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Miguel A, Smith C, Perea N, Johnson K, McDonell M, McPherson S. Development of Automated Reinforcement Management System (ARMS): Protocol for a Phase I Feasibility and Usability Study. JMIR Form Res 2021; 5:e25796. [PMID: 34279238 PMCID: PMC8329757 DOI: 10.2196/25796] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 04/12/2021] [Accepted: 05/31/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Alcohol use is directly related to over 3 million deaths worldwide every year. Contingency management is a cost-effective treatment for substance use disorders; however, few studies have examined its efficacy for alcohol use disorder. Recent technological advances have enabled the combined use of mobile apps and low-cost electronic breathalyzer devices to remotely monitor alcohol use. Leveraging this type of technology, our study group has recently developed an integrated contingency management system that would enable community treatment programs to remotely deliver contingency management to anyone who owns a smartphone. OBJECTIVE In this paper, we present a full description of our integrated contingency management system, Automated Reinforcement Management System (ARMS), and describe a protocol that will evaluate its feasibility and usability. METHODS Initially, 6 clinicians will participate in a 1-hour focus group where the study staff will navigate through ARMS as it would be used by clinicians and patients. Clinicians will provide feedback on the intervention in general, which will be used to modify ARMS to make it more user friendly, time saving, and relevant to treatment. A second focus group will summarize the changes made following the initial clinician feedback and will provide additional input regarding the potential utilization of ARMS. Thereafter, the clinicians' acceptability of ARMS will be evaluated using the System Usability Scale. Following the clinicians' assessments of ARMS and final modifications, the system will be evaluated in terms of feasibility and patient usability by using an A-B-A within-subject experimental design wherein 20 treatment-seeking individuals with alcohol use disorder will be recruited. The two A phases (control conditions) will each last 2 weeks, and the B phase (contingency management condition) will last 4 weeks. During all phases, participants will be asked to use the ARMS app to submit three breathalyzer samples per day (at 10 AM, 2 PM, and 8 PM). Participants will be prompted by the ARMS app at these predetermined times to record and submit their breathalyzer samples. During the A phases, participants will earn vouchers for every breathalyzer sample submitted, independent of their sample results. During the B phase, vouchers will be provided contingent upon the submission of alcohol-negative breathalyzer samples (breath alcohol content = 0.00). At the end of the A-B-A experiment trial, patients' usability of the ARMS app will be evaluated using the System Usability Scale. Feasibility will be measured based on whether the ARMS app helped significantly increase alcohol abstinence. RESULTS Recruitment for this study began in January 2021 and is expected to be completed by December 2021. CONCLUSIONS This study will provide the baseline capability for the implementation of a remotely monitored contingency management platform. If successful, ARMS has the potential to provide effective treatment for alcohol use disorders to individuals living in remote rural areas.
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Affiliation(s)
- Andre Miguel
- Elson S Floyd College of Medicine, Washington State University, Spokane, WA, United States
| | - Crystal Smith
- Elson S Floyd College of Medicine, Washington State University, Spokane, WA, United States
| | - Nicole Perea
- College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, WA, United States
| | - Kim Johnson
- Managed Health Connections, Spokane, WA, United States
| | - Michael McDonell
- Elson S Floyd College of Medicine, Washington State University, Spokane, WA, United States
| | - Sterling McPherson
- Elson S Floyd College of Medicine, Washington State University, Spokane, WA, United States
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Perkins ER, Joyner KJ, Patrick CJ, Bartholow BD, Latzman RD, DeYoung CG, Kotov R, Reininghaus U, Cooper SE, Afzali MH, Docherty AR, Dretsch MN, Eaton NR, Goghari VM, Haltigan JD, Krueger RF, Martin EA, Michelini G, Ruocco AC, Tackett JL, Venables NC, Waldman ID, Zald DH. Neurobiology and the Hierarchical Taxonomy of Psychopathology: progress toward ontogenetically informed and clinically useful nosology
. DIALOGUES IN CLINICAL NEUROSCIENCE 2021; 22:51-63. [PMID: 32699505 PMCID: PMC7365294 DOI: 10.31887/dcns.2020.22.1/eperkins] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The Hierarchical Taxonomy of Psychopathology (HiTOP) is an empirical structural
model of psychological symptoms formulated to improve the reliability and
validity of clinical assessment. Neurobiology can inform assessments of early
risk and intervention strategies, and the HiTOP model has greater potential to
interface with neurobiological measures than traditional categorical diagnoses
given its enhanced reliability. However, one complication is that observed
biological correlates of clinical symptoms can reflect various factors, ranging
from dispositional risk to consequences of psychopathology. In this paper, we
argue that the HiTOP model provides an optimized framework for conducting
research on the biological correlates of psychopathology from an ontogenetic
perspective that distinguishes among indicators of liability, current symptoms,
and consequences of illness. Through this approach, neurobiological research can
contribute more effectively to identifying individuals at high dispositional
risk, indexing treatment-related gains, and monitoring the consequences of
mental illness, consistent with the aims of the HiTOP framework.
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Affiliation(s)
- Emily R Perkins
- Department of Psychology, Florida State University, Tallahassee, Florida, US. Authors contributed equally to manuscript
| | - Keanan J Joyner
- Department of Psychology, Florida State University, Tallahassee, Florida, US. Authors contributed equally to manuscript
| | | | - Bruce D Bartholow
- Department of Psychological Sciences, University of Missouri, Columbia, Missouri, US
| | - Robert D Latzman
- Department of Psychology, Georgia State University, Atlanta, Georgia, US
| | - Colin G DeYoung
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, US
| | - Roman Kotov
- Department of Psychiatry, Stony Brook University, Stony Brook, New York, US
| | - Ulrich Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
| | - Samuel E Cooper
- Department of Psychiatry, University of Texas at Austin, Texas, US
| | | | - Anna R Docherty
- DDepartment of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah, US
| | - Michael N Dretsch
- US Army Medical Research Directorate - West, Walter Reed Army Institute for Research, Joint Base Lewis-McCord, Washington, US
| | - Nicholas R Eaton
- Department of Psychology, Stony Brook University, Stony Brook, New York, US
| | - Vina M Goghari
- Department of Psychology and Graduate Department of Psychological Clinical Science, University of Toronto, Ontario, Canada
| | - John D Haltigan
- DDepartment of Psychiatry, University of Toronto, and Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Robert F Krueger
- DDepartment of Psychology, University of Minnesota, Minneapolis, Minnesota, US
| | - Elizabeth A Martin
- DDepartment of Psychological Science, University of California, Irvine, California, US
| | - Giorgia Michelini
- Department of Psychiatry, Stony Brook University, Stony Brook, New York, US
| | - Anthony C Ruocco
- Department of Psychology and Graduate Department of Psychological Clinical Science, University of Toronto, Ontario, Canada
| | - Jennifer L Tackett
- Department of Psychology, Northwestern University, Evanston, Illinois, US
| | - Noah C Venables
- DMinneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, US
| | - Irwin D Waldman
- Department of Psychology, Emory University, Atlanta, Georgia, US
| | - David H Zald
- Department of Psychology, Vanderbilt University, Nashville, Tennessee, US
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103
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Berenz EC, Edalatian Zakeri S, Demos AP, Paltell KC, Bing-Canar H, Kevorkian S, Ranney R. Negative affect and alcohol craving in trauma-exposed young adult drinkers. Alcohol Clin Exp Res 2021; 45:1479-1493. [PMID: 34241905 DOI: 10.1111/acer.14641] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 05/05/2021] [Accepted: 05/12/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Clinical research indicates that successful posttraumatic stress disorder (PTSD) treatment does not lead to improvements in alcohol use outcomes in comorbid PTSD and alcohol use disorder (AUD). Emerging theory suggests that treating PTSD may not disrupt an association between negative affect and alcohol craving, which underlies negative reinforcement drinking. The goal of the current study was to determine the respective influences of PTSD symptoms, coping motives, and negative affect on trauma and alcohol cue reactivity to inform theoretical models of co-occurring PTSD and AUD. METHODS The sample consisted of 189 young adults (50.3% women; 49.2% current PTSD; 84.0% current AUD) who endorsed interpersonal trauma (e.g., sexual/physical assault) and current weekly alcohol use. Participants completed a trauma and alcohol cue reactivity assessment, in which subjective (e.g., craving, affect) and physiological (i.e., salivation) measures were recorded in response to 4 narrative (i.e., personalized trauma or standard neutral) and in vivo beverage (i.e., personalized alcohol or water) cue combinations. RESULTS Forward-fitted linear mixed-effects (LME) models confirmed that trauma cue-elicited craving was elevated among those high but not low in PTSD symptoms, consistent with prior research and theory. Trauma cue-elicited craving was fully explained by increases in negative affect, with no evidence of a direct effect of trauma cue on craving. PTSD symptoms moderated an association between trauma cue and negative affect (but not negative affect and craving), and coping motives for alcohol moderated an association between negative affect and craving (but not trauma cue and negative affect). CONCLUSIONS This study provides novel laboratory evidence for the respective contributions of negative affect, PTSD symptoms, and coping motives on alcohol craving in trauma-exposed drinkers. It offers a methodological framework in which to evaluate novel strategies that aim to disrupt negative reinforcement drinking in individuals with co-occurring PTSD and AUD.
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Affiliation(s)
- Erin C Berenz
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | | | - Alexander P Demos
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - Katherine C Paltell
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - Hanaan Bing-Canar
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - Salpi Kevorkian
- Department of Surgery, Virginia Commonwealth University, Richmond, VA, USA
| | - Rachel Ranney
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
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104
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Shi Z, Jagannathan K, Padley JH, Wang A, Fairchild VP, O'Brien CP, Childress AR, Langleben DD. The role of withdrawal in mesocorticolimbic drug cue reactivity in opioid use disorder. Addict Biol 2021; 26:e12977. [PMID: 33098179 DOI: 10.1111/adb.12977] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 09/21/2020] [Accepted: 09/26/2020] [Indexed: 01/08/2023]
Abstract
Opioid use disorder (OUD) is characterized by heightened cognitive, physiological, and neural responses to opioid-related cues that are mediated by mesocorticolimbic brain pathways. Craving and withdrawal are key symptoms of addiction that persist during physiological abstinence. The present study evaluated the relationship between the brain response to drug cues in OUD and baseline levels of craving and withdrawal. We used functional magnetic resonance imaging (fMRI) to examine brain responses to opioid-related pictures and control pictures in 29 OUD patients. Baseline measures of drug use severity, opioid craving, and withdrawal symptoms were assessed prior to cue exposure and correlated with subsequent brain responses to drug cues. Mediation analysis was conducted to test the indirect effect of drug use severity on brain cue reactivity through craving and withdrawal symptoms. We found that baseline drug use severity and opioid withdrawal symptoms, but not craving, were positively associated with the neural response to drug cues in the nucleus accumbens, orbitofrontal cortex, and amygdala. Withdrawal, but not craving, mediated the effect of drug use severity on the nucleus accumbens' response to drug cues. We did not find similar effects for the neural responses to stimuli unrelated to drugs. Our findings emphasize the central role of withdrawal symptoms as the mediator between the clinical severity of OUD and the brain correlates of sensitization to opioid-related cues. They suggest that in OUD, baseline withdrawal symptoms signal a high vulnerability to drug cues.
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Affiliation(s)
- Zhenhao Shi
- Center for Studies of Addiction, Department of Psychiatry University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA
| | - Kanchana Jagannathan
- Center for Studies of Addiction, Department of Psychiatry University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA
| | - James H. Padley
- Center for Studies of Addiction, Department of Psychiatry University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA
| | - An‐Li Wang
- Department of Psychiatry Icahn School of Medicine at Mount Sinai New York New York USA
| | - Victoria P. Fairchild
- Department of Psychology, Queens College The City University of New York New York New York USA
| | - Charles P. O'Brien
- Center for Studies of Addiction, Department of Psychiatry University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA
| | - Anna Rose Childress
- Center for Studies of Addiction, Department of Psychiatry University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA
| | - Daniel D. Langleben
- Center for Studies of Addiction, Department of Psychiatry University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA
- Annenberg Public Policy Center University of Pennsylvania Philadelphia Pennsylvania USA
- Behavioral Health Service Corporal Michael J. Crescenz Veterans Administration Medical Center Philadelphia Pennsylvania USA
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105
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Yücel M, Lee RSC, Fontenelle LF. A New Consensus Framework for Phenotyping and Treatment Selecting in Addiction and Obsessive-Compulsive-Related Disorders. JAMA Psychiatry 2021; 78:699-700. [PMID: 33825819 DOI: 10.1001/jamapsychiatry.2021.0243] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Murat Yücel
- BrainPark, The Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Melbourne, Victoria, Australia
| | - Rico S C Lee
- BrainPark, The Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Melbourne, Victoria, Australia
| | - Leonardo F Fontenelle
- BrainPark, The Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Melbourne, Victoria, Australia.,D'Or Institute for Research and Education and Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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106
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A Light in the Darkness: Repetitive Transcranial Magnetic Stimulation (rTMS) to Treat the Hedonic Dysregulation of Addiction. J Addict Med 2021; 14:272-274. [PMID: 31725426 DOI: 10.1097/adm.0000000000000575] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
: The present paper discusses the potential use of repetitive transcranial magnetic stimulation (rTMS) for the treatment of addiction, within a conceptual framework that includes the "dark side" of addiction. New findings suggest that rTMS may rescue specific reward system dysfunction that underlies the pathophysiology of addiction by exposing widely under-recognized and untreated key clinical and psychopathological aspects of addictive disorders. Our paper sheds light on the relevance of these hidden dimensions for the development of effective treatment interventions. In particular, we argue that rTMS may have an impact on craving by reversing the allostatic load of hedonic dysregulation.
