For those who are guilty of driving under the influence of alcohol, psychiatric comorbidity –…
Repeat DUI Offenders Suffer from Decision-Making Deficits
Researchers have uncovered evidence of a subtle decision-making deficit among second-time offenders of driving under the influence (DUI), which may help explain why these drunk drivers are more prone to hazardous risk-taking.
From previous studies, alcohol use has already been linked to neurocognitive impairments, particularly in the region of the brain where decision-making cognition takes place. However, decision-making impairments have not quite been clinically identified as a characteristic among individuals who suffer from alcohol-use problems. Furthermore, in standard DUI testing, drivers are tested for their blood alcohol concentration (BAC) and general cognitive impairment, yet decision-making processes are not usually considered.
To measure the prevalence of decision-making impairments among individuals who repeatedly commit DUI, Muzaffer Kasar, a resident in psychiatry at the Bakirkoy Research and Training Hospital in Istanbul, Turkey and colleague David J. Nutt, a professor of psychiatry at Imperial College London in Great Britain performed psychiatric assessments as well as conventional neuropsychological testing on 34 male second-time DUI offenders. The participants were selected from an alcohol rehabilitation program in which they were enrolled at the time of the study. Also, the researchers compared the participants with a control group that included 31 healthy non-offenders and matched the groups based on age, education, and alcohol use.
Aside from their psychiatric assessments, all of the participants were tested regarding their attention, visuospatial abilities, response inhibition, and comprising cognitive set-shifting. The researchers used a personality test known as the Temperament and Character Inventory (TCI) on the participants as well as a computerized version of a standard neurocognitive assessment called the Iowa Gambling Task (IGT) to measure participants’ personality patterns. Additionally, IGT testing is commonly used in alcohol problem studies since the exam simulates real-life decision-making situations.
As a result, the researchers discovered no significant differences when it came to the participants’ conventional neuropsychological tests or sociodemographics, according to the TCI exam, with the exception that the second-time DUI offenders had significantly higher scores when it came to measuring their “self-transcendence.” Secondly, the DUI offenders had considerably lower net scores than the non-offender controls on the IGT exam. The DUI offenders were also significantly more likely than the control group to make risky choices on the IGT exam. These findings indicate that the second-time DUI offenders are not affected by motor impulsiveness, but rather cognitive impulsiveness. The second-time DUI offenders are more susceptible to making poorer choices since their decision-making cognition, such as realizing the negative consequences from negative choices, are impaired. Typically, these decision-making deficits go undetected in standard neuropsychological testing since impulsivity patterns are not included in the assessment.
Because drunk driving incidences are responsible for more than 40% of fatal motor vehicular accidents, the researchers recommend that decision-making cognition should also be included in standard DUI testing. In 2008, 11,773 deaths occurred as the result of alcohol-related driving accidents (nearly one-third of all vehicular crashes), according to the U.S. Center for Disease Control and Prevention (CDC). The majority of alcohol-related vehicular fatalities involve younger adults aged 21–24 (about 34%), a driver with a BAC of 0.08% or higher (68%), and male drivers (75%). About 33% of all drunk driving accidents in the U.S. are caused by repeat offenders. In fact, drivers with a BAC of 0.08% or higher that are involved in alcohol-related vehicular fatalities are eight times more likely to be recidivist DUI offenders.
The study will be available in the December print issue of Alcoholism: Clinical & Experimental Research.
Source: HealthDay, Robert Preidt, Repeat DUI Offenders Have Reasoning Deficits: Study, September 8, 2010