Open AccessDecision‐making deficits in patients diagnosed with disordered gambling using the Cambridge Gambling task: the effects of substance use disorder comorbidity
Author(s) -
Zois Evangelos,
Kortlang Noreen,
VollstädtKlein Sabine,
Lemenager Tagrid,
Beutel Martin,
Mann Karl,
FauthBühler Mira
Publication year - 2014
Publication title -
brain and behavior
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.915
H-Index - 41
ISSN - 2162-3279
DOI - 10.1002/brb3.231
Subject(s) - comorbidity , gambling disorder , psychiatric comorbidity , task (project management) , psychology , psychiatry , iowa gambling task , impulse control disorder , substance use , clinical psychology , addiction , medicine , cognition , management , pathological , economics
Background Disordered gambling ( DG ) has often been associated with impaired decision‐making abilities, suggesting a dysfunction in the ventromedial prefrontal cortex (vm PFC ). Aims To our knowledge, no previous study has accurately considered the effect of substance use disorder ( SUD ) comorbidity (including nicotine dependence) on decision‐making impairments in DG . Methods and Materials We employed the Cambridge Gambling Task ( CGT ) to assess a big cohort of patients diagnosed with DG ( N = 80 ) against matched healthy controls ( HC s) ( N = 108 ). The cohort included DG patients with nicotine and alcohol dependence, alcohol dependence only and 12 “pure” nonsmokers with only DG diagnosis. Results Pure nonsmoking, nicotine dependent as well as alcoholic DG s with current nicotine dependence, demonstrated a decision making profile, characterized by poor decision‐making abilities and failure to make right choices (rational), closely resembling that of patients with vm PFC damage. Discussion This suggests that DG s with and without SUD comorbidity are equally affected in that domain of decision making abilities. Additionally, gambling diagnosis combined with alcohol and nicotine dependence involves a group of gambling patients with a relatively riskier decision making profile, showing that these patients apart from making irrational decisions take also more risks. Our findings highlight the importance of accounting for SUD comorbidities with useful implications for future research and therapy. Limitations of the current investigation are discussed.