Decision-making deficits in alcohol-dependent patients with and without comorbid personality disorder
Decision-making deficits in alcohol-dependent patients with and without comorbid personality disorder
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DOI：
10.1111/j.1530-0277.2006.00202.x
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发表时间：
2006-10-01
期刊：
影响因子：
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通讯作者：
Sabbe, Bernard
中科院分区：
文献类型：
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作者：
Dom, Geert;De Wilde, Bieke;Sabbe, Bernard
背景：在物质使用障碍(SUD)人群中，决策障碍是一个一致的发现。然而，决策缺陷并不是肥胖症所特有的，而且在其他精神障碍的背景下也有报道，如反社会和交界性人格障碍(PD)。在本研究中，我们比较了非物质滥用控制者(n=53)在爱荷华州赌博任务(IGT)上的决策绩效与3个戒酒依赖样本的决策绩效，即无任何PD的酗酒患者(n=38)，伴有A或C PD的酗酒患者(n=19)，以及伴有B PD的酗酒患者(n=23)。与对照组相比，所有3个酒精依赖亚组样本的表现都较差。在酒精亚组样本中，具有A或C组PD的酒精患者的IGT得分最高，其次是无PD的酒精患者，而B组的酒精患者受到的损害最大。结论：这些发现表明酒精依赖和B组PD都是决策障碍的基础，合并B组PD的酒精患者在决策过程中尤其受损。这些缺陷可能是B组酒精中毒患者的严重问题的基础，这些问题特别是在不适当的行为方面(例如，多物质滥用、法律和职业功能障碍)。
Background: Impairments in decision making are a consistent finding in substance use disorder (SUD) populations. However, decision-making deficits are not specific for SUDs and are also reported in the context of other psychiatric disorders such as antisocial and borderline personality disorders (PDs). Given the frequent comorbidity between SUD and cluster B PD, it might be questioned whether the decision-making impairments typically reported in SUD populations reflect the addictive disorder, the cluster B PD, or a combination of the 2.Methods: In the current study, we compare the decision-making performance of non-substance-abusing controls (n=53) on the Iowa Gambling Task (IGT) with the decision-making performance of 3 abstinent alcohol-dependent samples, i.e., alcoholic patients without any PD (n=38), alcoholic patients with a cluster A or C PD (n=19), and alcoholic patients with a cluster B PD (n=23).Results: Overall, all 3 alcohol-dependent subsamples performed inferior compared with controls. Between alcoholic subsamples, the alcoholic patients with a cluster A or C PD had the highest IGT score, followed by the alcoholic patients without a PD, while the cluster B alcoholic patients were the most impaired.Copnclusions: These findings suggest that impairments in decision making underlie both alcohol dependence and cluster B PD, and alcoholic patients with a comorbid cluster B PD are particularly impaired in their decision making. These deficits may underlie the severe problems that characterize cluster B alcoholic patients specifically in inappropriate behaviors (e.g., poly substance abuse, legal, and professional dysfunction).