Reduced planning depth and stronger probability discounting in alcohol and tobacco use disorder

Abstract

Background: Substance use disorders (SUDs) are associated with impaired goal-directed decision-making, but the specific cognitive mechanisms underlying these deficits remain unclear. Forward planning, a key component of goal-directed control, requires strategies to contain computational demand and ensure feasibility through heuristics such as reducing planning depth, pruning unlikely options, and discounting probabilistic outcomes. This study investigated whether individuals with alcohol use disorder (AUD) and tobacco use disorder (TUD) differ from healthy controls in their use of these heuristics during sequential decision-making. Methods: We examined participants from the general population meeting criteria for at least moderate AUD (n = 45), TUD (n = 49), or both (n = 45), and compared them with matched healthy control groups. To assess forward planning, we used a previously published probabilistic three-step Markov decision task. Computational modeling was used to infer individual planning depths and compare model variants incorporating low-probability pruning, probability discounting, or both. Results: A combined model including both low-probability pruning and probability discounting best explained participants' behavior and was subsequently used for analysis. Compared to matched healthy controls, all groups with SUD exhibited significantly reduced planning depth. Moreover, individuals with SUD tended to show stronger probability discounting, with this effect reaching statistical significance in the comorbid group. Conclusion: Individuals with AUD and/or TUD engaged in forward planning using similar strategies as healthy controls but exhibited reduced planning depth and a tendency toward stronger probability discounting. These findings suggest the presence of altered planning processes in SUD, which could contribute to maladaptive decision-making. Future research is needed to clarify whether such differences reflect pre-existing cognitive traits, consequences of substance use, or both, and to explore their potential relevance for intervention.