occurs at the latter phase of the game. In contrast, already during the first 20 trials, prior to se-
lecting from bad decks most subjects do generate anticipatory skin conductance responses,
which is a sign of a fear reaction (Bechara et al., 1997). Consequently, ‘somatic markers’ may
underpin successful performance by unconsciously labeling decks ‘advantageous’ or ‘disad-
vantageous’. Moreover, patients with damage to the vmPFC stick to bad decks, seemingly
disregard losses and hence underperform on IGT (Bechara, Tranel and Damasio, 2000).

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 Effects of anxiety on decision-making 281

1.2. SMH, IGT performance and anxiety

According to the conceptualization of Charles Spielberger (Spielberger, 1966; Spielberger,

Gorsuch and Lushene, 1970), we can differentiate between state and trait anxiety. State anxi-
ety is the specific emotional state, characterized by the physiological and psychological signs
and symptoms of anxiety (e.g. high level of arousal, dizziness, trembling, fearful apprehen-
sion and tension). Trait anxiety is a personality trait describing individual differences in the
propensity to experience anxiety in certain situations.
State and trait anxiety are associated with the tendency of perceiving certain situations or
stimuli as physically and/or psychologically threatening. Derived from the SMH, experienced
anxiety should influence the formation of somatic markers associated with threatening stimuli
and eventually influence decision-making. However, it is theoretically and empirically un-
clear in what way state or trait anxiety impacts decision making in general and IGT perfor-
mance in particular.
On the one hand, high-levels of anxiety are characterized by disturbing negative thoughts
and evaluations, and increased anticipation of future threats (Cassady and Johnson, 2002;
Hebre, 1988). These could decrease available cognitive resources. Moreover, state anxiety is
also characterized by increased arousal, which could lead to an altered pattern of the somatic
markers and thus negatively impact decision-making processes (Ernst and Paulus, 2005).
On the other hand, Mueller et al. (2010) suggest that worry as a core symptom of anxiety
can have a positive impact on decision-making and on IGT performance. Worry is defined as
negative thoughts and images focusing on future aversive events (Borkovec et al., 1983). It is
a common symptom in many anxiety disorders, and is also a core feature in Generalized Anxi-
ety Disorder (henceforward GAD). Because the tendency to worry can be associated with the
“exaggerated processing of uncertain/probabilistic negative events that occur in the future”
(Mueller et al., 2010, p. 166), it may support avoiding possible negative outcomes and may
lead to better IGT performance
Furthermore, situational relevancy seems to be a crucial issue. Bechara and Damasio
(2005) propose that only emotions integral to the given task are helpful for the decision-mak-
ing process. Thus somatic states triggered by situation-relevant fearful thoughts are beneficial
for decision making, whereas somatic markers associated with irrelevant anxious thoughts are
disruptive. This suggests that state anxiety induced by aspects of the actual situation is benefi-
cial, whereas state anxiety triggered by unrelated thoughts is disadvantageous. Regarding trait
anxiety a rather negative impact can be hypothesized: people with high trait anxiety may tend
to produce more disruptive thoughts and thus might form somatic markers unrelated to the sit-
uation.
Concerning empirical data, some studies found that trait anxiety is associated with poor
performance and a flat learning curve on IGT (de Visser et al., 2010; Miu, Heilman and
Houser, 2008). Similarly, Preston et al. (2007) found that anticipating unpleasant future
events that are not connected to IGT deteriorates task performance. In contrast, Mueller et al.
(2010) found that students with symptoms similar to Generalized Anxiety Disorder (GAD)
perform better on the IGT. Moreover, Werner, Duschek and Schandry (2009) observed that
trait anxiety predicted better IGT performance.

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282 P. Pajkossy, L. Dezsõ and Z. Zoltay Paprika

All in all, it seems that the impact of trait and/or state anxiety on decision-making is rather
controversial, and neither theoretical considerations, nor empirical data could clarify the im-
pact of anxiety on decision-making as yet.

