Decision-making biases, antisocial personality, and early-onset alcoholism

Background: Disinhibited, antisocial traits increase the risk for early-ons et alcoholism. Research also suggests that decision biases which favor imme diate large rewards regardless of long-term consequences may be important m echanisms associated with the biological substrates of antisocial traits. T his study tested the hypothesis that early-onset alcoholism with antisocial personality (ASP) would be associated with favoring immediate larger rewar ds despite their being associated with long-term losses. Methods: Twenty-seven early-onset alcoholics with and without a diagnosis o f ASP, eight subjects with ASP but no alcohol dependence, and 32 controls w ere tested on a task that manipulated the magnitude of immediate rewards an d the magnitude of long-term punishments. The sample was recruited from the community via advertisements. Results: Compared with subjects without ASP, subjects with ASP favored larg er immediate rewards de-spite long-term losses regardless of alcohol depend ence; however, they learned to shift their decisions in a more advantageous direction over time. A disadvantageous decision bias also was associated w ith drinking greater quantities of alcohol and having a lower IQ. Conclusions: This study suggests that ASP in a young adult noninstitutional ized sample was associated with a pattern of disadvantageous decision makin g similar to that observed in patients with antisocial behavioral character istics associated with lesions in the ventromedial frontal cortex. The data also suggest that this pattern of disadvantageous decision making is assoc iated with consuming larger quantities of alcohol but not consuming alcohol more frequently.