Executive dysfunction as a risk marker for substance abuse: the role of impulsive personality traits

Predicting alcohol use with subjective and objective measures of cognitive function in healthy college students

Objective: The current study examined the association between subjective and objective cognitive measures and alcohol use in college students. Objective cognitive impairment is associated with alcohol use, however subjective cognitive impairment remains understudied in at-risk populations. Participants: Data were collected from 140 undergraduate students at a mid-sized private university. Methods: We used the Behavior Rating Inventory for Executive Function-Adult (BRIEF-A) and the Rey-Osterrieth Complex Figure Task (ROCF) as our subjective and objective measures of cognitive functioning respectively. Results: In our regression model, the BRIEF-A was significantly associated with the AUDIT in college students such that more poorly perceived cognitive functioning predicted higher degrees of problematic drinking. However, the relationship between the ROCF and drinking was less clear. Conclusions: Our study shows that perception of one's cognitive functioning is related to alcohol use and may be a potential risk factor for hazardous drinking in college students. Our results also suggest that subjective functioning is more strongly related to alcohol use than objective functioning, however further research is needed to replicate our results.

The Relations Between an Inventory-Based Measure of Executive Function and Impulsivity Factors in Alcohol- and Cannabis-Relevant Outcomes

OBJECTIVE

While the lack of relation between performance- and inventory-based executive function (EF) measures is well documented, there remains ambiguity between self-report EFs and closely related constructs (e.g., impulsivity) assessed via the same method. The degree of convergence between purported EF measures with similar yet distinct constructs contain important theoretical implications for available EF assessment strategies and their construct validity. A newer measure of EF, the Behavior Regulation Inventory of Executive Functions-Adult (BRIEF-A), allows for more direct comparisons to self-reported measures of impulsivity, such as the commonly used Urgency, Planning, Perseverance, Sensation Seeking-Positive Urgency (UPPS-P) assessment.

METHOD

The present study used factor analysis and hierarchical regression to explore the associations between the BRIEF-A and UPPS-P, using alcohol and cannabis consumption across various outcomes (i.e., quantity-frequency and consequences) as an external criterion. Participants were 339 undergraduate students (Mage = 19.35; Female = 63%) from a large southwestern university.

RESULTS

The BRIEF-A and UPPS-P demonstrated strong correlations at both higher- and lower order facets. While the BRIEF-A was a significant correlate to many substance use outcomes, these relations were generally weaker than those seen with the UPPS-P. Hierarchical regression suggested limited contributions of the BRIEF-A over and above the UPPS-P.

CONCLUSIONS

Overall, this study suggested substantial overlap between impulsigenic factors and EFs when measured by self-report, and limited utility of EF measures to account for unique variance with substance use outcomes in this sample.

Distinct neural dynamics underlying risk and ambiguity during valued-based decision making

Uncertainty can be fractioned into risk and ambiguity psychologically and neurobiologically. However, whether and how risk and ambiguity are dissociated in terms of neural dynamics during value-based decision making remain elusive. The present event-related potential (ERP) study addressed these issues by asking participants to perform a wheel-of-fortune task either during a risky context (Experiment 1; N = 30) where outcome probability was known or during an ambiguous context (Experiment 2; N = 30) where outcome probability was unknown. Results revealed that the cue-P3 was more enhanced for risk versus ambiguity during the anticipatory phase, whereas the RewP was more increased for ambiguity than risk during the consummatory phase. Moreover, the SPN and the fb-P3 components were further modulated by the levels of risk and ambiguity, respectively. These findings demonstrate a neural dissociation between risk and ambiguity, which unfolds from the anticipatory phase to the consummatory phase.

Sex differences in addiction-relevant behavioral outcomes in rodents following early life stress

In humans, exposure to early life stress (ELS) is an established risk factor for the development of substance use disorders (SUDs) during later life. Similarly, rodents exposed to ELS involving disrupted mother-infant interactions, such as maternal separation (MS) or adverse caregiving due to scarcity-adversity induced by limited bedding and nesting (LBN) conditions, also exhibit long-term alterations in alcohol and drug consumption. In both humans and rodents, there is a range of addiction-related behaviors that are associated with drug use and even predictive of subsequent SUDs. In rodents, these include increased anxiety-like behavior, impulsivity, and novelty-seeking, altered alcohol and drug intake patterns, as well as disrupted reward-related processes involving consummatory and social behaviors. Importantly, the expression of these behaviors often varies throughout the lifespan. Moreover, preclinical studies suggest that sex differences play a role in how exposure to ELS impacts reward and addiction-related phenotypes as well as underlying brain reward circuitry. Here, addiction-relevant behavioral outcomes and mesolimbic dopamine (DA) dysfunction resulting from ELS in the form of MS and LBN are discussed with a focus on age- and sex-dependent effects. Overall, these findings suggest that ELS may increase susceptibility for later life drug use and SUDs by interfering with the normal maturation of reward-related brain and behavioral function.

The role of executive functions, social cognition and intelligence in predicting social adaptation of vulnerable populations

This study sought to evaluate the roles of and interactions between cognitive processes that have been shown to exhibit impact from socioeconomic status (SES) and living conditions in predicting social adaptation (SA) in a population of adults living in socially vulnerable conditions. Participants included 226 people between the ages of 18 and 60 who have been living in vulnerable contexts throughout life in Santiago, Chile. Data was collected through a battery of psychological assessments. A structural equation model (SEM) was implemented to examine the interrelationships among cognitive and social variables. Results indicate a significant relationship between executive function (EF) and SA through both social cognition (SC) and intelligence. Theory of Mind (ToM), a component of SC, was shown to exhibit a significant relationship with affective empathy; interestingly, this was negatively related to SA. Moreover, fluid intelligence (FI) was found to exhibit a positive, indirect relationship with SA through crystallized intelligence (CI). Evaluation of these results in the context of research on the impacts of SES and vulnerable living conditions on psychological function may allow for the development of more effective clinical, political, and social interventions to support psychosocial health among socially vulnerable populations.

Reliability and validity of a short Japanese version of the UPPS-P Impulsive Behavior Scale

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A Japanese version of the S-UPPS-P Impulsive Behavior Scale is needed.

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The original five-factor model had the best conformity index in all models.

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The five scales’ α coefficient and the test-retest reliability were high.

