Reward-Related Decision-Making Deficits and Elevated Impulsivity Among MDMA and Other Drug Users

Hanson, Karen L.; Luciana, Monica; Sullwold, Kristin

doi:10.1016/j.drugalcdep.2008.02.003

Cited by 125Psychedelics and Drug StudiesSubstance Abuse Treatment and OutcomesNeurotransmitter Receptor Influence on Behavior

Reward-Related Decision-Making Deficits and Elevated Impulsivity Among MDMA and Other Drug Users

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Hanson, Karen L., Luciana, Monica, Sullwold, Kristin·2008·Drug and Alcohol Dependence

DOI 10.1016/j.drugalcdep.2008.02.003PMC PMC2492887

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Abstract

Background The recreational drug, 3,4-methylenedioxymethamphetamine (MDMA; 'Ecstasy'), is a synthetic amphetamine derivative and a serotonin neurotoxin. MDMA use is associated with cognitive dysfunction and impulsivity, but since polydrug abuse is common among users it is difficult to attribute these problems specifically to MDMA. Moreover, few studies have examined reward-related cognitive processes. Our aim was to examine reward-related decision-making and impulsivity among MDMA users while controlling for polydrug use via appropriate comparison groups. Methods We examined decision-making [Iowa Gambling Task, IGT; Bechara, A., Damasio, A.R., Damasio, H., Anderson, S.W., 1994. Insensitivity to future consequences following damage to human prefrontal cortex. Cognition 50, 7-15], self-reported impulsivity (Multidimensional Personality Questionnaire-Brief Form [constraint subscale]; Barratt Impulsiveness Scale; Zuckerman Sensation Seeking Scale), and drug use among 22 abstinent MDMA users, 30 other drug users, and 29 healthy non-drug controls. Results MDMA and other drug users showed comparable patterns of decision-making and impulsivity. However, both drug groups demonstrated poorer IGT performance and elevated self-reported impulsivity relative to controls. Poorer decision-making was related to heavier drug use in the past year, heavier weekly alcohol use, and meeting lifetime substance use disorder (SUD) criteria for more drug classes. Elevated impulsivity was associated wit…

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The Iowa Gambling Task is less relevant to impulsivity and more relevant to sensitivity to reward and personal patterns of decision-making under uncertain risk.
“The literature suggests that the Iowa Gambling Task is less relevant to impulsivity and more relevant to sensitivity to reward and personal patterns of decision-making under uncertain risk (Hanson et al., 2008; Müller et al., 2021).”
From Problematic social media use and inhibitory control among post-secondary students (2025) · cites this paper as Hanson et al., 2008

