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McKenna BS, Anthenelli RM, Smith TL, Schuckit MA. Low versus high level of response to alcohol affects amygdala functional connectivity during processing of emotional stimuli. Alcohol Clin Exp Res 2022; 46:66-76. [PMID: 35064942 PMCID: PMC8820383 DOI: 10.1111/acer.14744] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 11/10/2021] [Accepted: 11/11/2021] [Indexed: 01/24/2023]
Abstract
BACKGROUND Low levels of response (low LR) to alcohol predict heavy drinking and alcohol problems. Functional magnetic resonance imaging (fMRI) studies of emotion processing have shown that low LR individuals exhibit lower activation in task-related brain regions following both placebo and alcohol administration, but these studies did not examine functional brain networks that might contribute to the phenomena. The current study expands upon the earlier results by evaluating whether functional connectivity differences between the amygdala and other brain regions modulated by emotional face processing are associated with LR. Based on prior findings, we hypothesized that low LR is related to lower functional connectivity in fronto-amygdalar functional circuits, which underlie the processing of emotional stimuli. METHODS Secondary analyses were conducted on data from a double-blind, placebo-controlled, within-subjects, cross-over study in 108 18-to-25-year-old low and high LR sex-matched pairs without alcohol use disorder at baseline. Participants performed modified emotional faces processing tasks after receiving placebo or approximately 0.7 ml/kg of ethanol. Psychophysiological interaction analyses examined functional connectivity between left and right amygdalae and related brain circuits using LR-by-alcohol general linear models. The data included 54 sex-matched pairs with 216 fMRI scans comprising alcohol and placebo conditions. RESULTS Compared with individuals with high LR, low LR subjects demonstrated lower functional connectivity between the amygdala and the frontal lobes, insula, and parietal regions, while processing angry and happy faces. Interactions showed lower connectivity following alcohol in low LR and higher connectivity in high LR groups. CONCLUSIONS Low LR individuals demonstrated lower functional connectivity in response both to placebo and a modest dose of ethanol. Attenuated connectivity among low LR individuals when processing emotional faces may contribute to an impaired ability to recognize alcohol intoxication in social situations and to appraise angry and happy emotions irrespective of whether alcohol is consumed.
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Affiliation(s)
- Benjamin S McKenna
- Department of Psychiatry, University of California, San Diego, Health Sciences, La Jolla, California, USA
- VA San Diego Healthcare System, San Diego, California, USA
| | - Robert M Anthenelli
- Department of Psychiatry, University of California, San Diego, Health Sciences, La Jolla, California, USA
| | - Tom L Smith
- Department of Psychiatry, University of California, San Diego, Health Sciences, La Jolla, California, USA
| | - Marc A Schuckit
- Department of Psychiatry, University of California, San Diego, Health Sciences, La Jolla, California, USA
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Gennarelli M, Monteleone P, Minelli A, Monteleone AM, Rossi A, Rocca P, Bertolino A, Aguglia E, Amore M, Bellino S, Bellomo A, Biondi M, Bucci P, Carpiniello B, Cascino G, Cuomo A, Dell'Osso L, di Giannantonio M, Giordano GM, Marchesi C, Oldani L, Pompili M, Roncone R, Rossi R, Siracusano A, Tenconi E, Vita A, Zeppegno P, Galderisi S, Maj M. Genome-wide association study detected novel susceptibility genes for social cognition impairment in people with schizophrenia. World J Biol Psychiatry 2022; 23:46-54. [PMID: 34132174 DOI: 10.1080/15622975.2021.1907722] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES People with schizophrenia (SCZ) present serious and generalised deficits in social cognition (SC), which affect negatively patients' functioning and treatment outcomes. The genetic background of SC has been investigated in disorders other than SCZ providing weak and sparse results. Thus, our aim was to explore possible genetic correlates of SC dysfunctions in SCZ patients with a genome-wide study (GWAS) approach. METHODS We performed a GWAS meta-analysis of data coming from two cohorts made of 242 and 160 SCZ patients, respectively. SC was assessed with different tools in order to cover its different domains. RESULTS We found GWAS significant association between the TMEM74 gene and the patients' ability in social inference as assessed by The Awareness of Social Inference Test; this association was confirmed by both SNP-based analysis (lead SNP rs3019332 p-value = 5.24 × 10-9) and gene-based analysis (p-value = 1.09 × 10-7). Moreover, suggestive associations of other genes with different dimensions of SC were also found. CONCLUSIONS Our study shows for the first time GWAS significant or suggestive associations of some gene variants with SC domains in people with SCZ. These findings should stimulate further studies to characterise the genetic underpinning of SC dysfunctions in SCZ.
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Affiliation(s)
- Massimo Gennarelli
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.,Genetics Unit, IRCCS Istituto Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Palmiero Monteleone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana" Section of Neuroscience, University of Salerno, Salerno, Italy
| | - Alessandra Minelli
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.,Genetics Unit, IRCCS Istituto Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Alessio Maria Monteleone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana" Section of Neuroscience, University of Salerno, Salerno, Italy
| | - Alessandro Rossi
- Section of Psychiatry, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Paola Rocca
- Department of Neuroscience, Section of Psychiatry, University of Turin, Turin, Italy
| | - Alessandro Bertolino
- Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy
| | - Eugenio Aguglia
- Department of Clinical and Molecular Biomedicine, Psychiatry Unit, University of Catania, Catania, Italy
| | - Mario Amore
- Section of Psychiatry, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Silvio Bellino
- Department of Neuroscience, Section of Psychiatry, University of Turin, Turin, Italy
| | - Antonello Bellomo
- Psychiatry Unit, Department of Medical Sciences, University of Foggia, Foggia, Italy
| | - Massimo Biondi
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Paola Bucci
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Bernardo Carpiniello
- Section of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Giammarco Cascino
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana" Section of Neuroscience, University of Salerno, Salerno, Italy
| | - Alessandro Cuomo
- Department of Molecular Medicine and Clinical Department of Mental Health, University of Siena, Siena, Italy
| | - Liliana Dell'Osso
- Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | | | - Carlo Marchesi
- Department of Neuroscience, Psychiatry Unit, University of Parma, Parma, Italy
| | - Lucio Oldani
- Department of Psychiatry, University of Milan, Milan, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Rita Roncone
- Unit of Psychiatry, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Rodolfo Rossi
- Section of Psychiatry, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Alberto Siracusano
- Department of Systems Medicine, Psychiatry and Clinical Psychology Unit, Tor Vergata University of Rome, Rome, Italy
| | - Elena Tenconi
- Psychiatric Clinic, Department of Neurosciences, University of Padua, Padua, Italy
| | - Antonio Vita
- Psychiatric Unit, School of Medicine, University of Brescia, Brescia, Italy.,Department of Mental Health, Spedali Civili Hospital, Brescia, Italy
| | - Patrizia Zeppegno
- Department of Translational Medicine, Psychiatric Unit, University of Eastern Piedmont, Novara, Italy
| | - Silvana Galderisi
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Mario Maj
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
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From Emotional (Dys)Regulation to Internet Addiction: A Mediation Model of Problematic Social Media Use among Italian Young Adults. J Clin Med 2021; 11:jcm11010188. [PMID: 35011929 PMCID: PMC8745641 DOI: 10.3390/jcm11010188] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/23/2021] [Accepted: 12/28/2021] [Indexed: 12/12/2022] Open
Abstract
Internet addiction (IA) has mostly been investigated with the fear of missing out and difficulties in emotional regulation. The present study examined the link between IA and variables related to problematic social media use (i.e., fear of missing out, social media addiction), together with emotional (dys)regulation and personality traits, providing new insights and an integrated assessment of IA. In total, 397 participants, aged 18-35 years (M = 22.00; SD = 3.83), were administered a set of questionnaires pertaining to IA, problematic social media use, emotional (dys)regulation, and personality traits. Pearson's correlations showed significant associations between IA and the investigated variables, and the tested mediation model highlighted the crucial role played by emotional (dys)regulation in the fear of missing out and problematic use of social networks. Overall, the findings provide support for a new integrated model for understanding the features, predictors, and risk factors of IA.