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The convergent validity of the five scales with personality scales was supported.

Objective

This study aimed to verify the reliability and validity of a Japanese version of the S-UPPS-P Impulsive Behavior Scale. This is expected to facilitate comparisons of findings between international and Japanese samples in studies of impulsivity.

Methods

Two surveys were conducted. In the first survey, 632 participants, aged 20–44 years old, completed a translated version of the Japanese S-UPPS-P Impulsive Behavior Scale, the Motor Impulsiveness Scale, a short form of the Big-Five scale, the short Grit scale, and the brief version of the self-control scale. Two weeks later, the second survey containing the S-UPPS-P and the motor impulsiveness scale were completed by 450 participants who had completed the first survey to examine test-retest reliability.

Results

In the first survey, an exploratory factor analysis was performed on the S-UPPS-P responses. A four-factor solution was the most suitable solution, with the factors of “Lack of Perseverance,” “Lack of Premeditation,” “Sensation Seeking,” and “Negative-Positive Urgency.” Then, a confirmatory factor analysis was performed. The conformity index of the original five-factor model was slightly better than that of the four-factor model. We also compared the five-factor model’s conformity index with three other models that had been examined in the original and other foreign language versions of the S-UPPS-P. The five-interrelated factor model had the best model fit. The reliability of the five scales was confirmed. The scales exhibited internal consistency with α coefficients ranging from 0.65 to 0.79, in addition to the test-retest reliability ranging from 0.74 to 0.80. The convergent validity of each S-UPPS-P scale was supported by high relationships with the four personality scales, with the highest correlation coefficients ranging from 0.37 to −0.67.

Conclusion

The reliability and validity of the Japanese version of the S-UPPS-P were confirmed, despite the minor limitations of the exploratory factor analysis providing a four-factor solution instead of a five-factor solution, and the α reliability coefficients of two scales being acceptable but rather low. Thus, comparisons of findings between international and Japanese studies on impulsivity could be facilitated.

Risky decision-making in individuals with substance use disorder: A meta-analysis and meta-regression review

BACKGROUND

This review aims to identify whether risky decision-making is increased in substance users, and the impact of substance type, polysubstance use status, abstinence period, and treatment status on risky decision-making.

METHODS

A literature search with no date restrictions was conducted to identify case-control studies or cross-sectional studies that used behavioral tasks to measure risky decision-making in substance users. A random-effects model was performed. GRADE criteria was used to assess the quality of evidence.

RESULTS

52 studies were enrolled. The result showed that the difference in risky decision-making performance between user groups and control groups was significant (SMD = - 0.590; 95%CI = - 0.849 to - 0.330; p < 0.001; I² = 93.4%; P_{heterogeneity} < 0.001). Subgroup analysis showed that users in the subgroups of alcohol (p < 0.001), tobacco (p < 0.01), cocaine (p < 0.001), opioid (p < 0.001), mixed group (p < 0.01), adult users (p < 0.001), small sample size (p < 0.001), large sample size (p < 0.01), low education (p < 0.001), high education (p < 0.001), short-abstinence period (p < 0.001), long-abstinence period (p < 0.001), without current polysubstance dependence (p < 0.001), and with treatment (p < 0.001) had increased risky decision-making when compared to the controls. On the other hand, elderly substance users with short-abstinence period showed increased risky decision-making. Moreover, current treatment status and polysubstance use may not influence the level of decision-making in substance users.

CONCLUSIONS

The results show that substance use is associated with impaired risky decision-making, indicating that interventions targeting risky decision-making in substance users should be developed for relapse prevention and rehabilitation.

Alcohol misuse to down-regulate positive emotions: A cross-sectional multiple mediator analysis among US military veterans

INTRODUCTION

The co-occurrence of posttraumatic stress disorder (PTSD) and alcohol misuse presents a pervasive and clinically relevant concern among US military veterans.

OBJECTIVE

The current investigation sought to examine the role of positive emotion dysfunction in the relation between PTSD symptomatology and alcohol misuse. To do so, we examined the separate and sequential roles of positive emotional intensity and positive emotional avoidance in the relation between PTSD symptoms and alcohol misuse among US military veterans.

METHOD

Cross-sectional data were collected from 468 US military veterans (M age = 37.74, 70.5% male, 69.0% White) who responded to an online survey.

RESULTS

Findings suggest that positive emotional avoidance, separately, and positive emotional intensity and positive emotional avoidance, sequentially, mediated the relation between PTSD symptoms and alcohol misuse.

CONCLUSIONS

Findings advance theory on the role of positive emotions and related processes in the co-occurrence of PTSD and alcohol misuse, and highlight important avenues for future research and treatment focused on the PTSD-alcohol misuse co-occurrence.

Trauma in childhood and adolescence and impaired executive functions are associated with uncertain reflective functioning in mothers with substance use disorder

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Uncertain reflective function in mothers with SUD are associated with trauma during childhood and adolescence.

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Impaired executive functions are significantly associated with uncertain reflective function.

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Certain reflective function is not associated with executive functions or trauma.

Aims

Impairments in reflective functioning are known to have adverse effects on the ability to display sensitive parenting as a caregiver. Several factors are associated with impairments in reflective functioning, such as impaired executive functioning and experienced trauma. We investigated how these factors contribute to an impaired reflective functioning style, such as pathological certain or uncertain reflective functioning. Extreme scores on these two subscales reflect two kinds of impairments in reflective functioning. We assessed executive functions, reflective functioning, and trauma in 43 mothers diagnosed with substance use disorders (SUD).

Methods

Certain or uncertain reflective functioning were assessed using the Reflective Functioning Questionnaire 8 (RFQ-8). Executive functions and trauma were assessed by administering various questionnaires, interviews and neuropsychological tests.

Results

High uncertain reflective functioning was more than six times as common (odds ratio) in mothers reporting high amounts of trauma in childhood and adolescence compared with mothers reporting low amounts of trauma. Impaired executive functions were also significantly associated with high uncertain reflective functioning. Certain reflective functioning did, however, not show any significant associations.

Conclusion

When the SUD mothers give information about relational trauma in childhood and adolescence, it might therefore be worth investigating and addressing the potential tendency to have an uncertain reflective functioning style.

