Impulsive decision-making predicts the course of substance-related and addictive disorders

Abstract Background This study investigated whether patterns of impulsive decision-making (i) differ between individuals with DSM-5 substance use disorders (SUD) or non-substance-related addictive disorders (ND) and healthy controls, and (ii) predict the increase of SUD and ND severity after one year. Methods In a prospective-longitudinal community study, 338 individuals (19–27 years, 59% female) were included in one of three groups: SUD (n = 100), ND (n = 118), or healthy controls (n = 120). Group differences in four impulsive decision-making facets were analyzed with the Bayesian priors: delay discounting (mean = 0.37, variance = 0.02), probability discounting for gains and for losses (each − 0.16, 0.02), and loss aversion (− 0.44, 0.02). SUD and ND severity were assessed at baseline and after 1 year (n = 312, 92%). Predictive associations between decision-making and SUD/ND severity changes were analyzed with the Bayesian prior: mean = 0.25, variance = 0.016. Results Compared with controls, the SUD group displayed steeper delay discounting and lower probability discounting for losses; the ND group displayed lower probability discounting for losses (posterior probabilities > 98%). SUD symptom increase after 1 year was predicted by steeper delay discounting and lower loss aversion; ND symptom increase by lower probability discounting for losses and lower loss aversion (posterior probabilities > 98%). There was low evidence for predictive relations between decision-making and the quantity-frequency of addictive behaviours. Discussion Impulsive decision-making characterizes SUD and ND and predicts the course of SUD and ND symptoms but not the engagement in addictive behaviours. Strength of evidence differed between different facets of impulsive decision-making and was mostly weaker than a priori expected.

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Exposure to maternal depressive symptoms and growth in adolescent substance use: The mediating role of delay discounting

Development and Psychopathology ◽

10.1017/s0954579420000486 ◽

2020 ◽

pp. 1-11

Author(s):

Julia W. Felton ◽

Anahí Collado ◽

Morgan Cinader ◽

Carl W. Lejuez ◽

Andrea Chronis-Tuscano ◽

...

Keyword(s):

Decision Making ◽

Substance Use ◽

Depressive Symptoms ◽

Maternal Depression ◽

Delay Discounting ◽

Adolescent Substance Use ◽

Maternal Depressive Symptoms ◽

Adolescent Substance ◽

Adolescent Risk ◽

Prospective Longitudinal

Abstract Maternal depression is associated with instability within the family environment and increases in offspring substance use across adolescence. Rates of delay discounting, or the tendency to select smaller rewards that are immediately available relative to larger, but delayed rewards, are also associated with steeper increases in substance use among youth. Moreover, recent research suggests that early unstable environments may reinforce youths’ propensity towards opportunistic decision making and delay discounting specifically. The current prospective, longitudinal study examined links between maternal depressive symptoms, adolescent delay discounting, and subsequent substance use. Participants included 247 adolescents and their mothers who were assessed annually over a 6-year period (from ages 13 to 19 years). Results supported a small but significant mediation effect. Specifically, maternal depressive symptoms predicted increases in adolescent delay discounting, which, in turn, predicted steeper increases in adolescent substance use over time. Thus, youth decision making may represent a mechanism linking maternal depression and adolescent risk behaviors. Findings indicate the potential for interventions targeting parental psychopathology to prevent subsequent adolescent substance use.

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Cue-induced effects on decision-making distinguish subjects with gambling disorder from healthy controls

10.1101/564781 ◽

2019 ◽

Author(s):

Alexander Genauck ◽

Milan Andrejevic ◽

Katharina Brehm ◽

Caroline Matthis ◽

Andreas Heinz ◽

...

Keyword(s):

Decision Making ◽

Loss Aversion ◽

Gambling Disorder ◽

Substance Dependence ◽

Receiver Operating Curve ◽

Addictive Disorders ◽

Emotional Cues ◽

Healthy Control ◽

Induced Changes ◽

Task Parameters

ABSTRACTWhile an increased impact of cues on decision-making has been associated with substance dependence, it is yet unclear whether this is also a phenotype of non-substance related addictive disorders, such as gambling disorder. To better understand the basic mechanisms of impaired decision-making in addiction, we investigated whether cue-induced changes in decision-making could distinguish gambling disorder (GD) from healthy control (HC) subjects. We expected that cue-induced changes in gamble acceptance and specifically in loss aversion would distinguish GD from HC subjects.30 GD subjects and 30 matched HC subjects completed a mixed gambles task where gambling and other emotional cues were shown in the background. We used machine learning and classification to carve out the importance of cue-dependency of decision-making and of loss aversion for distinguishing GD from HC subjects.Cross-validated classification yielded an area under the receiver operating curve (AUC-ROC) of 68.9% (p=0.002). Applying the classifier to an independent sample yielded an AUC-ROC of 65.0% (p=0.047). As expected, the classifier used cue-induced changes in gamble acceptance to distinguish GD from HC. Especially increased gambling during the presentation of gambling cues was characteristic of GD subjects. However, unexpectedly, cue-induced changes in loss aversion were irrelevant for distinguishing GD from HC subjects. To our knowledge, this is the first study to investigate the classificatory power of addiction-relevant behavioral task parameters when distinguishing GD from HC subjects. The results indicate that cue-induced changes in decision-making are a characteristic feature of addictive disorders, independent of a substance of abuse.

