Decision-Making in People Who Relapsed to Driving Under the Influence of Alcohol

Authors

  • Muzaffer Kasar,

    1. Department of Psychiatry (MK, AT), Department of Neuropsychology (CK), Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey; Institute of Cognitive Neurology (EG, FFM), Buenos Aires, Argentina; Department of Psychiatric and Social Issues (AT), Local Office of Ministry of Health, Istanbul, Turkey; and Institute of Neurosciences (FFM), Favaloro University, Buenos Aires, Argentina.
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  • Ezequiel Gleichgerrcht,

    1. Department of Psychiatry (MK, AT), Department of Neuropsychology (CK), Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey; Institute of Cognitive Neurology (EG, FFM), Buenos Aires, Argentina; Department of Psychiatric and Social Issues (AT), Local Office of Ministry of Health, Istanbul, Turkey; and Institute of Neurosciences (FFM), Favaloro University, Buenos Aires, Argentina.
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  • Cahit Keskinkilic,

    1. Department of Psychiatry (MK, AT), Department of Neuropsychology (CK), Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey; Institute of Cognitive Neurology (EG, FFM), Buenos Aires, Argentina; Department of Psychiatric and Social Issues (AT), Local Office of Ministry of Health, Istanbul, Turkey; and Institute of Neurosciences (FFM), Favaloro University, Buenos Aires, Argentina.
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  • Abdulkadir Tabo,

    1. Department of Psychiatry (MK, AT), Department of Neuropsychology (CK), Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey; Institute of Cognitive Neurology (EG, FFM), Buenos Aires, Argentina; Department of Psychiatric and Social Issues (AT), Local Office of Ministry of Health, Istanbul, Turkey; and Institute of Neurosciences (FFM), Favaloro University, Buenos Aires, Argentina.
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  • Facundo F. Manes

    1. Department of Psychiatry (MK, AT), Department of Neuropsychology (CK), Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey; Institute of Cognitive Neurology (EG, FFM), Buenos Aires, Argentina; Department of Psychiatric and Social Issues (AT), Local Office of Ministry of Health, Istanbul, Turkey; and Institute of Neurosciences (FFM), Favaloro University, Buenos Aires, Argentina.
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  • Declaration of interest: The authors report no conflicts of interest.

Reprint requests: Muzaffer Kasar, MD, Bakirkoy Ruh ve Sinir Hastaliklari Hastanesi 3.Psikiyatri Klinigi, Zuhuratbaba Mah. Demirkapi Cad., 34147 Bakirkoy/Istanbul, Turkey; Fax: +90212 5729595; E-mail:muzafferkasar@hotmail.com

Abstract

Background:  Alcohol use has been previously associated with neurocognitive impairments, especially in decision-making cognition. However, some studies have shown little to no decision-making deficits in relation to different characteristics of people with drinking problems. Relapsing to driving under the influence (DUI) of alcohol is an important issue with legal and psychosocial aspects. We evaluated decision-making performance in second-time DUI offenders by using the Iowa Gambling Task (IGT).

Method:  Thirty-four male second-time DUI offenders who had been selected for an official psychoeducational rehabilitation program and 31 healthy controls that were matched for age, education, and alcohol use were included. Along with psychiatric assessment, we applied conventional neuropsychological testing comprising cognitive set-shifting, response inhibition, attention, and visuospatial abilities. Also, we used the Temperament and Character Inventory (TCI) to assess personality patterns. A computerized version of IGT was used.

Results:  No significant differences were found between the groups in regard to sociodemographics and conventional neuropsychological testing. DUI participants had significantly higher scores only in “self-transcendence” subdomain of TCI. On the fifth block of the IGT, DUI participants had significantly lower net scores than controls (U = 380.0, < 0.05). Also, DUI participants chose significantly more risky decks compared to controls.

Conclusions:  Our results suggest that there may be subtle decision-making deficits in DUI participants, which goes undetected on conventional neuropsychological testing and which is not correlated with TCI subdomains related with impulsivity patterns.

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