Impaired Decision-Making, Higher Impulsivity, and Drug Severity in XXXX and @entity11532 .

@entity1 @entity146 @entity5516 @entity11532 @entity734
OBJECTIVES: Substance use disorder is characterized by impaired decision @entity5516 , impulsivity, and risk taking. @entity11532 shares many of these characteristics, and having both diagnoses may be associated with greater problems than either diagnosis alone. We investigated whether among substance-dependent individuals, comorbid @entity11532 would be associated with worse decision @entity5516 , greater impulsivity, risk taking, and drug severity. METHODS: Ninety-six substance-dependent individuals were recruited from a residential treatment program and divided into 1 of the 2 groups depending on whether they met Diagnostic and Statistical Manual of @entity146 , Fourth Edition, criteria for @entity11532 (SDPG, n = 26) or not (SD, n = 70). Ninety-two controls were recruited from the community. @entity1 completed a decision- @entity5516 task (modified Iowa Gambling Task), measures of impulsivity (Barratt Impulsivity Scale and Delay Discounting), and risk taking (Balloon Analog Risk Task). Decision @entity5516 was analyzed using a computational model. We tested for group differences using analysis of covariance or Kruskal-Wallis and appropriate post-hoc tests. RESULTS: The groups differed in decision- @entity5516 parameters (P < 0.001) and self-reported impulsivity (P < 0.001). All post-hoc comparisons were significant on these measures, and indicated stepwise changes in controls, followed by SD, followed by SDPG, with SDPG performing worse on decision @entity5516 and being more impulsive. Compared with SD, SDPG had greater drug severity (P < 0.001). No group differences were observed in delay discounting or risk taking. CONCLUSIONS: Compared with individuals with @entity734 without @entity11532 , those with both disorders demonstrated worse decision @entity5516 and significantly more drug-related symptoms. When evaluating @entity1 with @entity734 , clinicians should consider diagnostic assessments for gambling, as the co-occurrence of both disorders may impact clinical characteristics.