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Altered response to tryptophan supplementation after long-term abstention from MDMA (ecstasy) is highly correlated with human memory function
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A somatic marker theory of addiction
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Depression, Sexually Transmitted Infection, and Sexual Risk Behavior Among Young Adults in the United States
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Obesity and Its Relationship to Addictions: Is Overeating a Form of Addictive Behavior?
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Simultaneous blockade of dopamine and noradrenaline reuptake promotes disadvantageous decision making in a rat gambling task
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Decreased saliency processing as a neural measure of Barratt impulsivity in healthy adults
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Examining delay discounting of condom-protected sex among opioid-dependent women and non-drug-using control women
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Typology of club drug use among young adults recruited using time–space sampling
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Evidence of increased activation underlying cognitive control in ecstasy and cannabis users
Roberts, G. M. P., & Garavan, H. (2010) · NeuroImage · doi:10.1016/j.neuroimage.2010.04.192 · Cited by 80 · see citing works
Alcohol, stress hormones, and the prefrontal cortex: A proposed pathway to the dark side of addiction
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Impulsivity and executive functions in polysubstance-using rave attenders
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Medial prefrontal gray matter volume reductions in users of amphetamine-type stimulants revealed by combined tract-based spatial statistics and voxel-based morphometry
Daumann, J., Koester, P., Becker, B., Wagner, D. R., Imperati, D., Gouzoulis‐Mayfrank, E., & Tittgemeyer, M. (2010) · NeuroImage · doi:10.1016/j.neuroimage.2010.08.065 · Cited by 71 · see citing works
Resting-state activity in the left executive control network is associated with behavioral approach and is increased in substance dependence
Krmpotich, T. D., Tregellas, J. R., Thompson, L. L., Banich, M. T., Klenk, A. M., & Tanabe, J. (2013) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2013.01.021 · Cited by 70 · see citing works
Relationship of cognitive function and the acquisition of coping skills in computer assisted treatment for substance use disorders
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Associations With Substance Abuse Treatment Completion Among Drug Court Participants
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Decision-making in long-term cocaine users: Effects of a cash monetary contingency on Gambling task performance
Vadhan, N. P., Hart, C. L., Haney, M., van Gorp, W. G., & Foltin, R. W. (2009) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2009.02.003 · Cited by 58 · see citing works
Win-Concurrent Sensory Cues Can Promote Riskier Choice
Cherkasova, M. V., Clark, L., Barton, J. J. S., Schulzer, M., Shafiee, M., Kingstone, A. F., Stoessl, A. J., & Winstanley, C. A. (2018) · Journal of Neuroscience · doi:10.1523/jneurosci.1171-18.2018 · Cited by 58 · see citing works
Abnormal white matter integrity and decision-making deficits in alcohol dependence
Zorlu, N., Gelal, F. M., Kuserli, A., Cenik, E., Durmaz, E., Sarıçiçek, A., & Gülseren, Ş. (2013) · Psychiatry Research Neuroimaging · doi:10.1016/j.pscychresns.2013.06.014 · Cited by 51 · see citing works
Rash impulsiveness and reward sensitivity in relation to risky drinking by university students: Potential roles of frontal systems
Lyvers, M., Duff, H., Basch, V., & Edwards, M. S. (2012) · Addictive Behaviors · doi:10.1016/j.addbeh.2012.03.028 · Cited by 49 · see citing works
Grit in patients with substance use disorders
Griffin, M. L., McDermott, K. A., McHugh, R. K., Fitzmaurice, G. M., & Weiss, R. D. (2016) · American Journal on Addictions · doi:10.1111/ajad.12460 · Cited by 47 · see citing works
Dose-related effects of MDMA on psychomotor function and mood before, during, and after a night of sleep loss
Bosker, W. M., Kuypers, K. P. C., Conen, S., & Ramaekers, J. G. (2010) · Psychopharmacology · doi:10.1007/s00213-009-1767-1 · Cited by 46 · see citing works
Adolescent Drinking and Motivated Decision-Making: A Cotwin-Control Investigation with Monozygotic Twins
