Impulsive choice predicts short-term relapse in substance-dependent individuals attending an in-patient detoxification programme

2015 ◽  
Vol 45 (10) ◽  
pp. 2083-2093 ◽  
Author(s):  
L. Stevens ◽  
A. E. Goudriaan ◽  
A. Verdejo-Garcia ◽  
G. Dom ◽  
H. Roeyers ◽  
...  
Keyword(s):  
Decision Making ◽  
Delay Discounting ◽  
Iowa Gambling Task ◽  
Treatment Retention ◽  
Self Report ◽  
Stop Signal Task ◽  
Impulsive Choice ◽  
Short Term ◽  
Mediation Analyses ◽  
Substance Dependent

BackgroundImpulsivity is a hallmark characteristic of substance use disorders. Recently, studies have begun to explore whether increased impulsivity in substance-dependent individuals (SDIs) is associated with a greater propensity to relapse following treatment. Despite growing recognition of its multidimensional nature, however, most studies have treated impulsivity unilaterally. Accordingly, it remains unclear whether certain facets of impulsivity are more relevant to relapse than others. The aim of the current study was to examine the relationship between multiple facets of impulsivity and short-term relapse in SDIs. As a secondary aim, we explored the role of treatment retention in this relationship.MethodA personality-based impulsivity questionnaire (UPPS) and three neurocognitive tasks of impulsivity [stop-signal task (SST), delay discounting task (DDT) and Iowa gambling task (IGT)] were administered in a heterogeneous sample of 70 SDIs shortly following their entry in an in-patient detoxification programme. Mediation analyses were performed to explore whether the effects of impulsivity on relapse were mediated by treatment retention.ResultsPerformance on two neurocognitive indices of impulsive choice (i.e. delay discounting and impulsive decision-making) significantly predicted short-term relapse. The effects of delay discounting and impulsive decision-making on relapse propensity were mediated by treatment retention.ConclusionsNeurocognitive indices of impulsivity may be more sensitive to the prediction of relapse than trait-based self-report questionnaires. Post-treatment relapse in SDIs may be reduced by targeting the processes involved in impulsive choice and by improving treatment retention in SDIs with inflated impulsivity.

Impulsivity in patients with borderline personality disorder: a comprehensive profile compared with healthy people and patients with ADHD

2019 ◽  
Vol 50 (11) ◽  
pp. 1829-1838 ◽  
Author(s):  
Pavla Linhartová ◽  
Adéla Látalová ◽  
Richard Barteček ◽  
Jan Širůček ◽  
Pavel Theiner ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Cognitive Functioning ◽  
Iowa Gambling Task ◽  
Borderline Personality ◽  
Self Report ◽  
Stop Signal Task ◽  
Negative Urgency ◽  
Impulsive Choice ◽  
Impulsive Action

AbstractBackgroundImpulsivity is a core symptom of borderline personality disorder (BPD). Impulsivity is a heterogeneous concept, and a comprehensive evaluation of impulsivity dimensions is lacking in the literature. Moreover, it is unclear whether BPD patients manifest impaired cognitive functioning that might be associated with impulsivity in another patient group, such as ADHD, a frequent comorbidity of BPD.MethodsWe tested 39 patients with BPD without major psychiatric comorbidities and ADHD, 25 patients with ADHD, and 55 healthy controls (HC) using a test battery consisting of a self-report measure of impulsivity (UPPS-P questionnaire), behavioral measures of impulsivity – impulsive action (Go/NoGo task, stop signal task) and impulsive choice (delay discounting task, Iowa gambling task), and standardized measures of attention (d2 test), working memory (digit span), and executive functioning (Tower of London).ResultsPatients with BPD and ADHD, as compared with HC, manifested increased self-reported impulsivity except sensation seeking and increased impulsive choice; patients with ADHD but not BPD showed increased impulsive action and deficits in cognitive functioning. Negative urgency was increased in BPD as compared to both HC and ADHD groups and correlated with BPD severity.ConclusionsPatients with BPD without ADHD comorbidity had increased self-reported impulsivity and impulsive choice, but intact impulsive action and cognitive functioning. Controlling for ADHD comorbidity in BPD samples is necessary. Negative urgency is the most diagnostically specific impulsivity dimension in BPD.

