Elevated Impulsivity and Impaired Decision-Making in Abstinent Ecstasy (MDMA) Users Compared to Polydrug and Drug-Naïve Controls

Morgan, M.; Impallomeni, Lara Chiara; Pirona, Alessandro; Rogers, Robert D.

doi:10.1038/sj.npp.1300953

Cited by 111 publications

(83 citation statements)

References 57 publications

(93 reference statements)

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“…We have also examined performance of the same decision-making task by samples of current users of 3,4-methylenedioxymethamphetamine (MDMA), drug naive volunteers with no history of drug use at all, and polydrug users with a history of cannabis use equivalent to that of the MDMA users. While the MDMA users showed reduced attention towards gains and losses during risky choice compared to that of the other two samples, there was no difference between the decision-making of the polydrug (and cannabis) users and the nondrug using controls, suggesting that continued cannabis use does not impair risky choice as measured by this task (Morgan et al, 2006). Further work with decisionmaking tasks involving separable cognitive and affective components might clarify the connection between chronic cannabis use and risky choice.…”

Section: Discussionmentioning

confidence: 78%

The Effects of Low Doses of Δ-9 Tetrahydrocannabinol on Reinforcement Processing in the Risky Decision-Making of Young Healthy Adults

Rogers

Wakeley

Robson

et al. 2006

Neuropsychopharmacol

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Research suggests that risky decision-making is sensitive to neuromodulatory influences acting upon corticolimbic circuitry. However, while other evidence attests to effects of D-9 tetrahydrocannabinol (THC) on the activity of reward pathways, relatively little is known about the possible involvement of cannabinoid activity in risky choice. In this experiment, we examined the effects of a single sublingual 5 mg dose of THC on a test of risky decision-making (requiring choices between simultaneously presented gambles differing in their magnitude of gains, magnitude of losses and the probability with which these outcomes were delivered). Tests of non-normative decision-making involving risk-aversion when deciding between gains and risk-seeking choices when deciding between losses were also included. In all, 15 healthy adults were administered 5 mg THC and placebo in a double-blind, placebo-controlled, within-subject, crossover design. THC had three principal effects relative to placebo: (i) THC reduced choice of gambles with variable gains and losses, but increased choice of gambles with zero-expected value; (ii) THC reduced participants' attention towards losses when the probability of winning was low (and the probability of losing was high); and (iii) THC speeded participants' responses to gambles with large compared to small potential gains. These results suggest that THC mediates specific motivational processes and the processing of reinforcement cues during risky choice, perhaps reflecting altered CB 1 receptor or catecholamine activity within corticolimbic pathways.

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Section: Discussionmentioning

confidence: 78%

The Effects of Low Doses of Δ-9 Tetrahydrocannabinol on Reinforcement Processing in the Risky Decision-Making of Young Healthy Adults

Rogers

Wakeley

Robson

et al. 2006

Neuropsychopharmacol

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“…Nevertheless, other researchers reported risky decision-making among MDMA users compared with other drug users (Morgan et al, 2006;Quednow et al, 2007), which may be associated with genetic polymorphisms of the 5-HT transporter (Roiser et al, 2006). Possible reasons for this discrepancy include differences in sample characteristics (e.g., degree and recency of MDMA or other drug use) or methodologies (e.g., task-related factors, different aspects of decisionmaking).…”

Section: Reward-related Decision-makingmentioning

confidence: 95%

“…However, Morgan et al (2006) found risky decision-making among MDMA users relative to polydrug and drug-naïve controls, and Roiser et al (2006) detected reduced attention to the probability of winning on a risky choices task among MDMA users with the ss allele of the 5-HT transporter gene. Furthermore, MDMA users made more disadvantageous choices on the IGT relative to marijuana and non-drug controls, which may be related to poor inhibitory processes (Quednow et al, 2007) and reduced white matter integrity in the anterior corpus callosum (Moeller et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

Reward-related decision-making deficits and elevated impulsivity among MDMA and other drug users

