In Bechara's Gambling Task, how do control participants typically respond emotionally compared with patients with orbitofrontal damage?

• A. Controls show anticipatory anxiety before turning a card; damaged patients show anxiety after turning and losing
• B. Controls show no anxiety; patients show anticipatory anxiety before turning a card
• C. Both groups show anticipatory anxiety before every draw
• D. Controls show anxiety only after winning; patients only after losing

Answer: (A)

Bechara’s Gambling Task probes how emotional signals bias decision making. In healthy individuals, autonomic arousal—an anticipatory emotional state—builds up before a risky choice, helping them steer away from decks that will lead to losses. When orbitofrontal cortex function is intact, this anticipatory affect guides the decision even before the card is turned.

In contrast, those with orbitofrontal damage show a disruption in generating these anticipatory signals. They often don’t exhibit the pre-emptive emotional response before making a choice. Instead, their affective reaction tends to come after the outcome, particularly following losses, once the decision has already been executed.

This pattern reflects the orbitofrontal cortex’s role in predicting consequences and using visceral feedback to influence ongoing choices. Therefore, anticipatory anxiety before turning a card in controls and post-outcome anxiety after outcomes in damaged patients best captures the typical difference.