Substance use relapse associated with Iowa gambling task performances in polysubstance dependent alcoholics

2011 ◽  
Vol 26 (S2) ◽  
pp. 22-22
Author(s):  
B. De Wilde ◽  
B. Sabbe ◽  
W. Hulstijn ◽  
G. Dom
Keyword(s):  
Decision Making ◽  
Substance Use ◽  
High Risk ◽  
Addiction Treatment ◽  
Iowa Gambling Task ◽  
Age At Onset ◽  
Self Report ◽  
Gambling Task ◽  
Short Term ◽  
Neurocognitive Measures

IntroductionPolysubstance dependent alcoholics (PSA) show a high risk of relapse. Decision-making deficits might be predictive of relapse so that high-risk relapse PSA are easily identified and novel more effective treatment interventions can be found.ObjectivesTo evaluate the effect of decision-making as measured by neurocognitive measures like the Iowa Gambling Task (IGT) and the Delay Discounting Task (DDT) on short-term relapse in PSA. The possible confounding effects of personality disorders (PD) are also examined.MethodsForty-one PSA following an inpatient addiction treatment were questioned about their substance use. After two weeks of stable abstinence they performed self-report questionnaires (Barratt Impulsiveness Scale - Sensitivity to Punishment and Sensitivity to Reward Questionnaires) and neurocognitive measures of decision-making (DDT - IGT). Thirty-seven PSA were retrieved three months after treatment completion and questioned about their current substance use. Thirty-one healthy controls (HC) were also asked to perform the self-report questionnaires and neurocognitive measures.ResultsAll PSA showed decision-making deficits in comparison to the HC. Abstinence was associated with better IGT performances, an older age at onset, and a greater likelihood of a cluster C PD.ConclusionIGT performances but not DDT performances are associated with short-term relapse in PSA. It is assumed that the processes involved in the DDT are more important to the initiation of the addiction while the processes involved in the IGT are more important to the maintenance of and the relapse in the addiction.

scholarly journals Effects of Psychopathy on Neurocognitive Domains of Impulsivity in Abstinent Opiate and Stimulant Users

2021 ◽  
Vol 12 ◽  
Author(s):  
Elena Psederska ◽  
Nicholas D. Thomson ◽  
Kiril Bozgunov ◽  
Dimitar Nedelchev ◽  
Georgi Vasilev ◽  
...  
Keyword(s):  
Decision Making ◽  
Response Inhibition ◽  
Iowa Gambling Task ◽  
Memory Task ◽  
Stop Signal ◽  
Stop Signal Task ◽  
Gambling Task ◽  
Heroin Users ◽  
Neurocognitive Impairments ◽  
Substance Dependent