1.3. Declarative elaboration and anxiety

One specific factor through which anxiety could affect performance on IGT is the way people
learn throughout the task. Bechara et al. (1997) propose that up until the 30–50th selection sub-
jects do not have conscious knowledge concerning the rules of the game although they gradu-
ally shift from bad to good decks. Thus one can consider IGT as an implicit learning task,
where subjects learn to behave correctly but are unable to explicitly articulate the rules of the
contingencies. However, recent studies (Maia and McCelland, 2004; Bowman, Evans and
Turnbull, 2004) question the assumption of this cognitive impenetrability. For example, Maia
and McCelland (2004) found that those selecting more from the advantageous decks have ex-
plicit knowledge about the relative goodness or badness of the decks and that explicit knowl-
edge can be present already before the 20 th trial.
Anxiety is generally associated with increased declarative elaboration on choices (Calvo,
Avero and Miguel-Tobal, 2003), so it may be suspected that people with higher level of anxi-
ety form and test explicit hypotheses about the contingencies of the IGT. Combining the im-
plicit learning requirements of IGT and the tendency of anxious people to engage in declara-
tive elaboration, one may suspect that anxiety impairs implicit learning and thus IGT perfor-
mance through an exaggerated declarative elaboration (Miu et al., 2008). However, if declara-
tive knowledge is present already in the first phase of the IGT then anxiety-related declarative
elaboration might have beneficial effects on IGT performance.

1.4. Aims and hypotheses

In this study we coin ‘anxiety’ as an umbrella term to include both state and trait anxiety and
also worry. The purpose of our study was twofold. First, we intended to investigate the impact
of anxiety on IGT performance. Second, we examined the differences in declarative knowl-
edge among people with high and low levels of anxiety.
Based on Bechara and Damasio (2005) we predicted that trait anxiety deteriorates IGT
performance, since this personality trait is associated with increased likelihood of experienc-
ing disturbing or fearful thoughts that eventually reduce cognitive resources and lead to the
formation of somatic markers unrelated to the task. In contrast, task-related state anxiety will
be beneficial for task-performance, since it facilitates the formation of task-related somatic
markers and increased explicit elaboration. Besides, we investigated the impact of worry on
IGT performance. Based on findings of Mueller et al. (2010) we hypothesized that higher
scores on worry will be linked to better IGT performance. Note that we consider worry as a
trait variable, i.e. the general tendency of a person to engage in worrying.

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 Effects of anxiety on decision-making 283

We also assumed that people with high levels of state anxiety and worry will be more
likely to form correct declarative knowledge about the reward-punishment schedule and that
this declarative knowledge will lead to better IGT performance.

2. METHODS

2.1. IGT

The design of the task was identical to the IGT task described in subsection 1.1. The initial en-
dowment was 2000 Euros. Note, that subjects were not paid in cash for their participation,
thus incentive compatibility was not assured. Instructions were the Hungarian translation of
the original instructions and the experiment was administered on computer. The four decks
were displayed on the computer screen and subjects made their selections by pressing a key
corresponding to the deck. The probability distributions and the gains and losses were identi-
cal with the original IGT (Bechara et al., 1994), thus on the long-rung only decks C and D
were profitable. Subjects also received feedback on their actual and overall earnings.

2.2. Assessing the level of declarative knowledge

After the 100th trial subjects were presented with a final “Bonus choice”. The screen displayed
the original four decks again with the following instruction: “At the end you have one more
opportunity to win a large amount of money. Select the card which promises the largest gain
based on your previous experiences.” We assumed that selecting decks C or D reflects the
subjects’ knowledge about which decks are advantageous. Nonetheless, selecting from decks
C or D does not directly indicate the presence of declarative knowledge about the task-contin-
gencies. To check whether the subjects in fact possess declarative knowledge we applied a
short post-experiment questionnaire. Subjects answered several questions about the assumed
contingencies and rules of the task. In this paper our interest is only to analyze answers on two
of these questions. First, subjects had to indicate whether they believe that there was any rule
in the game. If the answer was yes, they were asked to formulate this rule in their own words.

2.3. Anxiety measures

Anxiety was measured by the Hungarian version of the Spielberger State-Trait Anxiety In-
ventory (Spielberger et al., 1970; Sipos, 1978). The inventory contains 40 items, with two
subscales: The State (henceforward STAI-S) subscale contains 20 items measuring the actual
level of anxiety, whereas the 20-item Trait subscale (henceforward STAI-T) measures a gen-
eral disposition to experience anxiety. Subjects have to indicate on a 4-point Likert-scale (an-
chored from 1 – not at all, to 4 – very much) to what extent each statement applies to them. The
sum of these responses is the total score for the two subscales.