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107
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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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108
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Distinct patterns of prefrontal cortical disengagement during inhibitory control in addiction: A meta-analysis based on population characteristics. Neurosci Biobehav Rev 2021; 127:255-269. [PMID: 33933507 DOI: 10.1016/j.neubiorev.2021.04.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 03/22/2021] [Accepted: 04/25/2021] [Indexed: 11/21/2022]
Abstract
Prefrontal cortical dysfunctions underlying inhibitory control deficits in addiction are complex and likely dependent on population characteristics. Here, we conducted a meta-analysis to examine alterations in brain activations during response inhibition in addicted individuals. We characterized imaging findings based on substance use status, diagnosis, substance classes, and task performance. Results revealed in those with active drug addiction hypoactivation of the left dorsal anterior cingulate cortex (dACC) and right middle frontal gyrus (MFG), compared with healthy controls. Weakening of the dACC and MFG activations was particularly pronounced in nicotine users, respectively. Impaired task performance was also associated with diminished MFG activation. In contrast, abstinent users did not exhibit any significant differences compared with healthy controls. Those with behavioral addictions were characterized by higher midcingulate cortical activation. Thus, the neural disengagement during response inhibition in active drug addiction was limited to a small number of prefrontal cortical regions and dependent on population characteristics. Finally, the evidence for potential normalization of hypofrontality following substance use cessation highlights the benefits of abstinence in restoring cerebral functions.
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109
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Keyser-Marcus LA, Ramey T, Bjork J, Adams A, Moeller FG. Development and Feasibility Study of an Addiction-Focused Phenotyping Assessment Battery. Am J Addict 2021; 30:398-405. [PMID: 33908104 DOI: 10.1111/ajad.13170] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 02/03/2021] [Accepted: 02/28/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Current methods of classifying individuals with substance use disorder (SUD) result in vast heterogeneity among persons within a given diagnosis. These approaches, while clinically allowing for distinctions between patient groups, are less than ideal when attempting to recruit a neurobehaviorally defined subset of subjects into clinical trials. To address this gap, alternative strategies have been proposed, including behavioral phenotyping. The NIDA Phenotyping Assessment Battery (PhAB) is a modular package of assessments and neurocognitive tasks that was developed for use in clinical trials. The goal of the present study is to assess the feasibility of the NIDA PhAB with regard to ease of administration and time burden. METHODS Healthy controls, persons with cocaine use disorder (CocUD), opioid use disorder (OUD), cannabis use disorder (CanUD), and combined opioid and cocaine use disorder (OCUD) were recruited from various sources (N = 595). Participants completed screening and one to three assessment visits. Time to complete the measures was recorded and a satisfaction interview was administered. RESULTS Of the participants enrolled, 381 were deemed eligible. The majority of eligible participants (83%) completed all assessments. The average completion time was 3 hours. High participant satisfaction ratings were noted, with over 90% of participants endorsing a willingness to participate in a similar study and recommend the study to others. CONCLUSION AND SCIENTIFIC SIGNIFICANCE: These findings corroborate the ease with which the PhAB may be easily incorporated into a study assessment visit without undue participant burden. The PhAB is an efficient method for behavioral phenotyping in addiction clinical trials. (Am J Addict 2021;00:00-00).
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Affiliation(s)
- Lori A Keyser-Marcus
- Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia.,Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia
| | - Tatiana Ramey
- Division of Therapeutics and Medical Consequences, National Institute on Drug Abuse, Bethesda, Maryland
| | - James Bjork
- Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia.,Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia
| | - Amanda Adams
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia
| | - F Gerard Moeller
- Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia.,Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia
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110
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Legault MCB, Liu HZ, Balodis IM. Neuropsychological Constructs in Gaming Disorders: a Systematic Review. Curr Behav Neurosci Rep 2021. [DOI: 10.1007/s40473-021-00230-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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111
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Akhurst J, Lovell M, Peacock A, Bruno R. A Systematic Review and Meta-Analysis of Cognitive Performance among People with Chronic Use of Opioids for Chronic Non-Cancer Pain. PAIN MEDICINE 2021; 22:979-993. [PMID: 33502504 DOI: 10.1093/pm/pnab005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Opioids, often prescribed for chronic non-cancer pain, may adversely affect cognition. Research has not been synthesized in recent years, during which time academic interest has increased. This study presents meta-analyses on cognitive performance in people taking opioids for chronic non-cancer pain (CNCP). METHODS We ran systematic literature searches in EMBASE, Medline, and PsycINFO. Eligible studies included people taking opioids for CNCP, an opioid-free group (i.e., case-control) or session (e.g., pre-post), and objective cognitive assessments. Using random-effects meta-analyses, we computed pooled effect sizes for differential task performance for each study design across five domains (motor performance, attention, working memory, executive functions, memory). RESULTS Seventeen studies were included. Case-control studies covered three control types (healthy, CNCP, taper-off). Pre-post studies were grouped into five follow-ups (four to six and six to nine weeks; three, six, and 12 months). Effect sizes ranged from 0.02-0.62. Cases showed small magnitude impairments in attention and memory compared with healthy controls. Although limited by small sample sizes, there was no clear evidence of impairment in cases compared with opioid-free controls with CNCP. Cases showed some cognitive improvements from opioid-free baseline to follow-up. Effects were strongest for attention and working memory and were apparent from four weeks to six months follow-up. Other effects were small and nonsignificant. CONCLUSIONS Opioid therapy for CNCP did not worsen cognitive performance and improved it for some domains. People who take opioids for CNCP may evidence deficits in attention and memory, but this is unlikely to translate to global impairment and likely relates to pain more so than opioids.
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Affiliation(s)
- Jane Akhurst
- School of Psychological Sciences, University of Tasmania, Tasmania, Australia
| | - Monica Lovell
- School of Psychological Sciences, University of Tasmania, Tasmania, Australia
| | - Amy Peacock
- School of Psychological Sciences, University of Tasmania, Tasmania, Australia.,National Drug and Alcohol Research Centre, University of New South Wales, New South Wales, Australia
| | - Raimondo Bruno
- School of Psychological Sciences, University of Tasmania, Tasmania, Australia.,National Drug and Alcohol Research Centre, University of New South Wales, New South Wales, Australia
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112
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Spagnolo PA, Garvey M, Hallett M. A dimensional approach to functional movement disorders: Heresy or opportunity. Neurosci Biobehav Rev 2021; 127:25-36. [PMID: 33848511 DOI: 10.1016/j.neubiorev.2021.04.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 03/10/2021] [Accepted: 04/07/2021] [Indexed: 11/28/2022]
Abstract
Functional movement disorders (FMD) are a common and disabling neuropsychiatric condition, part of the spectrum of functional neurological/conversion disorder. FMD represent one of the most enigmatic disorders in the history of medicine. However, in the twenty years after the first report of distinctive abnormal brain activity associated with functional motor symptoms, there have been tremendous advances in the pathophysiologic understanding of these disorders. FMD can be characterized as a disorder of aberrant neurocircuitry interacting with environmental and genetic factors. These developments suggest that research on FMD could be better served by an integrative, neuroscience-based approach focused on functional domains and their neurobiological substrates. This approach has been developed in 'Research Domain Criteria' (RDoC) project, which promotes a dimensional approach to psychiatric disorders. Here, we use the RDoC conceptualization to review recent neuroscience research on FMD, focusing on the domains most relevant to these disorders. We discuss how the adoption of a similar integrative framework may facilitate the identification of the mechanisms underlying FMD and could also have potential clinical applicability.
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Affiliation(s)
- Primavera A Spagnolo
- Mary Horrigan Connors Center for Women's Health and Gender Biology, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Human Motor Control Section, Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
| | - Marjorie Garvey
- Novel Strategies for Treatment of Developmental Psychopathology Program, Biomarker and Intervention Development for Childhood-Onset Mental Disorders Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Mark Hallett
- Human Motor Control Section, Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
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113
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Richards DK, Schwebel FJ, Sotelo M, Pearson MR. Self-reported symptoms of cannabis use disorder: Psychometric testing and validation. Exp Clin Psychopharmacol 2021; 29:157-165. [PMID: 34043399 PMCID: PMC8375671 DOI: 10.1037/pha0000455] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Cannabis use disorder (CUD) is commonly assessed using self-report items based on its symptoms as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM) that are scored on a dichotomous scale (yes/no) to indicate symptom presence; however, scoring items on a dichotomy may result in relatively limited sensitivity for research. Thus, we developed a 13-item measure of CUD, the Self-Reported Symptoms of CUD (SRSCUD), based on the 11 symptoms described in the DSM-5 that is scored on a 4-point response scale indicating degree of severity. In the present study, we conduct an initial evaluation of the psychometric properties of the SRSCUD. Past-month cannabis users (N = 2,077) were recruited from nine universities in nine states throughout the U.S. Each item of the SRSCUD loaded saliently onto a single factor of CUD symptoms in both exploratory and confirmatory factor analyses. The SRSCUD was strongly correlated with measures of cannabis use, dependence severity, and cannabis-related problems. In addition, the SRSCUD was moderately positively correlated with a well-known risk factor for CUD (coping motives) and moderately negatively correlated with a well-known protective factor for CUD (protective behavioral strategies). These correlations mostly remained statistically significant while controlling for CUD symptom count and diagnosis using dichotomized SRSCUD items. Receiver operator characteristic curve analyses revealed that the SRSCUD had excellent sensitivity/specificity for predicting probable CUD. Although more research evaluating performance of the SRSCUD compared to a clinical diagnosis is needed, we found preliminary evidence for construct validity of this measure. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Dylan K Richards
- Center on Alcohol, Substance Use, And Addictions (CASAA), University of New Mexico
| | - Frank J Schwebel
- Center on Alcohol, Substance Use, And Addictions (CASAA), University of New Mexico
| | - Melissa Sotelo
- Center on Alcohol, Substance Use, And Addictions (CASAA), University of New Mexico
| | - Matthew R Pearson
- Center on Alcohol, Substance Use, And Addictions (CASAA), University of New Mexico
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Nieto SJ, Grodin EN, Green R, Ray LA. Evaluation of the Addictions Neuroclinical Assessment (ANA) framework through deep phenotyping of problem drinkers. Drug Alcohol Depend 2021; 221:108603. [PMID: 33618192 PMCID: PMC8026564 DOI: 10.1016/j.drugalcdep.2021.108603] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 01/23/2021] [Accepted: 01/26/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND To advance the development of a neuroscience-informed understanding of alcohol use disorder (AUD) through the Addictions Neuroclinical Assessment (ANA) framework, the present study reports on deep phenotyping of a large sample of problem drinkers. METHODS Participants (n = 1679) were primarily heavy drinkers with and without AUD, who completed a phenotypic battery of well-validated scales and behavioral measures of alcohol use and problems, mood, attention, and impulsivity. These scales were subjected to sequential factor analytic work in order to derive a factor solution that explains biobehavioral variation in the sample. To assess the construct validity of the resulting factor solution, scores on each factor were associated with demographic and clinical indicators. RESULTS Factor analysis techniques using indicators of alcohol use and problems, mood, attention, and impulsivity implicated four functional domains that compliment and extend the proposed ANA domains: negative alcohol-related consequences, incentive salience, negative emotionality, and executive function. Demographic and clinical variables significantly predicted scores on all ANA domains. CONCLUSIONS This study provides an independent test of the recently proposed neuroscience-based ANA framework. Results largely support the novel approach in identifying four core constructs in problem drinkers. Future studies can deepen our understanding of how these domains are relevant to AUD by incorporating biomarkers.
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Affiliation(s)
- Steven J Nieto
- Department of Psychology, University of California at Los Angeles, Psychology Building 1285, Los Angeles, CA 90095, United States
| | - Erica N Grodin
- Department of Psychology, University of California at Los Angeles, Psychology Building 1285, Los Angeles, CA 90095, United States
| | - ReJoyce Green
- Department of Psychology, University of California at Los Angeles, Psychology Building 1285, Los Angeles, CA 90095, United States
| | - Lara A Ray
- Department of Psychology, University of California at Los Angeles, Psychology Building 1285, Los Angeles, CA 90095, United States; Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90095, United States.
