Influence of antisocial and psychopathic traits on decision-making biases in alcoholics

Alcohol Clin Exp Res. 2009 May;33(5):817-25. doi: 10.1111/j.1530-0277.2009.00901.x. Epub 2009 Mar 6.


Background: Although decision-making processes have become a principal target of study among addiction researchers, few studies have specifically examined decision-making among individuals with alcohol dependence (AD) and findings to date are mixed. The present study examined the relationship between AD and decision-making, and tested whether different facets of antisocial and psychopathic traits explain this association.

Methods: Participants were men with AD (n = 22), AD and comorbid antisocial personality disorder (AD + ASPD; n = 17), or a history of recreational alcohol use, but no current or lifetime symptoms of a substance use disorder, conduct disorder, or ASPD (n = 21). Decision-making was tested using the Iowa Gambling Task (IGT).

Results: Across groups, participants reported similar levels of awareness of the contingencies of the task, but the AD groups with and without ASPD had poorer IGT performance compared with controls (p < 0.05). A block-by-block analysis revealed that while AD had slow but steady improvement across the task, AD + ASPD exhibited initial improvement followed by a significant decrease in advantageous decision-making during the last 20 trials (p < 0.05). This was further confirmed via evidence that impulsive/antisocial personality traits but not psychopathic traits mediated poor IGT performance beyond ASPD diagnosis.

Conclusions: Alcohol-dependent males favored risky choices regardless of whether they met criteria for ASPD. However, decision-making deficits were more pronounced among those with ASPD, and personality traits characterized by impulsive and antisocial tendencies mediated the relationship between AD and decision-making.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Alcoholism / complications
  • Alcoholism / physiopathology
  • Alcoholism / psychology*
  • Antisocial Personality Disorder / complications
  • Antisocial Personality Disorder / physiopathology
  • Antisocial Personality Disorder / psychology*
  • Decision Making* / physiology
  • Humans
  • Male
  • Psychomotor Performance / physiology
  • Young Adult