Sensitivity to gains during risky decision-making differentiates chronic cocaine users from stimulant-naïve controls

Abstract

Background Chronic cocaine use has been consistently associated with decision-making impairments that contribute to the development and maintenance of drug-taking. However, the underlying cognitive processes of risk-seeking behaviours observed in chronic cocaine users (CU) have so far remained unclear. Here we therefore tested whether CU differ from stimulant-naïve controls in their sensitivity to gain, loss, and probability of loss information when making decisions under risk. Method A sample of 96 participants (56 CU and 40 controls) performed the no-feedback version of the Columbia Card Task, designed to assess risk-taking in relation to gain, loss, and probability of loss information. Additionally, cognitive performance and impulsivity were determined. Current and recent substance use was objectively assessed by toxicological urine and hair analysis. Results Compared to controls, CU showed increased risk-seeking in unfavourable decision scenarios in which the loss probability was high and the returns were low, and a tendency for increased risk aversion in more favourable decision scenarios. In comparison to controls, CU were less sensitive to gain, but similarly sensitive to loss and probability of loss information. Further analysis revealed that individual differences in sensitivity to loss and probability of loss information were related to cognitive performance and impulsivity. Conclusion Reduced sensitivity to gains in people with CU may contribute to their propensity for making risky decisions. While these alterations in gain sensitivity might directly relate to cocaine use per se, the individual psychopathological profile of CU might moderate sensitivity to loss information.

Chronic cocaine causes age-dependent increases in risky choice in both males and females.

“…In the real world, cocaine users engage in more risky sexual behavior and criminal activity than nonusers (Grella et al, 1995; Lejuez et al, 2005). In the laboratory, numerous behavioral instruments such as the Iowa Gambling Task (IGT) have been used to assess the impact of cocaine on risky decision making, and have consistently found that, similar to real-world findings, chronic cocaine use is associated with greater risk-taking behavior (Bornovalova et al, 2005; Fishbein et al, 2005; Gowin et al, 2018; Kluwe-Schiavon et al, 2020; Leland & Paulus, 2005; van der Plas et al, 2009; Verdejo-Garcia et al, 2007). High levels of risk taking associated with cocaine use can extend far into abstinence (Bolla et al, 2003; Verdejo-Garcia et al, 2014), which may render these individuals vulnerable to relapse.…”

A longitudinal investigation of blood neurofilament light chain levels in chronic cocaine users

“…The data were collected in the context of the Social Stress Cocaine Study (SSCP) at the Psychiatric Hospital of the University of Zurich. 15,25 The general exclusion criteria were a family history of genetically transmitted psychiatric disorders (h 2 >0.5, e.g., autism, schizophrenia, or bipolar disorder); any severe neurological disorder or brain injury; a current diagnosis of infectious disease or severe somatic disorder; a history of autoimmune, endocrine, or rheumatoid arthritis; intake of medication with potential action on the central nervous system or the physiological stress system during the previous three days; participation in a large previous study conducted by our lab, the Zurich Cocaine Cognition Study; 7,10 and (for women) being pregnant or breastfeeding. The criteria for inclusion of CU in the study were cocaine as the primary substance of use; a lifetime cumulative consumption of at least 100 g of cocaine, estimated by self-report; and a current abstinence duration of <6 months.…”

“…Thus, the extent to which these structural impairments are directly related to cocaine-induced brain pathology (neurotoxicity) rather than preexisting traits (predisposition) remains unclear. 8,9 Moreover, cocaine adulteration with neurotoxic compounds (e.g., the anthelmintic levamisole), 10,11 concomitant use of other illicit substances or alcohol, 12 and comorbidity with psychiatric disorders (e.g., depression) 12-15 might influence brain integrity in chronic cocaine users (CU) independently of cocaine intake itself. Considering the limitations of current diagnostic methods, which are mostly limited to cost-intensive neuroimaging measures, the introduction of new markers of active brain pathology may help clarify crucial questions on substance-induced brain pathology and provide new monitoring tools for physicians working in addiction medicine.…”

Cue-induced cocaine craving enhances psychosocial stress and vice versa in chronic cocaine users

“…In the context of the Social Stress Cocaine Project (SSCP) 40 69 CU and 54 HC were recruited. In- and exclusion criteria were tested during a screening-session.…”