Cocaine use disorder in females is associated with altered social decision-making: a study with the prisoner’s dilemma and the ultimatum game

Abstract

Background Chronic cocaine use is associated with cognitive deficits, including poor performance on neuropsychological tasks of memory, executive functions, theory of mind and decision-making. However, the relationship between cocaine use disorder and social decision-making remains unclear. This is particularly relevant given the fact that many cocaine abusers present impairments in social functioning. In this sense, game theory paradigms have been helping to comprehend the behavior of psychiatric patients when they directly engage in social situations, which may better approximate many of their real-life choices. Methods The present study investigated social decision-making in individuals with or without cocaine use disorder, examining their behavior in the Prisoner’s Dilemma and in the Ultimatum Game. Thus, 129 females diagnosed with cocaine use disorder and 55 females with no history of substance abuse were recruited and performed both social decision-making tasks. Additional assessments included information about demographics, patterns of substance consumption and executive function performance. Results Females with cocaine use disorder opted more often to not defect in the Prisoner’s Dilemma, while in the Ultimatum Game they frequently chose to accept the first and unfair offer as responders. These effects were more pronounced within females with long-term history of cocaine use. Associations between cocaine use disorder and altered social decision-making were independent from demographic and executive function variables. Conclusions The influence of cocaine use disorder on social decision-making was detected in both game paradigms, resulting in more cooperative behavior in the Prisoner’s Dilemma and higher acceptance rate of unfair offers in the Ultimatum Game. Further studies should focus on investigating these associations to shed light on the putative biopsychosocial factors underlying the observed effects.

Factors of influence in prisoner’s dilemma task: a review of medical literature

“…The use of the PD in medical literature commonly evolves around the study of social decision making including cooperation ( Testori, Hoyle & Eisenbarth, 2019 ), conflict ( McClure et al, 2007 ) and moral judgement ( Li, Zhu & Gummerum, 2014 ) as well as group dynamics and how these are affected in clinical populations ( Testori, Hoyle & Eisenbarth, 2019 ) and/or after pharmacological intervention ( Lane & Gowin, 2009 ; Rilling et al, 2012 ; Gabay et al, 2018 ). The PD game has also been used for the study of decision making and social characteristics in almost all psychiatric disorders, including psychotic and mood disorders, substance abuse and anxiety disorders (for relevant studies see McClure et al (2007) , Sorgi & Wout (2016) , Bitsch et al (2018b) , Viola et al (2019) ). The majority of these studies however, focus on Autism Spectrum Disorder and personality traits where atypical social behaviour is a core characteristic (for studies using the PD on these disorders see Sheldon, Sheldon & Osbaldiston (2000) , Halevy, Bornstein & Sagiv (2008) , Locey, Safin & Rachlin (2012) , Wang, Suri & Watts (2012) , Li, Zhu & Gummerum (2014) ; De Dreu, Dussel & Velden, 2015 , Weisel & Böhm (2015) ).…”

To produce or not to produce? Contrasting the effect of substance abuse in social decision-making situations

“…In the Ultimatum Game, where the first player proposes a division of money and the second player can either accept or reject the offer, the rejection rates of unfair offers were significantly higher for people with alcohol and heroin use disorder than control participants [ 13 ]. However, the rejection rates for most unfair offers in ecstasy and cocaine users remain unclear [ [14] , [15] , [16] ]. These studies suggest that SUD can affect social decision-making in turn-taking interaction situations, where participants have time to plan and execute a strategy.…”

“…Despite model predictions have been tested in several species [ 12 ],[ 16 ],[ 19 ], only a few studies have tested these predictions in human participants in sequential turn-taking tasks or non-real-time interaction tasks [ 17 , 18 ].…”

Decision-making under risk and theory of mind in adolescent offenders in provisional deprivation of liberty

“…In this regard, social cognition is also an important correlate of behavioral impulsivity and violence among adults and neuropsychiatric patients. 14,15 Although there is evidence that adults with criminal records with and without associated mental illnesses might perform worse on ToM tasks, 16,17 some studies are inconclusive 14,18 and few studies have explored this ability among adolescents accused of committing a crime. Altogether, considering that (i) social vulnerability related to adverse developmental experiences is associated with crime initiation and maintenance, with a peak rate of criminal justice reports among those in the late years of adolescence 19 ; that (ii) risky behaviors might reflect, at least in part, impairments to the capacity to properly evaluate losses, gains, and risks for each alternative identified; that (iii) ToM impairments might be associated with behavioral impulsivity, violence, and involvement in criminal activity; and (iv) that few studies have focused on deliberative decision-making under risk and social cognitive features in adolescent offenders; the primary aim of this study was to assess deliberative decision-making and ToM among adolescent offenders who are subject to provisional deprivation of liberty (temporary detention) due to conflict with the law and a control group (CG) of adolescents who are not.…”

“…In this regard, social cognition is also an important correlate of behavioral impulsivity and violence among adults and neuropsychiatric patients. 14 , 15 Although there is evidence that adults with criminal records with and without associated mental illnesses might perform worse on ToM tasks, 16 , 17 some studies are inconclusive 14 , 18 and few studies have explored this ability among adolescents accused of committing a crime.…”