Application of the Chinese Version of the BIS/BAS Scales in Participants With a Substance Use Disorder: An Analysis of Psychometric Properties and Comparison With Community Residents

Carver and White developed the Behavioral Inhibition/Behavioral Activation Scales (the BIS/BAS Scales) based on Reinforcement Sensitivity Theory proposed by Gray. Subsequent studies proposed that substance abuse was closely related to Behavioral Inhibition System (BIS) and Behavioral Activation System (BAS). However, researches on the psychometric properties of the BIS/BAS scales in clinical samples are scarce. The present study was conducted to analyze the applicability of the BIS/BAS scales in a sample suffering from a substance use disorder (SUD) and undergoing treatment in compulsory detoxification institutions (n = 1117). Meanwhile, 822 community residents were selected for comparison. Confirmatory factor analysis was carried out to examine the construct validity and the results showed that the five-factor model was the best fit for people with a substance use disorder' data. Besides, Cronbach's alpha coefficient for the total scale was 0.808, indicating the satisfactory internal consistency reliability. Analysis of the correlation coefficient of the questionnaire with the corresponding personality traits showed that BAS was more associated with the impulsive trait. Surprisingly, participants with a substance use disorder showed more insensitivity for the reward dimension compared with that of community residents and the result of comparison between two samples supported joint subsystems hypothesis. Generally, the BIS/BAS scales showed good reliability and validity. These findings provide more direct evidence on the personality traits of people with a substance use disorder and should form the basis for further research.

Deficient Decision Making in Pathological Gamblers Correlates With Gray Matter Volume in Medial Orbitofrontal Cortex

Individuals suffering from pathological gambling (PG) show impaired decision making, but it is still not clear how this impairment is related to other traits and neuroanatomical characteristics. In this study, we investigated how the influence of PG on decision making (1) is connected to different impulsivity facets and (2) how it is related to gray matter volume (GMV) in various brain regions. Twenty-eight diagnosed PG patients and 23 healthy controls completed the cups task to measure decision making. In this task, participants had to decide between safe and risky options, which varied in expected value (EV) between risk advantageous, equal EV, and risk disadvantageous choices. A delay discounting task and the Barrant Impulsiveness Scale were applied to assess multiple impulsivity facets. In addition, structural magnetic resonance images were acquired. In comparison to the control group PG patients demonstrated more deficits in decision making, indicated by less EV sensitivity, but there was no significant difference in number of overall risky choices. Also, PG patients showed increased impulsivity in nearly every dimension. Results revealed (1) a positive correlation between decision making impairments and non-planning impulsivity but no significant relation to other impulsivity facets. Although we found no GMV differences between PG patients and controls, (2) a regions of interest analysis showed a correlation between medial orbitofrontal GMV and EV sensitivity in PG patients. Our findings showed that (1) the association between decision making and impulsivity can also be found in PG patients, but only for certain impulsivity facets. This suggests that it is essential to consider measuring different dimensions, when investigating impulsivity in a PG sample. Secondly, our findings revealed that (2) dysfunctional decision making-particularly the component of risk evaluation-is related to decreased GMV in the medial orbitofrontal cortex, a brain region concerned with processing of rewards. Interestingly, we did not find more risky choices for PG patients, and thus, we assume that decision making deficits in PG are primarily related to risk evaluation, not risk seeking, which is in line with our GMV findings.

The association between executive functioning and parental stress and psychological distress is mediated by parental reflective functioning in mothers with substance use disorder

Mothers with a substance use disorder (SUD) have been found to exhibit heightened experience of stress and deficits in executive functioning (EF) and in parental reflective functioning (PRF). Although experiences of stress, EF and PRF are important for caregiving capacities; no studies have explored associations between the phenomena in mothers with SUD. This study aimed to examine the association between EF (working memory, inhibition, and cognitive flexibility) and different forms of stress (parental stress, general life stress, and psychological distress) in 43 mothers with SUD with infants. We further aimed to investigate whether PRF had a mediating function between EF and the experience of stress. The mothers completed self-report questionnaires regarding experiences of different types of stress, and we also used neuropsychological tests to assess EF and a semistructured interview to assess PRF. Results identified problems in EF were associated with higher parental stress and psychological distress but not with general life stress. Cognitive flexibility contributed uniquely to variance in parental stress, whereas working memory was a unique contributor to variance in psychological distress. PRF had a mediating function between EF and parental stress and between EF and psychological distress. Findings highlight the importance of considering individual differences in PRF when targeting EF in interventions trying to reduce the experience of parental stress and psychological distress in mothers with SUD.

Rumination and executive functions: Understanding cognitive vulnerability for psychopathology

INTRODUCTION

Both rumination, a pattern of repetitive, self-focused thought in response to distress, and deficits in executive functions (EFs), a set of cognitive abilities that facilitate higher-order thinking, have transdiagnostic associations with psychopathology. Although empirical studies suggest associations between EFs and rumination, this literature has not examined subtypes of rumination and different components of EFs. It also has not examined whether rumination and EFs explain overlapping variance in psychopathology, which is relevant to theoretical models suggesting that rumination might mediate the EF-psychopathology association.

METHODS

We used structural equation modeling to examine the association between latent factors for two types of rumination (anger and depressive) and three components of EF (a Common EF factor, and factors specific to updating working memory and shifting mental sets) and whether they independently relate to internalizing and externalizing psychopathology in a population sample of 764 young adults (mean age 23 years) from the Colorado Longitudinal Twin Study.

RESULTS

Depressive and Anger Rumination showed small correlations with a Common EF factor (rs = -.09 to -.11). Anger Rumination and Common EF ability were associated with independent variance in externalizing psychopathology, whereas Depressive Rumination, but not Common EF, was associated with internalizing psychopathology.

LIMITATIONS

Examination of cross-sectional relations in a population sample led to low symptom endorsement for psychopathology and necessitated examination of lifetime, rather than past-year, psychopathology.

CONCLUSIONS

Inconsistent with mediation hypotheses, Common EF abilities and rumination are correlated yet largely independent constructs that both predict psychopathology.