Malone, S. M., Luciana, M. M., Wilson, S., Sparks, J. C., Hunt, R. H., Thomas, K. M., & Iacono, W. G. (2014) · Behavior Genetics · doi:10.1007/s10519-014-9651-0 · Cited by 44 · see citing works
Self-citation
Differences in decision-making as a function of drug of choice
Gowin, J. L., Sloan, M. E., Ramchandani, V. A., Paulus, M. P., & Lane, S. D. (2017) · Pharmacology Biochemistry and Behavior · doi:10.1016/j.pbb.2017.09.007 · Cited by 40 · see citing works
Delayed transition from ambiguous to risky decision making in alcohol dependence during Iowa Gambling Task
Kim, Y., Sohn, H., & Jeong, J. (2011) · Psychiatry Research · doi:10.1016/j.psychres.2011.05.003 · Cited by 40 · see citing works
Criminal Law as it Pertains to ‘Mentally Incompetent Defendants’: A McNaughton Rule in the Light of Cognitive Neuroscience
Bennett, M. R. (2009) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670902721137 · Cited by 39 · see citing works
Animal Models of Drug Addiction
Belin‐Rauscent, A., & Belin, D. (2012) · InTech eBooks · doi:10.5772/52079 · Cited by 39 · see citing works
ΔFosB induction in orbitofrontal cortex potentiates locomotor sensitization despite attenuating the cognitive dysfunction caused by cocaine
Winstanley, C. A., Green, T. A., Theobald, D. E. H., Renthal, W. R., LaPlant, Q. C., Dileone, R., Chakravarty, S., & Nestler, E. J. (2008) · Pharmacology Biochemistry and Behavior · doi:10.1016/j.pbb.2008.12.007 · Cited by 38 · see citing works
Impaired Decision Making in Opiate Addiction Correlates With Anxiety and Self-directedness but Not Substance Use Parameters
Leménager, T., Richter, A., Reinhard, I., Gelbke, J., Beckmann, B., Heinrich, M., Kniest, A., Mann, K. F., & Hermann, D. (2011) · Journal of Addiction Medicine · doi:10.1097/adm.0b013e31820b3e3d · Cited by 38 · see citing works
Substrates of neuropsychological functioning in stimulant dependence: a review of functional neuroimaging research
Crunelle, C. L., Veltman, D. J., Booij, J., Oortmerssen, K. V. E., & van den Brink, W. (2012) · Brain and Behavior · doi:10.1002/brb3.65 · Cited by 37 · see citing works
STI/HIV Sexual Risk Behavior and Prevalent STI Among Incarcerated African American Men in Committed Partnerships: The Significance of Poverty, Mood Disorders, and Substance Use
Khan, M. R., Golin, C. E., Friedman, S. R., Scheidell, J. D., Adimora, A. A., Judon-Monk, S., Hobbs, M. M., Dockery, G., Griffin, S. C., Oza, K. K., et al. (2015) · AIDS and Behavior · doi:10.1007/s10461-015-1062-6 · Cited by 37 · see citing works
Major Depression and Risky Sexual Behavior Among Substance Dependent Patients: The Moderating Roles of Distress Tolerance and Gender
Tull, M. T., & Gratz, K. L. (2012) · Cognitive Therapy and Research · doi:10.1007/s10608-012-9490-3 · Cited by 35 · see citing works
Cognitive impulsivity in Parkinson's disease patients: Assessment and pathophysiology
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Cortical thinning in amphetamine-type stimulant users
Koester, P., Tittgemeyer, M., Wagner, D. R., Becker, B., Gouzoulis‐Mayfrank, E., & Daumann, J. (2012) · Neuroscience · doi:10.1016/j.neuroscience.2012.06.049 · Cited by 34 · see citing works
Neurocognitive impairments in MDMA and other drug users: MDMA alone may not be a cognitive risk factor
Hanson, K. L., & Luciana, M. M. (2009) · Journal of Clinical and Experimental Neuropsychology · doi:10.1080/13803390903042361 · Cited by 34 · see citing works
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Are personality and behavioral measures of impulse control convergent or distinct predictors of health behaviors?
Edmonds, G. W., Bogg, T., & Roberts, B. W. (2009) · Journal of Research in Personality · doi:10.1016/j.jrp.2009.06.006 · Cited by 33 · see citing works
Performance on the Iowa Gambling Task is related to magnitude of weight loss and salivary cortisol in a diet-induced weight loss intervention in overweight women
Witbracht, M. G., Laugero, K. D., Loan, M. D. V., Adams, S. H., & Keim, N. L. (2011) · Physiology & Behavior · doi:10.1016/j.physbeh.2011.04.035 · Cited by 33 · see citing works
Effects of repeated treatment with MDMA on working memory and behavioural flexibility in mice
Viñals, X., Maldonado, R. J., & Robledo, P. (2012) · Addiction Biology · doi:10.1111/j.1369-1600.2011.00421.x · Cited by 32 · see citing works
Contribution of impulsivity and novelty-seeking to the acquisition and maintenance of MDMA self-administration
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Cultural Protection from Polysubstance Use Among Native American Adolescents and Young Adults