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Acute alcohol effects on impulsive choice in adolescents

Journal of Psychopharmacology ◽

10.1177/0269881118822063 ◽

2019 ◽

Vol 33 (3) ◽

pp. 316-325

Author(s):

Nadine Bernhardt ◽

Elisabeth Obst ◽

Stephan Nebe ◽

Shakoor Pooseh ◽

Friedrich M Wurst ◽

...

Keyword(s):

Decision Making ◽

Family History ◽

Alcohol Consumption ◽

Delay Discounting ◽

Loss Aversion ◽

Alcohol Problems ◽

Impulsive Choice ◽

Alcohol Administration ◽

Alcohol Condition ◽

Alcohol Effects

Background: Neurodevelopmental and alcohol-induced changes in decision-making have been proposed to critically influence impulsive behaviour in adolescents. Objective: This study tested the influence of acute alcohol administration on impulsive choice in adolescents. Methods: Fifty-four males aged 18–19 years were tested in a single-blind placebo-controlled cross-over design. During alcohol administration (infusion resulting in an arterial blood alcohol concentration of 80 mg%) and placebo condition (saline infusion), participants performed a task battery providing estimates of delay discounting, probability discounting for gains, for losses and loss aversion, and also rated subjectively experienced alcohol effects. Additionally, baseline alcohol consumption (Alcohol Use Disorders Identification Test, blood phosphatidylethanol levels), motives (Drinking Motive Questionnaire, Alcohol Expectancy Questionnaire and Obsessive Compulsive Drinking Scale), family history and self-report measures of impulsivity (Barratt Impulsiveness Scale, Substance Use Risk Profile Scale) were provided. Results: No overall effects of treatment on choice behaviour were found. However, individual differences were observed. In the alcohol condition, more impulsive choice tendencies for delay discounting were associated with higher subjectively experienced alcohol effects. Further, higher risk aversion for probabilistic gains and higher loss aversion during alcohol condition were related to higher levels of real-life alcohol consumption and a family history of alcohol problems, respectively. Finally, the time to make a decision was substantially shortened for choices involving negative prospects. Conclusions: Contrary to common beliefs, acute alcohol intoxication did not generally incite impulsive decision-making. It rather appears that alcohol-induced behavioural changes in adolescents vary considerably depending on prior experiences and subjective effects of alcohol.

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Appetite-Regulating Hormone Ghrelin Predicts Decision-Making in Healthy Controls but Not Individuals With Low-Weight Eating Disorders

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.1271 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A623-A624

Author(s):

Naila Shiraliyeva ◽

Madeline Rogers Stull ◽

Danielle L Kahn ◽

Lauren Breithaupt ◽

Meghan Slattery ◽

...

Keyword(s):

