Decision making in substance use disorder patients: Reliability, convergent validity and sensitivity to change of a new behavioral measure.

OBJECTIVE

The Iowa Gambling Task (IGT) and the Delay Discounting Test (DDT) are two of the most widely used decision-making tests within the field of addiction research. The IGT creates a context of uncertainty where immediate rewards or long-term benefits are chosen, whilst the DDT measures the change in value of a reward as the time taken to obtain it increases. The objective of this study was to analyze the psychometric properties of a new task: Deciding about your health (DAYH), which integrates both components.

METHOD: Longitudinal observational study. The sample was composed of 97 patients being treated for cocaine use disorder. The DAYH, IGT, DDT and other instruments for measuring dependence severity were administered. Relapse was evaluated within 3 and 6 months after the baseline assessment.

RESULTS

Reliability was indicated by an intraclass correlation coefficient (r) of. 80. DAYH scores showed significant relationships with IGT (r = -.237; p <.05), although not with DDT (r =.048) scores. A relationship was also found between DAYH and dependency severity (r = -.213; p <.05) and craving (r = -.231; p <.05). The DAYH scores showed sensitivity to change, and the capacity to predict relapse.

CONCLUSIONS

These findings indicate the utility of DAYH for exploring decision-making in patients with substance use disorders. The relationships with IGT and DDT also indicate the need to further investigate how decisions are made in various contexts of choice.