scholarly journals Decision-making inflexibility in a reversal learning task is associated with severity of problem gambling symptoms but not with a diagnosis of substance use disorder

2019 ◽  
Author(s):  
Maria Fernanda Jara-Rizzo ◽  
Juan F. Navas ◽  
Jose A. Rodas ◽  
José C. Perales
Keyword(s):  
Decision Making ◽  
Substance Use ◽  
Substance Use Disorder ◽  
Reversal Learning ◽  
Gambling Disorder ◽  
Learning Task ◽  
Learning Curves ◽  
Gambling Problems ◽  
Mixed Effect ◽  
Addictive Disorders

Background: Decisions made by individuals with disordered gambling are markedly inflexible. However, whether anomalies in learning from feedback are gambling-specific, or extend beyond gambling contexts, remains an open question. More generally, addictive disorders –including gambling disorder– have been proposed to be facilitated by individual differences in feedback-driven decision-making inflexibility, which has been studied in the lab with the Probabilistic Reversal Learning Task (PRLT). In this task, participants are first asked to learn which of two choice options is more advantageous, on the basis of trial-by-trial feedback, but, once preferences are established, reward contingencies are reversed, so that the advantageous option becomes disadvantageous and vice versa. Inflexibility is revealed by a less effective reacquisition of preferences after reversal, which can be distinguished from more generalized learning deficits.Methods: In the present study, we compared PRLT performance across two groups of 25 treatment-seeking patients diagnosed with an addictive disorder and who reported gambling problems, and 25 matched controls [18 Males/7 Females in both groups, Mage(SDage) = 25.24 (8.42) and 24.96 (7.90), for patients and controls, respectively]. Beyond testing for differences in the shape of PRLT learning curves across groups, the specific effect of problematic gambling symptoms’ severity was also assessed independently of group assignment. In order to surpass previous methodological problems, full acquisition and reacquisition curves were fitted using generalized mixed-effect models. Results: Results showed that (1) controls did not significantly differ from patients in global PRLT performance nor showed specific signs of decision-making inflexibility; and (2) regardless of whether group affiliation was controlled for or not, gambling severity was specifically associated with more inefficient learning in phases with reversed contingencies. Conclusion: Decision-making inflexibility, as revealed by difficulty to reacquire decisional preferences based on feedback after contingency reversals, seems to be associated with gambling problems, but not necessarily with a substance-use disorder diagnosis. This result aligns with gambling disorder models in which domain-general compulsivity is linked to vulnerability to develop gambling-specific problems with exposure to gambling opportunities.

scholarly journals Decision-making inflexibility in a reversal learning task is associated with severity of problem gambling symptoms but not with a diagnosis of substance use disorder

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
María F. Jara-Rizzo ◽  
Juan F. Navas ◽  
Jose A. Rodas ◽  
José C. Perales
Keyword(s):  
Decision Making ◽  
Substance Use ◽  
Substance Use Disorder ◽  
Reversal Learning ◽  
Gambling Disorder ◽  
Learning Task ◽  
Learning Curves ◽  
Gambling Problems ◽  
Mixed Effect ◽  
Addictive Disorders