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54
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Neural and Behavioral Correlates of Impaired Insight and Self-awareness in Substance Use Disorder. Curr Behav Neurosci Rep 2021; 8:113-123. [DOI: 10.1007/s40473-021-00240-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Reward Deficiency Syndrome (RDS): A Cytoarchitectural Common Neurobiological Trait of All Addictions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111529. [PMID: 34770047 PMCID: PMC8582845 DOI: 10.3390/ijerph182111529] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/09/2021] [Accepted: 09/10/2021] [Indexed: 02/07/2023]
Abstract
Alcohol and other substance use disorders share comorbidity with other RDS disorders, i.e., a reduction in dopamine signaling within the reward pathway. RDS is a term that connects addictive, obsessive, compulsive, and impulsive behavioral disorders. An estimated 2 million individuals in the United States have opioid use disorder related to prescription opioids. It is estimated that the overall cost of the illegal and legally prescribed opioid crisis exceeds one trillion dollars. Opioid Replacement Therapy is the most common treatment for addictions and other RDS disorders. Even after repeated relapses, patients are repeatedly prescribed the same opioid replacement treatments. A recent JAMA report indicates that non-opioid treatments fare better than chronic opioid treatments. Research demonstrates that over 50 percent of all suicides are related to alcohol or other drug use. In addition to effective fellowship programs and spirituality acceptance, nutrigenomic therapies (e.g., KB220Z) optimize gene expression, rebalance neurotransmitters, and restore neurotransmitter functional connectivity. KB220Z was shown to increase functional connectivity across specific brain regions involved in dopaminergic function. KB220/Z significantly reduces RDS behavioral disorders and relapse in human DUI offenders. Taking a Genetic Addiction Risk Severity (GARS) test combined with a the KB220Z semi-customized nutrigenomic supplement effectively restores dopamine homeostasis (WC 199).
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56
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Di Tella M, Clerico M, Castelli L. Associations between socioemotional alterations, quality of life, and social functioning in multiple sclerosis: A scoping review. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02387-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AbstractThe main aim of the present scoping review is to systematically review the available studies that investigated the associations between socioemotional alterations (i.e., social cognition impairments/alexithymia/difficulties in emotion regulation) and both reduced QoL and social functioning in patients with Multiple Sclerosis (MS). The articles were selected from the PubMed, PsycINFO, and Scopus databases. The main exclusion criteria were qualitative studies, articles that did not use validated instruments, and studies that did not investigate the association between socioemotional skills and QoL/social functioning in MS. Of the eight studies fulfilling the inclusion criteria, six found significant associations between social cognitive and emotion regulation abilities and QoL/social functioning in patients with MS, while two found no significant relationships particularly between the performance on social cognition tasks and QoL measures. Overall, the majority of findings seem to highlight that socioemotional alterations contribute to impaired QoL and social functioning in MS. However, given the still limited evidence, future studies are needed to replicate and confirm the available results, paying attention to two principal aspects: the use of standardized and ecological tasks for the assessment of social cognition skills and the recruitment of samples involving patients with different types of MS.
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Social perception and knowledge impairments in severe alcohol use disorder: Group and individual-level findings. Drug Alcohol Depend 2021; 227:109009. [PMID: 34482036 DOI: 10.1016/j.drugalcdep.2021.109009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/15/2021] [Accepted: 07/23/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Consistent data highlight the presence and clinical significance of social cognition impairments in severe alcohol use disorder (SAUD). However, social perception and knowledge (i.e., the ability to interpret social situations and to identify latent social rules), an important social cognition component, has not yet been explored in this disorder. METHOD 35 patients with SAUD and 35 healthy controls (HC) completed the Social Perception and Knowledge test (PerSo), an experimental task requiring participants to comprehensively describe social situations and to identify the social rules illustrated in 8 pictures. We performed group and single-case analyses. RESULTS Patients with SAUD, as a group, spontaneously identified less relevant "where"/"who"/"what" aspects of the social situations (social perception) than HC. They were however able to provide these elements when explicitly asked to. They were also less able to identify the social rules that subtended the situations (social knowledge). Single-case analyses revealed that 23 % of patients were significantly impaired for social perception, and 34 % for social knowledge. DISCUSSION We provide novel evidence that SAUD is associated with social perception and knowledge impairments at the group level, and that these impairments strongly vary across patients. Such results should lead to the integration of social perception and knowledge impairments in the conceptualization and treatment of socio-affective difficulties in SAUD.
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58
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Schmid F, Moreau F, Benzerouk F, Raucher-Chéné D, Kaladjian A, Gierski F, Henry A. Faux Pas Recognition and Executive Processes in Patients with Alcohol Use Disorder: Toward an Investigation of Interindividual Heterogeneity. Arch Clin Neuropsychol 2021; 37:608-620. [PMID: 34530445 DOI: 10.1093/arclin/acab072] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Impairment of executive functions (EF) has been documented for decades in patients with alcohol use disorders (AUD), while more recent studies have also reported impaired theory of mind. Both have been associated with negative outcomes, particularly a high risk of relapse. However, the interrelatedness of EF and theory of mind impairments remains subject to debate. METHOD About 19 AUD outpatients and 20 healthy controls (HC) were asked to complete measures of motor inhibition, mental flexibility, and updating to assess EF, and the faux pas test to assess theory of mind. RESULTS As expected, patients' mean performances on EF and faux pas measures were poorer than those of HC. Correlational analyses revealed that executive processes were differentially related to faux pas subscores. Additional single-case analyses corroborated the strong association between EF and faux pas interpretation, as patients with AUD mostly had congruent performances (i.e., both EF and faux pas impaired or both EF and faux pas preserved). CONCLUSIONS This study highlights the interrelatedness of EF and faux pas performances in AUD, but also emphasizes the incomplete overlap of the cognitive processes involved in these tasks, with heterogeneous patterns of association. Based on these findings, tailored cognitive rehabilitation programs that simultaneously target EF and faux pas recognition could be developed to favor patients' social inclusion and reduce the risk of relapse. Results also argue in favor of systematic screening for EF and theory of mind impairments among AUD patients.
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Affiliation(s)
- Franca Schmid
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé, Société (C2S), Reims, France
| | - Franklin Moreau
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé, Société (C2S), Reims, France
| | - Farid Benzerouk
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé, Société (C2S), Reims, France.,Psychiatry Department, Reims University Hospital, Marne Mental Health Institute, Reims, France
| | - Delphine Raucher-Chéné
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé, Société (C2S), Reims, France.,Psychiatry Department, Reims University Hospital, Marne Mental Health Institute, Reims, France.,Douglas Mental Health University Institute, McGill University, Montreal, Canada
| | - Arthur Kaladjian
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé, Société (C2S), Reims, France.,Psychiatry Department, Reims University Hospital, Marne Mental Health Institute, Reims, France
| | - Fabien Gierski
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé, Société (C2S), Reims, France.,Psychiatry Department, Reims University Hospital, Marne Mental Health Institute, Reims, France.,Research Group on Alcohol and Drug Dependence (GRAP), INSERM-University of Picardy Jules Verne, Amiens, France
| | - Audrey Henry
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé, Société (C2S), Reims, France.,Psychiatry Department, Reims University Hospital, Marne Mental Health Institute, Reims, France
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Higher-Order Language Dysfunctions in Individuals with Alcohol Use Disorder. J Clin Med 2021; 10:jcm10184199. [PMID: 34575309 PMCID: PMC8471652 DOI: 10.3390/jcm10184199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/09/2021] [Accepted: 09/13/2021] [Indexed: 11/20/2022] Open
Abstract
Patients with alcohol use disorders (AUD) have difficulties with certain aspects of higher-order language functions (HOLF) but there is no data on a wide range of these functions in this group. Therefore, the aim of this study was to compare different aspects of HOLF in patients with AUD and healthy controls (HC). A total of 31 patients with AUD and 44 HC took part in the study. We assessed HOLF with the Right Hemisphere Language Battery (RHLB) and measured control variables: depression using the Patient Health Questionnaire (PHQ) as well as the speed of processing and executive functions with the Color Trails Test (CTT). Patients with AUD had lower results on nine RHLB tests. Moreover, AUD patients had higher scores on PHQ and longer reaction times on CTT. The differences in most RHLB results remained significant after co-varying the control variables. Patients with AUD have difficulties with making inferences from the text, understanding the meaning of individual words, metaphorical content, and prosody, which may impede the comprehension and production of discourse in which linguistic elements must be integrated with non-verbal cues and contextual information. These disturbances may impact various spheres of everyday life and negatively influence social, private, and professional functioning.