Learning & Perception 1 (2009) 2

284 P. Pajkossy, L. Dezsõ and Z. Zoltay Paprika

Worrying was measured by the Penn State Worry Questionnaire (henceforward PSWQ)
(Meyer et al., 1990). PSWQ is a 16-item questionnaire assessing respondents’ inclination to
worry. Subjects have to indicate on a 4-level scale (anchored from 0 – not at all to 4 – very
much) to what extent each statement refers to them. The PSWQ measures the general ten-
dency of an individual to worry, therefore the higher the total score of a subject, the more un-
easy or worrying he is. Because the Hungarian version of the PSWQ is not yet validated, we
conducted a reliability analysis which indicated that the scale has appropriate reliability
(Cronbach-alfa: 0.88).

2.4. Socio-economic status

Subjects provided additional data about age, gender and socio-economic status (hencefor-
ward SES). An index of SES was computed from the place of residence and the parents’ level
of education.

2.5. Procedure

Upon entering the computer lab subjects were welcomed and seated in front of a computer.
First, subjects filled out the STAI-S, then received the standard IGT instructions applied from
Bechara, Tranel and Damasio (2000). Next, subjects performed the IGT, with the “Bonus
choice” at the end. After that subjects filled out the post-experiment survey, STAI-T and
PSWQ. The experimental session was closed by debriefing.

2.6. Data analysis

The scores of the single items were added up to create the total score for STAI-T, STAI-S and
PSWQ. For creating high, medium and low ranges of anxiety, the 33rd and the 66th percentile
were computed as cut-off points for three groups (e.g. low/medium/high level of state anxi-
ety).
Regarding IGT performance, a ‘net score’ was calculated by subtracting the number of
bad selections from the number of good selections ((C+D)–(A+B)). In the same way, a net
score was also computed for every block of 20 selections, hence having a separate net score
for every block.
Concerning the “Bonus choice”, selecting from advantageous decks (C or D) was catego-
rized as ‘correct selection’, whereas selecting from disadvantageous decks (A and B) was la-
beled ‘incorrect selection’.
Two independent raters rated the answers on the post-experiment questionnaire into the
following 4 categories. 0: no description at all; 1: absolutely wrong description; 2: some ele-
ments of the description are correct but the description is incomplete; 3: complete or almost
complete description. The inter-rater reliability was high (r = .94, p < .001). Because of the
low sample size these 4 categories were further merged into 2 categories. The values 0 and 1
were merged into the category ‘no rule knowledge’, whereas the values of 2 and 3 were

Learning & Perception 1 (2009) 2

 Effects of anxiety on decision-making 285

merged into the category ‘partial or complete knowledge about task rules’. This dichotomous
variable was then involved in the analysis.

2.7. Subjects

Fifty undergrad students participated (mean age = 23.82, SD = 3.31 years, 28 female, 22
male) in the study. They were recruited from the Pázmány Péter Catholic University in Buda-
pest and from the Budapest University of Technology and Economics. Subjects were com-
pensated with extra credits for their participation.

3. RESULTS

3.1. Descriptive statistics

The average total score was 39.46 (SD: 11.95) for PSWQ, 36.98 (SD: 8.74) for STAI-S and
42.60 (SD: 8.92) for STAI-T. Average total net-score for IGT was 10.00 (SD: 25.32). Women
had higher IGT net score in the first block (t = –2.64 [48], p < .05). Apart from this, no gender
differences were found either in IGT performance, or in anxiety level. SES and age was only
related to the net score of the first block (r = –.35, p < .05 and r = –.35, p < .05 for SES and age,
respectively). STAI-T and STAI-S were correlated (r = .54, p < .001), and PSWQ also corre-
lated with STAI-S and STAI-T (r = 0.42, p < .001 and r = .67, p < .001, respectively).

3.2. IGT performance

The average learning curve derived from the net scores for each block is depicted in Figure 1.
Repeated measure ANOVA with block as within-subject factor (Block 1 to Block 5) and net
score as dependent variable confirmed the main effect of block (F[3.40, 166.82] = 12.11, p <
.001). Pairwise comparisons revealed that the only significant difference between the block
net scores was that between Block 1 and Block 2 (F[1, 49] = 25.30, p < .001).

