{"title":"甲基苯丙胺和酒精使用障碍的决策特征","authors":"Xinyu Cheng, Jing Shen, Junhui Li, Wei Yuan, Duanwei Wang, Hairong Wang, Ru-Yuan Zhang, Yu-Feng Xia, Xinyu Cao, Wannian Sha, Shuhua He, Yi Liu, Junjie Tang, Yi Zhang, Yuqi Cheng, Ti-Fei Yuan, Di Zhao","doi":"10.1016/j.bpsc.2025.08.008","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Aberrant decision-making is a hallmark of substance use disorders (SUDs), often impeding recovery. While uncertainty, comprising risk and ambiguity, is central to real-world choices, its distinct effects in SUDs remain underexplored. This study disentangles risk and ambiguity to identify context-specific impairments in methamphetamine (MUD) and alcohol use disorders (AUD).</p><p><strong>Methods: </strong>We used a Choice under Risk and Ambiguity (CRA) task to examine uncertainty decision-making (UDM) in 101 individuals with MUD, 56 with AUD, and their respective healthy control groups (HCs; n = 45 and n = 75). Group-level analyses applied a modified psychometric function to estimate decision parameters, while individual-level UDM indicators were derived using custom computational methods and subjective value models.</p><p><strong>Results: </strong>Individuals with MUD exhibited heightened reward sensitivity and a stronger preference for large rewards under high uncertainty, with flexible shifts across ambiguity levels. Besides, reward sensitivity under high ambiguity was linked to symptom severity. In contrast, individuals with AUD showed no evident decision-making impairments across conditions and, like HCs, adopted conservative strategies under ambiguity. Direct comparisons confirmed more pronounced UDM impairments in MUD than in AUD.</p><p><strong>Conclusion: </strong>These findings underscore the heterogeneity of decision-making patterns across SUDs, validating the need for precision in therapeutic strategies.</p>","PeriodicalId":93900,"journal":{"name":"Biological psychiatry. 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This study disentangles risk and ambiguity to identify context-specific impairments in methamphetamine (MUD) and alcohol use disorders (AUD).</p><p><strong>Methods: </strong>We used a Choice under Risk and Ambiguity (CRA) task to examine uncertainty decision-making (UDM) in 101 individuals with MUD, 56 with AUD, and their respective healthy control groups (HCs; n = 45 and n = 75). Group-level analyses applied a modified psychometric function to estimate decision parameters, while individual-level UDM indicators were derived using custom computational methods and subjective value models.</p><p><strong>Results: </strong>Individuals with MUD exhibited heightened reward sensitivity and a stronger preference for large rewards under high uncertainty, with flexible shifts across ambiguity levels. Besides, reward sensitivity under high ambiguity was linked to symptom severity. In contrast, individuals with AUD showed no evident decision-making impairments across conditions and, like HCs, adopted conservative strategies under ambiguity. Direct comparisons confirmed more pronounced UDM impairments in MUD than in AUD.</p><p><strong>Conclusion: </strong>These findings underscore the heterogeneity of decision-making patterns across SUDs, validating the need for precision in therapeutic strategies.</p>\",\"PeriodicalId\":93900,\"journal\":{\"name\":\"Biological psychiatry. Cognitive neuroscience and neuroimaging\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":4.8000,\"publicationDate\":\"2025-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Biological psychiatry. 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引用次数: 0
摘要
背景:异常决策是物质使用障碍(sud)的一个标志,经常阻碍康复。虽然不确定性(包括风险和模糊性)是现实世界选择的核心,但其对sud的独特影响仍未得到充分研究。本研究理清了风险和模糊性,以确定甲基安非他明(MUD)和酒精使用障碍(AUD)的情境特异性损伤。方法:我们使用风险和模糊选择(CRA)任务来检查101名MUD患者、56名AUD患者及其各自健康对照组(hc; n = 45和n = 75)的不确定性决策(UDM)。群体水平的分析采用改进的心理测量函数来估计决策参数,而个人水平的UDM指标则使用定制的计算方法和主观价值模型来推导。结果:MUD个体在高不确定性下表现出更高的奖励敏感性和对大奖励的更强偏好,并且在歧义水平上具有灵活的变化。此外,高模糊状态下的奖励敏感性与症状严重程度相关。相比之下,AUD患者在各种情况下都没有表现出明显的决策障碍,并且像hc一样,在模棱两可的情况下采取保守策略。直接比较证实,MUD患者的UDM损伤比AUD患者更明显。结论:这些发现强调了sud决策模式的异质性,验证了治疗策略的准确性。
Decision-Making Signatures of Methamphetamine and Alcohol Use Disorders.
Background: Aberrant decision-making is a hallmark of substance use disorders (SUDs), often impeding recovery. While uncertainty, comprising risk and ambiguity, is central to real-world choices, its distinct effects in SUDs remain underexplored. This study disentangles risk and ambiguity to identify context-specific impairments in methamphetamine (MUD) and alcohol use disorders (AUD).
Methods: We used a Choice under Risk and Ambiguity (CRA) task to examine uncertainty decision-making (UDM) in 101 individuals with MUD, 56 with AUD, and their respective healthy control groups (HCs; n = 45 and n = 75). Group-level analyses applied a modified psychometric function to estimate decision parameters, while individual-level UDM indicators were derived using custom computational methods and subjective value models.
Results: Individuals with MUD exhibited heightened reward sensitivity and a stronger preference for large rewards under high uncertainty, with flexible shifts across ambiguity levels. Besides, reward sensitivity under high ambiguity was linked to symptom severity. In contrast, individuals with AUD showed no evident decision-making impairments across conditions and, like HCs, adopted conservative strategies under ambiguity. Direct comparisons confirmed more pronounced UDM impairments in MUD than in AUD.
Conclusion: These findings underscore the heterogeneity of decision-making patterns across SUDs, validating the need for precision in therapeutic strategies.