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Risky decision-making in the Context of Contingency Management for Methamphetamine Use Disorder
Background: Risky decision-making is strongly implicated in adverse real-world risk-taking behaviour, and is associated with Substance Use Disorder, including Methamphetamine Use Disorder. Laboratory neurocognitive tasks typically utilized to assess risky decision-making have been able to distinguis...
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| Format: | Thesis |
| Language: | English |
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Department of Psychology
2020
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| _version_ | 1867613167836725248 |
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| access_status_str | Open Access |
| author | Lake, Marilyn Toni |
| author2 | Lipinska, Gosia |
| author_browse | Lake, Marilyn Toni Lipinska, Gosia |
| author_facet | Lipinska, Gosia Lake, Marilyn Toni |
| author_sort | Lake, Marilyn Toni |
| collection | Thesis |
| description | Background: Risky decision-making is strongly implicated in adverse real-world risk-taking behaviour, and is associated with Substance Use Disorder, including Methamphetamine Use Disorder. Laboratory neurocognitive tasks typically utilized to assess risky decision-making have been able to distinguish participants with Substance Use Disorder from controls, although considerable heterogeneity is still evident within substance-using populations, which remains largely unexplained. Preliminary evidence has also tied risky decision-making to treatment outcomes, although no research has investigated risk-decision-making within Methamphetamine Use Disorder in the context of Contingency Management treatment. Methods: This study aimed to investigate decision-making on the Iowa Gambling Task and the Balloon Analogue Risk at baseline as both a function and predictor of treatment response on an 8-week treatment of Contingency Management. Of 26 participants with Methamphetamine Use Disorder, 17 responded to Contingency Management treatment, whilst 9 were non-responders. Using various mixed-effect modelling techniques and ANCOVA, performance by nonresponders were compared to responders, as well as a group of 19 healthy, nonsubstance-using control participants. Results: Group differences between non-responders, responders and controls were exclusively obtained on the Iowa Gambling Task. A trend-level (p=.051), large effect size (g=-0.98) was observed in the effect of reward magnitude between non-responders and healthy controls. More specifically, non-responders tended to seek-out large short-term rewards in spite of long-term losses relative to controls, however, groups did not also differ in effect of short-term loss magnitude. Non-responders also appeared to demonstrate poorer learning than healthy controls, although this finding was also at trend-level (p=.081) with a medium effect size (g =-0.63). In addition, results showed that responders and non-responders were differentially influenced by the frequency of outcomes, where responders demonstrated a greater preference for frequent rewards and infrequent losses relative to non-responders. This difference was at trend-level (p=.053) and the effect was moderately sized (g =-0.74). Impulsivity did not moderate group differences in decision-making, but did positively predict a greater likelihood of relapse at least once during Contingency Management (p =.035), although this effect was small (OR=1.10). Poor overall performance on the IGT appeared to predict a greater likelihood of prolonged relapse on Contingency Management following initial relapse, although this was at trend-level (p =.071) with a small effect size (OR=1.80). Conclusion: Findings provide evidence for individual differences in risky decision-making within Methamphetamine User Disorder, suggesting that risky decision-making is unlikely to be a homogeneous characteristic of substance-using populations, as is typically treated in the literature. Risky decision-making may also act as a risk factor for poor treatment success on Contingency Management, which in turn suggests that assessing risky decision-making of individuals with Methamphetamine Use disorder prior to commencing Contingency Management treatment might assist in identifying those at high risk. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/31025 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:31:50.330Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2020 |
| publishDateRange | 2020 |
| publishDateSort | 2020 |
| publisher | Department of Psychology |
| publisherStr | Department of Psychology |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/31025 Risky decision-making in the Context of Contingency Management for Methamphetamine Use Disorder Lake, Marilyn Toni Lipinska, Gosia Ipser, Jonathan C. Psychological Research Background: Risky decision-making is strongly implicated in adverse real-world risk-taking behaviour, and is associated with Substance Use Disorder, including Methamphetamine Use Disorder. Laboratory neurocognitive tasks typically utilized to assess risky decision-making have been able to distinguish participants with Substance Use Disorder from controls, although considerable heterogeneity is still evident within substance-using populations, which remains largely unexplained. Preliminary evidence has also tied risky decision-making to treatment outcomes, although no research has investigated risk-decision-making within Methamphetamine Use Disorder in the context of Contingency Management treatment. Methods: This study aimed to investigate decision-making on the Iowa Gambling Task and the Balloon Analogue Risk at baseline as both a function and predictor of treatment response on an 8-week treatment of Contingency Management. Of 26 participants with Methamphetamine Use Disorder, 17 responded to Contingency Management treatment, whilst 9 were non-responders. Using various mixed-effect modelling techniques and ANCOVA, performance by nonresponders were compared to responders, as well as a group of 19 healthy, nonsubstance-using control participants. Results: Group differences between non-responders, responders and controls were exclusively obtained on the Iowa Gambling Task. A trend-level (p=.051), large effect size (g=-0.98) was observed in the effect of reward magnitude between non-responders and healthy controls. More specifically, non-responders tended to seek-out large short-term rewards in spite of long-term losses relative to controls, however, groups did not also differ in effect of short-term loss magnitude. Non-responders also appeared to demonstrate poorer learning than healthy controls, although this finding was also at trend-level (p=.081) with a medium effect size (g =-0.63). In addition, results showed that responders and non-responders were differentially influenced by the frequency of outcomes, where responders demonstrated a greater preference for frequent rewards and infrequent losses relative to non-responders. This difference was at trend-level (p=.053) and the effect was moderately sized (g =-0.74). Impulsivity did not moderate group differences in decision-making, but did positively predict a greater likelihood of relapse at least once during Contingency Management (p =.035), although this effect was small (OR=1.10). Poor overall performance on the IGT appeared to predict a greater likelihood of prolonged relapse on Contingency Management following initial relapse, although this was at trend-level (p =.071) with a small effect size (OR=1.80). Conclusion: Findings provide evidence for individual differences in risky decision-making within Methamphetamine User Disorder, suggesting that risky decision-making is unlikely to be a homogeneous characteristic of substance-using populations, as is typically treated in the literature. Risky decision-making may also act as a risk factor for poor treatment success on Contingency Management, which in turn suggests that assessing risky decision-making of individuals with Methamphetamine Use disorder prior to commencing Contingency Management treatment might assist in identifying those at high risk. 2020-02-11T12:05:22Z 2020-02-11T12:05:22Z 2019 2020-01-29T07:33:12Z Master Thesis Masters MSocSci http://hdl.handle.net/11427/31025 eng application/pdf Department of Psychology Faculty of Humanities |
| spellingShingle | Psychological Research Lake, Marilyn Toni Risky decision-making in the Context of Contingency Management for Methamphetamine Use Disorder |
| thesis_degree_str | Master's |
| title | Risky decision-making in the Context of Contingency Management for Methamphetamine Use Disorder |
| title_full | Risky decision-making in the Context of Contingency Management for Methamphetamine Use Disorder |
| title_fullStr | Risky decision-making in the Context of Contingency Management for Methamphetamine Use Disorder |
| title_full_unstemmed | Risky decision-making in the Context of Contingency Management for Methamphetamine Use Disorder |
| title_short | Risky decision-making in the Context of Contingency Management for Methamphetamine Use Disorder |
| title_sort | risky decision making in the context of contingency management for methamphetamine use disorder |
| topic | Psychological Research |
| url | http://hdl.handle.net/11427/31025 |
| work_keys_str_mv | AT lakemarilyntoni riskydecisionmakinginthecontextofcontingencymanagementformethamphetamineusedisorder |