3.3. The effects of trait and state anxiety on IGT performance

The IGT performance of subjects with different trait anxiety levels is presented in Figure 2a,
whereas the performance for the groups based on state anxiety level is depicted in Figure 2b.
To analyze the effect of state and trait anxiety on IGT performance a 5 (Block 1 to Block 5) × 3
(low/medium/high state anxiety) × 3 (low/medium/high trait anxiety) mixed design ANOVA
was run. Block as a within-subject variable had a significant main effect on IGT performance
(F[4, 164] = 10.78, p < .001), whereas main effects of the between-subjects variables were not
significant (STAI-S: F[2, 41] = 1.79, ns, STAI-T: F[2, 41] = 1.16, ns). The two-way interac-

Learning & Perception 1 (2009) 2

286 P. Pajkossy, L. Dezsõ and Z. Zoltay Paprika

Figure 1. IGT net score for each Block

tions between block vs. state anxiety (F[8, 164] = 3.77, p < .001) and block vs. trait anxiety
(F[8, 164] = 2.05, p < .05) were significant.
These interactions between block performance and state/trait anxiety were further ana-
lyzed by conducting several univariate ANOVAs with state and trait anxiety levels as be-
tween subject factors and net-score of the particular block as dependent variable. After per-
forming the Bonferroni correction for multiple comparisons, the only significant be-
tween-factor effects were the effect of state anxiety on card selection in Block 5 (F[2, 41] =
5.32, p < .05) and the effect of trait anxiety on card selection in Block 3 (F[2, 41] = 5.71,
p < .05). Games-Howell post-hoc tests revealed that in Block 3 high trait anxiety subjects se-

Figure 2a–2b. IGT net score for each block and for different levels of trait anxiety (Figure 2a) and
state anxiety (Figure 2b)

Learning & Perception 1 (2009) 2

 Effects of anxiety on decision-making 287

lected more disadvantageously than people with low or average trait anxiety level (p < .05 and
p < .1, respectively). In Block 5 high state anxiety subjects selected more advantageously than
those with low levels of state anxiety (p < .05).

3.4. Effect of trait worry on IGT performance

The IGT performance of subjects with low/medium/high levels of worry is presented in Fig-
ure 3. The impact of worry on IGT performance was analyzed using a 5 (Block 1 to Block 5) ×
3 (low/medium/high trait worry) mixed design ANOVA. Block had a significant main effect
(F[4, 19] = 11.17, p < .001), but worry did not (F[2, 47] = 0.86, ns). The two-way interaction
between block vs. trait worry (F[8, 188] = 2.08, p < .05) was significant. A series of one-way
ANOVAs were conducted with trait worry as between-subject factor and the net-score of the
particular blocks as dependent variable. After adjusting for multiple comparisons using the
Bonferroni correction no significant effect was found. Note, however, that without Bonferroni
correction the effect of worry on Block 5 scores was significant (F[2, 47] = 3.96, p < .05), and
post-hoc tests (Games-Howell test) revealed that subjects with high level of worry had higher
IGT net score than those with low level of worry (p < .01).

Figure 3. IGT net score for each block and for different levels of PSWQ

3.5. Anxiety and IGT learning pattern

The results of ANOVAs presented in 3.3 and 3.4 indicate that high trait anxiety is associated
with lower IGT net score in Block 3 (as opposed to low trait anxiety) and high state anxiety is
associated with higher IGT net score in Block 5 (as opposed to low state anxiety). This pattern

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288 P. Pajkossy, L. Dezsõ and Z. Zoltay Paprika

suggests that trait anxiety impacts learning in the first part of the IGT (apparent by Block 3),
whereas state anxiety exerts its effect in the latter phase (apparent by Block 5). To directly ad-
dress this issue, two further indexes of learning performance were calculated. Early Learning
Index (ELI) was computed by subtracting the net score of Block 1 from the net score of Block
3. Similarly, Late Learning Index (LLI) was computed by subtracting the net score of Block 5
from the net score of Block 3. Thus, these indexes represent to what extent the subjects shifted
their preferences from bad to good decks between the blocks. Mean ELI was 7.00 (SD =
10.85), whereas mean LLI was 1.48 (SD = 10.53). These values indicate that the bulk of learn-
ing occurs already in the first part of the task.
Controlling for mediator and suppression effects resulting from the correlation of state
and trait anxiety, the effects of these measures on ELI and LLI were tested with multiple linear
regressions. Worry was also involved in the analysis, since the uncorrected effect of trait
worry on Block 5 performance was significant. Both LLI and ELI were regressed on STAI-T,
STAI-S and PSWQ score. Zero-order correlations, parameters of the regression models and
the regression coefficients are presented in Table 1. ELI was negatively predicted by the
STAI-T score, whereas the STAI-S and PSWQ score did not affect learning in the first phase
(from Block 1 to 3). In contrast, in the second phase (from Block 3 to 5) both the STAI-S and
PSWQ score positively predicted further learning. Note also that the significant zero-order
correlation between STAI-T and LLI disappeared in the regression analysis when the effect of
state anxiety and worry was controlled. This suggests that the positive correlation coefficient
between trait anxiety and LLI is mediated through the effect of state anxiety and/or worry.

