Risk Processing in Patients with Alcohol Use Disorder

Decision-associated versus feedback related aspects might probably contribute to decision making in patients with alcohol use disorder (Sehrig, Weiss, Miller, and Rockstroh, 2019). During the Ballon Analog Risk Task (BART) ERPs were recorded in patients and healthy comparison subjects. During the BART the participants could make a choice to inflate a visual balloon. The participants could also choose among pumping and "cash out".

Balloon pumping was revealed to be rewarding when not pumping, wheras popping the balloon resulted in a loss.

It was found that both subject groups did exhibit the same choice behavior, however, they did differ in the ERP results. Patients with alcohol use disorder showed an enhanced P3 amplitude which did not depend on the level of risk. In addition, patients showed a reduced feedback related negativity (FRN) which suggests that they have impaired responses during loss. There was found a larger N2-P3 complex in the patients, and the larger P3 in alcohol use disorder patients might be due to more heavily processing of the decision prompt related to outcome-expectancies due to learning. The reward prediction did not differ among both groups.

In the patients with alcohol use disorder, higher impulsivity was related to risk modulated decision P3, but not on the FRN. Based on these results, it is suggested that the decision as well as feedback-associated processes might have an impact on difficulties in the engagement of effective use of daily activities (Sehrig et al., 2019).