Substance related disorders are associated with impaired valuation of delayed gratification and feedback processing: A multilevel meta-analysis and meta-regression.
Level 3 - non-randomized controlled study
Systematic review and multilevel meta-analysis of observational case-control studies.
PubMed 31778679 · doi:10.1016/j.neubiorev.2019.11.016
What was done
Authors conducted multilevel linear mixed-effects meta-analyses and meta-regressions comparing individuals with substance use disorders (SUDs) to non-using controls on two cognitive paradigms: the Delay Discounting Task (DD, measuring valuation of delayed gratification) and the Iowa Gambling Task (IGT, measuring feedback processing). Potential moderators included substance class, demographic variables, age of onset of use, and psychiatric comorbidities.
What was found
The abstract reports a moderate to large effect for SUD on both the IGT and DD compared to controls, but reports no exact numerical effect sizes, sample sizes, or p-values. The DD effect generalized across all substance classes, whereas the IGT showed a smaller impairment in cannabis-related disorders compared to other SUDs. Meta-regressions linked early onset of substance use and psychiatric comorbidities to stronger impairment on the DD.
Why it matters
This review distinguishes cognitive processes in addiction, indicating that feedback processing deficits vary across specific substance classes, while delayed gratification deficits are generalized and influenced by developmental onset and clinical comorbidities.
Limits
The abstract reports no numerical data, confidence intervals, number of studies, or participant counts. The underlying studies are observational case-control comparisons, preventing causal determinations about whether decision-making impairments precede or result from substance use.
Cited by
- supports People with substance use addiction discount future rewards significantly more steeply than non-addicted individuals, showing a strong bias toward smaller immediate rewards over larger delayed rewards.