Decision making measured by the Iowa Gambling Task in alcohol use disorder and gambling disorder: a systematic review and meta-analysis

Ildikó Kovács, Mara J. Richman, Zoltán Janka, Aniko Maraz, Bálint Andó

Research output: Contribution to journalReview article

25 Citations (Scopus)


Background and aims Gambling disorder (GD) and alcohol use disorder (AD) have similar features, such as elevated impulsivity and decision-making deficits, which are directly linked to relapse and poor therapeutic outcomes. Our aim was to assess decision-making characteristics in GD and AD patients compared to healthy controls (HC) based on one of the most frequently used measures of decision-making: the Iowa Gambling Task (IGT). Methods In our systematic literature search of three databases, we identified 1198 empirical articles that mentioned decision-making deficits with the use of the IGT in patients diagnosed with either AD or GD. Possible effects were calculated using meta-analysis. In the end, 17 studies (including 1360 participants) were suitable for inclusion in the meta-analysis reporting data for 23 group contrasts. Results The random effects estimate indicated impaired IGT performance in both AD patients (N = 500; d = −0.581, CI:-89.5 < δ < −26.6%) and an even greater deficit in GD patients (N = 292; d = −1.034, CI:-156.1 < δ < 50.7%) compared to HCs. Sampling variances were calculated for both AD (v1 = 0.0056) and GD groups (v2 = 0.0061), from which the z-score was calculated (z = −21.0785; p < 0.05), which indicates a statistically significant difference between AD and GD groups. No significant moderating effects of age, gender or education were found. Conclusions There is enough evidence to support that decision-making deficit associated with addictive disorders, and that the deficit is more expressed in gambling disorder than in alcohol use disorder. Impaired decision-making plays an important part in poor therapeutic outcomes, thus provides a promising opportunity for cognitive intervention.

Original languageEnglish
Pages (from-to)152-161
Number of pages10
JournalDrug and Alcohol Dependence
Publication statusPublished - Dec 1 2017


  • Alcohol use disorder
  • Decision-making
  • Gambling disorder
  • Impairment
  • Iowa Gambling Task
  • Meta-analysis

ASJC Scopus subject areas

  • Toxicology
  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)

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