Affective decision-making deficits, linked to a dysfunctional ventromedial prefrontal cortex, revealed in 10th grade Chinese adolescent binge drinkers

Abstract

The primary aim of this study was to test the hypothesis that adolescent binge drinkers, but not lighter drinkers, would show signs of impairment on tasks of affective decision-making as measured by the Iowa Gambling Test (IGT), when compared to adolescents who never drank.We tested 207 10th grade adolescents in Chengdu City, China, using two versions of the IGT, the original and a variant, in which the reward/punishment contingencies were reversed. This enables one to distinguish among different possibilities of impaired decision-making, such as insensitivity to long-term consequences, or hypersensitivity to reward. Furthermore, we tested working memory capacity using the Self-ordered Pointing Test (SOPT). Paper and pencil questionnaires were used to assess drinking behaviors and school academic performance.Results indicated that relative to never-drinkers, adolescent binge drinkers, but not other (ever, past 30-day) drinkers, showed significantly lower net scores on the original version of the IGT especially in the latter trials. Furthermore, the profiles of behavioral performance from the original and variant versions of the IGT were consistent with a decision-making impairment attributed to hypersensitivity to reward. In addition, working memory and school academic performance revealed no differences between drinkers (at all levels) and never-drinkers. Logistic regression analysis showed that after controlling for demographic variables, working memory, and school academic performance, the IGT significantly predicted binge-drinking.These findings suggest that a "myopia" for future consequences linked to hypersensitivity to reward is a key characteristic of adolescents with binge-drinking behavior, and that underlying neural mechanisms for this "myopia" for future consequences may serve as a predisposing factor that renders some adolescents more susceptible to future addictive behaviors.

Avaliação neuropsicológica do processo de tomada de decisões em crianças e adolescentes: uma revisão integrativa da literatura

“…Indeed, despite the fact that complete maturation of decisionmaking abilities is only achieved by late adolescence, early assessment of these skills can be useful in identifying difficulties in the decision process, considering that the executive functions of the type "hot" are highly connected to non-adaptive behavior in children and adolescents such as school suspension 17,27 , smoking and alcohol use 46,47 .…”

“…Among the studies reviewed, only eleven used the Iowa Gambling Task to assess decision-making 11,20,21,26,29,[47][48][49]51,52,54 . Seven of them used variations very similar to the original task in which there were small changes in the amount of the loan, gains and punishments after the choices 17,28,31,32,36,40,44 .…”

“…Among the 36 studies, 15 investigated the performance of children with a neuropsychiatric diagnosis (or maladaptive behavior pattern typical of psychopathology in childhood and adolescen ce) 11,17,25,27,32,35,36,[45][46][47][48][49]56,57,61 . Table 2 presents the description of all the papers, considering the paradigm used, the study sample, the experimental design, the main results and the level of evidence generated by the study.…”

The China Seven Cities Study (CSCS) consortium: adapting evidence-based prevention science from west to east

“…Program development took into consideration students' cultural/environmental influences, dispositional characteristics, particularly impulsivity, hostility, depression, mindfulness (attention), and affective decision making, and how these features impact substance use uptake and progression. In addition, findings from the CSCS-Chengdu Neurocognitive Study (CNS) added important knowledge about the neurocognitive basis for rapid acceleration in smoking and drinking behavior, involving multiple neural pathways regulating affective (emotionally laden) decisions [26][27][28]. The CSCS Longitudinal Study dataset with health risk behavior and psychosocial information for over 14,000 Chinese adolescents also provided valuable input to program development.…”

“…Other PR-TTAURC and CSCS studies have included an investigation of substance use among adolescent twin pairs in California and Qingdao to quantify the nature of environmental influences and how they interact with familial and genetic sources of variation in smoking-related behaviors [34]; an investigation of genetic factors underlying tobacco and alcohol use progression and their prevention [35]; a family study of cardiovascular risk factors in Qingdao [36], a study of the development and validation of a Chinese version of the Food Frequency Questionnaire for youth and adolescents [37]; an assessment of cognitive and neural mechanisms underlying tobacco and alcohol abuse [25][26][27]; and an assessment of tobacco use among rural Chinese children and their parents [38].…”