Table 1. Correlation coefficients between anxiety measures and learning indexes, and regression
model parameters/regression coefficients for multiple regression analysis (predicting learning indices
from scores of the questionnaires)

ELIb LLIc
a
Zero-order correlation
PSWQd –.01 .43**
STAI-Se –.083 .47***
STAI-Tf –.31* .31*
Model parameters
R square .128 .296
F-value 2.252+ 6.460**
Standardized regression coefficients of the predictors g
PSWQd .191 .353*
STAI-Se .105 .401**
STAI-Tf –.497* –.142
Notes:
a
Pearson product-moment correlation coefficients
b
Early Learning Index
c
Late Learning Index
d
Penn State Worry Questionnaire
e
Spielberger State-Trait Anxiety Inventory State version
f
Spielberger State-Trait Anxiety Inventory Trait version
g
all VIF-values (Variance Inflation Factor) are under 2.5.

Learning & Perception 1 (2009) 2

 Effects of anxiety on decision-making 289

3.6. “Bonus choice” and post-experiment survey

Eighteen out of the 50 subjects selected decks C or D in the “Bonus choice”. These 18 subjects
had higher total IGT net-score compared to those selecting decks A or B (t[48] = –2.21,
p < .05). For analyzing performance a 5 (Block 1 to Block 5) × 2 (“Bonus choice”: correct/in-
correct) mixed design ANOVA was performed. This revealed a significant main-effect of
block performance (F[4, 192] = 13.43, p < .001) and of “Bonus choice” (F [1, 48] = 4.87, p <
.05). The 2-way interaction between block performance and “Bonus choice” was not signifi-
cant (F [4, 192] = 1.69, ns).
Fifteen out of the 50 subjects provided a partially or fully precise description of the task
rule on the post-experiment survey. These people also tended to have better IGT performance,
although it falls short of significance (t[48] = –1.88, p < .1). A 5 (Block 1 to Block 5) × 2 (De-
scription: No knowledge vs. Knowledge Present) mixed design ANOVA revealed significant
main effect for block (F [4, 192] = 11.29, p < .001) and falls short of significance for the main
effect of block (F [1, 48] = 3.54, p < .1). The block by description interaction (F [4, 192] =
0.87, ns) was nonsignificant.
Thus, those selecting advantageously on “Bonus choice” performed better throughout the
IGT, and there was a tendency for better IGT performance for those providing correct explicit
knowledge about rules (see also Figures 4a and 4b). Interestingly, however, subjects select-
ing correctly on the “Bonus choice” do not overlap with those providing correct rule descrip-
tion (see Table 2). Chi-square test revealed that those who provide correct description of the
rule are not identical with those who make the right “Bonus choice” (c2[1] = 0.15, ns).

Figure 4a–4b. IGT net score for each block and for groups based on advantageous/disadvantageous
selection on “Bonus choice” (Figure 4a), and for groups based on correct/incorrect rule-descriptions
(Figure 4b)

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290 P. Pajkossy, L. Dezsõ and Z. Zoltay Paprika

Table 2. Observed distribution of “Bonus choice” by description

“Bonus choice”
Disadvantageous selection Advantageous selection
Rule-description No description 23 12
Correct description 9 6

3.7. Anxiety and knowledge of the task-rules

We tested whether different levels of state/trait anxiety and worry are related to differences in
the explicit knowledge of the IGT contingencies (as measured with the “Bonus choice” and by
the rule descriptions). The only significant difference was the higher STAI-S score for sub-
jects providing correct “Bonus choice” (t[48] = –2.84, p < .05 after the Bonferroni-correc-
tion).