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115
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Rawls E, Kummerfeld E, Zilverstand A. An integrated multimodal model of alcohol use disorder generated by data-driven causal discovery analysis. Commun Biol 2021; 4:435. [PMID: 33790384 PMCID: PMC8012376 DOI: 10.1038/s42003-021-01955-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 02/24/2021] [Indexed: 12/24/2022] Open
Abstract
Alcohol use disorder (AUD) has high prevalence and adverse societal impacts, but our understanding of the factors driving AUD is hampered by a lack of studies that describe the complex neurobehavioral mechanisms driving AUD. We analyzed causal pathways to AUD severity using Causal Discovery Analysis (CDA) with data from the Human Connectome Project (HCP; n = 926 [54% female], 22% AUD [37% female]). We applied exploratory factor analysis to parse the wide HCP phenotypic space (100 measures) into 18 underlying domains, and we assessed functional connectivity within 12 resting-state brain networks. We then employed data-driven CDA to generate a causal model relating phenotypic factors, fMRI network connectivity, and AUD symptom severity, which highlighted a limited set of causes of AUD. The model proposed a hierarchy with causal influence propagating from brain connectivity to cognition (fluid/crystalized cognition, language/math ability, & working memory) to social (agreeableness/social support) to affective/psychiatric function (negative affect, low conscientiousness/attention, externalizing symptoms) and ultimately AUD severity. Our data-driven model confirmed hypothesized influences of cognitive and affective factors on AUD, while underscoring that addiction models need to be expanded to highlight the importance of social factors, amongst others.
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Affiliation(s)
- Eric Rawls
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA.
| | - Erich Kummerfeld
- Institute for Health Informatics, University of Minnesota, Minneapolis, MN, USA
| | - Anna Zilverstand
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
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116
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Kittaneh AA, Patel S, Sidhu NK, Lechner WV, Kenne DR. Tobacco Use Status as a Function of Transgender Identity: The Mediating Role of Psychological Distress. Tob Use Insights 2021; 14:1179173X211004267. [PMID: 33854393 PMCID: PMC8013634 DOI: 10.1177/1179173x211004267] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 02/19/2021] [Indexed: 11/15/2022] Open
Abstract
Aim The current study examined differences between individuals identifying as transgender and people identifying as cisgender in terms of (1) psychological distress (eg, anxiety, depression, and suicidal ideation), (2) rates of combustible and e-cigarette use, and (3) the potential for elevated psychological distress stemming from transgender identification to be associated with increased rates of smoking and vaping. Method This was a secondary analysis of data from a study examining behavioral health, perceptions and behaviors associated with alcohol and other drug use, and mental health status at a large mid-western university. Differences in current use of cigarette and e-cigarette products were examined between self-identified transgender (n = 253) and cisgender (n = 18 371) respondents. Results Overall, 17.2% (n = 2727) of the sample endorsed past 30-day use of cigarettes or e-cigarettes. Results demonstrated a significant effect of gender identity, with individuals identifying as transgender reporting higher odds of using cigarettes or e-cigarettes (AOR = 2.82, 95% CI 1.26-6.31). Regression analyses revealed significant effects of transgender identity on symptoms of anxiety (b = 3.45, 95% CI = 1.64, 5.25, P < .001.); depression, (b = 4.14, 95% CI = 2.21, 6.07, P < .001); and suicidal ideation, (b = 2.51, 95% CI = 1.48, 3.55, P < .001.), respectively. Finally, we observed significant indirect effects of transgender identity on cigarette and e-cigarette product use via increased symptoms of depression (indirect effect = 0.13, 95% CI [0.07, 0.19], P < .05), and suicidal ideation (indirect effect = 0.22, 95% CI [0.15, 0.28], P < .05), but not symptoms of anxiety. Discussion This is the first study of our knowledge to examine the association between psychological symptoms and smoking and vaping products with transgender identity. The results of this study support previous findings that transgender individuals are at risk for elevated substance use and extend the literature by demonstrating this this risk is associated with elevated psychological distress.
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Affiliation(s)
- Ahmad A Kittaneh
- Department of Psychological Sciences, Kent State University, OH, USA
| | - Sweta Patel
- Center for Public Policy and Health, Kent State University, OH, USA
| | - Natasha K Sidhu
- Department of Psychological Sciences, Kent State University, OH, USA
| | - William V Lechner
- Department of Psychological Sciences, Kent State University, OH, USA
| | - Deric R Kenne
- Center for Public Policy and Health, Kent State University, OH, USA
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Miller MB, Freeman L, Park CJ, Hall NA, Deroche C, Sahota PK, McCrae CS. Insomnia treatment effects among young adult drinkers: Secondary outcomes of a randomized pilot trial. Alcohol Clin Exp Res 2021; 45:1136-1148. [PMID: 33745147 DOI: 10.1111/acer.14603] [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: 11/22/2020] [Revised: 02/05/2021] [Accepted: 03/16/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cognitive behavioral therapy for insomnia (CBT-I) has moderate-to-large effects on insomnia among young adult drinkers, with preliminary data indicating that improvements in insomnia may have downstream effects on alcohol-related consequences. However, the mechanism(s) by which insomnia treatment may facilitate reductions in alcohol-related problems is unclear. Secondary outcome data from a randomized pilot trial were used to examine CBT-I effects on four proposed mediators of the insomnia/alcohol link: alcohol craving, delay discounting, negative affect, and difficulties with emotion regulation. METHODS Young adults (ages 18 to 30 years) with insomnia who reported 1+ binge drinking episode (4/5+ drinks for women/men) in the past month were randomized to receive CBT-I (n = 28) or to a sleep hygiene control (n = 28). Outcomes were assessed at baseline, after 5 weeks of treatment, and at 1-month posttreatment. RESULTS Relative to those in sleep hygiene, CBT-I participants reported greater decreases in alcohol craving (d = 0.33) at the end of treatment and greater 1-month posttreatment decreases in delay discounting of large rewards (d = 0.42). CBT-I did not have a significant effect on delay discounting of smaller rewards or momentary negative affect. There was also no significant treatment effect on difficulties with emotion regulation, although findings were confounded by a significant group difference at baseline in difficulties with emotion regulation. CONCLUSIONS Treatment of insomnia may lead to improvements in alcohol craving and delay discounting of large rewards among young adult drinkers with insomnia. Additional research examining whether improvement in insomnia is a mechanism for improvement in addiction domains is warranted.
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Affiliation(s)
| | - Lindsey Freeman
- University of Missouri School of Medicine, Columbia, MO, USA
| | - Chan Jeong Park
- University of Missouri School of Medicine, Columbia, MO, USA
| | - Nicole A Hall
- University of Missouri School of Medicine, Columbia, MO, USA
| | - Chelsea Deroche
- University of Missouri School of Medicine, Columbia, MO, USA
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Bianchi PC, Gomes-de-Souza L, Costa-Ferreira W, Palombo P, Carneiro de Oliveira PE, Engi SA, Leão RM, Planeta CS, Crestani CC, Cruz FC. Chronic ethanol vapor exposure potentiates cardiovascular responses to acute stress in male but not in female rats. Biol Sex Differ 2021; 12:27. [PMID: 33726842 PMCID: PMC7962247 DOI: 10.1186/s13293-021-00371-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 03/01/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Ethanol use is related to a wide variety of negative health outcomes, including cardiovascular diseases. Stress is also involved in numerous pathologies, such as cardiovascular diseases and psychiatric disorders. Sexual dimorphism is an important factor affecting cardiovascular response and has been proposed as a potential risk factor for sex-specific health problems in humans. Here, we evaluated the effect of prolonged ethanol vapor inhalation on arterial pressure, heart rate, and tail skin temperature responses to acute restraint stress, investigating differences between male and female rats. METHODS We exposed male and female Long-Evans rats to ethanol vapor for 14 h, followed by ethanol withdrawal for 10 h, for 30 consecutive days, or to room air (control groups). The animals underwent surgical implantation of a cannula into the femoral artery for assessment of arterial pressure and heart rate values. The tail skin temperature was measured as an indirect measurement of sympathetic vasomotor response. RESULTS Chronic ethanol vapor inhalation reduced basal heart rate in both female and male rats. Sex-related difference was observed in the decrease of tail cutaneous temperature evoked by stress, but not in the pressor and tachycardiac responses. Furthermore, prolonged ethanol inhalation enhanced the blood pressure and heart rate increase caused by acute restraint stress in male, but not in female rats. However, no effect of chronic ethanol vapor was observed in the tail cutaneous temperature response to restraint in either sex. CONCLUSION Chronic ethanol vapor exposure increased the cardiovascular reactivity to stress in male, but not in female rats.
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Affiliation(s)
- Paula C. Bianchi
- Laboratory of Neuropsypharmacology, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Rod. Araraquara-Jaú km 1, Araraquara, SP 14801-902 Brazil
- Joint Graduate Program in Physiological Sciences UFSCar/UNESP, Rod. Washington Luís km 235, São Carlos, SP 13565-905 Brazil
- Laboratory of Pharmacology, Paulista Medicine School, Universidade Federal de São Paulo – UNIFESP, Leal Prado Building, Botucatu 862 Street, 04024-002, Vila Clementino, São Paulo, SP Brazil
| | - Lucas Gomes-de-Souza
- Laboratory of Neuropsypharmacology, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Rod. Araraquara-Jaú km 1, Araraquara, SP 14801-902 Brazil
- Joint Graduate Program in Physiological Sciences UFSCar/UNESP, Rod. Washington Luís km 235, São Carlos, SP 13565-905 Brazil
| | - Willian Costa-Ferreira
- Laboratory of Neuropsypharmacology, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Rod. Araraquara-Jaú km 1, Araraquara, SP 14801-902 Brazil
- Joint Graduate Program in Physiological Sciences UFSCar/UNESP, Rod. Washington Luís km 235, São Carlos, SP 13565-905 Brazil
| | - Paola Palombo
- Laboratory of Neuropsypharmacology, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Rod. Araraquara-Jaú km 1, Araraquara, SP 14801-902 Brazil
- Joint Graduate Program in Physiological Sciences UFSCar/UNESP, Rod. Washington Luís km 235, São Carlos, SP 13565-905 Brazil
| | - Paulo E. Carneiro de Oliveira
- Laboratory of Psychology, Psychology Department, Universidade Federal de São Carlos - UFSCar, Rod. Washington Luís km 235, São Carlos, SP 13565-905 Brazil
| | - Sheila A. Engi
- Laboratory of Pharmacology, Paulista Medicine School, Universidade Federal de São Paulo – UNIFESP, Leal Prado Building, Botucatu 862 Street, 04024-002, Vila Clementino, São Paulo, SP Brazil
- Joint Graduate Program in Pharmacology, Pharmacology and Molecular Biology Institute - INFAR, Três de Maio 100 Street, 04044-020, Vila Clementino, São Paulo, SP Brazil
| | - Rodrigo M. Leão
- Biomedical Sciences Institute, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais Brazil
| | - Cleopatra S. Planeta
- Laboratory of Neuropsypharmacology, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Rod. Araraquara-Jaú km 1, Araraquara, SP 14801-902 Brazil
- Joint Graduate Program in Physiological Sciences UFSCar/UNESP, Rod. Washington Luís km 235, São Carlos, SP 13565-905 Brazil
| | - Carlos C. Crestani
- Laboratory of Neuropsypharmacology, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Rod. Araraquara-Jaú km 1, Araraquara, SP 14801-902 Brazil
- Joint Graduate Program in Physiological Sciences UFSCar/UNESP, Rod. Washington Luís km 235, São Carlos, SP 13565-905 Brazil
| | - Fabio C. Cruz
- Laboratory of Pharmacology, Paulista Medicine School, Universidade Federal de São Paulo – UNIFESP, Leal Prado Building, Botucatu 862 Street, 04024-002, Vila Clementino, São Paulo, SP Brazil
- Joint Graduate Program in Pharmacology, Pharmacology and Molecular Biology Institute - INFAR, Três de Maio 100 Street, 04044-020, Vila Clementino, São Paulo, SP Brazil
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Joyner KJ, Yancey JR, Venables NC, Burwell SJ, Iacono WG, Patrick CJ. Reprint of: Using a co-twin control design to evaluate alternative trait measures as indices of liability for substance use disorders. Int J Psychophysiol 2021; 163:58-66. [PMID: 33685652 DOI: 10.1016/j.ijpsycho.2021.02.017] [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: 05/20/2019] [Revised: 11/18/2019] [Accepted: 11/20/2019] [Indexed: 11/26/2022]
Abstract
To establish a trait-dispositional variable as an indicator of liability for the development of substance use disorders (SUDs), the trait must share heritable variance with SUDs and its association should not be primarily attributable to a direct impact of SUDs on characteristics that define the trait. The current work applied a co-twin control (CTC) modeling approach to data from two monozygotic twin samples to investigate the degree to which different measures of trait-impulsiveness represent indicants of vulnerability to SUDs (liability indicators), or outcomes or concomitants of SUDs (exposure indicators). The Five Factor Model (FFM) trait of conscientiousness was assessed via self-report, and a counterpart neurobehavioral trait of disinhibition was assessed both through self-report and using self-report and brain response measures combined. FFM trait data were available for one twin sample (N = 298); data for variants of P3 brain response were available along with a scale measure of disinhibition in the other (N = 258). CTC analyses revealed only an exposure effect of SUD symptomatology on FFM conscientiousness, indicating that this self-report assessed trait does not index liability for SUDs. By contrast, the disinhibition scale measure showed pronounced liability and weaker exposure-based associations with SUDs - and when quantified using scale scores together with P3 brain response, the exposure-based association was eliminated, such that this disinhibition measure related to SUD symptoms exclusively as a function of liability influences. These findings highlight a distinct advantage of quantifying traits in neurobehavioral terms - namely, the capacity to effectively index dispositional liability for psychopathological outcomes.
