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Impulsive decision making in young adult social drinkers and detoxified alcohol-dependent patients: a cross-sectional and longitudinal study


Bernhardt, Nadine; Nebe, Stephan; Pooseh, Shakoor; Sebold, Miriam; Sommer, Christian; Birkenstock, Julian; Zimmermann, Ulrich S; Heinz, Andreas; Smolka, Michael N (2017). Impulsive decision making in young adult social drinkers and detoxified alcohol-dependent patients: a cross-sectional and longitudinal study. Alcoholism: Clinical and Experimental Research, 41(10):1794-1807.

Abstract

Background
Impulsive decision making relates to problematic substance use. Specifically, altered delay discounting (DD) has been suggested as a behavioral marker for addiction, while other relevant facets of choice impulsivity such as probability discounting (PD) or loss aversion are clearly understudied.
Methods
Two studies were performed collecting behavioral data on choice impulsivity with a value‐based decision‐making battery providing estimates of DD, PD for gains and losses, and loss aversion. Study (1): In a sample of 198 male 18‐year‐old social drinkers, we analyzed impulsive choice behavior and its association with alcohol consumption and self‐report measures of substance use‐related personality traits on a cross‐sectional level. Additionally, the predictive value of baseline choice behavior for the trajectories of alcohol consumption over a 12‐month follow‐up period was evaluated. Study (2): Behavioral data on choice impulsivity were collected for 114 detoxified patients with alcohol use disorder (AUD) and 98 control participants. We analyzed group differences at baseline and assessed the predictive value of choice impulsivity for relapse to heavy alcohol use in patients during a follow‐up period of 48 weeks.
Results
Study (1): Only DD was associated with baseline alcohol use, but no measure of choice impulsivity predicted the drinking trajectories over the following 12 months. Study (2): Compared to the control group, AUD patients showed higher DD, lower risk aversion regarding probabilistic gains, lower risk seeking regarding probabilistic losses, and lower loss aversion facing mixed prospects. Further, shallow discounting of probabilistic losses at baseline was predictive for relapse in patients.
Conclusions
All 4 domains of impulsive decision making were considerably altered in AUD patients though mostly not related to alcohol use in young adult social drinkers. This suggests that these facets of impulsive behavior may develop as consequences of chronic alcohol consumption. Furthermore, discounting of probabilistic losses might prove valuable in identifying patients vulnerable for relapse.

Abstract

Background
Impulsive decision making relates to problematic substance use. Specifically, altered delay discounting (DD) has been suggested as a behavioral marker for addiction, while other relevant facets of choice impulsivity such as probability discounting (PD) or loss aversion are clearly understudied.
Methods
Two studies were performed collecting behavioral data on choice impulsivity with a value‐based decision‐making battery providing estimates of DD, PD for gains and losses, and loss aversion. Study (1): In a sample of 198 male 18‐year‐old social drinkers, we analyzed impulsive choice behavior and its association with alcohol consumption and self‐report measures of substance use‐related personality traits on a cross‐sectional level. Additionally, the predictive value of baseline choice behavior for the trajectories of alcohol consumption over a 12‐month follow‐up period was evaluated. Study (2): Behavioral data on choice impulsivity were collected for 114 detoxified patients with alcohol use disorder (AUD) and 98 control participants. We analyzed group differences at baseline and assessed the predictive value of choice impulsivity for relapse to heavy alcohol use in patients during a follow‐up period of 48 weeks.
Results
Study (1): Only DD was associated with baseline alcohol use, but no measure of choice impulsivity predicted the drinking trajectories over the following 12 months. Study (2): Compared to the control group, AUD patients showed higher DD, lower risk aversion regarding probabilistic gains, lower risk seeking regarding probabilistic losses, and lower loss aversion facing mixed prospects. Further, shallow discounting of probabilistic losses at baseline was predictive for relapse in patients.
Conclusions
All 4 domains of impulsive decision making were considerably altered in AUD patients though mostly not related to alcohol use in young adult social drinkers. This suggests that these facets of impulsive behavior may develop as consequences of chronic alcohol consumption. Furthermore, discounting of probabilistic losses might prove valuable in identifying patients vulnerable for relapse.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:03 Faculty of Economics > Department of Economics
Dewey Decimal Classification:330 Economics
Uncontrolled Keywords:Delay discounting, probability discounting, risk loss aversion, alcohol dependence
Language:English
Date:October 2017
Deposited On:02 Aug 2019 09:32
Last Modified:25 Sep 2019 00:41
Publisher:Wiley-Blackwell Publishing, Inc.
ISSN:0145-6008
OA Status:Closed
Publisher DOI:https://doi.org/10.1111/acer.13481

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