Parental reflective functioning and executive functioning in mothers with substance use disorder

Having a substance use disorder (SUD) may adversely affect caregiving capacities. Reflective functioning (RF) and executive functioning (EF) are both important capacities for sensitive parenting, and are often impaired in a SUD. Only a few studies have explored the possible association between the two phenomena. In this study, we used a neuropsychological test battery to assess EF, and the Parent Development Interview to assess RF in a sample of mothers with a SUD (N = 43). Although parental RF (PRF) was associated with EF, when controlled for intelligence (IQ) and mental health, there was no significant association between EF and PRF. Mental health, however, showed a significant negative association with PRF. Splitting the group in two based on PRF level, mothers with a negative to low PRF exhibited more severe difficulties in SUD-related aspects, as well as in several EF components, compared to mothers with an adequate to high PRF, highlighting the association between EF and PRF. The results from this study contribute to enhance our understanding of the dynamics underlying vulnerability in PRF that mothers with small children may experience. We suggest EF to be a prerequisite for adequate PRF, and for interventions to be customized accordingly regarding parents with a SUD.

Uncertainty exposure causes behavioural sensitization and increases risky decision-making in male rats: toward modelling gambling disorder

BACKGROUND

An animal model of gambling disorder, previously known as pathological gambling, could advance our understanding of the disorder and help with treatment development. We hypothesized that repeated exposure to uncertainty during gambling induces behavioural and dopamine (DA) sensitization - similar to chronic exposure to drugs of abuse. Uncertainty exposure (UE) may also increase risky decision-making in an animal model of gambling disorder.

METHODS

Male Sprague Dawley rats received 56 UE sessions, during which animals responded for saccharin according to an unpredictable, variable ratio schedule of reinforcement (VR group). Control animals responded on a predictable, fixed ratio schedule (FR group). Rats yoked to receive unpredictable reward were also included (Y group). Animals were then tested on the Rat Gambling Task (rGT), an analogue of the Iowa Gambling Task, to measure decision-making.

RESULTS

Compared with the FR group, the VR and Y groups experienced a greater locomotor response following administration of amphetamine. On the rGT, the FR and Y groups preferred the advantageous options over the risky, disadvantageous options throughout testing (40 sessions). However, rats in the VR group did not have a significant preference for the advantageous options during sessions 20-40. Amphetamine had a small, but significant, effect on decision-making only in the VR group. After rGT testing, only the VR group showed greater hyperactivity following administration of amphetamine compared with the FR group.

LIMITATIONS

Reward uncertainty was the only gambling feature modelled.

CONCLUSION

Actively responding for uncertain reward likely sensitized the DA system and impaired the ability to make optimal decisions, modelling some aspects of gambling disorder.

Impulsivity influences betting under stress in laboratory gambling

Although recent research suggests that acute stress influences subsequent decision-making under ambiguity, less is known about the role of personality variables in this relationship. This study tested whether impulsivity traits and acute stress differentially influence the way in which a prior feedback is incorporated into further decisions involving ambiguity. Sixty college students (50% male; aged 18-25 years) were randomly assigned to a stress versus a non-stress condition before completing a laboratory gambling task. The results revealed that independently of the stress condition, subjects behaved as if the odds of winning increase after a single loss. Additionally, stress effects varied as a function of impulsivity traits. Individuals who lacked perseverance (i.e., had difficulty focusing on a difficult or boring task) gambled more after experiencing a loss in the stress condition than did those in the control condition. The present study supports that impulsivity traits can explain the differential effect of stress on the relationship between prior feedback and choices made under ambiguity.

A multifactorial and integrative approach to impulsivity in neuropsychology: insights from the UPPS model of impulsivity

Risky and excessive behaviors, such as aggressive and compulsive behaviors, are frequently described in patients with brain damage and have dramatic psychosocial consequences. Although there is strong evidence that impulsivity constitutes a key factor at play in these behaviors, the literature about impulsivity in neuropsychology is to date scarce. In addition, examining and understanding these problematic behaviors requires the assumption that impulsivity is a multidimensional construct. Consequently, this article aims at shedding light on frequent risky and excessive behaviors in patients with brain damage by focusing on a unified, comprehensive, and well-validated model, namely, the UPPS model of impulsivity. This model considers impulsivity as a multidimensional construct that includes four facets: urgency, (lack of) premeditation, (lack of) perseverance, and sensation seeking. Furthermore, we discuss the psychological mechanisms underlying the dimensions of impulsivity, as well as the laboratory tasks designed to assess each mechanism and their neural bases. We then present a scale specifically designed to assess these four dimensions of impulsivity in patients with brain damage and examine the data regarding this multidimensional approach to impulsivity in neuropsychology. This review supports the need to adopt a multifactorial and integrative approach toward impulsive behaviors, and the model presented provides a valuable rationale to disentangle the nature of brain systems and mechanisms underlying impulsive behaviors in patients with brain damage. It may also foster further relevant research in the field of impulsivity and improve assessment and rehabilitation of impulsive behaviors in clinical settings.

Exploring associations between self-regulatory mechanisms and neuropsychological functioning and driver behaviour after brain injury

The objective of this prospective one-year follow-up study was to explore the associations between self-regulatory mechanisms and neuropsychological tests as well as baseline and follow-up ratings of driver behaviour. The participants were a cohort of subjects with stroke and traumatic brain injury (TBI) who were found fit to drive after a multi-disciplinary driver assessment (baseline). Baseline measures included neuropsychological tests and ratings of self-regulatory mechanisms, i.e., executive functions (Behavior Rating Inventory of Executive Function-Adult Version; BRIEF-A) and impulsive personality traits (UPPS Impulsive Behavior Scale). The participants rated pre-injury driving behaviour on the Driver Behaviour Qestionnaire (DBQ) retrospectively at baseline and after one year of post-injury driving (follow-up). Better performance on neuropsychological tests was significantly associated with more post-injury DBQ Violations. The BRIEF-A main indexes were significantly associated with baseline and follow-up ratings of DBQ Mistakes and follow-up DBQ Inattention. UPPS (lack of) Perseverance was significantly associated with baseline DBQ Inattention, whereas UPPS Urgency was significantly associated with baseline DBQ Inexperience and post-injury DBQ Mistakes. There were no significant changes in DBQ ratings from baseline (pre-injury) to follow-up (post-injury). It was concluded that neuropsychological functioning and self-regulatory mechanisms are related to driver behaviour. Some aspects of driver behaviour do not necessarily change after brain injury, reflecting the influence of premorbid driving behaviour or impaired awareness of deficits on post-injury driving behaviour. Further evidence is required to predict the role of self-regulatory mechanisms on driver behaviour and crashes or near misses.