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Affiliation(s)
- Keanan J Joyner
- Florida State University, Department of Psychology, 1107 West Call Street, Tallahassee, FL 32306, USA
| | - James R Yancey
- Florida State University, Department of Psychology, 1107 West Call Street, Tallahassee, FL 32306, USA
| | - Noah C Venables
- University of Minnesota, Department of Psychiatry, 2450 Riverside Avenue, South Minneapolis, MN 55454, USA
| | - Scott J Burwell
- University of Minnesota, Department of Psychiatry, 2450 Riverside Avenue, South Minneapolis, MN 55454, USA
| | - William G Iacono
- University of Minnesota, Department of Psychology, 75 East River Parkway, Minneapolis, MN 55455, USA
| | - Christopher J Patrick
- Florida State University, Department of Psychology, 1107 West Call Street, Tallahassee, FL 32306, USA.
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Ray LA, Grodin EN, Leggio L, Bechtholt AJ, Becker H, Ewing SWF, Jentsch JD, King AC, Mason BJ, O’Malley S, MacKillop J, Heilig M, Koob GF. The future of translational research on alcohol use disorder. Addict Biol 2021; 26:e12903. [PMID: 32286721 PMCID: PMC7554164 DOI: 10.1111/adb.12903] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 03/06/2020] [Accepted: 03/13/2020] [Indexed: 12/13/2022]
Abstract
In March 2019, a scientific meeting was held at the University of California, Los Angeles (UCLA) Luskin Center to discuss approaches to expedite the translation of neurobiological insights to advances in the treatment of alcohol use disorder (AUD). A guiding theme that emerged was that while translational research in AUD is clearly a challenge, it is also a field ripe with opportunities. Herein, we seek to summarize and disseminate the recommendations for the future of translational AUD research using four sections. First, we briefly review the current landscape of AUD treatment including the available evidence-based treatments and their uptake in clinical settings. Second, we discuss AUD treatment development efforts from a translational science viewpoint. We review current hurdles to treatment development as well as opportunities for mechanism-informed treatment. Third, we consider models of translational science and public health impact. Together, these critical insights serve as the bases for a series of recommendations and future directions. Towards the goal of improving clinical care and population health for AUD, scientists are tasked with bolstering the clinical applicability of their research findings so as to expedite the translation of knowledge into patient care.
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Affiliation(s)
- Lara A. Ray
- University of California Los Angeles, Department of Psychology, Los Angeles, CA, USA
| | - Erica N. Grodin
- University of California Los Angeles, Department of Psychology, Los Angeles, CA, USA
| | - Lorenzo Leggio
- Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research and National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Bethesda, MD; Medication Development Program, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD; Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI, USA
| | - Anita J. Bechtholt
- National Institute on Alcohol Abuse and Alcoholism, Division of Treatment and Recovery Research, National Institutes of Health, Bethesda, MD, USA
| | - Howard Becker
- Charleston Alcohol Research Center, Department of Psychiatry and Behavioral Science; Department of Neuroscience, Medical University of South Carolina; Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | - Sarah W. Feldstein Ewing
- Oregon Health and Science University, Department of Child and Adolescent Psychiatry, Portland, Oregon, USA
| | - J. David Jentsch
- Binghamton University, Department of Psychology, Binghamton, NY, USA
| | - Andrea C. King
- University of Chicago, Department of Psychiatry and Behavioral Neuroscience, Chicago, IL, USA
| | - Barbara J. Mason
- The Scripps Research Institute, Pearson Center for Alcoholism and Addiction Research, La Jolla, CA, USA
| | | | - James MacKillop
- McMaster University and St. Joseph’s Healthcare Hamilton, Peter Boris Center for Addictions Research, Hamilton, ON, CAN
| | - Markus Heilig
- Linkoping University, Center for Social and Affective Neuroscience, Linkoping, Sweden
| | - George F. Koob
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA; National Institute on Drug Abuse, Baltimore, MD, USA
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121
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DeMartini KS, Gueorguieva R, Pearlson G, Krishnan-Sarin S, Anticevic A, Ji LJ, Krystal JH, O'Malley SS. Mapping data-driven individualized neurobehavioral phenotypes in heavy alcohol drinkers. Alcohol Clin Exp Res 2021; 45:841-853. [PMID: 33605439 DOI: 10.1111/acer.14580] [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: 11/11/2020] [Revised: 01/27/2021] [Accepted: 02/01/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Recent studies have examined the factor structure and associated correlates of three neurofunctional domains, executive function, incentive salience, and negative emotionality in the development and maintenance of alcohol use disorders in clinical samples. The current study sought to replicate and extend prior work by testing this 3-factor model, utilizing both exact and similar phenotypic measures, as well as novel measures, in a non-treatment-seeking sample. METHODS Self-report measures of alcohol addiction, impulsivity, behavior, and exposure to early-life stress were collected as part of baseline assessments for alcohol imaging and pharmacotherapy studies in 335 individuals. Confirmatory factor analysis (CFA) was used to examine model structure and fit. A multiple indicators, multiple causes (MIMIC) model identified predictors of latent factors identified by CFA. RESULTS Results supported an intercorrelated model with three factors: executive function, incentive salience, and emotionality. All factors were associated with current AUD, and incentive salience was uniquely associated with past 30-day drinking frequency. MIMIC results identified multiple significant predictors of these latent factors, including history of alcohol use disorder, positive family history of alcohol dependence, earlier age of first drink, and a history of childhood emotional abuse and physical neglect. CONCLUSIONS Our results support an intercorrelated 3-factor model of neurofunctional domains in alcohol use models, consistent with published findings. Because childhood physical neglect was a significant predictor of all latent factors, these results also highlight the significant negative impact of childhood neglect on later addiction development.
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Affiliation(s)
| | - Ralitza Gueorguieva
- Department of Psychiatry, Yale Medical School, New Haven, CT, USA.,Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Godfrey Pearlson
- Department of Psychiatry, Yale Medical School, New Haven, CT, USA.,Olin Neuropsychiatry Research Center, Institute of Living at Hartford Hospital, Hartford, CT, USA
| | | | - Alan Anticevic
- Department of Psychiatry, Yale Medical School, New Haven, CT, USA
| | - Lisa J Ji
- Department of Psychiatry, Yale Medical School, New Haven, CT, USA
| | - John H Krystal
- Department of Psychiatry, Yale Medical School, New Haven, CT, USA
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Kotov R, Krueger RF, Watson D, Cicero DC, Conway CC, DeYoung CG, Eaton NR, Forbes MK, Hallquist MN, Latzman RD, Mullins-Sweatt SN, Ruggero CJ, Simms LJ, Waldman ID, Waszczuk MA, Wright AGC. The Hierarchical Taxonomy of Psychopathology (HiTOP): A Quantitative Nosology Based on Consensus of Evidence. Annu Rev Clin Psychol 2021; 17:83-108. [PMID: 33577350 DOI: 10.1146/annurev-clinpsy-081219-093304] [Citation(s) in RCA: 181] [Impact Index Per Article: 60.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Traditional diagnostic systems went beyond empirical evidence on the structure of mental health. Consequently, these diagnoses do not depict psychopathology accurately, and their validity in research and utility in clinicalpractice are therefore limited. The Hierarchical Taxonomy of Psychopathology (HiTOP) consortium proposed a model based on structural evidence. It addresses problems of diagnostic heterogeneity, comorbidity, and unreliability. We review the HiTOP model, supporting evidence, and conceptualization of psychopathology in this hierarchical dimensional framework. The system is not yet comprehensive, and we describe the processes for improving and expanding it. We summarize data on the ability of HiTOP to predict and explain etiology (genetic, environmental, and neurobiological), risk factors, outcomes, and treatment response. We describe progress in the development of HiTOP-based measures and in clinical implementation of the system. Finally, we review outstanding challenges and the research agenda. HiTOP is of practical utility already, and its ongoing development will produce a transformative map of psychopathology.
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Affiliation(s)
- Roman Kotov
- Departments of Psychiatry and Psychology, Stony Brook University, Stony Brook, New York 11794, USA;
| | - Robert F Krueger
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - David Watson
- Department of Psychology, University of Notre Dame, Notre Dame, Indiana 46556, USA
| | - David C Cicero
- Department of Psychology, University of North Texas, Denton, Texas 76203, USA
| | | | - Colin G DeYoung
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - Nicholas R Eaton
- Departments of Psychiatry and Psychology, Stony Brook University, Stony Brook, New York 11794, USA;
| | - Miriam K Forbes
- Centre for Emotional Health, Department of Psychology, Macquarie University, Macquarie Park, New South Wales 2109, Australia
| | - Michael N Hallquist
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
| | - Robert D Latzman
- Department of Psychology, Georgia State University, Atlanta, Georgia 30303, USA
| | | | - Camilo J Ruggero
- Department of Psychology, University of North Texas, Denton, Texas 76203, USA
| | - Leonard J Simms
- Department of Psychology, University at Buffalo, State University of New York, Buffalo, New York 14260, USA
| | - Irwin D Waldman
- Department of Psychology, Emory University, Atlanta, Georgia 30322, USA
| | - Monika A Waszczuk
- Department of Psychology, Rosalind Franklin University, North Chicago, Illinois 60064, USA
| | - Aidan G C Wright
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
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123
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Stein ER, Votaw VR, Swan JE, Witkiewitz K. Validity and measurement invariance of the Addictions Neuroclinical Assessment incentive salience domain among treatment-seekers with alcohol use disorder. J Subst Abuse Treat 2021; 122:108227. [PMID: 33509416 DOI: 10.1016/j.jsat.2020.108227] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 08/28/2020] [Accepted: 11/26/2020] [Indexed: 12/19/2022]
Abstract
Incentive salience, or the attribution of motivational value to stimuli, is a biopsychological process that is disrupted in alcohol use disorder (AUD). The Addictions Neuroclinical Assessment (ANA) is a framework to characterize heterogeneity in addiction and establish a common assessment battery for research and clinical use. The ANA framework hypothesizes three constructs that correspond to processes in the etiology, course, and treatment of addiction: incentive salience, negative emotionality, and executive function. The current study extends prior findings on the ANA by validating the incentive salience construct among participants (n = 563) in a multisite prospective study of individuals entering treatment for AUD. We used confirmatory factor analysis to test a one-factor model of incentive salience. Indicators included items assessing perception of urges to drink from the Alcohol Dependence Scale, Impaired Control Scale, and Marlatt Relapse Interview. Results indicated the one-factor model fit the data well (χ2 (12) = 19.42, p = .08; RMSEA = 0.034 [90% CI: 0.000, 0.060], CFI = 0.992) and was measurement invariant across sex. Incentive salience was associated with drinking patterns (e.g., drinks per day, r = 0.447 [95% CI: 0.379, 0.514]); reasons for drinking (urges/temptation r = 0.529 [95% CI: 0.460, 0.599]); testing personal control, r = 0.384 (95% CI: 0.308, 0.461); social pressure, r = 0.549 (95% CI: 0.481, 0.617); and family history of AUD, r = 0.134. The incentive salience factor demonstrated greater predictive validity for drinking outcomes compared to alternative preexisting scales. Overall, this study provides support for the construct validity and measurement invariance of the ANA incentive salience construct in a sample of individuals seeking AUD treatment.
