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How Do People Control Their Behaviour?

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Why do some people have less control than others? Why can problem poker players not stop? Why do people get addicted? Why do bankers risk money in foolish ways, even though they should know better?

Science can provide answers to these questions with a surprisingly convincing amount of detail. It has been shown that patients with damage in their ventral prefrontal cortex (VPFC) are impaired in different types of decision-making

A gambling task has been used to measure decision-making in different types of people. In the so-called Iowa gambling task, participants are asked to choose cards from card decks. There are given bad decks with high wins but also high losses and good decks (with medium win and low loss). The good decks are ‘good’ because the total winnings from choosing them are higher.

It has been shown that for ‘normal’ (healthy) people, they will learn to choose the good decks before they can report that they are consciously choosing these decks because of the higher winnings in total. This task has been used on different types of people. 

Cocaine and marijuana users

Cocaine users performed worse than healthy control participants. Cocaine users improved in performance less than marijuana users but learn more. Marijuana users also performed worse than control participants. The heavier the drug use (coke and marijuana) the lower the performance.

Marijuana users were under-influenced by how much they lost and over-influenced by their gains. Cocaine abusers were inconsistent in their choices. 

Eating disorders

Patients with anorexia do worse than controls. The males had higher impulsivity scores, but this did not make their decisions any worse than those of the females in the study. Obese women (and not men) were more likely to choose immediate rewards (‘bad’ deck) than in ‘lean’ control and ignore the long-term consequences of their behaviour.


Schizophrenic patients perform on similar levels to people without schizophrenia, amazingly. 

However, later research showed that patients with positive symptoms were as good at the task as control participants but that negative symptom patients could not adapt when the previously ‘good’ decks became ‘bad’ decks, which resulted in them losing often. 

Alzheimer’s disease

Despite episodic memory deficiencies, Alzheimer’s patients performed on the same level as individuals without the disease on this task. 

Age differences

Individuals between the ages of 10 and 30 were tested. Participants in their mid- to late adolescence had a high level of approach behaviours (higher likelihood to choose good decks) in response to positive feedback and the older the adults were the more likely they were to avoid risky behaviours (to avoid bad decks).


Different types of offenders (violent offenders, drug, and sex offenders, drivers operating a vehicle while impaired, for instance) were tested and it was found that all the criminals were more likely to select bad decks.

Drug and sex offenders placed more attention on gains, rather than losses, whereas assault and murder criminals made less consistent choices and focus on immediate outcomes.


Research has shown how different types of people make decisions and that people who do not fall into the above categories are likely to learn how to act advantageously with time even before they are aware of why a certain action is advantageous. This is a very useful human ability to know about and to attempt to harness in daily decisions.

Also, it has been shown that the best way to choose your tasks is to focus on a larger later gain, to see past quick immediate fixed and to try to learn to act consistently.

We should use this research to make better decisions and to be aware of the reasons why different types of people might not be able to make decisions in the way that we expect that decisions should be made.

Elizabeth Kaplunov, PhD is a chartered psychologist who evaluates projects about health technology for disabled and vulnerable people. 


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