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Gautier M, Pabst A, Maurage P. Social decision making in severe alcohol use disorder: Scoping review and experimental perspectives. Alcohol Clin Exp Res 2021; 45:1548-1559. [PMID: 34342010 DOI: 10.1111/acer.14664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/21/2021] [Accepted: 06/16/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Patients with severe alcohol use disorder (SAUD) demonstrate multifaceted impairments in social cognition abilities, including emotional decoding or Theory of Mind. Such impairments are associated with real-life interpersonal difficulties, which in turn could contribute to the persistence of SAUD. However, little is known regarding how patients with SAUD make decisions in a social context and this literature has not been comprehensively reviewed. OBJECTIVES The main aim of this paper was to conduct the first review specifically focusing on social decision-making abilities in SAUD. Following PRISMA guidelines for scoping reviews, we describe existing knowledge regarding the 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 We searched three online databases (PubMed, PsycINFO, and Scopus) and identified 14 papers using behavioral tasks to assess 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 and of the restricted set of processes measured, we call for the extension of this field through more ecologically relevant and model-based paradigms in order to elucidate the underlying mechanisms of these effects.
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Affiliation(s)
- Mado Gautier
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Science Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
| | - Arthur Pabst
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Science Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
| | - Pierre Maurage
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Science Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
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Yang J, Kim S. Factors Affecting Alcohol Abstinence Intentions of Inpatients With Alcohol Use Disorder. J Psychosoc Nurs Ment Health Serv 2021; 59:23-32. [PMID: 34432593 DOI: 10.3928/02793695-20210819-05] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The current study investigated the effects of modifiable factors-alcohol abstinence self-efficacy, negative emotions, communication skills, and self-reflection-on alcohol abstinence intentions of 139 inpatients in South Korean psychiatric hospitals. Correlations between alcohol abstinence intentions and each factor were analyzed, and a hierarchical multiple regression was used to assess the relationship between alcohol abstinence intentions and general characteristics. Alcohol abstinence intentions were statistically significant among inpatients with a spouse (p = 0.018), higher education (p = 0.031), employment (p = 0.009), younger age (p < 0.001), and fewer admissions from alcohol use disorder (AUD) (p < 0.001). In addition, communication skills (p < 0.001) and self-reflection (p < 0.001) were predictors of alcohol abstinence intentions. Results confirm communication skills and self-reflection are modifiable factors that significantly contribute to increasing alcohol abstinence intentions among inpatients with AUD. Providing interventions that improve communication skills and self-reflection would help maintain alcohol abstinence and prevent relapse. [Journal of Psychosocial Nursing and Mental Health Services, 59(12), 23-32.].
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Zak PJ, Hayes K, Paulson E, Stringham E. Alcohol unleashes homo economicus by inhibiting cooperation. PLoS One 2021; 16:e0253296. [PMID: 34157027 PMCID: PMC8219160 DOI: 10.1371/journal.pone.0253296] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 06/01/2021] [Indexed: 01/07/2023] Open
Abstract
Human behavior lies somewhere between purely self-interested homo economicus and socially-motivated homo reciprocans. The factors that cause people to choose self-interest over costly cooperation can provide insights into human nature and are essential when designing institutions and policies that are meant to influence behavior. Alcohol consumption can shed light on the inflection point between selfish and selfless because it is commonly consumed and has global effects on the brain. The present study administered alcohol or placebo (N = 128), titrated to sex and weight, to examine its effect on cooperation in a standard task in experimental economics, the public goods game (PGG). Alcohol, compared to placebo, doubled the number of free-riders who contributed nothing to the public good and reduced average PGG contributions by 32% (p = .005). This generated 64% higher average profits in the PGG for those who consumed alcohol. The degree of intoxication, measured by blood alcohol concentration, linearly reduced PGG contributions (r = -0.18, p = .05). The reduction in cooperation was traced to a deterioration in mood and an increase in physiologic stress as measured by adrenocorticotropic hormone. Our findings indicate that moderate alcohol consumption inhibits the motivation to cooperate and that homo economicus is stressed and unhappy.
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Affiliation(s)
- Paul J. Zak
- Center for Neuroeconomics Studies, Claremont Graduate University, Claremont, CA, United States of America
| | - Kylene Hayes
- Center for Neuroeconomics Studies, Claremont Graduate University, Claremont, CA, United States of America
| | - Elizabeth Paulson
- Center for Neuroeconomics Studies, Claremont Graduate University, Claremont, CA, United States of America
| | - Edward Stringham
- Department of Economics, Trinity College, Hartford, CT, United States of America
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Hien DA, López-Castro T, Fitzpatrick S, Ruglass LM, Fertuck EA, Melara R. A unifying translational framework to advance treatment research for comorbid PTSD and substance use disorders. Neurosci Biobehav Rev 2021; 127:779-794. [PMID: 34062208 DOI: 10.1016/j.neubiorev.2021.05.022] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 05/13/2021] [Accepted: 05/20/2021] [Indexed: 11/20/2022]
Abstract
We provide a unifying translational framework that can be used to synthesize extant lines of human laboratory research in four neurofunctional domains that underlie the co-occurrence of posttraumatic stress and substance use disorders (PTSD+SUD). We draw upon the Alcohol and Addiction Research Domain Criteria (AARDOC) to include executive functioning, negative emotionality, reward, and added social cognition from the National Institute of Mental Health (NIMH) Research Domain Criteria into our framework. We review research findings across each of the four domains, emphasizing human experimental studies in PTSD, SUD, and PTSD+SUD for each domain. We also discuss the implications of research findings for treatment development by considering new ways of conceptualizing risk factors and outcomes at the level of the individual patient, which will enhance treatment matching and advance innovations in intervention.
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Affiliation(s)
- Denise A Hien
- Center of Alcohol & Substance Use Studies, Graduate School of Applied and Professional Psychology, Rutgers University-New Brunswick, Piscataway, New Jersey, United States.
| | - Teresa López-Castro
- Psychology Department, The City College of New York, New York, NY, United States
| | | | - Lesia M Ruglass
- Center of Alcohol & Substance Use Studies, Graduate School of Applied and Professional Psychology, Rutgers University-New Brunswick, Piscataway, New Jersey, United States; Psychology Department, The City College of New York, New York, NY, United States
| | - Eric A Fertuck
- Psychology Department, The City College of New York, New York, NY, United States
| | - Robert Melara
- Psychology Department, The City College of New York, New York, NY, United States
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A biological framework for emotional dysregulation in alcohol misuse: from gut to brain. Mol Psychiatry 2021; 26:1098-1118. [PMID: 33288871 DOI: 10.1038/s41380-020-00970-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 10/21/2020] [Accepted: 11/20/2020] [Indexed: 02/08/2023]
Abstract
Alcohol use disorder (AUD) has been associated with impairments in social and emotional cognition that play a crucial role in the development and maintenance of addiction. Repeated alcohol intoxications trigger inflammatory processes and sensitise the immune system. In addition, emerging data point to perturbations in the gut microbiome as a key regulator of the inflammatory cascade in AUD. Inflammation and social cognition are potent modulators of one another. At the same time, accumulating evidence implicates the gut microbiome in shaping emotional and social cognition, suggesting the possibility of a common underlying loop of crucial importance for addiction. Here we propose an integrative microbiome neuro-immuno-affective framework of how emotional dysregulation and alcohol-related microbiome dysbiosis could accelerate the cycle of addiction. We outline the overlapping effects of chronic alcohol use, inflammation and microbiome alterations on the fronto-limbic circuitry as a convergence hub for emotional dysregulation. We discuss the interdependent relationship of social cognition, immunity and the microbiome in relation to alcohol misuse- from binge drinking to addiction. In addition, we emphasise adolescence as a sensitive period for the confluence of alcohol harmful effects and emotional dysregulation in the developing gut-brain axis.