3.8. The effect of additional individual differences

Although we did not have the a priori intention to test the impact of additional individual dif-
ferences (gender or university-affiliation), we conducted post-hoc analyses on whether these
individual differences affect decision making. A 5 (Block 1 to Block 5) × 2 (Student of
Pázmány Péter Catholic University or Budapest University of Technology and Economics) ×
2 (male/female) mixed design ANOVA revealed significant main effect for block (F [4, 184]
= 12.70, p < .001) and significant two-way interaction between gender and block (F [4, 184] =
3.10, p < .05). No other main effects or interactions reached the level of significance. How-
ever, this gender difference in IGT performance does not influence the effects of the anxiety
measures on decision-making, because entering gender and university affiliation in the mixed
design ANOVAs of section 3.3 and 3.4 leaves the reported significant two-way interactions
between anxiety measures and IGT performance unaffected (results not reported here). On
the other hand, it is important to note, that higher-order interactions also emerge (i.e. a
four-way interaction between trait worry, gender, university affiliation and block). This indi-
cates that the effect of anxiety on decision-making might be moderated by other factors. How-
ever, due to low sample size, our design was not adequate to further investigate such complex
interactions.

4. DISCUSSION

The current study investigated the impact of anxiety and worry on decision-making measured
by the IOWA gambling task. Beyond this, we also examined whether anxiety is related to the
extent of declarative knowledge about the reward–punishment schedule in the game.
Nevertheless, before discussing the results, the general low performance level of the IGT
shall be mentioned and explained. The average total net score in our sample is not higher than
the pathological performance level identified by Bechara and Damasio (2002). This low per-

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 Effects of anxiety on decision-making 291

formance level is not unusual in studies using IGT, and can be explained by IGT’s sensitivity
to task-characteristics (Balodis, MacDonald and Olmstead, 2006). For example, cues that di-
rect attention to certain aspects of the task are very important (e.g. using different colors or a
happy/sad face after gains/losses or a bar presenting the subject’s overall earnings). In this re-
spect, our IGT-variant was characterized by a minimalist design, with less emphasis on these
types of cues. This may have made the task harder and the learning curve more flat.

4.1. Anxiety and IGT performance

Subjects with high state anxiety were characterized by higher net score for Block 5. In addi-
tion, switching from bad to good decks between Block 3 and Block 5 (as indexed by LLI) was
predicted by state anxiety level, whereas switch in the early phase of the game (as indexed by
ELI) was independent of state anxiety. This indicates that subjects with high levels of state
anxiety tended to select predominantly from decks C and D after the 60th trial. In contrast, low
state anxiety was associated with the tendency to perform on chance level even at the end of
the game. This pattern of results is in line with our hypothesis and can be explained by the sug-
gestion of Bechara and Damasio (2005), who stated that only anxiety/fear related to the cur-
rent situation is beneficial for decision making. High scores on the STAI-S indicate a tense
and anxious state before and during the task, which could partially result from the anxious ap-
prehension associated with the task and therefore may have led to the effective association of
decks and aversive somatic states. This is also supported by the observation that state anxiety
was associated with better performance in the second part of the game. Presumably, by this
time subjects with high state anxiety have already formed outcome-related somatic markers,
and these helped them to avoid disadvantageous decks. Accordingly, low state anxiety sub-
jects did not experience negative somatic states associated with the punishments and hence
they did not stop selecting from the bad decks.
The overall performance was not affected by trait anxiety either. However, in line with our
hypothesis, subjects with high trait anxiety tended to switch slower (in a later phase) to advan-
tageous decks, than those with low or medium levels. This is indicated on the one hand by the
difference between the net-score of subjects with high vs. medium/low levels of trait anxiety
in Block 3, which disappeared later in Block 4 and Block 5. One the other hand, the slow
learning pattern is also evidenced by the fact that early learning (as indexed by ELI) was nega-
tively, whereas late learning (as indexed by LLI) was positively related to STAI-T score. Fol-
lowing Bechara and Damasio (2005), we suggest that high trait anxiety subjects’ slow shift
from bad to good decks can be explained by their general disposition towards anxious appre-
hension and fearful thoughts. During performing the IGT, these thoughts might be mostly un-
related to the decks or to the task-rules and thus could hinder the formation of somatic markers
and might lead to the observed slow shift from bad to good decks.
Note also that the shift of subjects with high trait anxiety towards advantageous decks in
the late phase of the task is mediated by the level of state anxiety and/or worry (as indicated by
multiple regression analysis). This suggests that subjects with high levels of trait anxiety not
only have task-unrelated fearful thoughts, but due to their higher state anxiety level may also

