title: Decision making as a predictor of first ecstasy use: a prospective study.
abstract: BACKGROUND
  Ecstasy (+/-3,4-methylenedioxymethamphetamine) is a widely used recreational drug that may damage the serotonin system and may entail neuropsychological dysfunctions. Few studies investigated predictors for ecstasy use. Self-reported impulsivity does not predict the initiation of ecstasy use; the question is if neuropsychological indicators of impulsivity can predict first ecstasy use.
  
  
  OBJECTIVE
  This study tested the hypothesis that a neuropsychological indicator of impulsivity predicts initiation of ecstasy use.
  
  
  METHODS
  Decision-making strategy and decision-making reaction times were examined with the Iowa Gambling Task in 149 ecstasy-naive subjects. The performance of 59 subjects who initiated ecstasy use during a mean follow-up period of 18 months (range, 11-26) was compared with the performance of 90 subjects that remained ecstasy-naive.
  
  
  RESULTS
  Significant differences in decision-making strategy between female future ecstasy users and female persistent ecstasy-naive subjects were found. In addition, the gap between decision-making reaction time after advantageous choices and reaction time after disadvantageous choices was smaller in future ecstasy users than in persistent ecstasy-naives.
  
  
  CONCLUSIONS
  Decision-making strategy on a gambling task was predictive for future use of ecstasy in female subjects. Differences in decision-making time between future ecstasy users and persistent ecstasy-naives may point to lower punishment sensitivity or higher impulsivity in future ecstasy users. Because differences were small, the clinical relevance is questionable.
authors.affiliation: Department of Psychiatry-PB 0.429, Amsterdam Institute for Addiction Research Academic Medical Center, University of Amsterdam, PO Box 75867, 1070 AW Amsterdam, The Netherlands. t.schilt@amc.uva.nl
authors.forename: Thelma
authors.initials: T
authors.lastname: Schilt
authors.forename: Anneke E
authors.initials: AE
authors.lastname: Goudriaan
authors.forename: Maarten W
authors.initials: MW
authors.lastname: Koeter
authors.forename: Wim
authors.initials: W
authors.lastname: van den Brink
authors.forename: Ben
authors.initials: B
authors.lastname: Schmand
mesh_terms: D000293:Adolescent; D000328:Adult; D019969:Amphetamine-Related Disorders / Q000523:psychology*; D003657:Decision Making; D005260:Female; D005544:Forecasting; D005715:Gambling / Q000523:psychology; D006801:Humans; D008297:Male; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000009:adverse effects*; D009483:Neuropsychological Tests; D011446:Prospective Studies; D013997:Time Factors; D055815:Young Adult
chemical_list: D018817:N-Methyl-3,4-methylenedioxyamphetamine