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Affiliation(s)
- Elena R Stein
- Department of Psychology, 1 University of New Mexico, Albuquerque, NM 87131, United States of America; Center on Alcoholism, Substance Abuse, & Addictions, 2650 Yale SE MSC11-6280, Albuquerque, NM 87106, United States of America.
| | - Victoria R Votaw
- Department of Psychology, 1 University of New Mexico, Albuquerque, NM 87131, United States of America; Center on Alcoholism, Substance Abuse, & Addictions, 2650 Yale SE MSC11-6280, Albuquerque, NM 87106, United States of America
| | - Julia E Swan
- Department of Psychology, 1 University of New Mexico, Albuquerque, NM 87131, United States of America; Center on Alcoholism, Substance Abuse, & Addictions, 2650 Yale SE MSC11-6280, Albuquerque, NM 87106, United States of America
| | - Katie Witkiewitz
- Department of Psychology, 1 University of New Mexico, Albuquerque, NM 87131, United States of America; Center on Alcoholism, Substance Abuse, & Addictions, 2650 Yale SE MSC11-6280, Albuquerque, NM 87106, United States of America
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124
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Zhao J, Linn B, Bradizza C, Lucke J, Ruszczyk M, Stasiewicz P. Heterogeneity in DSM-5 Symptom Criteria: Phenotypes of Alcohol Use Disorder in a Sample Seeking Alcohol Treatment. Alcohol Alcohol 2021; 56:660-668. [PMID: 33420777 DOI: 10.1093/alcalc/agaa138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 11/27/2020] [Accepted: 11/28/2020] [Indexed: 11/14/2022] Open
Abstract
AIMS This study sought to identify phenotypic variations among individuals with alcohol use disorder (AUD) that may, in part, help improve the effectiveness of existing AUD interventions. METHODS Latent class analysis was conducted to examine the potential heterogeneity of AUD in a sample (N = 220; Mage = 51.19 years, standard deviation = 9.94; 37.7% female) of treatment-seeking participants diagnosed with AUD using DSM-5 criteria. RESULTS AND CONCLUSIONS Three distinct patterns of responses to the 11 DSM-5 AUD symptoms emerged: Class 1 (n = 114, 51.8%), Class 2 (n = 78, 35.5%) and Class 3 (n = 28, 12.7%). The identified profiles were further differentiated by demographics, alcohol-related constructs, individual difference characteristics and diagnostic and treatment variables. The findings have implications for refining AUD assessment as well as optimizing personalized treatment.
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Affiliation(s)
- Junru Zhao
- School of Social Work, University at Buffalo-The State University of New York, 1021 Main Street, Buffalo, NY 14203, USA
| | - Braden Linn
- Clinical and Research Institute on Addictions, University at Buffalo-The State University of New York, 1021 Main Street, Buffalo, NY 14203, USA
| | - Clara Bradizza
- School of Social Work, University at Buffalo-The State University of New York, 1021 Main Street, Buffalo, NY 14203, USA
| | - Joseph Lucke
- Department of Psychiatry, University at Buffalo-The State University of New York, 1021 Main Street, Buffalo, NY 14203, USA
| | - Melanie Ruszczyk
- School of Social Work, University at Buffalo-The State University of New York, 1021 Main Street, Buffalo, NY 14203, USA
| | - Paul Stasiewicz
- School of Social Work, University at Buffalo-The State University of New York, 1021 Main Street, Buffalo, NY 14203, USA
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125
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Wilcox CE, Clifford J, Ling J, Mayer AR, Bigelow R, Bogenschutz MP, Tonigan JS. Stroop-related cerebellar and temporal activation is correlated with negative affect and alcohol use disorder severity. Brain Imaging Behav 2021; 14:586-598. [PMID: 31115861 DOI: 10.1007/s11682-019-00126-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Impairment in cognitive control in alcohol use disorder (AUD) contributes to difficulty controlling alcohol use and, in many populations, difficulties with emotion regulation. However, the most reliable and robust marker of clinically-relevant deficits in cognitive control in AUD is unclear. Our aims were to measure relationships between BOLD signal during a Stroop task and AUD severity and change in BOLD signal and change in drinking over three weeks. We also aimed to explore the relationships between BOLD signal and subjective negative affect. Thirty-three individuals with AUD underwent a multisensory Stroop task during functional magnetic resonance imaging (fMRI), as well as a battery of neuropsychological tests and self-report assessments of negative affect and AUD severity. Greater activation in temporal gyrus and cerebellum during incongruent trials compared to congruent trials was observed, and percent signal change (incongruent minus congruent) in both clusters was positively correlated with AUD severity and self-reported negative affect. Neuropsychological task performance and self-reported impulsivity were not highly correlated with AUD severity. Hierarchical regression analyses indicated that percent signal change (incongruent minus congruent) in cerebellum was independently associated with negative affect after controlling for recent and chronic drinking. In a subset of individuals (n = 23) reduction in cerebellar percent signal change (incongruent minus congruent) was correlated with increases in percent days abstinent over 3 weeks. BOLD activation during this Stroop task may therefore be an important objective marker of AUD severity and negative affect. The potential importance of the cerebellum in emotion regulation and AUD severity is highlighted.
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Affiliation(s)
- Claire E Wilcox
- Mind Research Network , 1101 Yale Blvd. NE, Albuquerque, NM, 87106, USA.
| | - Joshua Clifford
- Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA
| | - Josef Ling
- Mind Research Network , 1101 Yale Blvd. NE, Albuquerque, NM, 87106, USA
| | - Andrew R Mayer
- Mind Research Network , 1101 Yale Blvd. NE, Albuquerque, NM, 87106, USA
| | - Rose Bigelow
- Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA
| | - Michael P Bogenschutz
- Department of Psychiatry, New York University School of Medicine, New York, NY, 10016, USA
| | - J Scott Tonigan
- Department of Psychology, Center on Alcoholism, Substance Abuse & Addictions, University of New Mexico, Albuquerque, NM, USA
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126
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Dacosta-Sánchez D, González-Ponce BM, Fernández-Calderón F, Rojas-Tejada AJ, Ordóñez-Carrasco JL, Lozano-Rojas OM. Profiles of patients with cocaine and alcohol use disorder based on cognitive domains and their relationship with relapse. Drug Alcohol Depend 2021; 218:108349. [PMID: 33342513 DOI: 10.1016/j.drugalcdep.2020.108349] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 07/07/2020] [Accepted: 09/28/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Relapse in drug use constitutes a research topic on addiction that is relevant for understanding both the addictive process and its clinical implications. The objective of this study was to explore if it is possible to identify patient profiles according to their performance on cognitive tasks whilst examining the relationship between such profiles and relapse. METHODS The sample consisted of 222 patients with dependence on cocaine and / or alcohol, of which 86 % were men. Cognitive domains related to salience, decision- making, and emotional processing were measured. RESULTS Latent class analysis revealed three patient profiles that differ in terms of performance on cognitive tasks. Two of these profiles are clearly differentiated in terms of their execution of the impulsive decision-making task. The third patient profile, unlike the latter two, is composed of patients with severe alterations in the three domains evaluated. Analysis revealed that patients in Profile 3 are those with the highest rates of relapse in cocaine (Profile 1 = 40.3 %; Profile 2 = 35.6 %; Profile 3 = 69.2 %; Chi2 = 9.169; p < .05) and cocaine and alcohol use (Profile 1 = 55.1 %; Profile 2 = 54.1 %; Profile 3 = 80 %; Chi2 = 6.698; p < .05). CONCLUSIONS The results support the postulates of the I-RISA model. From a clinical perspective, these findings highlight the need for a comprehensive evaluation of the cognitive domains involved in addiction.
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Affiliation(s)
- Daniel Dacosta-Sánchez
- Department of Clinical and Experimental Psychology. University of Huelva, Avda. Fuerzas Armadas s/n. 21071, Huelva, Spain
| | - Bella M González-Ponce
- Department of Clinical and Experimental Psychology. University of Huelva, Avda. Fuerzas Armadas s/n. 21071, Huelva, Spain
| | - Fermín Fernández-Calderón
- Department of Clinical and Experimental Psychology. University of Huelva, Avda. Fuerzas Armadas s/n. 21071, Huelva, Spain; Research Center on Natural Resources, Health and the Environment, University of Huelva, Ed. Experimental Sciences, 21071, Huelva, Spain
| | - Antonio J Rojas-Tejada
- Department of Psychology, University of Almeria, Crta. Sacramento s/n. 04120, Almeria, Spain
| | | | - Oscar M Lozano-Rojas
- Department of Clinical and Experimental Psychology. University of Huelva, Avda. Fuerzas Armadas s/n. 21071, Huelva, Spain; Research Center on Natural Resources, Health and the Environment, University of Huelva, Ed. Experimental Sciences, 21071, Huelva, Spain.
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127
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Koob GF. Drug Addiction: Hyperkatifeia/Negative Reinforcement as a Framework for Medications Development. Pharmacol Rev 2021; 73:163-201. [PMID: 33318153 PMCID: PMC7770492 DOI: 10.1124/pharmrev.120.000083] [Citation(s) in RCA: 154] [Impact Index Per Article: 51.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Compulsive drug seeking that is associated with addiction is hypothesized to follow a heuristic framework that involves three stages (binge/intoxication, withdrawal/negative affect, and preoccupation/anticipation) and three domains of dysfunction (incentive salience/pathologic habits, negative emotional states, and executive function, respectively) via changes in the basal ganglia, extended amygdala/habenula, and frontal cortex, respectively. This review focuses on neurochemical/neurocircuitry dysregulations that contribute to hyperkatifeia, defined as a greater intensity of negative emotional/motivational signs and symptoms during withdrawal from drugs of abuse in the withdrawal/negative affect stage of the addiction cycle. Hyperkatifeia provides an additional source of motivation for compulsive drug seeking via negative reinforcement. Negative reinforcement reflects an increase in the probability of a response to remove an aversive stimulus or drug seeking to remove hyperkatifeia that is augmented by genetic/epigenetic vulnerability, environmental trauma, and psychiatric comorbidity. Neurobiological targets for hyperkatifeia in addiction involve neurocircuitry of the extended amygdala and its connections via within-system neuroadaptations in dopamine, enkephalin/endorphin opioid peptide, and γ-aminobutyric acid/glutamate systems and between-system neuroadaptations in prostress corticotropin-releasing factor, norepinephrine, glucocorticoid, dynorphin, hypocretin, and neuroimmune systems and antistress neuropeptide Y, nociceptin, endocannabinoid, and oxytocin systems. Such neurochemical/neurocircuitry dysregulations are hypothesized to mediate a negative hedonic set point that gradually gains allostatic load and shifts from a homeostatic hedonic state to an allostatic hedonic state. Based on preclinical studies and translational studies to date, medications and behavioral therapies that reset brain stress, antistress, and emotional pain systems and return them to homeostasis would be promising new targets for medication development. SIGNIFICANCE STATEMENT: The focus of this review is on neurochemical/neurocircuitry dysregulations that contribute to hyperkatifeia, defined as a greater intensity of negative emotional/motivational signs and symptoms during withdrawal from drugs of abuse in the withdrawal/negative affect stage of the drug addiction cycle and a driving force for negative reinforcement in addiction. Medications and behavioral therapies that reverse hyperkatifeia by resetting brain stress, antistress, and emotional pain systems and returning them to homeostasis would be promising new targets for medication development.
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Affiliation(s)
- George F Koob
- National Institute on Alcohol Abuse and Alcoholism and National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
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128
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Pallanti S, Marras A, Makris N. A Research Domain Criteria Approach to Gambling Disorder and Behavioral Addictions: Decision-Making, Response Inhibition, and the Role of Cannabidiol. Front Psychiatry 2021; 12:634418. [PMID: 34603091 PMCID: PMC8484302 DOI: 10.3389/fpsyt.2021.634418] [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: 01/18/2021] [Accepted: 07/30/2021] [Indexed: 12/14/2022] Open
Abstract
Gambling Disorder (GD) has been recently re-classified in the DSM-5 under the "substance-related and addictive disorders," in light of its genetic, endophenotypic, and phenotypic resemblances to substance dependence. Diminished control is a core defining concept of psychoactive substance dependence or addiction and has given rise to the concept of "behavioral" addictions, which are syndromes analogous to substance addiction, but with a behavioral focus other than ingestion of a psychoactive substance. The main symptom clusters are represented by loss of control, craving/withdrawal, and neglect of other areas of life, whereas in a Research Domain Criteria (RDoC) perspective, GD patients exhibit deficits in the domain of "Positive valence systems," particularly in the "Approach motivation" and "Reward learning" constructs, as well as in the "Cognitive systems," primarily in the "Cognitive control" construct. In the Addictions Neuroclinical Assessment (ANA), three relevant domains for addictions emerge: "Incentive salience," "Negative Emotionality," and "Executive Function." The endocannabinoid system (ECS) may largely modulate these circuits, presenting a promising pharmaceutical avenue for treating addictions. Up to now, research on cannabidiol has shown some efficacy in Attention Deficit/Hyperactivity Disorder (ADHD), whereas in behavioral addictions its role has not been fully elucidated, as well as its precise action on RDoC domains. Herein, we review available evidence on RDoC domains affected in GD and behavioral addictions and summarize insights on the use of cannabidiol in those disorders and its potential mechanisms of action on reward, decisional, and sensorimotor processes.
