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Title: Trust-Based Decision-Making in the Health Context Discriminates Biological Risk Profiles in Type 1 Diabetes
Authors: Jorge, Helena 
Duarte, Isabel C. 
Baptista, Carla
Relvas, Ana Paula 
Castelo Branco, Miguel 
Keywords: Human decision-making; Diabetes type 1; Context-dependent trust game; Probabilistic learning; Norm violation; Treatment adherence; Metabolic control
Issue Date: 28-Jul-2022
Publisher: MDPI
Project: info:eu-repo/grantAgreement/FCT/UID/4950/2020/PT/CIBIT 
FIS-FIS-2015-01 DIA-DiaMarkData 
(EFSD) 2019-Innovative Measurement of Diabetes Outcomes 2019 
Serial title, monograph or event: Journal of Personalized Medicine
Volume: 12
Issue: 8
Place of publication or event: Basel
Abstract: Theoretical accounts on social decision-making under uncertainty postulate that individual risk preferences are context dependent. Generalization of models of decision-making to dyadic interactions in the personal health context remain to be experimentally addressed. In economic utility-based models, interactive behavioral games provide a framework to investigate probabilistic learning of sequential reinforcement. Here, we model an economic trust game in the context of a chronic disease (Diabetes Type 1) which involves iterated daily decisions in complex social contexts. Ninety-one patients performed experimental trust games in both economic and health settings and were characterized by a multiple self-report set of questionnaires. We found that although our groups can correctly infer pay-off contingencies, they behave differently because patients with a biological profile of preserved glycemic control show adaptive choice behavior both in economic and health domains. On the other hand, patients with a biological profile of loss of glycemic control presented a contrasting behavior, showing non-adaptive choices on both contexts. These results provide a direct translation from neuroeconomics to decision-making in the health domain and biological risk profiles, in a behavioral setting that requires difficult and self-consequential decisions with health impact. Our findings also provide a contextual generalization of mechanisms underlying individual decision-making under uncertainty.
Description: Supplementary Materials: The following supporting information can be downloaded at:, Table S1. Demographic Characteristics, Cognitive results, personality, self-report risk measures and eating behavior for healthy participants; Table S2. Descriptive statistics on economic and health context experimental task for healthy participants; Table S3. Repeated measure comparison (Friedman Non-parametric test) on economic and health related context experimental tasks for healthy participants; Table S4. (A) Repeated measures comparison between each mediator for Expected Value, Investment and Feedback (Friedman Non-parametric test for main effects of mediator and posthoc tests) on economic and health related context experimental tasks for NoMC and MC groups; (B) Posthoc tests for each variable (expected, investment and feedback) on economic and health related context experimental tasks for NoMC and MC groups.
Institutional Review Board Statement: Consent to participate in the study was obtained according to the Ethics approval by the Faculty of Medicine of the University of Coimbra (approval number CE-002/2014).
Data Availability Statement: Data can be provided by the corresponding author upon reasonable request. Please contact
ISSN: 2075-4426
DOI: 10.3390/jpm12081236
Rights: openAccess
Appears in Collections:I&D CES - Artigos em Revistas Internacionais

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