Negative affect mediates the relation between trait urgency and behavioral distress tolerance

Distress tolerance is associated with a range of psychopathology and risk-taking behavior. Current research suggests that the behavioral ability to persist at goal-directed behavior when distressed may be malleable. However, little is known about the contributing factors that underlie individual differences in distress tolerance. Trait urgency, or the tendency to act impulsively in the context of acute changes in affect, may predict distress tolerance because the prepotent response to avoid or remove an aversive state may undermine persistence. To date, most research has examined the role of negative urgency, a valenced subfactor of urgency, in relation to distress tolerance. However, the broad trait of urgency may be associated with a greater change in affect that precedes the inability to tolerate distress. The current study examined whether greater changes in negative affect was indeed a mediator in the relationship between trait urgency and behavioral distress tolerance. The effects of both positive and negative urgency on affect change were examined to investigate the potential contribution of the broader urgency trait. The results suggest that a greater change in negative affect over the course of a stressor mediated the association between both subfactors of urgency and distress tolerance. These findings suggest that trait urgency, regardless of valence, may be associated with experiencing greater changes in affect that ultimately undermine the ability to tolerate distress. These findings also highlight important components of distress tolerance that could inform behavioral interventions. (PsycINFO Database Record

Keeping Mind in Mind: Mentalizing and Executive Functioning in Substance-Abusing Infant Mothers: Effect on Dyadic Relationship and Infant Outcome

Although it is well documented that maternal substance abuse has a negative effect on the mother–child interaction, less is known about the pathways through which the interaction is compromised. The main objective of this research proposal is to describe an ongoing research project that focuses on associations between maternal executive function and the quality of mother–infant interaction when the mother has a history of substance abuse. We will also investigate the effects of multiple variables, including maternal relationship experiences, personality disposition, parental stress, comorbid mental illness, and addiction severity, on the dyadic interaction and child functioning. A group of 40–50 mothers with substance abuse problems and their infants aged 6–18 months will be included. The mothers will be assessed with neuropsychological tests, clinical interviews, self-administered questionnaires, and dyadic interaction observations as well as observation and assessment of child functioning. We will use a cross-sectional correlational design. The inclusion of the participants will end in October 2015. Further knowledge about the variables that are important for the mother–infant relationship can inform future research and clinical practice.

Alcohol and brief intervention for trauma victims

OBJECTIVE

to describe the causes and severities of trauma in patients who met the criteria for alcohol abuse or dependence according to Mini International Neuropsychiatric Interview, and to display the pattern of alcohol consumption and subsequent changes one year after trauma.

METHODS

a transversal and longitudinal quantitative study carried out between November 2012 and September 2013 in the ED. Medical and nursing students collected blood samples, applied the J section of the Mini International Neuropsychiatric Interview (MINI) and submitted alcohol abusers and dependents to BI. One year after admission, patients were contacted and asked about their patterns of alcohol use and their reasons for any changes.

RESULTS

from a sample of 507 patients admitted to the ED for trauma, 348 responded to MINI, 90 (25.9%) being abusers and 36 (10.3%) dependent on alcohol. Among the abusers, the most frequent cause of injury was motorcycle accident (35.6%) and among the dependents it was predominantly interpersonal violence (22.2%). Positive blood samples for alcohol were identified in 31.7% of the abusers and 53.1% of the dependents. One year after trauma, 66 abusers and 31 dependents were contacted, and it was ascertained that 36.4% of the abusers and 19.4% of the dependents had decreased alcohol consumption. The main reported reason for the reduction was the experienced trauma.

CONCLUSION

the motorcycle accident was the most common cause of injury. The detection of problematic alcohol use and implementation of BI are important strategies in the ED, however for alcohol abusers and dependents, BI was not the most reported reason for any changes in patterns of alcohol use.

Blunted feedback processing during risk-taking in adolescents with features of problematic Internet use

While the conceptualization of problematic Internet use (PIU) as a "behavioral addiction" resembling substance-use disorders is debated, the neurobiological underpinnings of PIU remain understudied. This study examined whether adolescents displaying features of PIU (at-risk PIU; ARPIU) are more impulsive and exhibit blunted responding in the neural mechanisms underlying feedback processing and outcome evaluation during risk-taking. Event-related potentials (ERPs) elicited by positive (i.e. reward) and negative (i.e. loss) feedback were recorded during performance on a modified version of the Balloon Analogue Risk Task (BART) among ARPIU (n=39) and non-ARPIU subjects (n=27). Compared to non-ARPIU, ARPIU adolescents displayed higher levels of urgency and lack of perseverance on the UPPS Impulsive Behavior Scale. Although no between-group difference in BART performance was observed, ERPs demonstrated overall decreased sensitivity to feedback in ARPIU compared to non-ARPIU adolescents, as indexed by blunted feedback-related negativity (FRN) and P300 amplitudes to both negative and positive feedback. The present study provides evidence for feedback processing during risk-taking as a neural correlate of ARPIU. Given recent concerns regarding the growing prevalence of PIU as a health concern, future work should examine the extent to which feedback processing may represent a risk factor for PIU, a consequence of PIU, or possibly both.

Influence of dorsolateral prefrontal cortex and ventral striatum on risk avoidance in addiction: a mediation analysis

BACKGROUND

Alterations in frontal and striatal function are hypothesized to underlie risky decision making in drug users, but how these regions interact to affect behavior is incompletely understood. We used mediation analysis to investigate how prefrontal cortex and ventral striatum together influence risk avoidance in abstinent drug users.

METHOD

Thirty-seven abstinent substance-dependent individuals (SDI) and 43 controls underwent fMRI while performing a decision-making task involving risk and reward. Analyses of a priori regions-of-interest tested whether activity in dorsolateral prefrontal cortex (DLPFC) and ventral striatum (VST) explained group differences in risk avoidance. Whole-brain analysis was conducted to identify brain regions influencing the negative VST-risk avoidance relationship.

RESULTS

Right DLPFC (RDLPFC) positively mediated the group-risk avoidance relationship (p < 0.05); RDLPFC activity was higher in SDI and predicted higher risk avoidance across groups, controlling for SDI vs.