Abstract Background Decisions made by individuals with disordered gambling are markedly inflexible. However, whether anomalies in learning from feedback are gambling-specific, or extend beyond gambling contexts, remains an open question. More generally, addictive disorders—including gambling disorder—have been proposed to be facilitated by individual differences in feedback-driven decision-making inflexibility, which has been studied in the lab with the Probabilistic Reversal Learning Task (PRLT). In this task, participants are first asked to learn which of two choice options is more advantageous, on the basis of trial-by-trial feedback, but, once preferences are established, reward contingencies are reversed, so that the advantageous option becomes disadvantageous and vice versa. Inflexibility is revealed by a less effective reacquisition of preferences after reversal, which can be distinguished from more generalized learning deficits. Methods In the present study, we compared PRLT performance across two groups of 25 treatment-seeking patients diagnosed with an addictive disorder and who reported gambling problems, and 25 matched controls [18 Males/7 Females in both groups, Mage(SDage) = 25.24 (8.42) and 24.96 (7.90), for patients and controls, respectively]. Beyond testing for differences in the shape of PRLT learning curves across groups, the specific effect of problematic gambling symptoms’ severity was also assessed independently of group assignment. In order to surpass previous methodological problems, full acquisition and reacquisition curves were fitted using generalized mixed-effect models. Results Results showed that (1) controls did not significantly differ from patients in global PRLT performance nor showed specific signs of decision-making inflexibility; and (2) regardless of whether group affiliation was controlled for or not, gambling severity was specifically associated with more inefficient learning in phases with reversed contingencies. Conclusion Decision-making inflexibility, as revealed by difficulty to reacquire decisional preferences based on feedback after contingency reversals, seems to be associated with gambling problems, but not necessarily with a substance-use disorder diagnosis. This result aligns with gambling disorder models in which domain-general compulsivity is linked to vulnerability to develop gambling-specific problems with exposure to gambling opportunities.

scholarly journals Reward-Related Decision-Making in Current and Past Disordered Gambling: Implications for Impulsive Choice and Risk Preference in the Maintenance of Gambling Disorder

2021 ◽  
Vol 15 ◽  
Author(s):  
Magdalen G. Schluter ◽  
David C. Hodgins
Keyword(s):  
Decision Making ◽  
Substance Use ◽  
Delay Discounting ◽  
Substance Use Disorder ◽  
Gambling Disorder ◽  
Risky Choice ◽  
Impulsive Choice ◽  
Trait Impulsivity ◽  
History Of

Impulsive reward-related decision-making (RRDM) is robustly associated with gambling disorder (GD), although its role in the development and perpetuation of GD is still being investigated. This project sought to examine the possible roles of impulsive and risky choice, two aspects of RRDM, in the perpetuation of GD. Additionally, the potential moderating role of comorbid substance misuse was considered. A total of 434 participants with symptoms of current GD and symptoms of concurrent substance use disorder (SUD; n = 105), current GD with past SUD (n = 98), past GD with current SUD (n = 53), or past GD with past substance use disorder (SUD; n = 92), and 96 healthy controls were recruited through MTurk. Participants completed a randomly adjusting delay discounting (a measure of impulsive choice) and probabilistic discounting (a measure of risky choice) task and self-report questionnaires of gambling participation, GD and SUD symptomology, and trait impulsivity. Although control participants showed significantly greater delay discounting compared to individuals with a current or history of GD, no significant group differences emerged between individuals with current GD or a history of GD. Individuals with current GD showed significantly less probabilistic discounting compared to individuals with a history of GD and control participants showed the greatest rates of probabilistic discounting. These effects remained after controlling for lifetime gambling symptom severity and trait impulsivity. Overall, these findings suggest a potential maintaining role of risky choice in gambling disorder, but do not support a maintaining role for impulsive choice.

Representative Bureaucracy Through Staff With Lived Experience: Peer Coproduction in the Field of Substance Use Disorder Treatment

2020 ◽  
Vol 50 (8) ◽  
pp. 880-897
Author(s):  
Sunggeun (Ethan) Park
Keyword(s):  
Decision Making ◽  
Substance Use ◽  
Lived Experience ◽  
Substance Use Disorder ◽  
The United States ◽  
Descriptive Representation ◽  
Representative Bureaucracy ◽  
Organizational Decision Making ◽  
Substance Use Disorder Treatment ◽  
Disorder Treatment

This study extends the representative bureaucracy literature by theorizing and empirically testing how staff sharing lived experience with service users can serve as user representatives in service provision processes (i.e., the peer coproduction mechanism). Using survey data from a representative sample of substance use disorder treatment clinics in the United States, we explore factors associated with descriptive representation (the presence of staff with firsthand experience of a substance use disorder in both frontline treatment and senior positions) and directors’ perceptions of recovering staff’s potential to serve as user representatives in individual care and organizational decision-making processes. Recovering staff accounted for a third of the field’s workforce, but the majority of the clinics did not employ them in senior staff positions. Regression results suggest that organizational leaders’ recognition of recovering staff’s unique representation capacities may facilitate greater descriptive representation and grant meaningful organizational decision-making authority to recovering staff. Multiple research and practice implications are discussed.

