Participants are presented with four virtual decks of cards on a computer screen. They are told that each deck holds cards that will either reward or penalize them, using game money. The goal of the game is to win as much money as possible. Unbeknownst to the participant, the decks differ from each other in the balance of reward versus penalty cards. Thus, some decks are "bad decks", and other decks are "good decks", because some decks will tend to reward the player more often than other decks. Participants are not told that the two "bad" decks have larger rewards and larger or more frequent penalties. On balance, the penalties in the "bad" decks outweigh the higher rewards they give. Therefore, participants should choose the decks with smaller rewards, as they will also give significantly fewer penalties and give a better long-term payout. By contrast, patients with
amygdala lesions never develop this physiological reaction to impending punishment. In another test, patients with
ventromedial prefrontal cortex (vmPFC) dysfunction were shown to choose outcomes that yield high immediate gains in spite of higher losses in the future. Bechara and his colleagues explain these findings in terms of the
somatic marker hypothesis. The Iowa gambling task is currently being used by a number of research groups using
fMRI to investigate which brain regions are activated by the task in healthy volunteers as well as clinical groups with conditions such as
schizophrenia and
obsessive compulsive disorder. ==Critiques==