Decision Making ◽

Delay Discounting ◽

Energy Homeostasis ◽

Area Under The Curve ◽

Healthy Controls ◽

Impulsive Behavior ◽

Healthy Individuals ◽

Preclinical Research ◽

Low Weight

Abstract Background: Ghrelin is an orexigenic hormone known to regulate appetite, glucose homeostasis, and other food-related functions. The potential role of ghrelin beyond energy homeostasis is not well understood. Ghrelin receptors are evident in the mesolimbic reward pathway, and preclinical research has shown that ghrelin administration increases impulsive behavior and choices in rats. However, little is known about whether and how ghrelin is associated with food-independent behavior and decision-making in humans. We investigated the relationship between ghrelin levels and monetary decision-making using a well-established behavioral paradigm in healthy individuals and individuals with a low-weight eating disorder (LWED), as patients with LWEDs have been shown to have high ghrelin levels and resistance to the effects of this hormone. We hypothesized that higher ghrelin levels would predict more impulsive choices of immediate rewards in healthy individuals, while this relationship would be less pronounced in individuals with LWEDs. Methods: Sixty-four female participants with a LWED and 34 healthy controls (HC), aged 10-22 years, presented after a 10-hour fast to undergo a standardized mixed meal followed by a delay discounting task. During this task, participants decided between smaller immediate and larger delayed monetary rewards. Based on their choices, the delay discounting parameter k was calculated as a marker of choice preferences with higher values indicating a stronger preference for the immediate smaller reward. Blood was drawn prior to and 30, 60, and 120 min after the meal for analysis of ghrelin, and area under the curve was calculated as a cumulative measurement of ghrelin levels. Results: As per study design, BMI was lower in the LWED group (17.3±1.5 kg/m2) compared to the HC group (mean±SD: 21.4±2.5 kg/m2; t[96]=11.33, p<0.0001, d=-1.99). Groups did not differ by age (LWED: 18.3±3.2 years, HC: 18.0±3.1 years; t[96]=-0.36, p=0.720, d=-0.10). Ghrelin levels were higher in the LWED compared to HC group (t[96]=-2.67, p=0.009, d=0.57). K was numerically lower in the LWED compared to the HC group, but the difference was not significant (t[96]=1.37, p=0.175, d=-0.30). Importantly, in HC higher ghrelin levels were associated with higher k values (r=0.37, p=0.032). This relationship was not observed in the LWED group (r=-0.13, p=0.304). Conclusions: In HC, higher levels of ghrelin predicted a stronger preference for smaller immediate rewards, which is consistent with increased impulsive choices shown in animal research. We did not observe this relationship in our LWED sample. Our results indicate that beyond energy homeostasis, ghrelin might play a broader role in reward-related behavior and decision-making, such as monetary choices. Future studies are required to further explore the role of ghrelin in human behavior in both clinical and non-clinical populations.

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P300 and delay-discounting in obsessive–compulsive disorder

European Archives of Psychiatry and Clinical Neuroscience ◽

10.1007/s00406-021-01302-7 ◽

2021 ◽

Author(s):

Vera Flasbeck ◽

Björn Enzi ◽

Christina Andreou ◽

Georg Juckel ◽

Paraskevi Mavrogiorgou

Keyword(s):

Neural Networks ◽

Decision Making ◽

Obsessive Compulsive Disorder ◽

Delay Discounting ◽

Oddball Paradigm ◽

P300 Latency ◽

Healthy Controls ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Source Density

AbstractPrevious research showed that dysfunctions of fronto-striatal neural networks are implicated in the pathophysiology of obsessive–compulsive disorder (OCD). Accordingly, patients with OCD showed altered performances during decision-making tasks. As P300, evoked by oddball paradigms, is suggested to be related to attentional and cognitive processes and generated in the medial temporal lobe and orbitofrontal and cingulate cortices, it is of special interest in OCD research. Therefore, this study aimed to investigate P300 in OCD and its associations with brain activity during decision-making: P300, evoked by an auditory oddball paradigm, was analysed in 19 OCD patients and 19 healthy controls regarding peak latency, amplitude and source density power in parietal cortex areas by sLORETA. Afterwards, using a fMRI paradigm, Blood–oxygen-level-dependent (BOLD) contrast imaging was conducted during a delay-discounting paradigm. We hypothesised differences between groups regarding P300 characteristics and associations with frontal activity during delay-discounting. The P300 did not differ between groups, however, the P300 latency over the P4 electrode correlated negatively with the NEO-FFI score openness to experience in patients with OCD. In healthy controls, P300 source density power correlated with activity in frontal regions when processing rewards, a finding which was absent in OCD patients. To conclude, associations of P300 with frontal brain activation during delay-discounting were found, suggesting a contribution of attentional or context updating processes. Since this association was absent in patients with OCD, the findings could be interpreted as being indeed related to dysfunctions of fronto-striatal neural networks in patients with OCD.

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Monetary Reward Discounting, Inhibitory Control, and Trait Impulsivity in Young Adults With Internet Gaming Disorder and Nicotine Dependence

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.628933 ◽

2021 ◽

Vol 12 ◽

Author(s):

Wan-Sen Yan ◽

Ruo-Ting Chen ◽

Meng-Meng Liu ◽

Dan-Hui Zheng

Keyword(s):