CONTROLS

Conversely, VST activity negatively influenced risk avoidance (p < 0.05); it was higher in SDI, and predicted lower risk avoidance. Whole-brain analysis revealed that, across group, RDLPFC and left temporal-parietal junction positively (p ≤ 0.001) while right thalamus and left middle frontal gyrus negatively (p < 0.005) mediated the VST activity-risk avoidance relationship.

CONCLUSION

RDLPFC activity mediated less risky decision making while VST mediated more risky decision making across drug users and controls. These results suggest a dual pathway underlying decision making, which, if imbalanced, may adversely influence choices involving risk. Modeling contributions of multiple brain systems to behavior through mediation analysis could lead to a better understanding of mechanisms of behavior and suggest neuromodulatory treatments for addiction.

Altering the Cognitive-Affective Dysfunctions of Psychopathic and Externalizing Offender Subtypes with Cognitive Remediation

Cognitive remediation is a treatment approach with the potential to translate basic science into more specific, mechanism-based interventions by targeting particular cognitive skills. The present study translated understanding of two well-defined cognitive-emotion dysfunctions into novel deficit-matched interventions and evaluated whether cognitive remediation would demonstrate specific and generalizable change. Two antisocial-subtypes, individuals with psychopathy and externalizing traits, are characterized by cognitive-affective problems that predispose them to engage in significant substance abuse and criminal behavior, culminating in incarceration. Whereas individuals with psychopathy fail to consider important contextual information, individuals with externalizing traits lack the capacity to regulate affective reactions. Training designed to remedy these subtype-specific deficits led to improvement on both trained and non-trained tasks. Such findings offer promise for changing neural and behavioral patterns, even for what many consider to be the most recalcitrant treatment population, and presage a new era of translating cognitive-affective science into increasingly specific and effective interventions.

NMDA receptor blockade in the prelimbic cortex activates the mesolimbic system and dopamine-dependent opiate reward signaling

RATIONALE

N-Methyl-D-aspartate (NMDA) receptors in the medial prefrontal cortex (mPFC) are involved in opiate reward processing and modulate sub-cortical dopamine (DA) activity. NMDA receptor blockade in the prelimbic (PLC) division of the mPFC strongly potentiates the rewarding behavioural properties of normally sub-reward threshold doses of opiates. However, the possible functional interactions between cortical NMDA and sub-cortical DAergic motivational neural pathways underlying these effects are not understood.

OBJECTIVE

This study examines how NMDA receptor modulation in the PLC influences opiate reward processing via interactions with sub-cortical DAergic transmission. We further examined whether direct intra-PLC NMDA receptor modulation may activate DA-dependent opiate reward signaling via interactions with the ventral tegmental area (VTA).

METHODS

Using an unbiased place conditioning procedure (CPP) in rats, we performed bilateral intra-PLC microinfusions of the competitive NMDA receptor antagonist, (2R)-amino-5-phosphonovaleric acid (AP-5), prior to behavioural morphine place conditioning and challenged the rewarding effects of morphine with DA receptor blockade. We next examined the effects of intra-PLC NMDA receptor blockade on the spontaneous activity patterns of presumptive VTA DA or GABAergic neurons, using single-unit, extracellular in vivo neuronal recordings.

RESULTS

We show that intra-PLC NMDA receptor blockade strongly activates sub-cortical DA neurons within the VTA while inhibiting presumptive non-DA GABAergic neurons. Behaviourally, NMDA receptor blockade activates a DA-dependent opiate reward system, as pharmacological blockade of DA transmission blocked morphine reward only in the presence of intra-PLC NMDA receptor antagonism.

CONCLUSIONS

These findings demonstrate a cortical NMDA-mediated mechanism controlling mesolimbic DAergic modulation of opiate reward processing.

The role of impulsivity traits and delayed reward discounting in dysregulated eating and drinking among heavy drinkers

Impulsivity is a multifaceted construct that has been linked to dysregulated eating and problematic alcohol use. The UPPS model identifies five personality-based impulsivity traits that have unique predictive utility: Negative Urgency, Perseverance, Premeditation, Sensation Seeking, and Positive Urgency. Delayed reward discounting (DRD) is an index of impulsive decision making characterized by preference for smaller immediate gains at the cost of larger delayed gains. In the current study, we sought to refine the influence of impulsive personality traits and DRD on disordered eating patterns and problematic drinking. One hundred and eight treatment-seeking heavy drinkers were assessed for UPPS impulsivity traits, DRD, disordered eating, alcohol use, and demographic information. With regard to disordered eating patterns, DRD predicted higher levels of Dietary Restraint and Weight and Shape Concerns. Negative Urgency predicted binge eating and Weight and Shape Concerns. Positive Urgency predicted Eating Concerns. Female sex predicted Eating, Weight, and Shape Concerns. When considering problematic alcohol use, only Negative Urgency and Sensation Seeking were predictive. This is the first study to examine both personality-based impulsivity and DRD in relation to pathological eating and drinking behavior. The results suggest the importance of disentangling the contributions of various impulsivity constructs on dysregulated eating.

Behavioural ratings of self-regulatory mechanisms and driving behaviour after an acquired brain injury

OBJECTIVE

To explore whether measurements of self-regulatory mechanisms and cognition predict driving behaviour after an acquired brain injury (ABI).

DESIGN

Consecutive follow-up study.

PARTICIPANTS

At baseline participants included 77 persons with stroke and 32 persons with a traumatic brain injury (TBI), all of whom completed a multidisciplinary driving assessment (MDA). A follow-up cohort of 34 persons that succeeded the MDA was included. Baseline measurements: Neuropsychological tests and measurements of self-regulatory mechanisms (BRIEF-A and UPPS Impulsive Behaviour Scale), driving behaviour (DBQ) and pre-injury driving characteristics (mileage, compensatory driving strategies and accident rates). Follow-up measurements: Post-injury driving characteristics were collected by mailed questionnaires from the participants who succeeded the MDA.

METHODS

A MDA, which included a medical examination, neuropsychological testing and an on-road driving test, was considered in the decision for or against granting a driver's license. Self-regulatory mechanisms and driving behaviour were examined for research purposes only.

