Impaired Decision-Making Under Risk in Individuals with Alcohol Dependence

Abstract

Background Alcohol dependence is associated with poor decision-making under ambiguity, that is, when decisions are to be made in the absence of known probabilities of reward and loss. However, little is known regarding decisions made by individuals with alcohol dependence in the context of known probabilities (decision under risk). In this study, we investigated the relative contribution of these distinct aspects of decision making to alcohol dependence. Methods Thirty recently detoxified and sober asymptomatic alcohol-dependent individuals, and thirty healthy control participants were tested for decision-making under ambiguity (using the Iowa Gambling Task), and decision-making under-risk (using the Cups Task and Coin Flipping Task). We also tested their capacities for working memory storage (Digit-span Forward), and dual-tasking (Operation-span Task). Results Compared to healthy control participants, alcohol-dependent individuals made disadvantageous decisions on the Iowa Gambling Task, reflecting poor decisions under ambiguity. They also made more risky choices on the Cups and Coin Flipping Tasks reflecting poor decision-making under risk. In addition, alcohol-dependent participants showed some working memory impairments, as measured by the dual tasking, and the degree of this impairment correlated with high-risk decision-making, thus suggesting a relationship between processes sub-serving working memory and risky decisions. Conclusion These results suggest that alcohol dependent individuals are impaired in their ability to decide optimally in multiple facets of uncertainty (i.e., both risk and ambiguity), and that at least some aspects of these deficits are linked to poor working memory processes.

Impaired decision-making under risk is associated with gaming-specific inhibition deficits among college students with Internet gaming disorder

“…This effect was primarily driven by an increased number of disadvantageous risky options chosen by IGD participants on RD trials. These results broadly parallel our previous study in IGD (Yao et al, 2015) and other findings obtained among individuals with pathological gambling (Brevers et al, 2012) and alcohol dependence (Brevers et al, 2014), suggesting that possible shared alterations in decision-making among individuals with IGD and with other addiction-related disorders. These findings provide additional support to the notion that individuals with IGD have deficits in decision-making under risk (Dong et al, 2013;Lin et al, 2015;Pawlikowski and Brand, 2011;Yao et al, 2014).…”

“…Unlike the IGT, during the Cups task the values and associated probabilities of potential gains and losses are explicit; as such this task is considered a measure of decision-making under risk (Brand et al, 2007;Brevers et al, 2014).…”

Decision-Making Measured by the Iowa Gambling Task in Patients with Alcohol Use Disorders Choosing Harm Reduction versus Relapse Prevention Program

“…These results are in agreement with the literature. Patients with AUD exhibit poorer performance in decision-making [9,29] and clinical characteristics seem not to be correlated. Such as Loeber et al [30], the number of previous withdrawals does not appear to be predictive of decision-making skills.…”

“…We know that IGT performances are lower in subjects with working memory impairment. However, it's not a necessary and sufficient condition for a decision-making impairment [9,33]. Decision-making impairment could be secondary due to a deficiency in the production of somatic markers [1].…”

“…To make a choice between different options, the value of each option is examined, subserved by different areas [8]. Compared to controls, alcoholics had widespread reduced gray matter volume in the ventromedial prefrontal cortex, dorsal anterior cingulate and right hippocampal formation [9,10]. Poor decision-making is associated with neuropsychological deficits and also with premorbid high impulsivity, low cognitive abilities, as well as nutritional factors including vitamins deficiencies or level of alcohol consumption [11].…”