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Lewis B, Price JL, Garcia CC, Ebner NC, Nixon SJ. The impact of emotional face stimuli on working memory performance among men and women with alcohol use disorder. Addict Behav 2021; 114:106731. [PMID: 33218841 PMCID: PMC8406622 DOI: 10.1016/j.addbeh.2020.106731] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 10/05/2020] [Accepted: 11/03/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Individuals with alcohol use disorder (AUD) often display compromise in emotional processing and non-affective neurocognitive functions. However, relatively little empirical work explores their intersection. In this study, we examined working memory performance when attending to and ignoring facial stimuli among adults with and without AUD. We anticipated poorer performance in the AUD group, particularly when task demands involved ignoring facial stimuli. Whether this relationship was moderated by facial emotion or participant sex were explored as empirical questions. METHODS Fifty-six controls (30 women) and 56 treatment-seekers with AUD (14 women) completed task conditions in which performance was advantaged by either attending to or ignoring facial stimuli, including happy, neutral, or fearful faces. Group, sex, and their interaction were independent factors in all models. Efficiency (accuracy/response time) was the primary outcome of interest. RESULTS An interaction between group and condition (F1,107 = 6.03, p < .02) was detected. Individual comparisons suggested this interaction was driven by AUD-associated performance deficits when ignoring faces, whereas performance was equivalent between groups when faces were attended. Secondary analyses suggested little influence of specific facial emotions on these effects. CONCLUSIONS These data provide partial support for initial hypotheses, with the AUD group demonstrating poorer working memory performance conditioned on the inability to ignore irrelevant emotional face stimuli. The absence of group differences when scenes were to be ignored (faces remembered) suggests the AUD-associated inability to ignore irrelevance is influenced by specific stimulus qualities.
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Affiliation(s)
- Ben Lewis
- University of Florida, Department of Psychiatry, Gainesville, FL, United States; University of Florida, Department of Psychology, Gainesville, FL, United States; University of Florida, Center for Addiction Research & Education, Gainesville, FL, United States.
| | - Julianne L Price
- University of Florida, Department of Psychiatry, Gainesville, FL, United States; University of Florida, Department of Psychology, Gainesville, FL, United States; University of Florida, Center for Addiction Research & Education, Gainesville, FL, United States
| | - Christian C Garcia
- University of Florida, Department of Psychiatry, Gainesville, FL, United States; University of Florida, Department of Psychology, Gainesville, FL, United States; University of Florida, Center for Addiction Research & Education, Gainesville, FL, United States
| | - Natalie C Ebner
- University of Florida, Department of Psychology, Gainesville, FL, United States; University of Florida, Department of Aging and Geriatric Research, Institute on Aging, Gainesville, FL, United States; University of Florida, Center for Cognitive Aging and Memory, Gainesville, FL, United States
| | - Sara Jo Nixon
- University of Florida, Department of Psychiatry, Gainesville, FL, United States; University of Florida, Department of Psychology, Gainesville, FL, United States; University of Florida, Center for Addiction Research & Education, Gainesville, FL, United States
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66
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Lannoy S, Duka T, Carbia C, Billieux J, Fontesse S, Dormal V, Gierski F, López-Caneda E, Sullivan EV, Maurage P. Emotional processes in binge drinking: A systematic review and perspective. Clin Psychol Rev 2021; 84:101971. [PMID: 33497920 PMCID: PMC8275688 DOI: 10.1016/j.cpr.2021.101971] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 12/10/2020] [Accepted: 01/08/2021] [Indexed: 12/24/2022]
Abstract
Binge drinking is a widespread alcohol consumption pattern commonly engaged by youth. Here, we present the first systematic review of emotional processes in relation to binge drinking. Capitalizing on a theoretical model describing three emotional processing steps (emotional appraisal/identification, emotional response, emotional regulation) and following PRISMA guidelines, we considered all identified human studies exploring emotional abilities among binge drinkers. A literature search was conducted in PubMed, Scopus, and PsychINFO, and a standardized methodological quality assessment was performed for each study. The main findings offered by the 43 studies included are: 1) regarding emotional appraisal/identification, binge drinking is related to heightened negative emotional states, including greater severity of depressive and anxiety symptoms, and have difficulties in recognizing emotional cues expressed by others; 2) regarding emotional response, binge drinkers exhibit diminished emotional response compared with non-binge drinkers; 3) regarding emotional regulation, no experimental data currently support impaired emotion regulation in binge drinking. Variability in the identification and measurement of binge drinking habits across studies limits conclusions. Nevertheless, current findings establish the relevance of emotional processes in binge drinking and set the stage for new research perspectives to identify the nature and extent of emotional impairments in the onset and maintenance of excessive alcohol use.
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Affiliation(s)
- Séverine Lannoy
- Stanford University, Department of Psychiatry and Behavioral Sciences, Stanford, California, USA; Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium.
| | - Theodora Duka
- Behavioral and Clinical Neuroscience, School of Psychology, University of Sussex, Brighton, UK; Sussex Addiction and Intervention Centre, University of Sussex, Brighton, UK
| | - Carina Carbia
- APC Microbiome Ireland, Biosciences Building, University College Cork, Cork, Ireland
| | - Joël Billieux
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
| | - Sullivan Fontesse
- Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
| | - Valérie Dormal
- Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
| | - Fabien Gierski
- Cognition Health and Society Laboratory (EA 6291), Université de Reims Champagne-Ardenne, Reims, France; Psychiatry and Addictology Departments, CHU de Reims & EPSM Marne, Reims, France
| | - Eduardo López-Caneda
- Psychological Neuroscience Laboratory, Research Center in Psychology (CIPsi), School of Psychology, University of Minho, Campus, Gualtar, Braga, Portugal
| | - Edith V Sullivan
- Stanford University, Department of Psychiatry and Behavioral Sciences, Stanford, California, USA
| | - Pierre Maurage
- Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium.
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Lannoy S, Dricot L, Benzerouk F, Portefaix C, Barrière S, Quaglino V, Naassila M, Kaladjian A, Gierski F. Neural Responses to the Implicit Processing of Emotional Facial Expressions in Binge Drinking. Alcohol Alcohol 2021; 56:166-174. [PMID: 33075804 DOI: 10.1093/alcalc/agaa093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 09/01/2020] [Accepted: 09/01/2020] [Indexed: 01/06/2023] Open
Abstract
AIMS Emotional processing is a crucial ability in human and impairments in the processing of emotions are considered as transdiagnostic processes in psychopathology. In alcohol use disorder, numerous studies have investigated emotional processing and showed emotional deficits related to the perpetuation of alcohol use. Recent studies have also explored this topic in binge drinking, but few studies are available. In this paper, we explored whether emotional difficulties in binge drinking may be extended to implicit emotion processing. METHODS We compared 39 binge drinkers (BD) and 40 non-binge drinkers who performed a gender categorization task while faces represented emotional expressions of anger, fear, happiness and sadness. Emotional brain responses were assessed thanks to functional magnetic resonance imaging. Emotional versus non-emotional conditions were first contrasted in the whole sample and groups were then compared. RESULTS Emotional condition led to differential activations than non-emotional condition, supporting the validity of the paradigm. Regarding group comparisons, BD exhibited higher activations in the left posterior cerebellum (anger processing) and the right anterior cingulate (fear processing) as well as lower activations in the left insula (happiness), the right post-central gyrus, the right cingulate gyrus and the right medial frontal gyrus (sadness processing). CONCLUSIONS Beyond emotional identification, BD presented differential brain responses following the implicit processing of emotions. Emotional difficulties in binge drinking might be related to a more automatic/unconscious processing of emotions.