Background: Psychopathy and substance use disorders (SUDs) are both characterized by neurocognitive impairments reflecting higher levels of impulsivity such as reward-driven decision-making and deficient inhibitory control. Previous studies suggest that psychopathy may exacerbate decision-making deficits, but it may be unrelated to other neurocognitive impairments among substance dependent individuals (SDIs). The aim of the present study was to examine the role of psychopathy and its interpersonal-affective and impulsive-antisocial dimensions in moderating the relationships between dependence on different classes of drugs and neurocognitive domains of impulsivity.Method: We tested 693 participants (112 heroin mono-dependent individuals, 71 heroin polysubstance dependent individuals, 115 amphetamine mono-dependent individuals, 76 amphetamine polysubstance dependent individuals, and 319 non-substance dependent control individuals). Participants were administered the Psychopathy Checklist: Screening Version (PCL:SV) and seven neurocognitive tasks measuring impulsive choice/decision-making (Iowa Gambling Task; Cambridge Gambling Task; Kirby Delay Discounting Task; Balloon Analog Risk Task), and impulsive action/response inhibition (Go/No-Go Task, Immediate Memory Task, and Stop Signal Task).Results: A series of hierarchical multiple regressions revealed that the interpersonal-affective dimension of psychopathy moderated the association between decision-making, response inhibition and both amphetamine and heroin dependence, albeit differently. For amphetamine users, low levels of interpersonal-affective traits predicted poor decision-making on the Iowa Gambling Task and better response inhibition on the Stop Signal task. In contrast, in heroin users high interpersonal-affective psychopathy traits predicted lower risk taking on the Cambridge Gambling Task and better response inhibition on the Go/No-Go task. The impulsive-antisocial dimension of psychopathy predicted poor response inhibition in both amphetamine and heroin users.Conclusions: Our findings reveal that psychopathy and its dimensions had both common and unique effects on neurocognitive function in heroin and amphetamine dependent individuals. Our results suggest that the specific interactions between psychopathy dimensions and dependence on different classes of drugs may lead to either deficient or superior decision-making and response inhibition performance in SDIs, suggesting that psychopathy may paradoxically play a protective role for some neurocognitive functions in specific subtypes of substance users.

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)

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.

Delay Discounting, Treatment Motivation and Treatment Retention Among Substance-Dependent Individuals Attending an in Inpatient Detoxification Program

2015 ◽  
Vol 49 ◽  
pp. 58-64 ◽  
Author(s):  
Laura Stevens ◽  
Antonio Verdejo-García ◽  
Herbert Roeyers ◽  
Anna E. Goudriaan ◽  
Wouter Vanderplasschen
Keyword(s):  
Delay Discounting ◽  
Treatment Retention ◽  
Treatment Motivation ◽  
Substance Dependent

scholarly journals Diminished Cortical Thickness is Associated with Impulsive Choice in Adolescence

2017 ◽  
Author(s):  
Marieta Pehlivanova ◽  
Daniel H. Wolf ◽  
Aristeidis Sotiras ◽  
Antonia Kaczkurkin ◽  
Tyler M. Moore ◽  
...  
Keyword(s):  
Decision Making ◽  
Delay Discounting ◽  
Cortical Thickness ◽  
Brain Structure ◽  
Brain Networks ◽  
Additive Models ◽  
Impulsive Choice ◽  
Negative Outcomes ◽  
Large Sample ◽  
Structural Brain

ABSTRACTAdolescence is characterized by both maturation of brain structure and increased risk of negative outcomes from behaviors associated with impulsive decision-making. One important index of impulsive choice is delay discounting (DD), which measures the tendency to prefer smaller rewards available soon over larger rewards delivered after a delay. However, it remains largely unknown how individual differences in structural brain development may be associated with impulsive choice during adolescence. Leveraging a unique large sample of 427 human youths (208 males and 219 females) imaged as part of the Philadelphia Neurodevelopmental Cohort, we examined associations between delay discounting and cortical thickness within structural covariance networks. These structural networks were derived using non-negative matrix factorization, an advanced multivariate technique for dimensionality reduction, and analyzed using generalized additive models with penalized splines to capture both linear and nonlinear developmental effects. We found that impulsive choice, as measured by greater discounting, was most strongly associated with diminished cortical thickness in structural brain networks that encompassed the ventromedial prefrontal cortex, orbitofrontal cortex, temporal pole, and temporoparietal junction. Furthermore, structural brain networks predicted DD above and beyond cognitive performance. Taken together, these results suggest that reduced cortical thickness in regions known to be involved in value-based decision-making is a marker of impulsive choice during the critical period of adolescence.SIGNIFICANCERisky behaviors during adolescence, such as initiation of substance use or reckless driving, are a major source of morbidity and mortality. In this study, we present evidence from a large sample of youths that diminished cortical thickness in specific structural brain networks is associated with impulsive choice. Notably, the strongest association between impulsive choice and brain structure was seen in regions implicated in value-based decision-making; namely, the ventromedial prefrontal and orbitofrontal cortices. Moving forward, such neuroanatomical markers of impulsivity may aid in the development of personalized interventions targeted to reduce risk of negative outcomes resulting from impulsivity during adolescence.

