Impaired Decision-making in Adolescents

Impaired Decision-making in Adolescents: A Vulnerability Factor for the Development of Substance Use and Abuse.

There is clear evidence that aggressive behavior and disruptive behavior disorders (DBD) in middle childhood are associated with an increased risk for substance abuse in adolescence. However, the exact underlying mechanism of this increased risk is unknown. It is likely that a biopsychological vulnerability in some aggressive children and children with DBD makes them liable to substance use and abuse. The investigators hypothesize that deficient decision making is such a biopsychological factor. In this study the investigators aim to test the latter hypothesis by investigating the decision making ability in a group of adolescents with DBD with and without substance use disorders. Decision-making is assessed with the IOWA Gambling Task (GT). This task mimics real-life situations in the way it factors uncertainty, reward and punishment. The GT is specifically designed to assess impaired decision-making in individuals who are unable to learn from their mistakes and make decisions that repeatedly lead to negative consequences. This characteristic may be common to individuals with externalizing disorders such as DBD, psychopathy, and substance use disorders.

Study Overview

• Status: Completed
• Conditions: Substance-Related Disorders; Adolescent Psychiatry; Antisocial Personality Disorders

Detailed Description

This study consists of two substudies with adolescents in the age of 14-21 years. The first study group consist of adolescents with DBD with (n=30) and without (n=30) substance use disorders. These adolescents are recruited from orthopsychiatric, forensic psychiatric, and judicial institutions.

The second study group consists of a) ex-patients of the Utrecht Coping Power Program (UCPP)who previously participated to a follow-up study, and b) ex-patients who were treated as a child at an outpatient clinic of the UMC Utrecht. These latter groups were taken together and subdivided into a group with (n=30) and without (n=30) substance use problems.

For both studies healthy controls (n=80) are recruited. The investigators will start with healthy controls from earlier studies, and those are extented and will serve as control group for both studies.

• Study Type: Observational
• Enrollment (Actual): 152

Contacts and Locations

Study Locations

• Netherlands
  • Utrecht, Netherlands, 3584 CX
    • University Medical Center Utrecht

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 14 years to 21 years (Child, Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

DBD adolescents were recruited from judicial and forensic institutions. Healthy controls consisted of volunteers.

Description

Inclusion Criteria:

• Having a DISC diagnosis DBD

Exclusion Criteria:

• Having the DISC diagnosis Schizophrenia

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Control
• Time Perspectives: Cross-Sectional

Collaborators and Investigators

• Sponsor: UMC Utrecht
• Collaborators: National Institute on Drug Abuse (NIDA); ZonMw: The Netherlands Organisation for Health Research and Development
• Investigators: Principal Investigator: Walter Matthys, MD, PhD, UMC Utrecht

Publications and helpful links

General Publications

• Ernst M, Grant SJ, London ED, Contoreggi CS, Kimes AS, Spurgeon L. Decision making in adolescents with behavior disorders and adults with substance abuse. Am J Psychiatry. 2003 Jan;160(1):33-40. doi: 10.1176/appi.ajp.160.1.33.

Study record dates

Study Major Dates

• Study Start: April 1, 2006
• Primary Completion (Actual): June 1, 2007
• Study Completion (Actual): September 1, 2007

Study Registration Dates

• First Submitted: March 2, 2007
• First Submitted That Met QC Criteria: December 3, 2010
• First Posted (Estimate): December 6, 2010

Study Record Updates

• Last Update Posted (Estimate): December 6, 2010
• Last Update Submitted That Met QC Criteria: December 3, 2010
• Last Verified: December 1, 2010

More Information

Terms related to this study

• Keywords: Disruptive Behavior Disorders, Substance abuse,; Iowa Gambling Task, Decision Making.
• Additional Relevant MeSH Terms: Mental Disorders; Chemically-Induced Disorders; Pathologic Processes; Substance-Related Disorders; Personality Disorders; Disease; Antisocial Personality Disorder
• Other Study ID Numbers: 05-271; ZonMw 31100001 (Other Identifier: ZonMw); NIDA DA 16135 (Other Identifier: NIDA)