Selective Impairment of Social-Contract Reasoning in Males With Substance Use Disorder: Eye-Tracking Evidence

Abstract

This study investigated deficits in social contract reasoning among 78 males with Substance Use Disorder (SUD) and 56 matched healthy controls using eye-tracking. A 2 × 2 mixed-design revealed a specific impairment: while both groups showed the classic content effect (better performance on social contract rules), the SUD group was significantly less accurate only on social contract tasks. Eye-tracking analyses further revealed that healthy controls preferentially attended to cost–benefit regions during social-contract trials, whereas the SUD group allocated significantly less attention to these critical areas. This dissociation indicates a deficit not in general logical ability but in the attentional processing of social cost information, which is associated with poorer social contract reasoning. The findings identify an attentional mechanism underlying social dysfunction in addiction and suggest a target for cognitive rehabilitation focused on processing social obligation cues.