Young Adults ◽

Nicotine Dependence ◽

Inhibitory Control ◽

Delay Discounting ◽

Internet Gaming Disorder ◽

Reward Processing ◽

Probability Discounting ◽

Healthy Controls ◽

Gaming Disorder ◽

Internet Gaming

Internet Gaming Disorder (IGD) has been considered a potential behavioral or non-substance addiction that requires further investigation. Recognition of the commonalities between IGD and Substance Use disorders (SUD) would be of great help to better understand the basic mechanisms of addictive behaviors and excessive Internet gaming. However, little research has targeted a straightforward contrast between IGD and SUD on neuropsychological aspects. The present study thus aimed to explore the associations of reward processing and inhibitory control with IGD and nicotine dependence (ND) in young adults. Fifty-eight IGD and 53 ND individuals, as well as 57 age- and gender-matched healthy controls, were assessed with a series of measurements including the Delay-discounting Test (DDT), Probability Discounting Test (PDT), the Stroop Color-Word Task, a revised Go/No Go Task, and the Barratt Impulsiveness Scale (BIS-11). Multivariate analysis of variance (mANOVA) models revealed that both IGD and ND groups scored higher than healthy controls on the BIS-11 attentional, motor, and non-planning impulsiveness (Cohen's d = 0.41–1.75). Higher degrees of delay discounting on the DDT were also found in IGD and ND groups compared to healthy controls (Cohen's d = 0.53–0.69). Although IGD group did not differ from healthy controls on the PDT, ND group had a lower degree of probability discounting than healthy controls (Cohen's d = 0.55), suggesting a reduction in risk aversion. Furthermore, ND subjects showed a lower correct accuracy in the incongruent trials of the Stroop task than healthy controls (Cohen's d = 0.61). On the Go/No Go task, both IGD and ND groups had a lower correct accuracy in the No-Go trials than healthy controls (Cohen's d = 1.35–1.50), indicating compromised response inhibition. These findings suggested that IGD was linked to both anomalous reward discounting and dysfunctional inhibitory control, which was comparable with one typical SUD category (i.e., ND). This study might promote a better understanding of the pathogenesis of IGD as a potential addictive disorder similar to SUD.

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Decision Making Under Ambiguity and Under Risk in Depressed Suicide Attempters, Depressed Non-attempters and Healthy Controls

10.26226/morressier.5885d719d462b8028d892b9d ◽

2017 ◽

Author(s):

Eberhard A. Deisenhammer

Keyword(s):

Decision Making ◽

Healthy Controls ◽

Suicide Attempters

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Differences in Reward and Persistency characterise Behavior in Chronic Pain for the Iowa Gambling Task in a Web-based Lab-in-the-field study (Preprint)

10.2196/preprints.26307 ◽

2020 ◽

Author(s):

Lili Zhang ◽

Himanshu Vashisht ◽

Alekhya Nethra ◽

Brian Slattery ◽

Tomas Ward

Keyword(s):

Decision Making ◽

Social Media ◽

Chronic Pain ◽

Iowa Gambling Task ◽

Learning Curves ◽

Self Report ◽

Healthy Controls ◽

Gambling Task ◽

Convenience Sample ◽

Pain Experiences

BACKGROUND Chronic pain is a significant world-wide health problem. It has been reported that people with chronic pain experience decision-making impairments, but these findings have been based on conventional lab experiments to date. In such experiments researchers have extensive control of conditions and can more precisely eliminate potential confounds. In contrast, there is much less known regarding how chronic pain impacts decision-making captured via lab-in-the-field experiments. Although such settings can introduce more experimental uncertainty, it is believed that collecting data in more ecologically valid contexts can better characterize the real-world impact of chronic pain. OBJECTIVE We aim to quantify decision-making differences between chronic pain individuals and healthy controls in a lab-in-the-field environment through taking advantage of internet technologies and social media. METHODS A cross-sectional design with independent groups was employed. A convenience sample of 45 participants were recruited through social media - 20 participants who self-reported living with chronic pain, and 25 people with no pain or who were living with pain for less than 6 months acting as controls. All participants completed a self-report questionnaire assessing their pain experiences and a neuropsychological task measuring their decision-making, i.e. the Iowa Gambling Task (IGT) in their web browser at a time and location of their choice without supervision. RESULTS Standard behavioral analysis revealed no differences in learning strategies between the two groups although qualitative differences could be observed in learning curves. However, computational modelling revealed that individuals with chronic pain were quicker to update their behavior relative to healthy controls, which reflected their increased learning rate (95% HDI from 0.66 to 0.99) when fitted with the VPP model. This result was further validated and extended on the ORL model because higher differences (95% HDI from 0.16 to 0.47) between the reward and punishment learning rates were observed when fitted on this model, indicating that chronic pain individuals were more sensitive to rewards. It was also found that they were less persistent in their choices during the IGT compared to controls, a fact reflected by their decreased outcome perseverance (95% HDI from -4.38 to -0.21) when fitted using the ORL model. Moreover, correlation analysis revealed that the estimated parameters had predictive value for the self-reported pain experiences, suggesting that the altered cognitive parameters could be potential candidates for inclusion in chronic pain assessments. CONCLUSIONS We found that individuals with chronic pain were more driven by rewards and less consistent when making decisions in our lab-in-the-field experiment. In this case study, it was demonstrated that compared to standard statistical summaries of behavioral performance, computational approaches offered superior ability to resolve, understand and explain the differences in decision- making behavior in the context of chronic pain outside the lab.

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