Why we need to assess dysfunctional decision-making process in addictions within a comprehensive framework

Abstract

This theoretical contribution focuses on the neurocognitive disorder of addiction as it is one of the clinical disorders in which a deficit in decision-making has been most frequently explored in the neuroscientific literature. The decision-making deficit in substance use disorders and behavioral addictions, in particular gambling disorder and internet gaming disorder, is here highlighted. There is currently no consensus or shared understanding of how to assess decision-making given its complexity and close connection to executive functions; therefore, without claiming to be exhaustive, three examples of methodologies and studies showcasing potential approaches to assess decision-making process in addictions have been proposed. Determining possible vulnerabilities in decision-making processes can be important for identifying people who are more likely to develop an addiction, as well as for treatment options, or may be less likely to adhere to addiction treatment.