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Affiliation(s)
- Séverine Lannoy
- Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA 94305, USA.,Louvain Experimental Psychopathology (LEP), Psychological Science Research Institute, Université catholique de Louvain, 10 Place Cardinal Mercier, 1348 Louvain-la-Neuve, Belgium.,Cognition Health and Society Laboratory (EA 6291), Université de Reims Champagne-Ardenne, 57 rue Pierre Taittinger, 51571 Reims, France
| | - Laurence Dricot
- Institute of Neuroscience, Université Catholique de Louvain, 81 Avenue E Mounier, 1200 Brussels, Belgium
| | - Farid Benzerouk
- Cognition Health and Society Laboratory (EA 6291), Université de Reims Champagne-Ardenne, 57 rue Pierre Taittinger, 51571 Reims, France.,Department of Psychiatry, CHU Reims, EPSM Marne, 8 rue Roger Aubry, 51100 Reims, France
| | - Christophe Portefaix
- Department of Medical Imaging, Maison Blanche Hospital, Reims University Hospital, 45 Avenue Cognacq Jay, 51100 Reims, France.,CReSTIC Laboratory (EA 3804), University of Reims Champagne-Ardenne, Campus Moulin de la Housse, Chemin des Rouliers, 51680 Reims, France
| | - Sarah Barrière
- Department of Psychiatry, CHU Reims, EPSM Marne, 8 rue Roger Aubry, 51100 Reims, France
| | - Véronique Quaglino
- Laboratoire CRP-CPO (EA 7273), Université de Picardie Jules Verne, Chemin du Thil, 80025 Amiens, France
| | - Mickaël Naassila
- INSERM U1247 GRAP, Research Group on Alcohol and Drugs, Université de Picardie Jules Verne, Avenue Laennec, 80054 Amiens, France
| | - Arthur Kaladjian
- Cognition Health and Society Laboratory (EA 6291), Université de Reims Champagne-Ardenne, 57 rue Pierre Taittinger, 51571 Reims, France.,Department of Psychiatry, CHU Reims, EPSM Marne, 8 rue Roger Aubry, 51100 Reims, France
| | - Fabien Gierski
- Cognition Health and Society Laboratory (EA 6291), Université de Reims Champagne-Ardenne, 57 rue Pierre Taittinger, 51571 Reims, France.,Department of Psychiatry, CHU Reims, EPSM Marne, 8 rue Roger Aubry, 51100 Reims, France.,INSERM U1247 GRAP, Research Group on Alcohol and Drugs, Université de Picardie Jules Verne, Avenue Laennec, 80054 Amiens, France
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Rupp CI, Junker D, Kemmler G, Mangweth-Matzek B, Derntl B. Do Social Cognition Deficits Recover with Abstinence in Alcohol-Dependent Patients? Alcohol Clin Exp Res 2021; 45:470-479. [PMID: 33523497 PMCID: PMC7986754 DOI: 10.1111/acer.14537] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 12/15/2020] [Indexed: 12/19/2022]
Abstract
Background Despite growing evidence of the presence and clinical relevance of deficits in social cognition in individuals with alcohol use disorder (AUD), less is known about the potential of “natural” recovery with abstinence in this neurocognitive domain. This study investigated the abstinence‐based recovery of neurocognitive social abilities in alcohol‐dependent patients (ADP) using a prospective longitudinal design with follow‐up assessment under controlled conditions of abstinence during alcohol dependence inpatient treatment. Methods Seventy‐seven participants (42 ADP and 35 healthy controls [HC]) performed social cognition testing, including facial emotion recognition, perspective taking, and affective responsiveness twice (baseline/T1 and follow‐up/T2) during comparable follow‐up periods. Assessment of social cognition in abstinent ADP was conducted at the beginning (T1; within the first 2 weeks) and at the end (T2; within the last 2 weeks) of long‐term (2 months) abstinence‐oriented alcohol dependence inpatient treatment. Only patients abstinent for >14 days (last heavy drinking day >21 days) at baseline (T1) and who remained abstinent at follow‐up (T2) were included. Results ADP, who on average were nearly 2 months abstinent at T1, showed poorer social cognition in all 3 areas (emotion recognition, perspective taking, and affective responsiveness) than HC. There was no difference between groups on the change in performance over time, and group differences (ADP vs. HC) remained significant at T2, indicating persistent social cognition deficits in ADP following controlled abstinence during inpatient treatment. Conclusions Our findings indicate no natural recovery of social cognition impairments in ADP during an intermediate to long‐term period of abstinence (2+ months), the usual active treatment phase. Research aimed at developing interventions that focus on the improvement of social cognition deficits (e.g., social cognition training) and determining whether they benefit short‐ and long‐term clinical outcomes in AUD seems warranted.
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Affiliation(s)
- Claudia I Rupp
- Division of Psychiatry I, Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - David Junker
- Division of Psychiatry I, Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - Georg Kemmler
- Division of Psychiatry I, Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - Barbara Mangweth-Matzek
- Division of Psychiatry II, Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, Medical University Tübingen, Tübingen, Germany.,LEAD Graduate School and Research Network, University of Tübingen, Tübingen, Germany
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Cabé N, Lanièpce A, Pitel AL. Physical activity: A promising adjunctive treatment for severe alcohol use disorder. Addict Behav 2021; 113:106667. [PMID: 33074123 DOI: 10.1016/j.addbeh.2020.106667] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 09/16/2020] [Accepted: 09/17/2020] [Indexed: 11/16/2022]
Abstract
Substance use disorder develops from complex interactions between socio-environmental and neurobiological factors. A neurocognitive model of addiction, the triadic model, proposes that Alcohol Use Disorder (AUD) is the result of an imbalance between the reflective and the impulsive subcomponents along with a disruption of the regulatory subcomponent. Physical activity is considered as an emerging treatment for severe AUD (sAUD). This short review examines the efficacy and mechanisms of action of physical intervention as an adjunctive treatment in severe AUD (sAUD) within the theoretical framework of the triadic model. Physical activity is a feasible, safe, and less stigmatizing approach than classical treatments. It improves sAUD patients' mental and physical comorbidities. The key finding of this short review is that physical activity could contribute to a rebalancing of the triadic model in sAUD patients by 1) improving neuroplasticity and cognitive functioning, 2) reducing impulsivity and urgency, and improving emotional regulation, and 3) reducing craving. This rebalancing could eventually reduce the risk of relapse. However, due to methodological issues, it remains difficult to observe an effect of physical activity on drinking outcomes. At best, a trend towards a reduction in alcohol consumption was noted. The mechanisms that could explain the benefits of physical activity in sAUD patients involve multiple physiological processes such as dopaminergic or glutamatergic transmission and signaling or neuroplasticity. Future randomized controlled trials should include neuropsychological and impulsivity assessments, in more controlled environments. Physical activity could contribute to a personalization of sAUD treatment using each subcomponent of the triadic model as a therapeutic target. Physical exercise could be an adjunctive treatment for sAUD patients, favoring the benefit of more usual treatments such as cognitive behavioral therapies. It could also be a stand-alone intervention in less severe patients.
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Affiliation(s)
- Nicolas Cabé
- Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000 Caen, France; Service d'Addictologie, Centre Hospitalier Universitaire de Caen, 14000 Caen, France
| | - Alice Lanièpce
- Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000 Caen, France
| | - Anne Lise Pitel
- Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000 Caen, France; Institut Universitaire de France (IUF), France.
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70
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Laniepce A, Lahbairi N, Cabé N, Pitel AL, Rauchs G. Contribution of sleep disturbances to the heterogeneity of cognitive and brain alterations in alcohol use disorder. Sleep Med Rev 2021; 58:101435. [PMID: 33578081 DOI: 10.1016/j.smrv.2021.101435] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/22/2020] [Accepted: 10/27/2020] [Indexed: 12/28/2022]
Abstract
Cognitive and brain alterations are common in alcohol use disorder and vary importantly from one patient to another. Sleep disturbances are also very frequent in these patients and remain largely neglected even though they can persist after drinking cessation. Sleep disturbances may be the consequence of specific brain alterations, resulting in cognitive impairments. But sleep disruption may also exacerbate alcohol-related brain abnormalities and cognitive deficits through common pathophysiological mechanisms. Besides, sleep disturbances seem a vulnerability factor for the development of alcohol use disorder. From a clinical perspective, sleep disturbances are known to affect treatment outcome and to increase the risk of relapse. In this article, we conducted a narrative review to provide a better understanding of the relationships between sleep disturbances, brain and cognition in alcohol use disorder. We suggest that the heterogeneity of brain and cognitive alterations observed in patients with alcohol use disorder could at least partially be explained by associated sleep disturbances. We also believe that sleep disruption could indirectly favor relapse by exacerbating neuropsychological impairments required in psychosocial treatment and for the maintenance of abstinence. Implications for clinical practice as well as perspectives for future research are proposed.
