Drug Addicts’ Decision Making Deficits: Behavioral Performance, Underlying Reasons and Interventions

作者: 刘 洋 , 宋洪文 , 寇 娟 , 邹枝玲 :西南大学心理学部,重庆;

关键词: 物质滥用决策障碍原因探究干预方法Drug Addiction Decision Making Deficits Underlying Reasons Intervention Methods

物质成瘾在我国已经成为一个严峻的社会问题。在一定程度上成瘾被归结为决策障碍(decision deficits)。具体表现为成瘾者以长期的身体、心理和社会功能损失为代价去寻求即时享乐;不能根据之前决策的结果灵活调整策略等。本文总结了国内外有关成瘾者决策缺陷的研究。主要包括物质成瘾者决策障碍的一般表现,原因探究和相关的干预方法。对于我们深入了解成瘾者决策障碍提供了理论和实践指导。

Abstract: Drug addiction has become an urgent issue in our society. To some extent, the emergency of addic-tion is attributed to an individual’s decision making deficits. Specifically speaking, the drug abusers would prefer to choose the option that brings immediate profit at the expense of long-term lose in terms of physical, psychological and social functions. Besides, they could not learn from their former choice and insisted on the sub-optimal decisions. Through reviewing relative articles, we summa-rized the drug addicts’ decision making performance, the underlying reasons, and then provided some interventions, which could shed light on the research of addiction theoretically and practically.

文章引用: 刘 洋 , 宋洪文 , 寇 娟 , 邹枝玲 (2014) 物质成瘾者决策障碍:行为表现、原因探究及其干预。 心理学进展, 4, 849-856. doi: 10.12677/AP.2014.46110


[1] 邱迎伟, 江桂华, 苏欢欢, 马晓芬, 李黎明, 田军章, 张雪林(2013). 海洛因成瘾患者眶额叶皮层功能连接异常与决策能力缺失的关系. 南方医科大学学报, 33期, 1117-1121.

[2] 严万森, 李纾, 隋南(2011). 成瘾人群的决策障碍: 研究范式与神经机制. 心理科学进展, 5期, 652-663.

[3] 王烜, 何洁, 张萌(2013). 海洛因成瘾者经过短期到长期的戒除后仍存在决策能力损伤. 第十六届中国心理学学术会议.

[4] Alfonso, J. P., Caracuel, A., Delgado-Pastor, L. C., & Verdejo-García, A. (2011). Combined goal management training and mindfulness meditation improve executive functions and decision-making performance in abstinent polysubstance abusers. Drug and Alcohol Dependence, 117, 78-81.

[5] Anderson, A. L., Reid, M. S., Li, S. H., Holmes, T., Shemanski, L., Slee, A., & Elkashef, A. M. (2009). Modafinil for the treatment of cocaine dependence. Drug and Alcohol Dependence, 104, 133-139.

[6] Bechara, A., Dolan, S., Denburg, N., Hindes, A., Anderson, S. W., & Nathan, P. E. (2001). Decision-making deficits, linked to a dysfunctional ventromedial prefrontal cortex, revealed in alcohol and stimulant abusers. Neuropsychologia, 39, 376- 389.

[7] Bechara, A., & Martin, E. M. (2004). Impaired decision making related to working memory deficits in individuals with substance addictions. Neuropsychology, 18, 152.

[8] Clark, L., Bechara, A., Damasio, H., Aitken, M. R. F., Sahakian, B. J., & Robbins, T. W. (2008). Differential effects of insular and ventromedial prefrontal cortex lesions on risky decision-making. Brain, 131, 1311-1322.

[9] Clark, L., & Robbins, T. W. (2002). Decision-making deficits in drug addiction. Trends in Cognitive Sciences, 6, 361-363.

[10] Dom, G., Sabbe, B. G. C. C., Hulstijn, W., & Van Den Brink, W. (2005). Substance use disorders and the orbitofrontal cortex systematic review of behavioural decision-making and neuroimaging studies. The British Journal of Psychiatry, 187, 209-220.

[11] Ersche, K. D., & Sahakian, B. J. (2007). The neuropsychology of amphetamine and opiate dependence: Implications for treatment. Neuropsychology Review, 17, 317-336.

[12] Fishbein, D. H., Eldreth, D. L., Hyde, C., Matochik, J. A., London, E. D., Contoreggi, C., & Grant, S. (2005). Risky decision making and the anterior cingulate cortex in abstinent drug abusers and nonusers. Cognitive Brain Research, 23, 119-136.

[13] Grant, S., Contoreggi, C., & London, E. D. (2000). Drug abusers show impaired performance in a laboratory test of decision making. Neuropsychologia, 38, 1180-1187.

