Sensitivity to gains during risky decision-making differentiates chronic cocaine users from stimulant-naive controls

BackgroundAlthough chronic cocaine use has been frequently associated with decision-making impairments that are supposed to contribute to the development and maintenance of cocaine addiction, it has remained unclear how risk-seeking behaviours observed in chronic cocaine users (CU) come about. Here we therefore test whether risky decision-making observed in CU is driven by alterations in individual sensitivity to the available information (gain, loss, and risk).\n\nMethodA sample of 96 participants (56 CU and 40 controls) performed the no-feedback (\"cold\") version of the Columbia Card Task. Structured psychiatric interviews and a comprehensive neuropsychological test battery were additionally conducted. Current and recent substance use was objectively assessed by toxicological urine and hair analysis.\n\nResultsCompared to controls, CU showed increased risk-seeking in unfavourable decision scenarios in which the risk was high and the returns were low, and a tendency for increased risk aversion in favourable decision scenarios. These differences arose from the fact that CU were less sensitive to gain, but similarly sensitive to loss and risk information in comparison to controls. Further analysis revealed that individual differences in sensitivity to loss and risk were related to cognitive performance and impulsivity.\n\nConclusionThe reduced sensitivity to gain information in people with CU may contribute to their propensity for making risky decisions. While these alterations in the sensitivity to gain might be directly related to cocaine use per se, the individual psychopathological profile of CU might moderate their sensitivity to risk and loss impulsivity.