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Affiliation(s)
- Alice Laniepce
- Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000 Caen, France
| | - Najlaa Lahbairi
- Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000 Caen, France
| | - Nicolas Cabé
- Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000 Caen, France; Service d'Addictologie, Centre Hospitalier Universitaire de Caen, 14000 Caen, France
| | - Anne-Lise Pitel
- Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000 Caen, France; Institut Universitaire de France (IUF), France
| | - Géraldine Rauchs
- Normandie Univ, UNICAEN, PSL Université de Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000 Caen, France.
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Maurage P, Pabst A, Lannoy S, D'Hondt F, de Timary P, Gaudelus B, Peyroux E. Tackling heterogeneity: Individual variability of emotion decoding deficits in severe alcohol use disorder. J Affect Disord 2021; 279:299-307. [PMID: 33096328 PMCID: PMC7738413 DOI: 10.1016/j.jad.2020.10.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 09/02/2020] [Accepted: 10/11/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Severe alcohol use disorder (SAUD) is associated with social cognition deficits. Patients with SAUD are impaired for the recognition of emotional facial expressions, particularly at early stages of abstinence. These deficits damage interpersonal relations and increase relapse risk. However, uncertainties still abound on their variation across emotions and on the heterogeneity of emotional impairments across patients. We addressed these questions by exploring how the deficit varies according to emotions' type/intensity and patients' heterogeneity. METHODS Sixty-five recently detoxified patients with SAUD and 65 matched healthy controls performed the Facial Emotion Recognition Test, assessing the ability to identify six emotions (anger, contempt, disgust, fear, happiness, sadness) displayed by morphed faces with various intensities. Accuracy scores and detection thresholds were collected for each emotion. Beyond group comparisons, multiple single-case analyses determined the percentage of patients presenting decoding deficits for each emotion. RESULTS When current depression and anxiety symptoms were controlled for, patients did not present a general emotion decoding deficit, but were rather characterized by specific deficits for disgust/contempt in accuracy, and for disgust in detection threshold scores. Single-case analyses showed that only a third of patients presented a clinically significant emotional deficit. CONCLUSIONS Patients with SAUD only present emotional decoding deficits for specific interpersonal emotions (disgust/contempt) when subclinical psychopathological states are controlled for, and show no general emotional impairment. This goes against the proposal of a generalized social cognition deficit in this population. This group effect moreover masks a massive heterogeneity across patients, which has implications at experimental and clinical levels.
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Affiliation(s)
- Pierre Maurage
- Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium.
| | - Arthur Pabst
- Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
| | - Séverine Lannoy
- Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium; Stanford University, Department of Psychiatry and Behavioral Sciences, Stanford, CA, USA
| | - Fabien D'Hondt
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France; CHU Lille, Clinique de Psychiatrie, CURE, Lille, France; Centre National de Ressources et de Résilience Lille-Paris (CN2R), Lille, France
| | - Philippe de Timary
- Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium; Department of Adult Psychiatry, Saint-Luc Academic Hospital & Institute of Neuroscience, UCLouvain, Brussels, Belgium
| | - Baptiste Gaudelus
- Centre de Neurosciences Cognitives, UMR 5229, CNRS, Bron, France; Service Universitaire de Réhabilitation, SUR-CL3R, Centre Hospitalier Le Vinatier, Lyon, France
| | - Elodie Peyroux
- Centre de Neurosciences Cognitives, UMR 5229, CNRS, Bron, France; Service Universitaire de Réhabilitation, SUR-CL3R, Centre Hospitalier Le Vinatier, Lyon, France
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Disorders of vocal emotional expression and comprehension: The aprosodias. HANDBOOK OF CLINICAL NEUROLOGY 2021; 183:63-98. [PMID: 34389126 DOI: 10.1016/b978-0-12-822290-4.00005-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Abstract
Alcohol use disorder (AUD) commonly is associated with compromise in neurobiological and/or neurobehavioral processes. The severity of this compromise varies across individuals and outcomes, as does the degree to which recovery of function is achieved. This narrative review first summarizes neurobehavioral, neurophysiological, structural, and neurochemical aberrations/deficits that are frequently observed in people with AUD after detoxification. Subsequent sections review improvements across these domains during recovery, taking into account modulators of recovery to the extent permitted. Where appropriate, the discussion includes work integrating outcomes across domains, leveraging the strengths of diverse experimental methods. Interventions to ameliorate neurobiological or neurobehavioral deficits do not constitute a primary objective of this review. However, their consideration is a logical inclusion. Therefore, a limited introduction to existing methods is also presented.
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Affiliation(s)
- Sara Jo Nixon
- Department of Psychiatry, University of Florida, Gainesville, Florida.,Center for Addiction Research & Education, University of Florida, Gainesville, Florida
| | - Ben Lewis
- Department of Psychiatry, University of Florida, Gainesville, Florida.,Center for Addiction Research & Education, University of Florida, Gainesville, Florida
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74
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Affiliation(s)
- Edith V. Sullivan
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, Calif
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Maurage P, Bollen Z, Masson N, D'Hondt F. Eye Tracking Studies Exploring Cognitive and Affective Processes among Alcohol Drinkers: a Systematic Review and Perspectives. Neuropsychol Rev 2020; 31:167-201. [PMID: 33099714 DOI: 10.1007/s11065-020-09458-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 09/23/2020] [Indexed: 11/28/2022]
Abstract
Acute alcohol intoxication and alcohol use disorders are characterized by a wide range of psychological and cerebral impairments, which have been widely explored using neuropsychological and neuroscientific techniques. Eye tracking has recently emerged as an innovative tool to renew this exploration, as eye movements offer complementary information on the processes underlying perceptive, attentional, memory or executive abilities. Building on this, the present systematic and critical literature review provides a comprehensive overview of eye tracking studies exploring cognitive and affective processes among alcohol drinkers. Using PRISMA guidelines, 36 papers that measured eye movements among alcohol drinkers were extracted from three databases (PsycINFO, PubMed, Scopus). They were assessed for methodological quality using a standardized procedure, and categorized based on the main cognitive function measured, namely perceptive abilities, attentional bias, executive function, emotion and prevention/intervention. Eye tracking indexes showed that alcohol-related disorders are related to: (1) a stable pattern of basic eye movement impairments, particularly during alcohol intoxication; (2) a robust attentional bias, indexed by increased dwell times for alcohol-related stimuli; (3) a reduced inhibitory control on saccadic movements; (4) an increased pupillary reactivity to visual stimuli, regardless of their emotional content; (5) a limited visual attention to prevention messages. Perspectives for future research are proposed, notably encouraging the exploration of eye movements in severe alcohol use disorders and the establishment of methodological gold standards for eye tracking measures in this field.
