Increased risk-taking decision-making but not altered response to punishment in stimulant-using young adults.

Stimulant-using and stimulant-naive young adults performed the "risky gains" decision-making task [Paulus, M.P., Rogalsky, C., Simmons, A., Feinstein, J.S., Stein, M.B., 2003. Increased activation in the right insula during risk-taking decision making is related to harm avoidance and neuroticism. Neuroimage 19(4), 1439-1448]. On each trial, the numbers 20, 40, and 80 are presented individually in ascending order. Subjects press a button to receive the displayed number in points. The 20 is always associated with a gain of 20 points (safe response). There is a chance that waiting to select a 40 or 80 will result in punishment of 40 or 80 points, respectively (risky response). All subjects made fewer risky responses immediately following punished trials (p<.001). Stimulant-users made more risky responses than never-users overall (p<.02) but showed the same inhibition effect of punishment on next-trial risky responding. Risk-taking in the task correlated with measures of sensation-seeking and impulsivity, but not other personality measures, anxiety, or tendency toward alcohol use disorders. Results are consistent with the hypothesis that stimulant-users show increased risk-taking but are not less sensitive to punishments than controls. By requiring selection from a sequence of individual options presented according to a fixed schedule, rather than allowing deliberation between simultaneously available options, the risky gains task may model a different sort of risk-taking than other tasks.