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Let's Open the Decision-Making Umbrella: A Framework for Conceptualizing and Assessing Features of Impaired Decision Making in Addiction.
Neuropsychology Review ( IF 5.8 ) Pub Date : 2018-10-06 , DOI: 10.1007/s11065-018-9387-3
Lucien Rochat 1 , Pierre Maurage 2, 3 , Alexandre Heeren 2, 3 , Joël Billieux 4, 5, 6
Affiliation  

Decision-making impairments play a pivotal role in the emergence and maintenance of addictive disorders. However, a sound conceptualization of decision making as an umbrella construct, encompassing its cognitive, affective, motivational, and physiological subcomponents, is still lacking. This prevents an efficient evaluation of the heterogeneity of decision-making impairments and the development of tailored treatment. This paper thus unfolds the various processes involved in decision making by adopting a critical approach of prominent dual- or triadic-process models, which postulate that decision making is influenced by the interplay of impulsive-automatic, reflective-controlled, and interoceptive processes. Our approach also focuses on social cognition processes, which play a crucial role in decision making and addictive disorders but were largely ignored in previous dual- or triadic-process models. We propose here a theoretical framework in which a range of coordinated processes are first identified on the basis of their theoretical and clinical relevance. Each selected process is then defined before reviewing available results underlining its role in addictive disorders (i.e., substance use, gambling, and gaming disorders). Laboratory tasks for measuring each process are also proposed, initiating a preliminary process-based decision-making assessment battery. This original approach may offer an especially informative view of the constitutive features of decision-making impairments in addiction. As prior research has implicated these features as risk factors for the development and maintenance of addictive disorders, our processual approach sets the scene for novel and transdiagnostic experimental and applied research avenues.

中文翻译:

让我们打开决策伞:一个概念化和评估成瘾中受损决策特征的框架。

决策障碍在成瘾性疾病的发生和维持中起着关键作用。但是,仍然缺乏将决策作为涵盖其认知,情感,动机和生理子组成部分的总体构想的合理概念化。这妨碍了对决策障碍异质性和定制治疗方法的有效评估。因此,本文通过采用突出的双重或三重过程模型的批判方法来展开决策过程中涉及的各个过程,这些方法假定决策受到冲动自动过程,反射控制过程和互感过程的相互作用的影响。我们的方法还着重于社会认知过程,它们在决策和成瘾性疾病中起着至关重要的作用,但在以前的双重或三重过程模型中却被很大程度上忽略。我们在这里提出一个理论框架,其中首先根据它们的理论和临床相关性确定一系列协调的过程。然后定义每个选定的过程,然后再审查可得的结果,强调其在成瘾性疾病(即,吸毒,赌博和游戏性疾病)中的作用。还提出了用于测量每个过程的实验室任务,从而启动了一个基于过程的初步决策评估小组。这种原始的方法可以提供成瘾的决策障碍的构成特征的特别有益的见解。
更新日期:2018-10-06
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