@article{ref1,
title="Stages of dysfunctional decision-making in addiction",
journal="Pharmacology, biochemistry, and behavior",
year="2018",
author="Verdejo-García, Antonio and Chong, Trevor T-J and Stout, Julie C. and Yücel, Murat and London, Edythe D.",
volume="164",
number="",
pages="99-105",
abstract="Drug use is a choice with immediate positive outcomes, but long-term negative consequences. Thus, the repeated use of drugs in the face of negative consequences suggests dysfunction in the cognitive mechanisms underpinning decision-making. This cognitive dysfunction can be mapped into three stages: the formation of preferences involving valuation of decision options; choice implementation including motivation, self-regulation and inhibitory processes; and feedback processing implicating reinforcement learning. This article reviews behavioral studies that have examined alterations in these three stages of decision-making in people with substance use disorders. Relative to healthy individuals, those with alcohol, cannabis, stimulant and opioid use disorders value risky options more highly during the formation of preferences; have a greater appetite for superficially attractive rewards during choice implementation; and are both more efficient in learning from rewards and less efficient in learning from losses during feedback processing. These observed decision-making deficits are most likely due to both premorbid factors and drug-induced effects. Because decision-making deficits have been prospectively associated with a greater risk of drug relapse, we advocate for greater research on modulating the component stages that give rise to dysfunctional decision-making in disorders of addiction.<br><br>Copyright © 2016. Published by Elsevier Inc.<p /> <p>Language: en</p>",
language="en",
issn="0091-3057",
doi="10.1016/j.pbb.2017.02.003",
url="http://dx.doi.org/10.1016/j.pbb.2017.02.003"
}