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Affiliation(s)
- Stefano Pallanti
- Institute of Neurosciences, Florence, Italy.,Albert Einstein College of Medicine and Montefiore Medical Center, New York, NY, United States
| | - Anna Marras
- Institute of Neurosciences, Florence, Italy.,Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Nikolaos Makris
- Departments of Psychiatry and Neurology, Center for Morphometric Analysis, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
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129
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Exploring dopaminergic transmission in gambling addiction: A systematic translational review. Neurosci Biobehav Rev 2020; 119:481-511. [DOI: 10.1016/j.neubiorev.2020.09.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 08/16/2020] [Accepted: 09/26/2020] [Indexed: 12/15/2022]
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130
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Ekhtiari H, Verdejo-Garcia A, Moeller SJ, Zare-Bidoky M, Baldacchino AM, Paulus M. Editorial: Brain and Cognition for Addiction Medicine: From Prevention to Recovery. Front Psychiatry 2020; 11:590030. [PMID: 33329140 PMCID: PMC7732613 DOI: 10.3389/fpsyt.2020.590030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 09/22/2020] [Indexed: 12/02/2022] Open
Affiliation(s)
- Hamed Ekhtiari
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Antonio Verdejo-Garcia
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | - Scott J. Moeller
- Department of Psychiatry, Stony Brook Medicine, Stony Brook, NY, United States
| | - Mehran Zare-Bidoky
- School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Martin Paulus
- Laureate Institute for Brain Research, Tulsa, OK, United States
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131
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Schmid F, Benzerouk F, Barrière S, Henry A, Limosin F, Kaladjian A, Gierski F. Heterogeneity of Executive Function Abilities in Recently Detoxified Patients with Alcohol Use Disorder: Evidence from a Cluster Analysis. Alcohol Clin Exp Res 2020; 45:163-173. [PMID: 33190273 DOI: 10.1111/acer.14517] [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: 06/16/2020] [Revised: 11/08/2020] [Accepted: 11/09/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Impairments of executive functions (EF) have been consistently reported in patients with alcohol use disorder (AUD), mostly in studies which were based on comparisons of means between groups. However, given the high heterogeneity in AUD patients, this approach could actually cover a wide range of EF patterns. In the present study, we addressed the paucity of the literature about cognitive heterogeneity in AUD by applying a cluster analytical approach on EF measures. METHODS Seventy-eight withdrawn AUD patients and 77 healthy Control participants completed measures targeting a variety of EF components. We then used cluster analysis to identify subgroups of AUD patients. Furthermore, the AUD subgroups were compared to the Control group to establish their specific EF patterns. RESULTS Findings showed that AUD patients could be divided into 3 clusters based on their EF performances. A first cluster accounting for half of the AUD sample was characterized by unimpaired EF (Cluster 1). The 2 other clusters displayed major EF deficits but differed regarding the deficient EF component. While Cluster 2 was mainly impaired on measures of rule deduction and mental flexibility, Cluster 3 was mainly characterized by a lower processing speed and impaired inhibition of an ongoing motor response. Differences in EF performances of AUD patients could be related to differences in premorbid cognitive reserve, impulsiveness patterns, and withdrawal complications. CONCLUSIONS This study highlights the importance of the cognitive heterogeneity in AUD by showing that AUD patients display substantially different EF patterns. Future studies should try to go beyond mere group comparisons to further deepen our understanding about cognitive differences between AUD patients. In the long run, this could lead to more personalized prevention and treatment programs specifically tailored to the patient's impairments.
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Affiliation(s)
- Franca Schmid
- From the, Laboratoire Cognition Santé, Société (C2S - EA 6291), (FS, FB, AH, AK, FG), Université de Reims Champagne-Ardenne, Reims, France
| | - Farid Benzerouk
- From the, Laboratoire Cognition Santé, Société (C2S - EA 6291), (FS, FB, AH, AK, FG), Université de Reims Champagne-Ardenne, Reims, France.,CHU de Reims, EPSM Marne, (FB, SB, AH, AK, FG), Pôle Universitaire de Psychiatrie, Reims, France
| | - Sarah Barrière
- CHU de Reims, EPSM Marne, (FB, SB, AH, AK, FG), Pôle Universitaire de Psychiatrie, Reims, France
| | - Audrey Henry
- From the, Laboratoire Cognition Santé, Société (C2S - EA 6291), (FS, FB, AH, AK, FG), Université de Reims Champagne-Ardenne, Reims, France.,CHU de Reims, EPSM Marne, (FB, SB, AH, AK, FG), Pôle Universitaire de Psychiatrie, Reims, France
| | - Frédéric Limosin
- Paris Descartes Faculté de Médecine, (FL), Université de Paris, Paris, France.,Département de Psychiatrie, Hôpital Européen Georges-Pompidou, (FL), AP-HP. Centre - Université de Paris, Paris, France.,Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, INSERM, (FL), Université de Paris, Paris, France
| | - Arthur Kaladjian
- From the, Laboratoire Cognition Santé, Société (C2S - EA 6291), (FS, FB, AH, AK, FG), Université de Reims Champagne-Ardenne, Reims, France.,CHU de Reims, EPSM Marne, (FB, SB, AH, AK, FG), Pôle Universitaire de Psychiatrie, Reims, France
| | - Fabien Gierski
- From the, Laboratoire Cognition Santé, Société (C2S - EA 6291), (FS, FB, AH, AK, FG), Université de Reims Champagne-Ardenne, Reims, France.,CHU de Reims, EPSM Marne, (FB, SB, AH, AK, FG), Pôle Universitaire de Psychiatrie, Reims, France.,INSERM U1247 GRAP, Groupe de recherche sur l'alcool et les pharmacodépendances, (FG), Université de Picardie Jules Verne, Amiens, France
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132
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Blum K, Green R, Smith J, Llanos-Gomez L, Baron D, Badgaiyan RD. Hypothesizing High Negative Emotionality as a Function of Genetic Addiction Risk Severity (GARS) Testing in Alcohol Use Disorder (AUD). JOURNAL OF SYSTEMS AND INTEGRATIVE NEUROSCIENCE 2020; 7. [PMID: 35096419 PMCID: PMC8793765 DOI: 10.15761/jsin.1000245] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Kenneth Blum
- Graduate College, Western University Health Sciences, Pomona, CA, USA.,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.,The Kenneth Blum Neurogenetic & Behavioral Institute (Division of iVitalize Inc.), Austin, TX, USA
| | - Richard Green
- Division of precision Medicine, Precision Translational Medicine, San Antonio, Tx, USA
| | - Jessica Smith
- Division of precision Medicine, Precision Translational Medicine, San Antonio, Tx, USA
| | - Luis Llanos-Gomez
- The Kenneth Blum Neurogenetic & Behavioral Institute (Division of iVitalize Inc.), Austin, TX, USA
| | - David Baron
- Graduate College, Western University Health Sciences, Pomona, CA, USA
| | - Rajendra D Badgaiyan
- Department of Psychiatry, Icahn School of Medicine Mt Sinai, New York, NY, USA.,Department of Psychiatry, South Texas Veteran Health Care System, Audie L. Murphy Memorial VA Hospital, San Antonio, TX, Long School of Medicine, University of Texas Medical Center, San Antonio, TX, USA
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133
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Koob GF, Powell P, White A. Addiction as a Coping Response: Hyperkatifeia, Deaths of Despair, and COVID-19. Am J Psychiatry 2020; 177:1031-1037. [PMID: 33135468 DOI: 10.1176/appi.ajp.2020.20091375] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- George F Koob
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, Md. (all authors); National Institute on Drug Abuse, Bethesda, Md. (Koob)
| | - Patricia Powell
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, Md. (all authors); National Institute on Drug Abuse, Bethesda, Md. (Koob)
| | - Aaron White
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, Md. (all authors); National Institute on Drug Abuse, Bethesda, Md. (Koob)
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134
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Bohnsack JP, Pandey SC. Histone modifications, DNA methylation, and the epigenetic code of alcohol use disorder. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2020; 156:1-62. [PMID: 33461661 DOI: 10.1016/bs.irn.2020.08.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Alcohol use disorder (AUD) is a leading cause of morbidity and mortality. Despite AUD's substantial contributions to lost economic productivity and quality of life, there are only a limited number of approved drugs for treatment of AUD in the United States. This chapter will update progress made on the epigenetic basis of AUD, with particular focus on histone post-translational modifications and DNA methylation and how these two epigenetic mechanisms interact to contribute to neuroadaptive processes leading to initiation, maintenance and progression of AUD pathophysiology. We will also evaluate epigenetic therapeutic strategies that have arisen from preclinical models of AUD and epigenetic biomarkers that have been discovered in human populations with AUD.
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Affiliation(s)
- John Peyton Bohnsack
- Center for Alcohol Research in Epigenetics, Department of Psychiatry, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Subhash C Pandey
- Center for Alcohol Research in Epigenetics, Department of Psychiatry, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States; Jesse Brown VA Medical Center, Chicago, IL, United States; Department of Anatomy and Cell Biology, University of Illinois at Chicago, Chicago, IL, United States.
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135
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Bowyer CB, Joyner KJ, Latzman RD, Venables NC, Foell J, Patrick CJ. A Model-Based Strategy for Interfacing Traits of the DSM-5 AMPD With Neurobiology. J Pers Disord 2020; 34:586-608. [PMID: 33074055 DOI: 10.1521/pedi.2020.34.5.586] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The DSM-5 alternative model for personality disorders (AMPD) groups traits into domains based on factor analyses of self-report data. AMPD traits may need to be configured differently to interface with neurobiology. Focusing on biobehavioral risk for externalizing problems in 334 adults, the authors used structural modeling to evaluate how well alternative configurations of AMPD traits, operationalized using the Personality Inventory for DSM-5 (PID-5), interface with neural indicators of externalizing liability. A model specifying two correlated factors defined by traits within the PID-5 Disinhibition domain and brain-response indicators of externalizing proneness exhibited inadequate fit. However, a model using PID-5 traits with better coverage of biobehavioral externalizing liability evidenced good fit. Scores on this PID-5 trait factor, termed "PID-5 Externalizing Proneness," converged well with criterion measures of externalizing proneness and diverged from measures of threat sensitivity. Findings illustrate how AMPD traits can be configured for use in investigations of biobehavioral risk for psychopathology.
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Affiliation(s)
| | | | | | | | - Jens Foell
- Florida State University, Tallahassee, Florida
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136
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Edemann-Callesen H, Barak S, Hadar R, Winter C. Choosing the Optimal Brain Target for Neuromodulation Therapies as Alcohol Addiction Progresses—Insights From Pre-Clinical Studies. CURRENT ADDICTION REPORTS 2020. [DOI: 10.1007/s40429-020-00316-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Abstract
Purpose of the Review
Development of addiction involves a transition from reward-driven to habitual behavior, mediated by neuroplastic changes. Based on preclinical findings, this article article reviews the current knowledge on the use of neuromodulation therapies to target alcohol addiction and essentially reduce relapse.
Recent Findings
To date, only a limited number of preclinical studies have investigated the use of neuromodulation in alcohol addiction, with the focus being on targeting the brain reward system. However, as addiction develops, additional circuits are recruited. Therefore, a differential setup may be required when seeking to alter the chronic alcohol-dependent brain, as opposed to treating earlier phases of alcohol addiction.
Summary
To promote enduring relapse prevention, the choice of brain target should match the stage of the disorder. Further studies are needed to investigate which brain areas should be targeted by neuromodulating strategies, in order to sufficiently alter the behavior and pathophysiology as alcohol addiction progresses.
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137
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Creswell KG, Chung T, Skrzynski CJ, Bachrach RL, Jackson KM, Clark DB, Martin CS. Drinking beyond the binge threshold in a clinical sample of adolescents. Addiction 2020; 115:1472-1481. [PMID: 31984600 PMCID: PMC8071609 DOI: 10.1111/add.14979] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 09/16/2019] [Accepted: 01/21/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND AIMS Nearly all the research conducted on high-intensity drinking has focused on college and school-based samples, with recent calls for research to understand this risky drinking pattern in non-school-based samples and across time. This study aimed to characterize predictors and consequences of non-binge drinking, age- and gender-adjusted binge drinking (level I) and drinking at levels representing two or more times (level II) and three or more times the level I binge threshold (level III) in a clinical sample of adolescents followed into young adulthood. DESIGN Cross-sectional associations between non-binge drinking, binge levels, and negative alcohol-related consequences were examined during adolescence; prospective analyses tested whether adolescent non-binge drinking and binge levels predicted alcohol use disorder (AUD) symptoms in young adulthood and whether changes in drinking motives over time were associated with binge levels in young adulthood. SETTING US clinical settings. PARTICIPANTS A total of 432 adolescents (aged 12-18 years) with alcohol-related problems followed into young adulthood (aged 19-25 years). MEASUREMENTS Life-time drinking history, Structured Clinical Interview for DSM AUDs, and Inventory of Drinking Situations. FINDINGS Results were generally consistent with a distinction between binge level I versus levels II-III on various negative alcohol-related consequences in adolescence (Ps < 0.05) that were maintained in young adulthood (Ps < 0.01). The maintenance of relatively high endorsement of enhancement and social motives over time was associated with binge levels II-III in young adulthood (Ps < 0.001); decreases in coping motives were associated with less risky drinking in adulthood (P = 0.003). CONCLUSIONS Among US adolescents with alcohol-related problems who were followed-up in young adulthood (aged 19-25 years), standard threshold binge drinking (five or more drinks per occasion; level I) was generally associated with fewer alcohol-related consequences and problem behaviors than binge drinking at two or more times (level II) or three or more times (level III) the standard binge threshold.
