Hulka L M, Eisenegger C, Preller K H, Vonmoos M, Jenni D, Bendrick K, Baumgartner M R, Seifritz E, Quednow B B
Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland.
Behavioural and Clinical Neuroscience Institute, Department of Experimental Psychology, University of Cambridge, Cambridge, UK.
Psychol Med. 2014 Apr;44(5):1015-28. doi: 10.1017/S0033291713001839. Epub 2013 Jul 22.
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 decision-making deficits. Therefore, we investigated whether recreational and dependent cocaine users exhibit alterations in social and non-social decision-making.
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.
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.
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.
适应不良的决策被认为是可卡因成瘾的核心特征。事实上，大量研究报告称，依赖可卡因的使用者在非社会决策任务和与奖励相关的冲动性方面存在缺陷。然而，尚未对可卡因使用者的社会决策进行研究。此外，即使是娱乐性和非依赖性可卡因使用是否与决策缺陷有关也尚不清楚。因此，我们调查了娱乐性和依赖性可卡因使用者在社会决策和非社会决策方面是否存在改变。
评估了健康对照组（n = 68）、娱乐性可卡因使用者（n = 68）和依赖性可卡因使用者（n = 30）在经典决策范式（爱荷华赌博任务、延迟折扣）和社会互动范式（分配游戏、独裁者游戏）中的表现。
与对照组相比，两个可卡因使用者组在社会互动任务中的决策都更有利于自己，因为可卡因使用者更喜欢为自己获得更高的金钱回报。在爱荷华赌博任务中，只有依赖性可卡因使用者更有可能选择不利的牌组，这反映出决策能力较差。在延迟折扣任务中，他们也更有可能选择即时较小的奖励而非更大的延迟奖励。
我们的结果表明，娱乐性和依赖性可卡因使用者在与他人互动时都更关注自己的金钱收益。此外，主要是依赖性可卡因使用者在即时奖励方面缺乏远见且更冲动。总体而言，娱乐性使用者已存在社会互动缺陷，而非社会决策缺陷主要出现在依赖性可卡因使用者中。因此，社会互动训练和认知矫正策略可能会提高可卡因依赖治疗的成功率和生活质量。