scholarly journals Acute exposure to nicotine vapor causes short-term increases in impulsive choice in rats

2019 ◽  
Author(s):  
R.J. Flores ◽  
F.Z. Alshbool ◽  
P. Giner ◽  
L.E. O’Dell ◽  
I.A. Mendez
Keyword(s):  
Delay Discounting ◽  
Male Rats ◽  
Enzyme Linked Immunosorbent Assay ◽  
Impulsive Choice ◽  
Short Term ◽  
Serum Cotinine ◽  
Choice Preference ◽  
Long Term Changes ◽  
Stable Performance

AbstractBackgroundPrevious studies have shown that exposure to nicotine smoke increases impulsivity. Surprisingly, research investigating the effects of electronic cigarette nicotine vapor exposure on impulsivity has not been conducted. Therefore, the present study examined the effects of nicotine vapor exposure on impulsive choice.MethodsTwenty-four adult male rats were trained in the delay discounting task to choose between small immediate food rewards or larger food rewards with delayed deliveries. After 24 days of training in the delay discounting task, rats were passively exposed to vapor containing either 0, 12, or 24 mg/mL of nicotine for 10 days. To monitor exposure to nicotine, serum cotinine levels were assessed on exposure days 1, 5, and 10 using enzyme-linked immunosorbent assay (ELISA). Following vapor exposure, rats were retrained in the delay discounting task until stable performance was achieved, and the effects of nicotine vapor exposure on choice preference were assessed.ResultsRats that were exposed to 12 and 24 mg/mL nicotine vapor displayed higher serum cotinine levels, relative to those exposed to 0 mg/mL nicotine vapor. There were no differences in impulsive choice between any of the vapor groups when tested 15-21 days after exposure. However, increases in impulsive choice were observed when testing immediately following exposure to 24 mg/mL nicotine vapor, relative to immediately following exposure to 0 mg/mL nicotine vapor.ConclusionsFindings suggest that while exposure to nicotine vapor may not cause long-term changes in decision making, it can cause short-term increases in impulsive choice, an effect that can have negative social and health consequences.

scholarly journals Altered social and non-social decision-making in recreational and dependent cocaine users

2013 ◽  
Vol 44 (5) ◽  
pp. 1015-1028 ◽  
Author(s):  
L. M. Hulka ◽  
C. Eisenegger ◽  
K. H. Preller ◽  
M. Vonmoos ◽  
D. Jenni ◽  
...  
Keyword(s):  
Decision Making ◽  
Social Interaction ◽  
Delay Discounting ◽  
Iowa Gambling Task ◽  
Treatment Success ◽  
Dictator Game ◽  
Gambling Task ◽  
Social Decision ◽  
Cocaine Users ◽  
Social Decision Making

BackgroundMaladaptive decision-making is assumed to be a core feature of cocaine addiction. Indeed, numerous studies have reported deficits in non-social decision-making tasks and reward-related impulsivity in dependent cocaine users. However, social decision-making has not been examined in cocaine users yet. Moreover, it is unknown if even recreational and non-dependent cocaine use is linked to decision-making deficits. Therefore, we investigated whether recreational and dependent cocaine users exhibit alterations in social and non-social decision-making.MethodThe performance of healthy controls (n = 68), recreational cocaine users (n = 68) and dependent cocaine users (n = 30) in classical decision-making paradigms (Iowa Gambling Task, Delay Discounting) and in social interaction paradigms (Distribution Game, Dictator Game) was assessed.ResultsDecisions in the social interaction tasks of both cocaine user groups were more self-serving compared with controls as cocaine users preferred higher monetary payoffs for themselves. In the Iowa Gambling Task, only dependent cocaine users were more likely to choose disadvantageous card decks, reflecting worse decision-making. They were also more likely to choose immediate smaller rewards over larger delayed rewards in the Delay Discounting task.ConclusionsOur results imply that both recreational and dependent cocaine users are more concerned with their own monetary gain when interacting with another person. Furthermore, primarily dependent cocaine users are less foresighted and more impulsive regarding immediate reward. Overall, social interaction deficits are already present in recreational users, while non-social decision-making deficits occur predominantly in dependent cocaine users. Thus, social interaction training and cognitive remediation strategies may improve treatment success and quality of life in cocaine dependence.