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Affiliation(s)
- Kasey G. Creswell
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Tammy Chung
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Rachel L. Bachrach
- Center for Health Equity Research and Promotion, Mental Illness Research, Education and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Kristina M. Jackson
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
| | - Duncan B. Clark
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
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138
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Bachrach RL, Chung T. Moderators of Substance Use Disorder Treatment for Adolescents. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2020; 50:498-509. [PMID: 32716211 DOI: 10.1080/15374416.2020.1790379] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE This brief review covers the current state of the literature on moderators of adolescent substance use disorder (SUD) treatment. These moderators provide information on "for whom" a specific treatment may work best. METHOD We used Google Scholar, PubMed, PsycInfo, and manual search of relevant reference lists to identify eligible peer-reviewed publications from January 2005 to December 2019. RESULTS We summarize 21 published studies (including meta-analyses, randomized clinical trials, and correlational work) testing moderators and/or predictors of adolescent SUD treatment outcomes. Conclusions are, thus, limited by the relatively small number of studies. Results suggest that, for adolescents with co-occurring externalizing pathology or those higher in SUD severity, more intensive treatment appears to be more effective. Other findings were often inconsistent (e.g., examining sex or race/ethnicity as a moderator) between studies, making it challenging to provide clear recommendations for personalizing SUD treatment choice. CONCLUSIONS Future research may need to shift focus from exploring often unchangeable moderators (e.g., race/ethnicity) to factors that are potentially modifiable with treatment. Additionally, testing models that include mediators of treatment effects-that is, factors that help to explain "how" treatment works-along with moderators (moderated-mediation) may provide the most benefit in understanding both "for whom" and "how" to tailor SUD treatment to optimally meet an adolescent's personal needs.
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Affiliation(s)
- Rachel L Bachrach
- Center for Health Equity Research and Promotion, Mental Illness Research, Education and Clinical Center, VA Pittsburgh Healthcare System
| | - Tammy Chung
- Rutgers, Institute for Health, Health Care Policy and Aging Research, The State University of New Jersey
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139
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Davidov A, Greer TL. Pathology-Congruent Biases as Biomarkers for Psychopathology. Psychiatr Ann 2020. [DOI: 10.3928/00485713-20200504-01] [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: 11/20/2022]
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140
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Imburgio MJ, Banica I, Hill KE, Weinberg A, Foti D, MacNamara A. Establishing norms for error-related brain activity during the arrow Flanker task among young adults. Neuroimage 2020; 213:116694. [PMID: 32142881 PMCID: PMC7197955 DOI: 10.1016/j.neuroimage.2020.116694] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 02/14/2020] [Accepted: 02/27/2020] [Indexed: 02/08/2023] Open
Abstract
Psychological assessments typically rely on self-report and behavioral measures. Augmenting these with neurophysiological measures of the construct in question may increase the accuracy and predictive power of these assessments. Moreover, thinking about neurophysiological measures from an assessment perspective may facilitate under-utilized research approaches (e.g., brain-based recruitment of participants). However, the lack of normative data for most neurophysiological measures has prevented the comparison of individual responses to the general population, precluding these approaches. The current work examines the distributions of two event-related potentials (ERPs) commonly used in individual differences research: the error-related negativity (ERN) and error positivity (Pe). Across three lab sites, 800 unselected participants between the ages of 18 and 30 performed the arrow version of a Flanker task while EEG was recorded. Percentile scores and distributions for ERPs on error trials, correct trials, and the difference (ΔERN, ΔPe; error minus correct) at Fz, Cz and Pz are reported. The 25th, 50th, and 75th percentile values for the ΔERN at Cz were -2.37 μV, -5.41 μV, and -8.65 μV, respectively. The same values for ΔPe at Cz were 7.51 μV, 11.18 μV, and 15.55 μV. Females displayed significantly larger ΔPe magnitudes and smaller ΔERN magnitudes than males. Additionally, normative data for behavioral performance (accuracy, post-error slowing, and reaction time) on the Flanker task is reported. Results provide a means by which ERN and Pe amplitudes of young adults elicited by the arrow Flanker task can be benchmarked, facilitating the classification of neural responses as 'large,' 'medium,' or 'small'. The ability to classify responses in this manner is a necessary step towards expanded use of these measures in assessment and research settings. These norms may not apply to ERPs elicited by other tasks, and future work should establish similar norms using other tasks.
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Affiliation(s)
- Michael J Imburgio
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, USA.
| | - Iulia Banica
- Department of Psychology, McGill University, Montreal, QC, Canada
| | - Kaylin E Hill
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA
| | - Anna Weinberg
- Department of Psychology, McGill University, Montreal, QC, Canada
| | - Dan Foti
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA
| | - Annmarie MacNamara
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, USA
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141
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Abstract
In this targeted review, we summarize current knowledge on substance-use disorder
(SUD)-related cognitive deficits, the link between these deficits and clinical outcomes,
and the cognitive training, remediation, and pharmacological approaches that have the
potential to rescue cognition. We conclude that: (i) people with SUDs have moderate
deficits in memory, attention, executive functions, and decision-making (including
reward expectancy, valuation, and learning); (ii) deficits in higher-order executive
functions and decision-making are significant predictors of relapse; (iii) cognitive
training programs targeting reward-related appetitive biases, cognitive remediation
strategies targeting goal-based decision-making, and pharmacotherapies targeting memory,
attention, and impulsivity have potential to rescue SUD-related cognitive deficits. We
suggest avenues for future research, including developing brief, clinically oriented
harmonized cognitive testing suites to improve individualized prediction of treatment
outcomes; computational modeling that can achieve deep phenotyping of cognitive subtypes
likely to respond to different interventions; and phenotype-targeted cognitive,
pharmacological, and combined interventions. We conclude with a tentative model of
neuroscience-informed precision medicine.
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Affiliation(s)
| | - Gloria Garcia-Fernandez
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia; Department of Psychology, University of Oviedo, Spain
| | - Geert Dom
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), Antwerp University (UA), Antwerp, Belgium
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142
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Voon V, Grodin E, Mandali A, Morris L, Doñamayor N, Weidacker K, Kwako L, Goldman D, Koob GF, Momenan R. Addictions NeuroImaging Assessment (ANIA): Towards an integrative framework for alcohol use disorder. Neurosci Biobehav Rev 2020; 113:492-506. [PMID: 32298710 DOI: 10.1016/j.neubiorev.2020.04.004] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 03/30/2020] [Accepted: 04/05/2020] [Indexed: 02/08/2023]
Abstract
Alcohol misuse and addiction are major international public health issues. Addiction can be characterized as a disorder of aberrant neurocircuitry interacting with environmental, genetic and social factors. Neuroimaging in alcohol misuse can thus provide a critical window into underlying neural mechanisms, highlighting possible treatment targets and acting as clinical biomarkers for predicting risk and treatment outcomes. This neuroimaging review on alcohol misuse in humans follows the Addictions Neuroclinical Assessment (ANA) that proposes incorporating three functional neuroscience domains integral to the neurocircuitry of addiction: incentive salience and habits, negative emotional states, and executive function within the context of the addiction cycle. Here we review and integrate multiple imaging modalities focusing on underlying cognitive processes such as reward anticipation, negative emotionality, cue reactivity, impulsivity, compulsivity and executive function. We highlight limitations in the literature and propose a model forward in the use of neuroimaging as a tool to understanding underlying mechanisms and potential clinical applicability for phenotyping of heterogeneity and predicting risk and treatment outcomes.
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Affiliation(s)
- Valerie Voon
- Department of Psychiatry, University of Cambridge, Cambridge, UK; Behavioural and Clinical Neurosciences Institute, Cambridge, UK; Cambridgeshire and Peterborough NHS Trust, Cambridge, UK.
| | - Erica Grodin
- Clinical NeuroImaging Research Core, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, UK
| | - Alekhya Mandali
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Laurel Morris
- Behavioural and Clinical Neurosciences Institute, Cambridge, UK; Department of Psychology, University of Cambridge, Cambridge, UK
| | - Nuria Doñamayor
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | | | - Laura Kwako
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, UK
| | - David Goldman
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, UK
| | - George F Koob
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, UK
| | - Reza Momenan
- Clinical NeuroImaging Research Core, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, UK
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143
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Chang CH, Chang YC, Cheng H, Tzang RF. Treatment Efficacy of Internet Gaming Disorder With Attention Deficit Hyperactivity Disorder and Emotional Dysregulaton. Int J Neuropsychopharmacol 2020; 23:349-355. [PMID: 32047929 PMCID: PMC7311645 DOI: 10.1093/ijnp/pyaa010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 01/16/2020] [Accepted: 02/10/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Recent youth with Attention Deficit Hyperactivity Disorder (ADHD) noticed emotional dysregulation if they had Internet Gaming Disorder (IGD). This study aims to understand the treatment efficacy of IGD with ADHD and emotional dysregulaton. METHOD A total of 101 ADHD youths were recruited. We used the Chen Internet Addiction Scale and IGD criteria of the diagnotsic statistical manual (DSM)-5 to confirm IGD. The Swanson, Nolan, and Pelham questionnaire Version IV was used for symptoms of ADHD and oppositional defiant disorder. Disruptive mood dysregulation disorder was assessed by psychiatrist. RESULTS There is a new phenomenon that emotional dysregulation has been frequently noticed in severely gaming-addicted ADHD youth. Treatment efficacy of IGD is good when the underlying symptom of ADHD is controlled. Symptom scores of disruptive mood dysregulation (DMDD) were significantly reduced by 71.9%, 74.8%, and 84.4% at week 2, 3, and 4, respectively (P ≤ .001) after adjusting baseline symptom severity. CONCLUSION IGD may strongly arouse emotional dysregulation. Future DSM criteria could consider these gaming-addicted youth as a specific subclass of ADHD.
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Affiliation(s)
- Chuan-Hsin Chang
- Agricultural Biotechnology Research Center, Academia Sinica, Taipei, Taiwan
| | - Yue-Cune Chang
- Department of Mathematics, Tamkang University, Taipei, Taiwan
| | - Helen Cheng
- Department of Psychiatry, Christian Hospital, Changhua, Taiwan
| | - Ruu-Fen Tzang
- Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan,Mackay Medical Colleges, New Taipei City, Taiwan,Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan,Correspondence: Ruu-Fen Tzang, MD, Department of Psychiatry, Mackay Memorial Hospital, Number 92, Sec. 2, Zhong Shan N Road, Taipei 104, Taiwan ()
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144
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Silveira S, Shah R, Nooner KB, Nagel BJ, Tapert SF, de Bellis MD, Mishra J. Impact of Childhood Trauma on Executive Function in Adolescence-Mediating Functional Brain Networks and Prediction of High-Risk Drinking. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 5:499-509. [PMID: 32299789 DOI: 10.1016/j.bpsc.2020.01.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 01/07/2020] [Accepted: 01/22/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Childhood trauma is known to impart risk for several adverse life outcomes. Yet, its impact during adolescent development is not well understood. We aimed to investigate the relationships among childhood trauma, functional brain connectivity, executive dysfunction (ED), and the development of high-risk drinking in adolescence. METHODS Data from the National Consortium on Alcohol and Neurodevelopment in Adolescence (sample size = 392, 55% female) cohort were used. This included resting-state functional magnetic resonance imaging at baseline, childhood trauma and ED self-reports, and detailed interviews on alcohol and substance use collected at baseline and at 4 annual follow-ups. We used longitudinal regression analyses to confirm the relationship between childhood trauma and ED, identified the mediating functional brain network hubs, and used these linkages to predict future high-risk drinking in adolescence. RESULTS Childhood trauma severity was significantly related to ED in all years. At baseline, distributed functional connectivity from hub regions in the bilateral dorsal anterior cingulate cortex, right anterior insula, right intraparietal sulcus, and bilateral pre- and postcentral gyri mediated the relationship between childhood trauma and ED. Furthermore, high-risk drinking in follow-up years 1-4 could be predicted with high accuracy from the trauma-affected functional brain networks that mediated ED at baseline, together with age, childhood trauma severity, and extent of ED. DISCUSSION Functional brain networks, particularly from hub regions important for cognitive and sensorimotor control, explain the relationship between childhood trauma and ED and are important for predicting future high-risk drinking. These findings are relevant for the prognosis of alcohol use disorders.