[14] Gottdiener, W. H., Murawski, P., & Kucharski, L. T. (2008). Using the delay discounting task to test for failures in ego control in substance abusers. Psychoanalytic Psychology, 25, 533-549.

[15] Kirby, K. N., & Petry, N. M. (2004). Heroin and cocaine abusers have higher discount rates for delayed rewards than alcoholics or non-drug-using controls. Addiction, 99, 461-471.

[16] Koob, G. F., & Le Moal, M. (2005). Plasticity of reward neurocircuitry and the “dark side” of drug addiction. Nature Neuroscience, 8, 1442-1444.

[17] Lemenager, T., Richter, A., Reinhard, I., Gelbke, J., Beckmann, B., Heinrich, M., & Hermann, D. (2011). Impaired decision making in opiate addiction correlates with anxiety and self-directedness but not substance use parameters. Journal of Addiction Medicine, 5, 203-213.

[18] Leshner, A. I. (1997). Addiction is a brain disease, and it matters. Science, 278, 45-47.

[19] Li, X., Zhang, F., Zhou, Y., Zhang, M., Wang, X., & Shen, M. (2013). Decision-making deficits are still present in heroin abusers after short-to long-term abstinence. Drug and Alcohol Dependence, 130, 61-67.

[20] Madden, G. J., Bickel, W. K., & Jacobs, E. A. (1999). Discounting of delayed rewards in opioid-dependent outpatients: Exponential or hyperbolic discounting functions? Experimental and Clinical Psychopharmacology, 7, 284-293.

[21] Mazur, J. E., & Vaughan, W. (1987). Molar optimization versus delayed reinforcement as explanations of choice between fixed-ratio and progressive-ratio schedules. Journal of the Experimental Analysis of Behavior, 48, 251-261.

[22] Mischel, W., Shoda, Y., & Rodriguez, M. I. (1989). Delay of gratification in children. Science, 244, 933-938.

[23] Paulus, M. P., Feinstein, J. S., Simmons, A., & Stein, M. B. (2004). Anterior cingulate activation in high trait anxious subjects is related to altered error processing during decision making. Biological Psychiatry, 55, 1179-1187.

[24] Patterson, J. C., Holland, J., & Middleton, R. (2006). Neuropsychological performance, impulsivity, and comorbid psychiatric illness in patients with pathological gambling undergoing treatment at the CORE Inpatient Treatment Center. Southern Medical Journal, 99, 36-43.

[25] Robbins, T. W., Ersche, K. D., & Everitt, B. J. (2008). Drug addiction and the memory systems of the brain. Annals of the New York Academy of Sciences, 1141, 1-21.

[26] Saal, D., Dong, Y., Bonci, A., & Malenka, R. C. (2003). Drugs of abuse and stress trigger a common synaptic adaptation in dopamine neurons. Neuron, 37, 577-582.

[27] Schoenbaum, G., Roesch, M. R., & Stalnaker, T. A. (2006). Orbitofrontal cortex, decision-making and drug addiction. Trends in Neurosciences, 29, 116-124.

[28] Tanabe, J., Thompson, L., Claus, E., Dalwani, M., Hutchison, K., & Banich, M. T. (2007). Prefrontal cortex activity is reduced in gambling and nongambling substance users during decision-making. Human Brain Mapping, 28, 1276-1286.

[29] Vassileva, J., Petkova, P., Georgiev, S., Martin, E. M., Tersiyski, R., Raycheva, M., & Marinov, P. (2007). Impaired decision-making in psychopathic heroin addicts. Drug and Alcohol Dependence, 86, 287-289.

[30] Volkow, N. D., Fowler, J. S., & Wang, G. J. (2003). The addicted human brain: Insights from imaging studies. The Journal of Clinical Investigation, 111, 1444-1451.

[31] Volkow, N. D., Fowler, J. S., & Wang, G. J. (2004). The addicted human brain viewed in the light of imaging studies: Brain circuits and treatment strategies. Neuropharmacology, 47, 3-13.

[32] Xiao, L., Bechara, A., Gong, Q., Huang, X., Li, X., Xue, G., & Johnson, C. A. (2013). Abnormal affective decision making revealed in adolescent binge drinkers using a functional magnetic resonance imaging study. Psychology of Addictive Behaviors, 27, 443-454.

[33] Yücel, M., Yücel, M., & Lubman, D. I. (2007). Neurocognitive and neuroimaging evidence of behavioural dysregulation in human drug addiction: Implications for diagnosis, treatment and prevention. Drug and Alcohol Review, 26, 33-39.