scholarly journals Changes in cocaine consumption are associated with fluctuations in self-reported impulsivity and gambling decision-making

2015 ◽  
Vol 45 (14) ◽  
pp. 3097-3110 ◽  
Author(s):  
L. M. Hulka ◽  
M. Vonmoos ◽  
K. H. Preller ◽  
M. R. Baumgartner ◽  
E. Seifritz ◽  
...  
Keyword(s):  
Decision Making ◽  
Delay Discounting ◽  
Response Bias ◽  
Iowa Gambling Task ◽  
Delay Of Gratification ◽  
Significant Group ◽  
Cocaine Use ◽  
Group Time ◽  
Cognitive Impulsivity ◽  
Cocaine Users

Background.In cross-sectional studies, cocaine users generally display elevated levels of self-reported and cognitive impulsivity. To what extent these impairments are stable v. variable markers of cocaine use disorder, and, thus, are pre-existing or drug-induced, has not yet been systematically investigated.Method.We conducted a longitudinal study with cocaine users who changed or maintained their consumption intensity, measuring self-reported impulsivity with the Barratt Impulsiveness Scale (BIS-11), and cognitive impulsivity with the Rapid Visual Processing task (RVP), Iowa Gambling task (IGT), and Delay Discounting task (DD) at baseline and at 1-year follow-up. We assessed 48 psychostimulant-naive controls and 19 cocaine users with decreased, 19 users with increased, and 19 users with unchanged cocaine intake after 1 year as confirmed by hair analysis.Results.Results of linear multilevel modelling showed significant group × time interactions for the BIS-11 total score and the IGT total card ratio. Increasers showed a trend for elevated scores, whereas decreasers exhibited reduced self-reported impulsivity scores within 1 year. Surprisingly, increasers’ IGT performance was improved after 1 year, whereas decreasers’ performance deteriorated. By contrast, neither RVP response bias B″ nor DD total score showed substantial group × time interactions. Importantly, BIS-11 and DD revealed strong test–retest reliabilities.Conclusion.Self-reported impulsivity (BIS-11) and decision-making impulsivity (IGT) covary with changing cocaine use, whereas response bias and delay discounting remain largely unaffected. Thus, self-reported impulsivity and gambling decision-making were strongly state-dependent in a stimulant-using population and may be suitable to monitor treatment success, whereas delay of gratification was confirmed as a potential endophenotype of stimulant addiction.

Brain Activation Imaging in Emotional Decision Making and Mental Health: A Review—Part 1

2020 ◽  
pp. 155005942091663
Author(s):  
Ronald J. Bonnstetter ◽  
Thomas F. Collura
Keyword(s):  
Decision Making ◽  
Subjective Experience ◽  
Brain Activity ◽  
Brain Activation ◽  
Self Report ◽  
Imaging Method ◽  
Short Term ◽  
Assessment Validation ◽  
Eeg Recordings ◽  
Decision Making Model

In part 1 of this article, we describe an approach and methodology that bridges 2 worlds: the internal, subjective experience of emotions and thoughts, and the external world of brain electrical activity. Using a novel event-related brain activation imaging method, we demonstrate that within single trials, short-term mental processes, on the order of 100 ms, can be clearly related to observed brain activation in controlled experiments. We use an ipsative assessment validation process that combines self-report with real-time EEG recordings to provide a combined picture of both the mental and the brain activity, during short-term reactions, emotions, and decisions regarding controlled information. Part 2 provides a detailed description of the emerging emotional decision-making model.

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