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Affiliation(s)
- Pierre Maurage
- Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium.
| | - Zoé Bollen
- Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
| | - Nicolas Masson
- Numerical Cognition Group, Psychological Sciences Research Institute and Neuroscience Institute, UCLouvain, Louvain-la-Neuve, Belgium.,Institute of Cognitive Science and Assessment (COSA), Department of Behavioural and Cognitive Sciences (DBCS), Faculty of Humanities, Education and Social Sciences (FHSE), University of Luxembourg, Luxembourg, Luxembourg
| | - Fabien D'Hondt
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Université de Lille, Lille, France.,Centre National de Ressources et de Résilience (CN2R), Lille, France
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Pabst A, Peyroux E, Rolland B, de Timary P, Maurage P. Hostile attributional bias in severe alcohol use disorder. J Psychiatr Res 2020; 129:176-180. [PMID: 32755750 DOI: 10.1016/j.jpsychires.2020.06.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/20/2020] [Accepted: 06/30/2020] [Indexed: 11/16/2022]
Abstract
Impairments in social cognition have been documented in severe alcohol use disorder (SAUD) over the past two decades. They have been linked with lower social functioning and poor treatment outcomes, illustrating their key role in the disorder. However, studies investigating social cognition in SAUD have largely focused on emotional decoding and theory of mind abilities, neglecting other important processes. We expand this line of research by exploring the association between SAUD and hostile attributional biases (i.e., the tendency to attribute hostile intentions to others), another clinically relevant subcomponent of social cognition. Thirty-five patients with SAUD and thirty-five matched healthy controls completed the short version of the Ambiguous Intentions Hostility Questionnaire, a validated measure assessing participants' perceived hostility, blame attribution and aggression in relation to vignettes depicting social situations with negative outcomes and ambiguous intent. Patients with SAUD attributed more hostile intentions to others than did healthy controls. Moreover, this hostile attributional bias was associated with increased interpersonal problems in SAUD, as measured through the Inventory of Interpersonal Problems. We thus evidence hostile attributional bias in SAUD and extend the growing literature on social cognition impairments in this population. Furthermore, these findings corroborate the recent proposal that patients with SAUD exhibit biases toward socially threatening information. The association between hostile attributional bias and interpersonal problems suggests that targeting this bias in treatment may reduce the relapse risk resulting from interpersonal deficits. Recommendations are made to further explore the clinical relevance of hostile attributional bias in SAUD.
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Affiliation(s)
- Arthur Pabst
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
| | - Elodie Peyroux
- Centre de Neurosciences Cognitives, UMR 5229, CNRS, Bron, France, & Service Universitaire de Réhabilitation, SUR-CL3R, Centre Hospitalier Le Vinatier, Bron, France
| | - Benjamin Rolland
- Service Universitaire d'Addictologie de Lyon (SUAL), Université de Lyon, Centre Hospitalier Le Vinatier, Bron, France
| | - Philippe de Timary
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium; Department of Adult Psychiatry, Saint-Luc Academic Hospital & Institute of Neuroscience, UCLouvain, Brussels, Belgium
| | - Pierre Maurage
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium.
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Fama R, Le Berre AP, Sullivan EV. Alcohol's Unique Effects on Cognition in Women: A 2020 (Re)view to Envision Future Research and Treatment. Alcohol Res 2020; 40:03. [PMID: 32923307 PMCID: PMC7473713 DOI: 10.35946/arcr.v40.2.03] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Alcohol use and misuse is increasing among women. Although the prevalence of drinking remains higher in men than women, the gender gap is narrowing. This narrative review focuses on the cognitive sequelae of alcohol consumption in women. Studies of acute alcohol effects on cognition indicate that women typically perform worse than men on tasks requiring divided attention, memory, and decision-making. Beneficial effects of moderate alcohol consumption on cognition have been reported; however, a number of studies have cautioned that other factors may be driving that association. Although chronic heavy drinking affects working memory, visuospatial abilities, balance, emotional processing, and social cognition in women and men, sex differences mark the severity and specific profile of functional deficits. The accelerated or compressed progression of alcohol-related problems and their consequences observed in women relative to men, referred to as "telescoping," highlights sex differences in the pharmacokinetics, pharmacodynamics, cognitive, and psychological consequences of alcohol. Brain volume deficits affecting multiple systems, including frontolimbic and frontocerebellar networks, contribute to impairment. Taken together, sex-related differences highlight the complexity of this chronic disease in women and underscore the relevance of examining the roles of age, drinking patterns, duration of abstinence, medical history, and psychiatric comorbidities in defining and understanding alcohol-related cognitive impairment.
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Affiliation(s)
- Rosemary Fama
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
- Neuroscience Program, SRI International, Menlo Park, California
| | - Anne-Pascale Le Berre
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
| | - Edith V Sullivan
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
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Pabst A, Heeren A, Maurage P. Socio-affective processing biases in severe alcohol use disorders: Experimental and therapeutic perspectives. Addict Behav 2020; 106:106382. [PMID: 32171955 DOI: 10.1016/j.addbeh.2020.106382] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 02/11/2020] [Accepted: 03/02/2020] [Indexed: 12/26/2022]
Abstract
Previous literature has consistently reported socio-affective information processing impairments in patients with severe alcohol use disorder (SAUD). Some recent studies have also suggested that these patients might exhibit biases toward stimuli indicating social threat, such as angry or disgusted faces. Such biases have been largely documented in other psychopathological disorders like anxiety, where they play a critical role in the emergence and maintenance of the disorder. A comprehensive understanding of these biases in SAUD would thus deepen the understanding of interpersonal difficulties and relapse-related factors. However, to date, no study has directly explored these biases in SAUD. In order to initiate efforts to address this issue, we first review preliminary evidence supporting the hypothesis of biased processing of social threat in SAUD. Then, we identify possible pathways through which such biases might negatively impact the course of the disorder. Finally, we provide precise recommendations and available materials to develop research in this promising field, and underline the related theoretical and clinical perspectives.
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Affiliation(s)
- Arthur Pabst
- Louvain Experimental Psychopathology Research Group, Psychological Sciences Research Institute, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Alexandre Heeren
- Louvain Experimental Psychopathology Research Group, Psychological Sciences Research Institute, Université Catholique de Louvain, Louvain-la-Neuve, Belgium; Clinical Neuroscience Division, Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - Pierre Maurage
- Louvain Experimental Psychopathology Research Group, Psychological Sciences Research Institute, Université Catholique de Louvain, Louvain-la-Neuve, Belgium; Clinical Neuroscience Division, Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium.
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79
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Lewis B, Garcia CC, Bohan R, Nixon SJ. Impact of polysubstance use on social and non-affective cognitive performance among treatment-seeking individuals with alcohol use disorders. Addict Behav 2020; 106:106359. [PMID: 32109774 DOI: 10.1016/j.addbeh.2020.106359] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 01/22/2020] [Accepted: 02/17/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND Individuals with alcohol use disorder (AUD) display deficits across a range of cognitive processes. Decrements in social cognition may be particularly important for interpersonal functioning and post-treatment adaptation. Although social cognitive deficits are associated with chronic use of numerous substances, the role of polysubstance use in AUD-associated deficits remains largely unaddressed. METHODS Community volunteers (n = 49; 22 men) and inpatient treatment-seekers with AUD were administered neurocognitive tasks indexing emotion processing and non-affective cognitive functioning. Tasks included an emotion discrimination task, a working memory task with affective stimuli, a general face processing (control) task, two measures of executive function, and two measures of visual spatial function. AUD subgroups included individuals with no recent (6-month) polysubstance use (AUD-Only; n = 22; 15 men), and those with at least weekly use (Poly-SU; n = 22; 18 men). RESULTS Poly-SU individuals evinced disadvantaged performance relative to other groups on the emotion discrimination task [ps ≤ 0.001], affective working memory task [ps ≤ 0.050], and two executive function measures [ps ≤ 0.051]. No differences were observed for visual spatial functioning [ps ≥ 0.498] or general face processing [ps ≥ 0.190]. No performance differences between AUD-Only and community volunteers were noted. CONCLUSIONS Results extend the emerging literature exploring emotion processing in AUD and add to the established literature regarding cognitive deficits in this population. The data suggest that among individuals with AUD, those with polysubstance use may be particularly vulnerable to deficits in decoding emotional face content. The current work highlights the need to incorporate more nuanced and careful considerations of polysubstance use in the design and analysis for future investigations of alcohol-associated deficits in emotion processing.
