Decision-making dysfunctions in addiction

This chapter provides an overview of the decision-making dysfunctions which identified in people with substance addictions, as compared with non-drug-using groups, via cognitive tasks that challenge different aspects of choice. It reviews empirical evidence regarding five types of cognitive tasks, related to five different aspects of decision-making: reflection impulsivity, delay discounting, decision-making under risk, decision-making under ambiguity and social decision-making. The chapter begins with the most highly used legal substance, and then progress with the most frequent drugs of concern among addiction treatment settings: cannabis, stimulants and opiates. It shows that the relevance of sociodemographic, personality, and clinical factors whenever they seem relevant to interpret decision-making profiles. The relationship between decision-making dysfunctions and trait characteristics among individuals with alcohol addiction suggests that some of these dysfunctions may be premorbid and hence act as potential vulnerability factors for the development of alcoholism.