Capacité en matière de prise de décisions chez des récidivistes de conduite avec capacités affaiblies par l’alcool
Objectives:  Poor decision making in ambiguous high-risk situations, such as driving while impaired (DWI) by alcohol, may differentiate DWI recidivists from non-offenders. In this study, we test the hypothesis that DWI recidivists (R) will exhibit poorer decision-making performance on the Iowa Gambling Task (IGT), and in line with the Somatic Marker Hypothesis, weaker anticipatory somatic activation (using skin conductance response as index) than non-offenders (C, comparison group).   Methods: DWI recidivists and non-DWI control drivers were recruited, [R (n=23) and C (n=24), mean ages (± SD) 44.17(10.03) and 37.29 (10.60) years respectively]. Participant selection criteria included ≥ 18 years old and ≥2 DWI convictions for group R and 0 DWI convictions lifetime and a driver’s license for group C. The participants performed the IGT, a decision-making neurocognitive task containing 100 card selection trials that we divided into 5 blocks for analyses. A 2 (group) x 5 (blocks) repeated measures ANOVA was used to compare group R performance on the IGT versus group C, followed by post hoc independent t-tests on aggregated blocks 1-2 (decision under ambiguity) & 3-5 (decision under high risk) to identify the source of group X block significant interactions. Two 3 (group) x 5 (blocks) repeated measures ANOVAs (for good decks and for bad decks) were used to compare the aSCR of groups C and R. Results: ANOVA repeated measures on blocks 1 to 5 produced a significant effect of group by block interaction F(1,45)=5.28, p=.03, partial ƞ2 =.11.  Post hoc t-tests on aggregated blocks 3 to 5 were statistically significant, t(45) = 3.38, p = .002. A significant group x block interaction effect was found for good decks aSCR, F(8,160)=2.33, p=.02, partial ƞ2 =.10 .  Conclusion:  DWI recidivists performed more poorly than controls on the IGT, persistently making decisions based on potential immediate gains and neglecting associated loss risks and long-term outcome. This suggests they have reduced neurocognitive decision-making capacities distinguishable from the general population.  While DWI recidivists’ behaviour appears as impulsive, these results suggest that their behaviour pattern involves decision-making difficulties.  Larger sample sizes may be needed to detect a between-group effect in the aSCR analyses, as they were considerably underpowered.
driving while impaired recidivists decision making driving under the influence relapse alcohol dependence neurocognitive function