Relationship between impulsivity and decision making in cocaine dependence.

Department of Psychiatry and Behavioral Science, University of Texas Health Science Center at Houston, TX, USA.
Psychiatry Research (Impact Factor: 2.68). 07/2010; 178(2):299-304. DOI: 10.1016/j.psychres.2009.11.024
Source: PubMed

ABSTRACT Impulsivity and decision making are associated on a theoretical level in that impaired planning is a component of both. However, few studies have examined the relationship between measures of decision making and impulsivity in clinical populations. The purpose of this study was to compare cocaine-dependent subjects to controls on a measure of decision making (the Iowa Gambling Task or IGT), a questionnaire measure of impulsivity (the Barratt Impulsiveness Scale or BIS-11) and a measure of behavioural inhibition (the immediate memory task or IMT), and to examine the interrelationship among these measures. Results of the study showed that cocaine-dependent subjects made more disadvantageous choices on the IGT, had higher scores on the BIS and more commission errors on the IMT. Cognitive model analysis showed that choice consistency factors on the IGT differed between cocaine-dependent subjects and controls. However, there was no significant correlation between IGT performance and the BIS total score or subscales or IMT commission errors. These results suggest that in cocaine-dependent subjects there is little overlap between decision making as measured by the IGT and impulsivity/behavioural inhibition as measured by the BIS and IMT.

1 Follower
  • [Show abstract] [Hide abstract]
    ABSTRACT: Abstract Background: Impulsivity may underlie the poor treatment retention and high relapse rates observed in cocaine-dependent persons. However, observed differences in measures of impulsivity between cocaine-dependent and healthy control participants often do not reach clinical significance, suggesting that the clinical relevance of these differences may be limited. Objectives: To examine which measures of impulsivity (i.e. self-report impulsivity, self-report personality, neurocognitive testing) best distinguish cocaine-dependent and healthy control participants (i.e. showing differences at least 1.5 standard deviations [SD] from controls). Optimal measures were considered to demonstrate sufficient classification accuracy. Methods: Sixty-five recently abstinent cocaine-dependent and 25 healthy control participants were assessed using select neurocognitive tests and self-report questionnaires including the NEO Personality Inventory-Revised (NEO-PI-R), Temperament and Character Inventory (TCI), Barratt Impulsiveness Scale (BIS-11a), and the Frontal Systems Behavior Scale (FrSBe). Results: When corrected for years of education and gender, neurocognitive measures did not demonstrate clinically significant differences between cocaine-dependent and control participants. The personality measures TCI Purposefulness and Congruent Second Nature and NEO-PI-R Impulsiveness, and the self-rating measures FrSBe Disinhibition and BIS-11 Motor Impulsivity and Total successfully identified clinically meaningful elevations in impulsivity within cocaine-dependent participants (>1.5 SDs from controls). Furthermore, these measures achieved 84-93% accuracy in discriminating cocaine-dependent from control participants. Conclusion: Clinically significant neurocognitive impairment in cocaine-dependent participants was not observed in this sample. As the BIS-11 or FrSBe are brief to administer, accurate, and have been shown to predict treatment retention and relapse, these measures appear to be optimal, relative to the personality measures, for examining trait impulsivity in cocaine dependence.
    The American Journal of Drug and Alcohol Abuse 08/2014; 40(6):1-8. DOI:10.3109/00952990.2014.939752 · 1.47 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Cocaine users exhibit a wide range of behavioral impairments accompanied by brain structural, neurochemical and functional abnormalities. Metabolic mapping studies in cocaine users and animal models have shown extensive functional alterations throughout the striatum, limbic system, and cortex. Few studies, however, have evaluated the persistence of these effects following cessation of cocaine availability. The purpose of this study, therefore, was to assess the functional effects of re-exposure to cocaine in nonhuman primates after the discontinuation of cocaine self-administration for 30 or 90 days, using the quantitative autoradiographic 2-[(14)C]deoxyglucose (2DG) method. Rhesus monkeys self-administered cocaine (fixed interval 3-min schedule, 30 infusions per session, 0.3 mg/kg/infusion) for 100 sessions followed by 30 (n=4) or 90 days (n=3) during which experimental sessions were not conducted. Food-reinforced control animals (n=5) underwent identical schedules of reinforcement. Animals were then re-exposed to cocaine or food for one final session and the 2DG method applied immediately after session completion. Compared to controls, re-exposure to cocaine after 30 or 90 day drug-free periods resulted in lower rates of glucose utilization in ventral and dorsal striatum, prefrontal and temporal cortex, limbic system, thalamus, and midbrain. These data demonstrate that vulnerability to the effects of cocaine persists for as long as 90 days after cessation of drug use. While there was some evidence for recovery (fewer brain areas were affected by cocaine re-exposure at 90 days as compared to 30 days), this was not uniform across regions, thus suggesting that recovery occurs at different rates in different brain systems.
    Neuropharmacology 06/2014; 85. DOI:10.1016/j.neuropharm.2014.06.003 · 4.82 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Cocaine use disorder is associated with cognitive deficits. However, the literature remains somewhat ambiguous with respect to which distinct cognitive functions are the most impaired in cocaine use disorder and to how duration of abstinence affects cognitive recovery. Here, we performed a meta-analysis to determine the cognitive domains impaired in cocaine abuse/dependence and the duration of abstinence necessary to achieve cognitive recovery. Methods: A literature search yielded 46 studies that assessed cognitive dysfunction in subjects with cocaine abuse/dependence. Effect-size estimates were calculated using the Comprehensive Meta-Analysis V2, for the following 11 cognitive domains: attention, executive functions, impulsivity, speed of processing, verbal fluency/language, verbal learning and memory, visual learning and memory, visuospatial abilities, and working memory. Within these 11 domains, effect-size estimates were calculated on the basis of abstinence duration: short- (positive for drugs urine screening), intermediate- (<= 12 weeks), and long-term (>= 20 weeks) abstinence. Results: Findings revealed moderate impairment across 8 cognitive domains during intermediate abstinence. The most impaired domains were attention, impulsivity, verbal learning/memory, and working memory. For some domains (attention, speed of processing, and verbal learning/memory), impairments were smaller during short-term abstinence than during intermediate abstinence. Finally, small effect-size estimates were found for long-term abstinence. Discussion: These results suggest significant impairment across multiple cognitive domains in cocaine abusers, and that some of these deficits may be partially masked by the residual or acute withdrawal effects of cocaine. Cognitive dysfunctions remain stable during the first months of abstinence and may abate after 5 months of sobriety.
    Journal of Addiction Medicine 09/2014; 8(5). DOI:10.1097/ADM.0000000000000066 · 1.71 Impact Factor

Full-text (2 Sources)

Available from
Jun 1, 2014