Brockie, T., Campbell, J., Dana-Sacco, G., Farley, J., Belcher, H., Kub, J., Nelson, K. E., Ivanich, J., Yang, L., Wallen, G., et al. (2022) · Prevention Science · doi:10.1007/s11121-022-01373-5 · Cited by 25 · see citing works
Interaction between serotonin transporter promoter and dopamine receptor D4 polymorphisms on decision making
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The Primacy of Cognition in the Manifestations of Substance Use Disorders
Cadet, J. L., & Bisagno, V. (2013) · Frontiers in Neurology · doi:10.3389/fneur.2013.00189 · Cited by 29 · see citing works
Reward processing deficits and impulsivity in high-risk offspring of alcoholics: A study of event-related potentials during a monetary gambling task
Kamarajan, C., Pandey, A., Chorlian, D., Manz, N., Stimus, A. T., Bauer, L., Hesselbrock, V., Schuckit, M., Kuperman, S., Kramer, J., et al. (2015) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2015.09.005 · Cited by 30 · see citing works
Sex differences in addiction-relevant behavioral outcomes in rodents following early life stress
Rincón‐Cortés, M. (2023) · Addiction Neuroscience · doi:10.1016/j.addicn.2023.100067 · Cited by 26 · see citing works
Abstinent Heroin Addicts Tend to Take Risks: ERP and Source Localization
Zhao, Q., Li, H., Hu, B., Wu, H., & Liu, Q. (2017) · Frontiers in Neuroscience · doi:10.3389/fnins.2017.00681 · Cited by 26 · see citing works
Neuropsychological Impairment and Its Association with Violence Risk in Japanese Forensic Psychiatric Patients: A Case-Control Study
Nishinaka, H., Nakane, J., Nagata, T., Imai, A., Kuroki, N., Sakikawa, N., Omori, M., Kuroda, O., Hirabayashi, N., Igarashi, Y., et al. (2016) · PLoS ONE · doi:10.1371/journal.pone.0148354 · Cited by 25 · see citing works
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Risky alcohol use and age at onset of regular alcohol consumption in relation to frontal lobe indices, reward sensitivity, and rash impulsiveness
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Decision-making in Polydrug Amphetamine-type Stimulant Users: an fMRI Study
Koester, P., Volz, K. G., Tittgemeyer, M., Wagner, D. R., Becker, B., Gouzoulis‐Mayfrank, E., & Daumann, J. (2013) · Neuropsychopharmacology · doi:10.1038/npp.2013.43 · Cited by 21 · see citing works
The effects of psychiatric distress, inhibition, and impulsivity on decision making in patients with substance use disorders: A matched control study
van Toor, D., Roozen, H. G., Evans, B. E., Rombout, L., van de Wetering, B. J. M., & Vingerhoets, A. J. J. M. (2010) · Journal of Clinical and Experimental Neuropsychology · doi:10.1080/13803395.2010.493300 · Cited by 20 · see citing works
Decision-Making Under Risk, but Not Under Ambiguity, Predicts Pathological Gambling in Discrete Types of Abstinent Substance Users
Wilson, M. J., & Vassileva, J. (2018) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2018.00239 · Cited by 20 · see citing works
Beyond sensation seeking: a conceptual framework for individual differences in psychostimulant drug effects in healthy humans
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Neural correlates of traditional Chinese medicine induced advantageous risk-taking decision making.
Lee, T. M. Y., Guo, L.-G., Shi, H.-Z., Li, Y.-Z., Luo, Y.-J., Sung, C., Chan, C. C. H., & Lee, T. M. C. (2009) · Brain and Cognition · doi:10.1016/j.bandc.2009.06.006 · Cited by 23 · see citing works
Resting-state functional connectivity within orbitofrontal cortex and inferior frontal gyrus modulates the relationship between reflection level and risk-taking behavior in internet gaming disorder
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Problematic social media use and inhibitory control among post-secondary students
Shannon, H., Montgomery, M., Guimond, S., & Hellemans, K. (2025) · Addictive Behaviors · doi:10.1016/j.addbeh.2025.108307 · Cited by 16 · see citing works
Differences in resting-state functional connectivity according to the level of impulsiveness in patients with internet gaming disorder
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The role of anxiety in decision-making
Kirsch, M., & Windmann, S. (2009) · University of Zagreb University Computing Centre (SRCE) · Cited by 16 · see citing works
Chronic co-administration of the cannabinoid receptor agonist WIN55,212-2 during puberty or adulthood reverses 3,4 methylenedioxymetamphetamine (MDMA)-induced deficits in recognition memory but not in effort-based decision making
