Roopesh B N, Sharma Manoj K, Tripathy Saswatika, Benegal Vivek
Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
Department of Clinical Psychology, Central Institute of Psychiatry, Ranchi, Jharkhand, India.
Ind Psychiatry J. 2017 Jan-Jun;26(1):39-44. doi: 10.4103/ipj.ipj_82_16.
Patients who are diagnosed with alcohol-dependent syndrome (ADS) are shown to have neuropsychological deficits, especially executive function (EF) deficits. Among the EFs, decision-making is one such function which has consistently been shown to be impaired in people who are dependent on alcohol, compared to controls. Decision-making in this population is usually assessed with gambling-type tasks. However, some of these tasks are ambiguous, work on chance factors, rarely match with real-life gambling situations, and/or involve nonconscious mechanisms.
The current study compared 26 male patients with ADS (P-ADS) with equal number of their nonalcohol-dependent male siblings on sensation seeking and explicit gambling task (EGT). EGT is similar to the Iowa gambling task in administration, but varies from it as it involves a single outcome and provides unambiguous, explicit, and continuous feedback for the participants.
The results did not show any significant relationship between decision-making variables and sensation seeking. However, despite unambiguous, explicit, and continuous feedback, patients showed significantly poor decision-making as compared to the siblings of the P-ADS group. This study throws light on why people who are addicted to alcohol have difficulties in decision-making, despite knowing the adverse effects.
被诊断为酒精依赖综合征(ADS)的患者存在神经心理学缺陷,尤其是执行功能(EF)缺陷。在执行功能中,决策是其中一项功能,与对照组相比,长期以来一直显示依赖酒精的人在这项功能上存在受损情况。该人群的决策通常通过赌博类任务进行评估。然而,其中一些任务具有模糊性,受机会因素影响,很少与现实生活中的赌博情况相符,和/或涉及非意识机制。
本研究将26名患有酒精依赖综合征的男性患者(P-ADS)与其数量相等的非酒精依赖男性同胞在寻求刺激和显性赌博任务(EGT)方面进行了比较。EGT在实施过程中与爱荷华赌博任务相似,但不同之处在于它涉及单一结果,并为参与者提供明确、清晰且持续的反馈。
结果未显示决策变量与寻求刺激之间存在任何显著关系。然而,尽管有明确、清晰且持续的反馈,但与P-ADS组的同胞相比,患者的决策能力明显较差。本研究揭示了为什么酗酒成瘾者尽管知道不良影响,但在决策方面仍存在困难。