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292 P. Pajkossy, L. Dezsõ and Z. Zoltay Paprika

produce task-related fearful thoughts. These are beneficial for IGT performance in the latter
phases of the task, and so might compensate for the slow learning in the first phase of the task.
The relationship between trait worry and IGT performance seemed to be very similar to
that of state anxiety. High worriers tended to select more from advantageous decks at the end
of the game and their switch from bad to good decks was most pronounced at the second part
of the game, as evidenced by the significant predictive power of PSWQ on LLI in the multiple
linear regression analysis. This latter indicates that the effect of worry on IGT performance is
independent of state anxiety. These results partially confirm the results of Mueller et al.
(2010), who observed that GAD and trait worry was associated with better IGT performance.
These authors suggested that worrying involves the exaggerated processing of future negative
events and this explains high worriers’ superior performance. The results are also in line with
the increasing number of observations reporting that worry has a positive impact on cognitive
performance as measured with academic or job performance (Siddique et al., 2006; Watkins,
2008), and that it is associated with better executive functions (Price and Mohlman, 2007).

4.2. The role of declarative knowledge in IGT performance

We used two measures to assess declarative knowledge about task-contingencies: in the

post-experiment survey subjects indicated their perceived and applied task-rules (if any),
whereas in the “Bonus choice” they made a final selection based on their judgment about
which decks might be associated with gains. Interestingly, our results showed that only a mi-
nority of the subjects possessed explicit knowledge about the task/contingencies. This indi-
cates that declarative knowledge is not always present in IGT tasks. However, those who had
declarative knowledge performed better on IGT. Thus declarative knowledge may contribute
to IGT performance.
We could not confirm our hypothesis about the association of anxiety and declarative
knowledge. Only state anxiety was linked to correct choices on the “Bonus choice” (but not to
correct rule-descriptions). This implies that state anxiety was associated with the ability to de-
cide which decks were more advantageous, however, this ability was not coupled with de-
tailed knowledge of the rules.

4.3. Limitations

Finally, some limitations shall be taken into account when interpreting and generalizing our
results. First, there are some methodological issues: the Hungarian version of the PSWQ is not
yet validated, thus the conclusions associated with trait worry should be treated with caution
(despite the demonstrated reliability and convergent validity of the scale in our study). More-
over, the low sample size did not permit us to investigate the interaction of university affilia-
tion or gender with anxiety. Subjects from different universities might have different
socio-economic and cultural background, which may cause differences in both their anxiety
level and in their approach to a task with monetary reward. Similarly, gender differences are
found both in anxiety (e.g. Egloff and Schmukle, 2004) and in IGT performance (Bolla et al.,

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 Effects of anxiety on decision-making 293

2004; Reavis and Overman, 2001). Thus further research should clarify, whether gender or
socioeconomic variables interact with anxiety level in determining IGT performance. Addi-
tionally, since incentive compatibility was not assured it is not sure whether subjects’ behav-
ior reflected their real behavior habits. Finally, state anxiety was assessed only by subjective
ratings (in the STAI-S questionnaire), which is sensitive to self-report bias.
A conceptual limitation must be also noted: the applied quasi-experimental design is not
suitable to determine causal pathways, which limits the interpretations of the results. This is
particularly important regarding the association between state anxiety and decision-making:
here the replication of our results using direct manipulation of state anxiety is clearly war-
ranted.

5. CONCLUSION AND FURTHER RESEARCH

Our evidence suggests that the fine-graded conceptualization of anxiety is a beneficial re-
search strategy when investigating the effects of anxiety on decision-making, because differ-
ent conceptualizations of anxiety are differently related to decision-making performance. In
our study, task-related state anxiety advantageously affected learning in IGT, and we suggest
that this might be caused by the effective linkage of somatic markers to response options asso-
ciated with the situation. In contrast, trait anxiety was associated with slow learning in IGT.
This can be explained by task-unrelated thoughts, which disturbed the formation of somatic
markers. Worry was also associated with better IGT performance, which may be due to the
excessive processing of possible future threats.
The idea that explicit knowledge is formed during the IGT task was only indirectly and
partially bolstered, and we could not prove that the beneficial effects of state anxiety and
worry are mediated by the formation of correct explicit knowledge. This issue needs further
tackling for instance using real-time explicit-knowledge measurements in each block of 10
trials.

ACKNOWLEDGEMENTS

This work is connected to the scientific program of the “Development of quality-oriented and
harmonized R+D+I strategy and functional model at BME” project. This project is supported
by the New Hungary Development Plan (Project ID: TÁMOP-4.2.1/B-09/1/
KMR-2010-0002).

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