Monetary delay discounting in gambling and cocaine dependence with personality comorbidities

Abstract

Background: Cocaine addiction and pathological gambling are commonly associated with steeper (impulsive) discounting of delayed rewards, which promotes ongoing drug and gambling behaviors. However, it is yet unclear whether impulsive delay discounting is a stable trait in cocaine and gambling disorders during abstinence, and whether it is significantly impacted by dysfunctional personality beliefs. Methods: The aim of this study was to compare the delay discounting rates of four groups: 47 cocaine users with comorbid personality disorders, 41 cocaine users without psychiatric comorbidities, 28 pathological gamblers without psychiatric comorbidities, and 36 healthy comparison individuals. We also examined the association between dysfunctional personality beliefs and delay discounting rates. Participants completed the Kirby Delay Discounting Questionnaire and the Beck Personality Belief Questionnaire as part of a larger battery. Results: We used non-parametric tests to compare discounting rates between the groups, and bivariate correlation analyses to examine the association between beliefs and discounting rates within each of the groups. We found that discounting rates were significantly higher in individuals with disordered gambling compared to controls. Specifically in cocaine users with Cluster B personality disorders, higher discounting rates were associated with the intensity of "dependent" dysfunctional beliefs (e.g., "I am needy and weak"). Conclusions: Pain is a significant persisting problem for one in three cancer survivors, requiring ongoing assessment, even months later. We conclude that impulsive delay discounting is increased in gambling relative to controls and linked to personality beliefs in cocaine users with Cluster B personality disorders.

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