Factors underlying risk taking in heroin-dependent individuals: Feedback processing and environmental contingencies

Evidence suggests that factors influencing risk-taking include whether decisions are made based on emotions (affective systems) or cognitions (deliberative systems), the processing of feedback (e.g., deciding to attend a rehabilitation facility for opioid addiction treatment after an intervention held by a family member), and attention to environmental contingencies (e.g., considering the probability of an outcome such as the likelihood of contracting tetanus from a shared needle; or the gains and losses associated with a decision, such as the benefits and costs of taking drugs). Although drug-dependent individuals tend to take more risks than non-drug users, the factors underlying risk-taking are unknown. The current study tested, for the first time, the influences of performance feedback (i.e., whether feedback about performance is integrated into decision-making in heroin-dependent individuals) and attention to environmental contingencies (i.e., the influence of the probability of a loss, the gain amount, and the loss amount associated with a scenario) on risk-taking in heroin-dependent individuals. Heroin-dependent patients undergoing maintenance therapy for opioid addiction (n = 25) and healthy controls (n = 27) completed the feedback and no-feedback conditions of the Columbia Card Task (CCT). Analyses of covariance, controlling for education and task design (the order in which the CCT conditions were completed) as covariates revealed a significant interaction between (a) probability, gain and loss amount, and group, and (b) group and probability. Our findings suggest that heroin-dependent patients pay less attention to environmental contingencies during risk-taking than controls. Addressing these factors may facilitate greater adherence to treatment programs and lower rates of relapse.