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Social decision-making in severe alcohol use disorder: Scoping review and experimental perspectives.

BACKGROUND
Patients with severe alcohol use disorder (SAUD) demonstrate multifaceted impairments in social cognition abilities like emotional decoding or Theory of Mind. Such impairments are related to real-life interpersonal difficulties, which in turn might be involved in the persistence of SAUD. However, far less is known regarding how patients with SAUD make decisions in social context, and this literature has not yet been gathered in a comprehensive review.


OBJECTIVES
The main aim of this paper was to offer the first review specifically focusing on social decision-making abilities in SAUD. Following PRISMA guidelines for scoping reviews, we described existing knowledge regarding the actual difficulties experienced by patients with SAUD during social interactions. Our second objective was to propose perspectives for future research, based on the shortcomings identified in the available literature.


DESIGN
 Three online databases (PubMed, Psycinfo, Scopus) were searched, and we identified 14 papers which used behavioural tasks assessing social decision-making in patients with SAUD.


RESULTS
Included studies assessed social decision-making through three paradigms: 1) economic games (four papers), 2) moral dilemmas (four papers), and 3) interpersonal problem-solving (six papers). Results indicated that patients with SAUD behave differently from controls in all three paradigms.


CONCLUSIONS
Previous studies suggested large-scale social decision-making impairments or biases in SAUD. However, in light of the limited number of studies available, as well as of the restricted set of processes measured, we call for the extension of this field through more ecologically relevant and model-based paradigms allowing for the elucidation of the underlying mechanisms.