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Creupelandt C, D'Hondt F, de Timary P, Falagiarda F, Collignon O, Maurage P. Selective visual and crossmodal impairment in the discrimination of anger and fear expressions in severe alcohol use disorder. Drug Alcohol Depend 2020; 213:108079. [PMID: 32554170 DOI: 10.1016/j.drugalcdep.2020.108079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 05/12/2020] [Accepted: 05/14/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Severe alcohol use disorder (SAUD) is associated with impaired discrimination of emotional expressions. This deficit appears increased in crossmodal settings, when simultaneous inputs from different sensory modalities are presented. However, so far, studies exploring emotional crossmodal processing in SAUD relied on static faces and unmatched face/voice pairs, thus offering limited ecological validity. Our aim was therefore to assess emotional processing using a validated and ecological paradigm relying on dynamic audio-visual stimuli, manipulating the amount of emotional information available. METHOD Thirty individuals with SAUD and 30 matched healthy controls performed an emotional discrimination task requiring to identify five emotions (anger, disgust, fear, happiness, sadness) expressed as visual, auditory, or auditory-visual segments of varying length. Sensitivity indices (d') were computed to get an unbiased measure of emotional discrimination and entered in a Generalized Linear Mixed Model. Incorrect emotional attributions were also scrutinized through confusion matrices. RESULTS Discrimination levels varied across sensory modalities and emotions, and increased with stimuli duration. Crucially, performances also improved from unimodal to crossmodal conditions in both groups, but discrimination for anger crossmodal stimuli and fear crossmodal/visual stimuli remained selectively impaired in SAUD. These deficits were not influenced by stimuli duration, suggesting that they were not modulated by the amount of emotional information available. Moreover, they were not associated with systematic emotional error patterns reflecting specific confusions between emotions. CONCLUSIONS These results clarify the nature and extent of crossmodal impairments in SAUD and converge with earlier findings to ascribe a specific role for anger and fear in this pathology.
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Affiliation(s)
- Coralie Creupelandt
- Louvain Experimental Psychopathology Research Group (UCLEP), Psychological Sciences Research Institute (IPSY) and Institute of Neuroscience (IoNS), UCLouvain, B-1348, Louvain-la-Neuve, Belgium.
| | - Fabien D'Hondt
- Univ. Lille, Inserm, CHU Lille, U1172, Lille Neuroscience & Cognition, F-59000 Lille, France; CHU Lille, Clinique de Psychiatrie, CURE, F-59000, Lille, France; Centre National de Ressources et de Résilience Lille-Paris (CN2R), F-59000, Lille, France.
| | - Philippe de Timary
- Louvain Experimental Psychopathology Research Group (UCLEP), Psychological Sciences Research Institute (IPSY) and Institute of Neuroscience (IoNS), UCLouvain, B-1348, Louvain-la-Neuve, Belgium; Department of Adult Psychiatry, Saint-Luc Academic Hospital, B-1200, Brussels, Belgium.
| | - Federica Falagiarda
- Crossmodal Perception and Plasticity laboratory (CPP-Lab), Psychological Sciences Research Institute (IPSY) and Institute of Neuroscience (IoNS), UCLouvain, B-1348, Louvain-la-Neuve, Belgium.
| | - Olivier Collignon
- Crossmodal Perception and Plasticity laboratory (CPP-Lab), Psychological Sciences Research Institute (IPSY) and Institute of Neuroscience (IoNS), UCLouvain, B-1348, Louvain-la-Neuve, Belgium; Centre for Mind/Brain Studies, University of Trento, Trento, Italy.
| | - Pierre Maurage
- Louvain Experimental Psychopathology Research Group (UCLEP), Psychological Sciences Research Institute (IPSY) and Institute of Neuroscience (IoNS), UCLouvain, B-1348, Louvain-la-Neuve, Belgium.
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81
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Karabanowicz E, Tyburski E, Karasiewicz K, Sokołowski A, Mak M, Folkierska-Żukowska M, Radziwiłłowicz W. Metaphor Processing Dysfunctions in Schizophrenia Patients With and Without Substance Use Disorders. Front Psychiatry 2020; 11:331. [PMID: 32390887 PMCID: PMC7193109 DOI: 10.3389/fpsyt.2020.00331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 04/02/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patients with schizophrenia have difficulties comprehending metaphors, which significantly impedes communication. However, this topic has not been thoroughly studied in people with a dual diagnosis. On this basis, we formulated two research aims: a) to compare the ability to comprehend metaphors in schizophrenia patients without (SZ) and with substance use disorder (SZ-SUD) and b) to determine the relationship between the processing of metaphorical content and the severity of psychopathological symptoms in both clinical groups. METHODS A total of 40 individuals with SZ and 40 individuals with SZ-SUD took part in the study. The control group was composed of 40 individuals without a psychiatric or neurological diagnosis. Four subtests from the Right Hemisphere Language Battery (Picture Metaphor Test, Written Metaphor Test, Picture Metaphor Explanation Test, Written Metaphor Explanation Test) were used to measure the ability to understand and explain metaphors. RESULTS Both groups of individuals with schizophrenia (SZ and SZ-SUD) scored lower than individuals from the control group on all tests of metaphor processing. However, no differences were observed between the two clinical groups. SZ-SUD patients had better results for Picture Metaphor Explanation than for Written Metaphor Explanation. Negative symptoms were found to be significant predictors of difficulties with understanding and explaining metaphors. CONCLUSION Individuals with schizophrenia, regardless of their substance use disorder (SUD) status, exhibit impaired metaphorical content processing. SUD in schizophrenia is not associated with significant impairments in understanding and explaining metaphorical content. Moreover, impairments in processing metaphorical content are associated with more severe negative symptoms of schizophrenia.
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Affiliation(s)
- Ewa Karabanowicz
- Institute of Psychology, University of Szczecin, Szczecin, Poland
| | - Ernest Tyburski
- Institute of Psychology, SWPS University of Social Sciences and Humanities, Poznan, Poland
| | | | - Andrzej Sokołowski
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Monika Mak
- Independent Clinical Psychology Unit, Pomeranian Medical University, Szczecin, Poland
| | - Monika Folkierska-Żukowska
- Interdisciplinary Centre for Behavioural Genetics Research, Faculty of Psychology, University of Warsaw, Warsaw, Poland
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Nigro G, Matarazzo O, Ciccarelli M, D’Olimpio F, Cosenza M. To chase or not to chase: A study on the role of mentalization and alcohol consumption in chasing behavior. J Behav Addict 2019; 8:743-753. [PMID: 31891312 PMCID: PMC7044581 DOI: 10.1556/2006.8.2019.67] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND AND AIMS Chasing is a behavioral marker and a diagnostic criterion for gambling disorder. Although chasing has been recognized to play a central role in gambling disorder, research on this topic is relatively scarce. This study investigated the association between chasing, alcohol consumption, and mentalization among habitual gamblers. METHOD A total of 132 adults took part in the study. Participants were administered the South Oaks Gambling Screen, the Alcohol Use Disorders Identification Test, the Reflective Functioning Questionnaire, and a laboratory task assessing chasing behavior. Participants were randomly assigned to three experimental conditions (Control, Loss, and Win). To deeply investigate chasing behavior, participants were requested to indicate the reasons for stopping or continuing playing at the end of the experimental session. RESULTS Logistic regression analysis showed that the choice to stop or continue playing depended on experimental condition and alcohol use. Hierarchical linear regression indicated that chasing propensity was affected by experimental condition, alcohol consumption, and deficit in mentalization. The results of path analysis showed that hypermentalizing predicts chasing not only directly, but also indirectly via alcohol consumption. CONCLUSIONS Overall, these results for the first time showed that hypermentalization plays a key role in chasing behavior over and above gambling severity. Since these findings support the idea that chasers and non-chasers are different subtypes of gamblers, clinical interventions should consider the additive role of chasing in gambling disorder.
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Affiliation(s)
- Giovanna Nigro
- Department of Psychology, Università degli Studi della Campania “Luigi Vanvitelli”, Caserta, Italy,Corresponding author: Giovanna Nigro; Department of Psychology, Università degli Studi della Campania “Luigi Vanvitelli”, Viale Ellittico, 31, 81100, Caserta, Italy; Phone: +39 3392707662; Fax: +39 0823274759; E-mail:
| | - Olimpia Matarazzo
- Department of Psychology, Università degli Studi della Campania “Luigi Vanvitelli”, Caserta, Italy
| | - Maria Ciccarelli
- Department of Psychology, Università degli Studi della Campania “Luigi Vanvitelli”, Caserta, Italy
| | - Francesca D’Olimpio
- Department of Psychology, Università degli Studi della Campania “Luigi Vanvitelli”, Caserta, Italy
| | - Marina Cosenza
- Department of Psychology, Università degli Studi della Campania “Luigi Vanvitelli”, Caserta, Italy
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