Schulz, S., Becker, T., Nagel, U., von Ameln-Mayerhofer, A., & Koch, M. (2013) · Pharmacology Biochemistry and Behavior · doi:10.1016/j.pbb.2013.03.011 · Cited by 15 · see citing works
Interrelationship of Opioid Dependence, Impaired Impulse Control, and Depressive Symptoms: An Open-Label Cross-Sectional Study of Patients in Maintenance Therapy
Peters, L., & Soyka, M. (2018) · Neuropsychobiology · doi:10.1159/000494697 · Cited by 15 · see citing works
Causes and Consequences of Drug Abuse: A Comparison Between Synthetic Drug and Heroin Users in Urban China
Yang, X., & Xia, G. (2019) · AIDS Education and Prevention · doi:10.1521/aeap.2019.31.1.1 · Cited by 15 · see citing works
Decision making under explicit risk is impaired in individuals with human immunodeficiency virus (HIV)
Fujiwara, E., Tomlinson, S. E., Purdon, S. E., Gill, M. J., & Power, C. (2015) · Journal of Clinical and Experimental Neuropsychology · doi:10.1080/13803395.2015.1057481 · Cited by 14 · see citing works
Low-frequency repetitive transcranial magnetic stimulation inhibits the development of methamphetamine-induced conditioned place preference
Wu, X.-Q., Zan, G., Ju, Y., Chen, T., Guo, L., Jiao, D., Jiang, H., Deng, Y.-Z., Liu, J., & Zhao, M. (2018) · Behavioural Brain Research · doi:10.1016/j.bbr.2018.07.004 · Cited by 14 · see citing works
The impact of self-reported life stress on current impulsivity in cocaine dependent adults
Ross, E. L., Yoon, J. H., Mahoney, J. J., Omar, Y., Newton, T. F., & Garza, R. D. L. (2013) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2013.06.002 · Cited by 14 · see citing works
Glucose and corticosterone changes in developing and adult rats following exposure to (±)-3,4-methylendioxymethamphetamine or 5-methoxydiisopropyltryptamine
Graham, D. L., Herring, N. R., Schaefer, T. L., Vorhees, C. V., & Williams, M. T. (2009) · Neurotoxicology and Teratology · doi:10.1016/j.ntt.2009.08.012 · Cited by 13 · see citing works
Determinants of risk-taking in HIV-associated neurocognitive disorders.
Gómez, D., Power, C., Gill, M. J., & Fujiwara, E. (2017) · Neuropsychology · doi:10.1037/neu0000366 · Cited by 12 · see citing works
Impulsivity, Sensation Seeking, and Decision-Making in Long-Term Abstinent Cannabis Dependent Patients
Delibaş, D. H., Akseki, H. S., Erdoğan, E., Zorlu, N., & Gülseren, Ş. (2017) · Nöro Psikiyatri Arşivi · doi:10.5152/npa.2017.19304 · Cited by 12 · see citing works
Reward sensitivity and outcome expectancies as predictors of ecstasy use in young adults
Smerdon, M. J., & Francis, A. J. P. (2011) · Addictive Behaviors · doi:10.1016/j.addbeh.2011.07.027 · Cited by 10 · see citing works
Chronic 3,4-Methylenedioxymethamphetamine (MDMA) Use Is Related to Glutamate and GABA Concentrations in the Striatum But Not the Anterior Cingulate Cortex
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Authors: Hanson, K. L., Luciana, M., & Sullwold, K.
Affiliations: San Diego State University (US)
University of Minnesota (US)
Corresponding author: Hanson, Karen L.
ORCID: Hanson, Karen L.
Luciana, Monica
Venue: Drug and Alcohol Dependence
Publisher: Elsevier BV
Published: 2008-07
Volume: 96
Issue: 1-2
Pages: 99-110
ISSN: 0376-8716 (ISSN-L)
DOI: 10.1016/j.drugalcdep.2008.02.003
PMC: PMC2492887
OpenAlex: W1968643679
Cited by: 125
References: 107
Citations by year: 2026: 1 · 2025: 5 · 2024: 3 · 2023: 6 · 2022: 3 · 2021: 2 · 2020: 2 · 2019: 2 · 2018: 7 · 2017: 6 · 2016: 6 · 2015: 6 · 2014: 5 · 2013: 11 · 2012: 19
FWCI: 15.21
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Drug and Alcohol Dependence (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute on Alcohol Abuse and Alcoholism (T32AA013525)
National Institute of Mental Health (T32MH017069)
Topics: Social Sciences › Psychology › Clinical Psychology › Psychedelics and Drug Studies
Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
Keywords: MDMA, ecstasy, impulsivity, polydrug use, Iowa Gambling Task, substance use disorders, alcohol consumption, depression, sensation seeking, serotonin neurotoxicity, cognitive impairment
MeSH terms: Adult, Alcohol Drinking, Cognition Disorders, Decision Making, Female, Gambling, Humans, Impulsive Behavior, Male, Personality, Personality Inventory, Surveys and Questionnaires, Reward, N-Methyl-3,4-methylenedioxyamphetamine, Substance-Related Disorders, Amphetamine-Related Disorders, Control Groups

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Reward-Related Decision-Making Deficits and Elevated Impulsivity Among MDMA and Other Drug Users

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