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Individuals with substance use disorders continue to use the substance despite repeated negative consequences. To elucidate the mechanism of this trait, German investigators used complex decision-making tasks in 35 healthy controls and 43 alcohol-dependent patients in an inpatient program who had not had a drink in about a month.
On the computer-based task, participants chose between two geometric figures that were either rewarded with money or punished with monetary loss. To maximize reward, the participants had to infer whether a given stimulus was more likely to be rewarded, based on whether the same stimulus had just been rewarded or punished. Analyses corrected for variables such as cognitive-testing results, gray-matter density, smokin…