RESULTS

At baseline, self-regulatory mechanisms were significantly associated to aberrant driving behaviour, but not with neuropsychological data or with the outcome of the on-road driving test. Aspects of self-regulation were associated to driving behaviour at follow-up.

CONCLUSION

It is recommended that self-regulatory measurements should regularly be considered in the driving assessments after ABI.

Maladaptive decision making and substance use outcomes in high-risk individuals: preliminary evidence for the role of 5-HTTLPR variation

OBJECTIVE

Individuals with multiple alcohol-dependent (AD) relatives are at increased risk for substance use disorders (SUDs). Prospective, longitudinal studies of high-risk (HR) individuals afford the opportunity to determine potential risk markers of SUDs. The current study assessed the effect of familial risk and genetic variation on Iowa Gambling Task (IGT) performance and tested for an association between IGT performance and SUD outcomes.

METHOD

Individuals from multiplex AD families (n = 63) and low-risk (LR; n = 45) control families, ages 16-34 years, were tested using a computerized version of the IGT. SUD outcomes were assessed at approximately yearly intervals. 5-HTTLPR and COMT genotypes were available for the majority of participants (n = 86).

RESULTS

HR offspring showed poorer performance overall on the IGT and especially poor performance on the final trial block (Block 5), indicating a failure to improve decision making with previous experience. The 5-HTTLPR short-allele homozygote participants performed worse than long-allele carriers, with HR S/S carriers exhibiting particularly poor performance. There was no main effect of COMT on IGT performance and no significant COMT by Risk interaction. Significantly more individuals in the HR than LR group met criteria for SUD. Importantly, disadvantageous performance on IGT Block 5 was significantly associated with an earlier age at SUD onset.

CONCLUSIONS

This is the first study to show that both familial risk of SUD and 5-HTTLPR variation impact performance on the IGT. Poorer IGT performance was associated with earlier onset of SUD, suggesting that HR individuals who fail to appropriately attend to long-term costs and benefits during a decision-making task are especially at risk for developing SUD in adolescence and young adulthood.

Post-stroke driving: examining the effect of executive dysfunction

INTRODUCTION

Executive dysfunction can refer to both neurocognitive deficits and behavioral symptoms that include impaired judgment, slow decision making, disorganization, impulsiveness, and risk-taking behaviors. Executive dysfunction is relatively common in the post-stroke population but is often undetected. The impact of executive dysfunction on post-stroke driving is unclear but it may pose a risk to affected drivers and other road users.

AIM

The aim of this study was to investigate the relationship between executive functioning following stroke and driving performance.

METHODOLOGY

A case-control study design was used. Purposive sampling was used to recruit stroke participants (n=19) and healthy controls (n=22). Participants were screened using a battery of psychometric assessments including the Montreal Cognitive Assessment and the Benton Judgment of Line Orientation. Driving performance was assessed using the STISIM driving simulator. Executive function was assessed using the Behavioural Assessment of the Dysexecutive Syndrome (BADS) and the Trail Making Test Part B.

RESULTS

The control participants performed better than the stroke participants on the driving assessment and psychometric assessments. There was an association between the scores of the Trail Making Test Part B (Rho=0.34, p=0.034) and the Key Search Test of the BADS (Rho=-0.61, p=0.005), and the driving assessment scores. However, there was no association between the overall BADS scores and the driving assessment scores of the stroke participants.

CONCLUSIONS

The stroke participants underperformed in the driving assessment and the psychometric assessments that detected neurocognitive deficits, which included executive function. The Trail Making Test Part B and Key Search Test of the BADS were related to identify participants' deterioration in driving performance. Practical Applications: In clinical practice, the latter could be used as an indication of a post-stroke driver's performance.

Dysfunctional decision-making in pathological gambling: pattern specificity and the role of impulsivity

Dysfunctional decision-making in individuals with pathological gambling (PGs) may result from dominating reward-driven processes, indicated by higher impulsivity. In the current study we examined (1) if PGs show specific decision-making impairments related to dominating reward-driven processes rather than to strategic planning deficits and (2) whether these impairments are related to impulsivity. Nineteen PGs according to DSM-IV and 19 matched control subjects undertook the Cambridge Gambling Task (CGT) to assess decision-making. The delay discounting paradigm (DDP) as well as the UPPS Impulsive Behavior Scale (measuring urgency, premeditation, perseverance and sensation seeking) were administered as multidimensional measures of impulsivity. Results revealed that (1) PGs exhibited higher risk seeking and an immediate reward focus in the CGT and, in contrast, comparable strategic planning to the control group. (2) Decision-making impairments were related to more severe delay discounting and, specifically, to increased urgency and less premeditation. Our findings suggest (1) the necessity to disentangle decision-making components in order to improve etiological models of PGs, and (2) that urgency and premeditation are specifically related to disadvantageous decision-making and should be tackled in intervention strategies focusing on emotion tolerance and control strategies.

The impact of cognitive control, incentives, and working memory load on the P3 responses of externalizing prisoners

The P3 amplitude reduction is one of the most common correlates of externalizing. However, few studies have used experimental manipulations designed to challenge different cognitive functions in order to clarify the processes that impact this reduction. To examine factors moderating P3 amplitude in trait externalizing, we administered an n-back task that manipulated cognitive control demands, working memory load, and incentives to a sample of male offenders. Offenders with high trait externalizing scores did not display a global reduction in P3 amplitude. Rather, the negative association between trait externalizing and P3 amplitude was specific to trials involving inhibition of a dominant response during infrequent stimuli, in the context of low working memory load, and incentives for performance. In addition, we discuss the potential implications of these findings for externalizing-related psychopathologies. The results complement and expand previous work on the process-level dysfunction contributing to externalizing-related deficits in P3.

Impulsivity and substance-related attentional bias: a meta-analytic review

BACKGROUND

Previous research demonstrates the role of attentional bias in addictive behaviors. Impulsivity is thought to affect the strength of attentional biases, and thus, attentional biases might be one mechanism by which impulsivity affects addictive behaviors. However, whether or not impulsivity is related to attentional biases across different conceptualizations of impulsivity and attentional biases has yet to be examined as an initial test of such causal models.

METHODS

The authors completed a meta-analysis of 13 published research studies examining the relationship between substance-related attentional bias and different conceptualizations of impulsivity.

