Reward sensitivity, decisional bias, and metacognitive deficits in cocaine drug addiction

The present research explored the effect of reward-sensitivity bias and metacognitive deficits in Substance Use Disorder (SUD) in decisional-making process. BAS (Behavioral Activation System) was considered as a predictive marker of dysfunctional behavior at IOWA. Secondly, we tried to relate this motivational system bias to some self-reported metacognitive measures (self-knowledge; strategic planning; flexibility; efficacy) in decisional processes. Thrirty-four SUD subjects (cocaine dependent) and thirthy-nine controls (CG) were submitted to IOWA task. SUD were associated with poorer performance on the IGT and dysfunctional metacognition ability (unrealistic representation). Reward-sensitivity (higher BAS, BAS-RR and BAS-D) increasing was observed in SUD more than CG, and it was found to be able to explain (regression analysis) the main behavioral deficits. More generally BAS-RR increasing may be considered as a predictive measure of a more risk-taking and dysfunctional behavior not only in pathological (SUD) subjects but also in subclinical sample (higher-BAS controls). The likely brain correlates (ventromedial prefrontal cortex, VMPFC, dysfunction) of this motivational and cognitive deficits were discussed.