Risky decision-making in the balloon analogue risk task – the role of noradrenaline and cortisol

Rationale Stress can significantly alter decision-making, often promoting riskier choices. While prior research suggests a link between acute stress and increased risk-taking, the specific contributions of cortisol and noradrenaline—two key neuroendocrine stress mediators—remain unclear. Objectives Investigate how the pharmacological manipulation of two key neuroendocrine stress mediators (cortisol and noradrenaline) influences risk-taking behavior in healthy individuals. Methods In a double-blind, randomized study, we examined the individual and combined effects of hydrocortisone (20 mg) and yohimbine (20 mg; an α₂-adrenergic receptor antagonist) on risky decision-making in 96 healthy adults (48 women, 48 men). Participants completed the Balloon Analogue Risk Task (BART) before and after drug administration, allowing for within-subject comparisons relative to individual baselines. Results While the pharmacological manipulation effectively elevated cortisol concentration and salivary alpha amylase activity (as proxy for noradrenaline levels), no substantial effects on risk-taking behavior emerged, contrasting with some earlier findings. Exploratory analyses of associations with personality traits (anxiety, aggression, sensation seeking) and baseline levels of testosterone and estradiol revealed only weak and inconsistent relationships. Conclusions These findings underscore the complexity of stress effects on decision-making and suggest that pharmacological activation of stress systems may not straightforwardly mimic psychosocial stress. Methodological factors such as timing, dosage, receptor specificity, and task familiarity likely play critical roles in modulating these effects.