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

Abstract

Background Maladaptive 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 decisionmaking deficits. Therefore, we investigated whether recreational and dependent cocaine users exhibit alterations in social and non-social decision-making. Method The 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. Results Decisions 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. Conclusions Our 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.

Functional changes of the reward system underlie blunted response to social gaze in cocaine users

“…The present data were collected in the context of the Zurich Cocaine Cognition Study (13,15,55,56). For study I, 80 CUs and 63 stimulant drug-naïve control participants were included, whereas a subpopulation of 16 CUs and 16 HCs participated in study II (for recruitment details, see SI Materials and Methods).…”

“…Previous results suggest that cocaine users (CUs) show impairments in different facets of social cognition, particularly in emotional empathy, mental perspective taking, and emotion recognition in prosody, which are related to deficits in real-life social behavior such as fewer social contacts and more criminal offenses (13,14). Furthermore, in money distribution games, CUs act more self-servingly and less altruistically than stimulant-naïve controls (15). Volkow et al (9) postulated that neuroadaptations in the reward systems of drug users (e.g., ventral striatum and orbitofrontal cortex) alter reward processing such that the value of the abused drug is enhanced and concurrently the value of nondrug rewards, including social interaction, is reduced.…”

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

“…Prior studies have consistently shown that dependent cocaine users exhibit disadvantageous decision-making strategies in tasks such as the Iowa Gambling Task (IGT) and preferences for smaller immediate over larger but delayed rewards as measured with the Delay Discounting Task (DD) (Bechara et al 2002;Hulka et al 2014;Kjome et al 2010;Verdejo-Garcia et al 2007). Impulsivity, a multi-facetted concept, is generally defined as a predisposed tendency toward rapid and unplanned reaction patterns without much foresight regarding possible consequences (Moeller et al 2001a).…”

Social cognition in cocaine addiction

“…A paramount question is whether social reward deficits are a cause or a consequence of cocaine addiction. This very same laboratory has provided preliminary evidence regarding this question, showing that social decision-making deficits occur in both recreational and dependent cocaine users (19), therefore suggesting social deficits are a vulnerability factor for cocaine addiction. However, it is also well known that cocaine detrimentally impacts orbitofrontal cortex functions (20), such that even recreational exposure to cocaine may impair or worsen the orbitofrontal ability to properly weigh up social bonds and social rules.…”