Note: This article is based on a research paper titled “Aberrant Cost–Benefit Integration During Effort-Based Decision Making Relates to Severity of Substance Use Disorders” by Allison M. Stuppy-Sullivan, Joshua W. Buckholtz, and Arielle Baskin-Sommers (2020).

Substance use disorders (SUDs) are complex conditions that have a significant impact on individuals and society as a whole. Understanding the factors that contribute to the development and severity of SUDs is crucial for effective intervention and treatment strategies. Recent research has shown that aberrant cost–benefit decision making is a key factor associated with individual differences in the expression of SUDs. While previous studies have mainly focused on the influence of delay-cost sensitivity on SUDs, a new study investigates another aspect of cost–benefit decision making called effort-based choice.

What is aberrant cost–benefit decision making?

Aberrant cost–benefit decision making refers to a deviation from typical decision-making processes, particularly when it comes to assessing the value of different options in relation to their associated costs. In the context of SUDs, individuals with aberrant cost–benefit decision making may prioritize immediate rewards or fail to consider the long-term consequences of their actions. This can lead to dysfunctional decision making and a higher likelihood of engaging in substance use despite the negative impact it may have on their lives.

Real-World Example: Imagine an individual who regularly engages in heavy drinking. Despite experiencing health problems, strained relationships, and financial difficulties as a result, they continue to prioritize the immediate pleasure and relief that alcohol brings, rather than considering the long-term negative consequences.

How does severity of substance use disorders affect decision making?

The severity of SUDs has a significant impact on decision making, particularly in the realm of effort-based choice. The severity of SUDs can be measured by assessing the level of dysfunction and impairment an individual experiences as a result of their substance use. In the study, researchers found that individuals with more severe SUDs were less likely to consider information about expected value when making decisions that involve varying levels of effort and reward.

Real-World Example: Let’s consider a person with a severe opioid addiction. They might find it increasingly difficult to factor in the effort required to obtain the drug versus the resulting pleasure, leading them to engage in high-effort behaviors even when the rewards are lesser in value.

This lack of sensitivity to expected value signals during effort-based decision making suggests that individuals with more severe SUDs struggle with integrating multiple decision variables to guide their behavior. This impairment in decision making may contribute to the persistence and escalation of substance use, as individuals are less inclined to consider the true cost of their actions.

What is the Effort Expenditure for Rewards Task (EEfRT)?

The Effort Expenditure for Rewards Task (EEfRT) is a psychological tool used to assess effort-based decision making. It involves presenting individuals with a series of choices between high-effort, high-reward options and low-effort, low-reward options. By analyzing an individual’s decision-making patterns during this task, researchers can gain insights into how they evaluate the potential rewards and costs associated with engaging in effortful behaviors.

In the aforementioned study, the researchers administered the EEfRT in a community sample of individuals with SUDs. The findings indicated that those with more severe SUDs were less likely to utilize information about expected value when making decisions involving effortful behaviors. This reduced sensitivity to expected value signals suggests that these individuals struggle with integrating various decision variables when determining whether to engage in effortful actions.

Real-World Example: Consider a person grappling with a cocaine addiction. Despite experiencing negative physical and mental health effects, they may find it challenging to evaluate the true cost of their actions and ultimately choose to engage in the effortful behaviors required to obtain cocaine.

Implications of the Research

The research findings have significant implications for the understanding and treatment of individuals with SUDs. By highlighting the role of cost–benefit integration during effort-based decision making, the study sheds light on one of the underlying mechanisms contributing to the persistence and severity of SUDs.

The findings suggest that interventions and treatments should focus not only on reducing the immediate rewards of substance use but also on improving individuals’ ability to consider the long-term costs associated with their actions. This can be achieved through targeted interventions that enhance decision-making skills and encourage the integration of multiple decision variables.

Dr. Allison M. Stuppy-Sullivan, one of the researchers involved in the study, emphasizes this point, stating,

“Our research highlights the need to focus on helping individuals with substance use disorders better weigh the costs and benefits of their actions. By improving their ability to integrate various decision variables, we can ultimately enhance their decision-making processes and contribute to improved treatment outcomes.”

In conclusion, the study on aberrant cost–benefit integration during effort-based decision making provides valuable insights into the mechanisms underlying the severity and persistence of substance use disorders. By identifying the difficulties individuals with more severe SUDs face in integrating multiple decision variables, the research has paved the way for targeted interventions and treatments that aim to improve decision-making processes and enhance treatment outcomes.

Declaration of Conflicting Interests

The authors of the research paper have declared no conflicting interests regarding the study.

For more details, refer to the original research paper here.