Influence of antisocial and psychopathic traits on decision-making biases in alcoholics.
BACKGROUND
Although decision-making processes have become a principal target of study among addiction researchers, few studies have specifically examined decision-making among individuals with alcohol dependence (AD) and findings to date are mixed. The present study examined the relationship between AD and decision-making, and tested whether different facets of antisocial and psychopathic traits explain this association.


METHODS
Participants were men with AD (n = 22), AD and comorbid antisocial personality disorder (AD + ASPD; n = 17), or a history of recreational alcohol use, but no current or lifetime symptoms of a substance use disorder, conduct disorder, or ASPD (n = 21). Decision-making was tested using the Iowa Gambling Task (IGT).


RESULTS
Across groups, participants reported similar levels of awareness of the contingencies of the task, but the AD groups with and without ASPD had poorer IGT performance compared with controls (p < 0.05). A block-by-block analysis revealed that while AD had slow but steady improvement across the task, AD + ASPD exhibited initial improvement followed by a significant decrease in advantageous decision-making during the last 20 trials (p < 0.05). This was further confirmed via evidence that impulsive/antisocial personality traits but not psychopathic traits mediated poor IGT performance beyond ASPD diagnosis.


CONCLUSIONS
Alcohol-dependent males favored risky choices regardless of whether they met criteria for ASPD. However, decision-making deficits were more pronounced among those with ASPD, and personality traits characterized by impulsive and antisocial tendencies mediated the relationship between AD and decision-making.
Miranda
Robert
R
Center for Alcohol and Addiction Studies, Brown University, Providence, RI 02912, USA. Robert_Miranda_Jr@brown.edu
MacKillop
James
J
Meyerson
Lori A
LA
Justus
Alicia
A
Lovallo
William R
WR
D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000150:complications / Q000503:physiopathology / Q000523:psychology*; D000987:Antisocial Personality Disorder / Q000150:complications / Q000503:physiopathology / Q000523:psychology*; D003657:Decision Making / Q000502:physiology; D006801:Humans; D008297:Male; D011597:Psychomotor Performance / Q000502:physiology; D055815:Young Adult