Hanson

Luciana

Sullwold

2008

Drug and Alcohol Dependence

101

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Background-The recreational drug, MDMA (3,4-methylenedioxymethamphetamine; 'Ecstasy'), is a synthetic amphetamine derivative and a serotonin neurotoxin. MDMA use is associated with cognitive dysfunction and impulsivity, but since polydrug abuse is common among users it is difficult to attribute these problems specifically to MDMA. Moreover, few studies have examined rewardrelated cognitive processes. Our aim was to examine reward-related decision-making and impulsivity among MDMA users while controlling for polydrug use via appropriate comparison groups.Methods-We examined decision-making (Iowa Gambling Task; IGT; Bechara et al., 1994), selfreported impulsivity (Multidimensional Personality Questionnaire -Brief Form [Constraint subscale]; Barratt Impulsiveness Scale; Zuckerman Sensation Seeking Scale), and drug use among 22 abstinent MDMA users, 30 other drug users, and 29 healthy non-drug controls.Results-MDMA and other drug users showed comparable patterns of decision-making and impulsivity. However, both drug groups demonstrated poorer IGT performance and elevated selfreported impulsivity relative to controls. Poorer decision-making was related to heavier drug use in the past year, heavier weekly alcohol use, and meeting lifetime substance use disorder (SUD) criteria for more drug classes. Elevated impulsivity was associated with heavier drug use, heavier weekly alcohol use, more lifetime SUDs, and higher self-reported depression levels.Conclusions-These findings contradict the idea that MDMA is specifically associated with deficient decision-making. Drug users, in general, may be at risk for decision-making deficits and elevated impulsivity. Such behaviors may represent trait factors that lead to the initiation of drug and alcohol use, and/or they may represent behavior patterns that are exacerbated by extensive use.

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“…For example, ecstasy users revealed elevated impulsivity on the Matching Familiar Figures Test (MFFT) (Morgan et al 1998;Morgan et al 2002;Morgan et al 2006;Quednow et al 2007) and on trait impulsivity (Morgan et al 1998;Parrott, 2000b;Butler and Montgomery, 2004) (Dafters, 2006;Vollenweider 1998), and on trait impulsivity . Previous studies also found that polydrug users, including users who had or had not used ecstasy, reported similar levels of impulsivity (Morgan et al 1998;Tuchtenhagen et al 2000;Daumann et al 2001;Morgan et al 2002;Butler and Dafters et al 2004;Hoshi et al 2007a;Hanson et al 2008), suggesting that elevated impulsivity may characterise drug users in general and not specifically those who have a history of ecstasy use.…”

Section: Introductionmentioning

confidence: 99%

Evidence of increased activation underlying cognitive control in ecstasy and cannabis users

Roberts

Garavan

2010

NeuroImage

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Evidence suggests that users of ecstasy (3,4-methylenedioxymethamphetamine) have behavioural and cognitive deficits and show increased impulsivity. Impulse control impairments have been shown to be common to a number of addictive behaviours and may constitute a risk factor for drug abuse and dependence. The aim of this study was to investigate brain activation during response inhibition and performance monitoring in current recreational drug users who predominantely used ecstasy. Twenty drug users (ten female) and twenty healthy controls were scanned during performance of a response inhibition GO/NOGO task using functional magnetic resonance imaging. No performance deficits were evident. However, the drug user group revealed elevated frontal and parietal BOLD response during successful inhibitions, and temporal, frontal, and cingulate hyperactivity during commision errors. In addition, the users showed reduced deactivation in the default-mode network during task performance. Whether contributing to or arising from drug use, these results reveal dysregulation in brain regions subserving cognitive control and default mode processes in current recreational drug users mirroring effects previously observed for "harder" drugs of abuse.

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Elevated Impulsivity and Impaired Decision-Making in Abstinent Ecstasy (MDMA) Users Compared to Polydrug and Drug-Naïve Controls

Cited by 111 publications

References 57 publications

The Effects of Low Doses of Δ-9 Tetrahydrocannabinol on Reinforcement Processing in the Risky Decision-Making of Young Healthy Adults

The Effects of Low Doses of Δ-9 Tetrahydrocannabinol on Reinforcement Processing in the Risky Decision-Making of Young Healthy Adults

Reward-related decision-making deficits and elevated impulsivity among MDMA and other drug users

Evidence of increased activation underlying cognitive control in ecstasy and cannabis users

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