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Affiliation(s)
- Sarita Silveira
- Department of Psychiatry, University of California San Diego, La Jolla, California; Neural Engineering and Translation Labs, University of California San Diego, La Jolla, California
| | - Rutvik Shah
- Department of Psychiatry, University of California San Diego, La Jolla, California; Neural Engineering and Translation Labs, University of California San Diego, La Jolla, California
| | - Kate B Nooner
- Department of Psychology, University of North Carolina, Wilmington, North Carolina
| | - Bonnie J Nagel
- Departments of Psychiatry and Behavioral Neuroscience, Oregon Health and Science University, Portland, Oregon
| | - Susan F Tapert
- Department of Psychiatry, University of California San Diego, La Jolla, California
| | - Michael D de Bellis
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina
| | - Jyoti Mishra
- Department of Psychiatry, University of California San Diego, La Jolla, California; Neural Engineering and Translation Labs, University of California San Diego, La Jolla, California
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145
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Votaw VR, Pearson MR, Stein E, Witkiewitz K. The Addictions Neuroclinical Assessment Negative Emotionality Domain Among Treatment-Seekers with Alcohol Use Disorder: Construct Validity and Measurement Invariance. Alcohol Clin Exp Res 2020; 44:679-688. [PMID: 31957027 DOI: 10.1111/acer.14283] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 12/20/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND The Addictions Neuroclinical Assessment (ANA), a framework for measuring heterogeneity in alcohol use disorder (AUD), focuses on 3 domains that reflect neurobiological dysfunction in addiction and correspond to the cycles of addiction: executive function, incentive salience, and negative emotionality. Kwako and colleagues (Am J Psychiatry 176:744, 2019) validated a 3-factor model of the ANA with neuropsychological and self-report indicators among treatment-seekers and non-treatment-seekers with and without AUD. The present analysis replicated and extended these findings in a treatment-seeking sample, focusing on the negative emotionality domain. METHODS Participants (n = 563; 58.8% male; mean age = 34.3) were part of a multisite prospective study of individuals entering AUD treatment. We examined the factor structure of the negative emotionality domain at the baseline, 6-month follow-up, and 12-month follow-up assessments. The Beck Depression Inventory, Beck Anxiety Inventory, State-Trait Anger Expression Inventory-Trait Anger Subscale, and 3 Drinker Inventory of Consequences items assessing negative affective consequences were indicators in the model. RESULTS Results indicated that a 1-factor model was an excellent fit at all assessments and that the negative emotionality domain was time and gender invariant. Furthermore, negative emotionality was associated with drinking patterns and reasons for alcohol use (i.e., drinking because of negative emotions and urges/withdrawal) at all assessments. CONCLUSIONS This analysis provides evidence for the construct validity and measurement invariance of the ANA negative emotionality domain among AUD treatment-seekers. Future studies are needed to evaluate prospective associations between negative emotionality and specific treatment modalities, and whether individuals with greater negative emotionality are more likely to respond to treatment that targets drinking to relieve negative affective states.
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Affiliation(s)
- Victoria R Votaw
- From the, Department of Psychology, (VRV, ES, KW), Center on Alcoholism, Substance Abuse, & Addictions, University of New Mexico, Albuquerque, New Mexico
| | - Matthew R Pearson
- Center on Alcoholism, Substance Abuse, & Addictions, (MRP), University of New Mexico, Albuquerque, New Mexico
| | - Elena Stein
- From the, Department of Psychology, (VRV, ES, KW), Center on Alcoholism, Substance Abuse, & Addictions, University of New Mexico, Albuquerque, New Mexico
| | - Katie Witkiewitz
- From the, Department of Psychology, (VRV, ES, KW), Center on Alcoholism, Substance Abuse, & Addictions, University of New Mexico, Albuquerque, New Mexico
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146
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Balodis IM. Neuropsychology in GD: old and new directions. Curr Opin Behav Sci 2020. [DOI: 10.1016/j.cobeha.2019.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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147
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Joyner KJ, Yancey JR, Venables NC, Burwell SJ, Iacono WG, Patrick CJ. Using a co-twin control design to evaluate alternative trait measures as indices of liability for substance use disorders. Int J Psychophysiol 2020; 148:75-83. [PMID: 31857192 PMCID: PMC10659239 DOI: 10.1016/j.ijpsycho.2019.11.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 11/18/2019] [Accepted: 11/20/2019] [Indexed: 11/16/2022]
Abstract
To establish a trait-dispositional variable as an indicator of liability for the development of substance use disorders (SUDs), the trait must share heritable variance with SUDs and its association should not be primarily attributable to a direct impact of SUDs on characteristics that define the trait. The current work applied a co-twin control (CTC) modeling approach to data from two monozygotic twin samples to investigate the degree to which different measures of trait-impulsiveness represent indicants of vulnerability to SUDs (liability indicators), or outcomes or concomitants of SUDs (exposure indicators). The Five Factor Model (FFM) trait of conscientiousness was assessed via self-report, and a counterpart neurobehavioral trait of disinhibition was assessed both through self-report and using self-report and brain response measures combined. FFM trait data were available for one twin sample (N = 298); data for variants of P3 brain response were available along with a scale measure of disinhibition in the other (N = 258). CTC analyses revealed only an exposure effect of SUD symptomatology on FFM conscientiousness, indicating that this self-report assessed trait does not index liability for SUDs. By contrast, the disinhibition scale measure showed pronounced liability and weaker exposure-based associations with SUDs - and when quantified using scale scores together with P3 brain response, the exposure-based association was eliminated, such that this disinhibition measure related to SUD symptoms exclusively as a function of liability influences. These findings highlight a distinct advantage of quantifying traits in neurobehavioral terms - namely, the capacity to effectively index dispositional liability for psychopathological outcomes.
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Affiliation(s)
- Keanan J Joyner
- Florida State University, Department of Psychology, 1107 West Call Street, Tallahassee, FL 32306, USA
| | - James R Yancey
- Florida State University, Department of Psychology, 1107 West Call Street, Tallahassee, FL 32306, USA
| | - Noah C Venables
- University of Minnesota, Department of Psychiatry, 2450 Riverside Avenue, South Minneapolis, MN 55454, USA
| | - Scott J Burwell
- University of Minnesota, Department of Psychiatry, 2450 Riverside Avenue, South Minneapolis, MN 55454, USA
| | - William G Iacono
- University of Minnesota, Department of Psychology, 75 East River Parkway, Minneapolis, MN 55455, USA
| | - Christopher J Patrick
- Florida State University, Department of Psychology, 1107 West Call Street, Tallahassee, FL 32306, USA.
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148
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Perkins ER, Latzman RD, Patrick CJ. Interfacing neural constructs with the Hierarchical Taxonomy of Psychopathology: 'Why' and 'how'. Personal Ment Health 2020; 14:106-122. [PMID: 31456351 DOI: 10.1002/pmh.1460] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 06/03/2019] [Accepted: 06/10/2019] [Indexed: 12/11/2022]
Abstract
The Hierarchical Taxonomy of Psychopathology (HiTOP) represents a crucial step forward in the empirical refinement of psychiatric nosology. Although grounded in factor analyses of clinical symptoms and affiliated traits, HiTOP encourages research using measures of other types, including neural-system variables, to clarify coherent processes contributing to the hierarchical structure of psychopathology. However, systematic strategies for interfacing HiTOP dimensions with neural-system variables have not been put forth. We discuss reasons for considering neurobiological systems in relation to HiTOP (i.e. 'why') and propose alternative strategies that might be used to develop an interface between HiTOP and neurobiology (i.e. 'how'). In particular, we highlight potential advantages and limitations of establishing this interface through reference to (i) HiTOP dimensions themselves, or conventional personality trait models linked to HiTOP; (ii) alternative trait constructs designed to link conventional personality models and neurobiological measures; and (iii) mechanistic models of neurobiological processes relevant to HiTOP constructs, derived from computational modelling. We discuss the importance of establishing an interface between HiTOP and neurobiology to develop a more comprehensive, mechanistic understanding of psychopathology and to guide the refinement of the HiTOP model. Such efforts have the potential to guide the development and provision of effective, individualized psychological treatment.
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Affiliation(s)
- Emily R Perkins
- Department of Psychology, Florida State University, Tallahassee, FL, 32306-4301, USA
| | - Robert D Latzman
- Department of Psychology, Georgia State University, Atlanta, GA, 30302-5010, USA
| | - Christopher J Patrick
- Department of Psychology, Florida State University, Tallahassee, FL, 32306-4301, USA
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Brain-wide functional architecture remodeling by alcohol dependence and abstinence. Proc Natl Acad Sci U S A 2020; 117:2149-2159. [PMID: 31937658 DOI: 10.1073/pnas.1909915117] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Alcohol abuse and alcohol dependence are key factors in the development of alcohol use disorder, which is a pervasive societal problem with substantial economic, medical, and psychiatric consequences. Although our understanding of the neurocircuitry that underlies alcohol use has improved, novel brain regions that are involved in alcohol use and novel biomarkers of alcohol use need to be identified. The present study used a single-cell whole-brain imaging approach to 1) assess whether abstinence from alcohol in an animal model of alcohol dependence alters the functional architecture of brain activity and modularity, 2) validate our current knowledge of the neurocircuitry of alcohol abstinence, and 3) discover brain regions that may be involved in alcohol use. Alcohol abstinence resulted in the whole-brain reorganization of functional architecture in mice and a pronounced decrease in modularity that was not observed in nondependent moderate drinkers. Structuring of the alcohol abstinence network revealed three major brain modules: 1) extended amygdala module, 2) midbrain striatal module, and 3) cortico-hippocampo-thalamic module, reminiscent of the three-stage theory. Many hub brain regions that control this network were identified, including several that have been previously overlooked in alcohol research. These results identify brain targets for future research and demonstrate that alcohol use and dependence remodel brain-wide functional architecture to decrease modularity. Further studies are needed to determine whether the changes in coactivation and modularity that are associated with alcohol abstinence are causal features of alcohol dependence or a consequence of excessive drinking and alcohol exposure.
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150
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Jurado-Barba R, Sion A, Martínez-Maldonado A, Domínguez-Centeno I, Prieto-Montalvo J, Navarrete F, García-Gutierrez MS, Manzanares J, Rubio G. Neuropsychophysiological Measures of Alcohol Dependence: Can We Use EEG in the Clinical Assessment? Front Psychiatry 2020; 11:676. [PMID: 32765317 PMCID: PMC7379886 DOI: 10.3389/fpsyt.2020.00676] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 06/29/2020] [Indexed: 01/03/2023] Open
Abstract
Addiction management is complex, and it requires a bio-psycho-social perspective, that ought to consider the multiple etiological and developmental factors. Because of this, a large amount of resources has been allocated to assess the vulnerability to dependence, i.e., to identify the processes underlying the transition from substance use to dependence, as well as its course, in order to determine the key points in its prevention, treatment, and recovery. Consequently, knowledge \from neuroscience must be taken into account, which is why different initiatives have emerged with this objective, such as the "Research Domain Criteria" (RDoC), and the "Addiction Neuroclinical Assessment" (ANA). Particularly, neuropsychophysiological measures could be used as markers of cognitive and behavioral attributes or traits in alcohol dependence, and even trace clinical change. In this way, the aim of this narrative review is to provide an overview following ANA clinical framework, to the most robust findings in neuropsychophysiological changes in alcohol dependence, that underlie the main cognitive domains implicated in addiction: incentive salience, negative emotionality, and executive functioning. The most consistent results have been found in event-related potential (ERP) analysis, especially in the P3 component, that could show a wide clinical utility, mainly for the executive functions. The review also shows the usefulness of other components, implicated in affective and substance-related processing (P1, N1, or the late positive potential LPP), as well as event-related oscillations, such as theta power, with a possible use as vulnerability or clinical marker in alcohol dependence. Finally, new tools emerging from psychophysiology research, based on functional connectivity or brain graph analysis could help toward a better understanding of altered circuits in alcohol dependence, as well as communication efficiency and effort during mental operations. This review concludes with an examination of these tools as possible markers in the clinical field and discusses methodological differences, the need for more replicability studies and incipient lines of work. It also uses consistent findings in psychophysiology to draw possible treatment targets and cognitive profiles in alcohol dependence.
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Affiliation(s)
- Rosa Jurado-Barba
- Biomedical Research Institute, Hospital 12 de Octubre, Madrid, Spain.,Department of Psychology, Education and Health Science Faculty, Camilo José Cela University, Madrid, Spain
| | - Ana Sion
- Biomedical Research Institute, Hospital 12 de Octubre, Madrid, Spain.,Addictive Disorders Network, Carlos III Institute, Madrid, Spain
| | | | - Isabel Domínguez-Centeno
- Department of Psychology, Education and Health Science Faculty, Camilo José Cela University, Madrid, Spain
| | | | - Francisco Navarrete
- Addictive Disorders Network, Carlos III Institute, Madrid, Spain.,Neuroscience Institute, Miguel Hernández University-CSIC, Alicante, Spain
| | - María Salud García-Gutierrez
- Addictive Disorders Network, Carlos III Institute, Madrid, Spain.,Neuroscience Institute, Miguel Hernández University-CSIC, Alicante, Spain
| | - Jorge Manzanares
- Addictive Disorders Network, Carlos III Institute, Madrid, Spain.,Neuroscience Institute, Miguel Hernández University-CSIC, Alicante, Spain
| | - Gabriel Rubio
- Biomedical Research Institute, Hospital 12 de Octubre, Madrid, Spain.,Addictive Disorders Network, Carlos III Institute, Madrid, Spain.,Medicine Faculty, Complutense de Madrid University, Madrid, Spain
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