scholarly journals Trading off the cost of conflict against expected rewards

2018 ◽  
Author(s):  
Nura Sidarus ◽  
Stefano Palminteri ◽  
Valérian Chambon
Keyword(s):  
Decision Making ◽  
Reinforcement Learning ◽  
Cognitive Control ◽  
Reversal Learning ◽  
Computational Models ◽  
Learning Task ◽  
Learning Rates ◽  
Different Types ◽  
Irrelevant Distractors ◽  
The Cost

AbstractValue-based decision-making involves trading off the cost associated with an action against its expected reward. Research has shown that both physical and mental effort constitute such subjective costs, biasing choices away from effortful actions, and discounting the value of obtained rewards. Facing conflicts between competing action alternatives is considered aversive, as recruiting cognitive control to overcome conflict is effortful. Yet, it remains unclear whether conflict is also perceived as a cost in value-based decisions. The present study investigated this question by embedding irrelevant distractors (flanker arrows) within a reversal-learning task, with intermixed free and instructed trials. Results showed that participants learned to adapt their choices to maximize rewards, but were nevertheless biased to follow the suggestions of irrelevant distractors. Thus, the perceived cost of being in conflict with an external suggestion could sometimes trump internal value representations. By adapting computational models of reinforcement learning, we assessed the influence of conflict at both the decision and learning stages. Modelling the decision showed that conflict was avoided when evidence for either action alternative was weak, demonstrating that the cost of conflict was traded off against expected rewards. During the learning phase, we found that learning rates were reduced in instructed, relative to free, choices. Learning rates were further reduced by conflict between an instruction and subjective action values, whereas learning was not robustly influenced by conflict between one’s actions and external distractors. Our results show that the subjective cost of conflict factors into value-based decision-making, and highlights that different types of conflict may have different effects on learning about action outcomes.

Risky decision-making in individuals with substance use disorder: A meta-analysis and meta-regression review

2020 ◽  
Vol 237 (7) ◽  
pp. 1893-1908
Author(s):  
Shujuan Chen ◽  
Pingyuan Yang ◽  
Tianzhen Chen ◽  
Hang Su ◽  
Haifeng Jiang ◽  
...  
Keyword(s):  
Decision Making ◽  
Substance Use ◽  
Substance Use Disorder ◽  
Meta Analysis ◽  
Risky Decision Making ◽  
Risky Decision ◽  
Meta Regression

Substance-Related and Addictive Disorders

2017 ◽  
pp. 175-178
Author(s):  
Myrna M. Weissman ◽  
John C. Markowitz ◽  
Gerald L. Klerman
Keyword(s):  
Substance Abuse ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Substance Use Disorder ◽  
Relapse Prevention ◽  
Addictive Disorders ◽  
Better Than

This chapter includes an overview of the use of IPT for patients with substance abuse (e.g., alcohol, opiates, cocaine, and nicotine) and addictive disorders. The available data do not allow us to recommend IPT as a treatment for patients with a substance use disorder. There have been several negative IPT trials in this population, and in this setting IPT has been found to be no better than a control condition. However, some small studies in process are more optimistic for its use in narrowly defined samples. Based on the published literature, approaches other than IPT that focus on sobriety or relapse prevention may be preferable for patients with substance use disorders. IPT has never been intended as a treatment for all patients with all conditions, and substance abuse may be an area where its application has limited utility.

scholarly journals Decision Making Impairment: A Shared Vulnerability in Obesity, Gambling Disorder and Substance Use Disorders?

PLoS ONE ◽  
2016 ◽  
Vol 11 (9) ◽  
pp. e0163901 ◽  
Author(s):  
Nuria Mallorquí-Bagué ◽  
Ana B. Fagundo ◽  
Susana Jimenez-Murcia ◽  
Rafael de la Torre ◽  
Rosa M. Baños ◽  
...  
Keyword(s):  
Decision Making ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Gambling Disorder
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