Stages of dysfunctional decision-making in addiction

Research output: Contribution to journalArticleResearchpeer-review

22 Citations (Scopus)

Abstract

Drug use is a choice with immediate positive outcomes, but long-term negative consequences. Thus, the repeated use of drugs in the face of negative consequences suggests dysfunction in the cognitive mechanisms underpinning decision-making. This cognitive dysfunction can be mapped into three stages: the formation of preferences involving valuation of decision options; choice implementation including motivation, self-regulation and inhibitory processes; and feedback processing implicating reinforcement learning. This article reviews behavioral studies that have examined alterations in these three stages of decision-making in people with substance use disorders. Relative to healthy individuals, those with alcohol, cannabis, stimulant and opioid use disorders value risky options more highly during the formation of preferences; have a greater appetite for superficially attractive rewards during choice implementation; and are both more efficient in learning from rewards and less efficient in learning from losses during feedback processing. These observed decision-making deficits are most likely due to both premorbid factors and drug-induced effects. Because decision-making deficits have been prospectively associated with a greater risk of drug relapse, we advocate for greater research on modulating the component stages that give rise to dysfunctional decision-making in disorders of addiction.

Original languageEnglish
Pages (from-to)99-105
Number of pages7
JournalPharmacology, Biochemistry and Behavior
Volume164
DOIs
Publication statusPublished - Jan 2018

Cite this

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title = "Stages of dysfunctional decision-making in addiction",
abstract = "Drug use is a choice with immediate positive outcomes, but long-term negative consequences. Thus, the repeated use of drugs in the face of negative consequences suggests dysfunction in the cognitive mechanisms underpinning decision-making. This cognitive dysfunction can be mapped into three stages: the formation of preferences involving valuation of decision options; choice implementation including motivation, self-regulation and inhibitory processes; and feedback processing implicating reinforcement learning. This article reviews behavioral studies that have examined alterations in these three stages of decision-making in people with substance use disorders. Relative to healthy individuals, those with alcohol, cannabis, stimulant and opioid use disorders value risky options more highly during the formation of preferences; have a greater appetite for superficially attractive rewards during choice implementation; and are both more efficient in learning from rewards and less efficient in learning from losses during feedback processing. These observed decision-making deficits are most likely due to both premorbid factors and drug-induced effects. Because decision-making deficits have been prospectively associated with a greater risk of drug relapse, we advocate for greater research on modulating the component stages that give rise to dysfunctional decision-making in disorders of addiction.",
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Stages of dysfunctional decision-making in addiction. / Verdejo-Garcia, Antonio; Chong, Trevor T.-J.; Stout, Julie C.; Yucel, Murat; London, Edythe D.

In: Pharmacology, Biochemistry and Behavior, Vol. 164, 01.2018, p. 99-105.

Research output: Contribution to journalArticleResearchpeer-review

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AU - Verdejo-Garcia, Antonio

AU - Chong, Trevor T.-J.

AU - Stout, Julie C.

AU - Yucel, Murat

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