RESULTS

There was a small and significant effect size between impulsivity and substance-related attentional bias (r=0.20), which was moderated by impulsivity measurement type (Qb=5.91, df=1, p<0.05): there was a stronger relationship between behavioral impulsivity and substance-related attentional bias (r=0.22) than trait impulsivity and substance-related attentional bias (r=0.10). Different components of behavioral impulsivity and trait impulsivity did not affect the relationship.

CONCLUSIONS

This study is the first systematic and empirical demonstration of the relationship between substance-related attentional bias and impulsivity and suggests viability of future examinations of casual models relating these constructs. Since trait and behavioral conceptualizations differentially relate to substance-related attentional bias, the current review further supports research suggesting how disaggregation of multidimensional constructs can lead to more robust relationships.

Family history of alcohol dependence modulates functional neurophysiology in mood/anxiety disorders

BACKGROUND

A family history (FH) of alcohol dependence (AD) not only increases the risk for AD, but is also associated with an increased risk for mood and anxiety disorders. However, it is unknown how a FH of AD affects neural substrates in patients with mood and anxiety disorders. In this study we examined the effects of an alcoholic FH on cognitive and emotional functions in these patients using functional magnetic resonance imaging (fMRI). Method In a sample of non-alcoholic patients with depressive and/or anxiety disorders from the Netherlands Study of Depression and Anxiety (NESDA) neuroimaging study, patients with a first-degree FH of AD (FH + ; n = 31) were compared with patients without a FH (FH-; n = 77) on performance and brain activation during visuospatial planning and emotional word encoding. Results were compared with those of healthy controls (HCs) without a FH of AD (n = 31).

RESULTS

FH+ patients performed slower during planning with increasing task load, coupled with stronger blood oxygen level-dependent responses in dorsal prefrontal areas compared with FH- patients and HCs. FH was not associated with performance differences during word encoding, but right insula activation during positive word encoding was present in FH+ patients, comparable with HCs, but absent in FH- patients.

CONCLUSIONS

This study demonstrates subtle impairments during planning in FH+ compared with FH- patients and HCs, whereas activation during mood-incongruent stimuli in FH+ patients was similar to HCs but not FH- patients, suggesting that the presence of a FH of AD is a useful marker for the neurophysiological profile in mood/anxiety disorders and possible predictor for treatment success.

Impulsivity but not sensation seeking is associated with opioid analgesic misuse risk in patients with chronic pain

Impulsivity and sensation seeking have been associated with substance use disorders, including opioid use disorders. This pilot study sought to examine whether impulsivity and sensation seeking, as measured by the Barratt Impulsiveness Scale (BIS) and Sensation Seeking Scale (SSS), were associated with opioid analgesic misuse risk in chronic, low-back pain patients prescribed opioid analgesics. Participants were 42 chronic, low-back pain patients enrolled in a larger study examining problematic opioid analgesic use. Impulsivity was assessed using the BIS, sensation seeking was measured using the SSS, and opioid analgesic misuse risk was assessed using the Current Opioid Misuse Measure (COMM). Significant bivariate associations were found between the COMM and the following predictor variables: age and the three BIS subscales: Attentional Impulsiveness, Non-planning Impulsiveness, and Motor Impulsiveness. Using a multivariate linear regression, after controlling for age, the BIS subscales accounted for 29.0% of the variance in the COMM. Attentional Impulsiveness was the only significant BIS subscale. These results suggest a potential relationship between impulsivity, but not sensation seeking, and risk for opioid analgesic misuse. Impulsivity is not a prominent trait observed in chronic pain patients; however, it may be an important risk factor for opioid analgesic misuse for a subset of individuals with chronic pain. As such, these findings suggest that additional exploration of this potential risk factor is warranted.

The effects of AMPA receptor blockade in the prelimbic cortex on systemic and ventral tegmental area opiate reward sensitivity

RATIONALE

The medial prefrontal cortex (mPFC) is a key neural region involved in opiate-related reward memory processing. AMPA receptor transmission in the mPFC modulates opiate-related reward memory processing, and chronic opiate exposure is associated with alterations in intra-mPFC AMPA receptor function.

OBJECTIVE

The objectives of this study were to examine how pharmacological blockade of AMPA receptor transmission in the prelimbic (PLC) division of the mPFC may modulate opiate reward memory acquisition and whether opiate exposure state may modulate the functional role of intra-PLC AMPA receptor transmission during opiate reward learning.

METHODS

Using an unbiased conditioned place preference (CPP) procedure in rats, we performed discrete, bilateral intra-PLC microinfusions of the AMPA receptor antagonist, 6,7-dinitroquinoxaline-2,3-dione, prior to behavioral morphine CPP conditioning, using sub-reward threshold conditioning doses of either systemic (0.05 mg/kg; i.p.) or intra-ventral tegmental area (VTA) morphine (250 ng/0.5 μl).

RESULTS

We show that, in both opiate-naïve and opiate-dependent states, intra-PLC blockade of AMPA receptor transmission, but not the infralimbic cortex, increases the behavioral reward magnitude of systemic or intra-VTA morphine. This effect is dependent on dopamine (DA)ergic signaling because pre-administration of cis-(Z)-flupenthixol-dihydrochloride (α-flu), a broad-spectrum dopamine receptor antagonist, blocked the morphine-reward potentiating effects of AMPA receptor blockade.

CONCLUSIONS

These findings suggest a critical role for intra-PLC AMPA receptor transmission in the processing of opiate reward signaling. Furthermore, blockade of AMPA transmission specifically within the PLC is capable of switching opiate reward processing to a DA-dependent reward system, independently of previous opiate exposure history.

Executive cognitive dysfunction and ADHD in cocaine dependence: searching for a common cognitive endophenotype for addictive disorders

BACKGROUND

Cocaine-dependent individuals (CDI) present executive cognitive function (ECF) deficits, but the impact of psychiatric comorbidities such as Attention-Deficit Hyperactivity Disorder (ADHD) on neuropsychological functioning is still poorly understood. The aim of this study was to investigate if CDI with ADHD (CDI + ADHD) would have a distinct pattern of executive functioning when compared with CDI without ADHD (CDI).

METHODS

We evaluated 101 adults, including 69 cocaine-dependent subjects (divided in CDI and CDI + ADHD) and 32 controls. ECF domains were assessed with Digits Forward (DF), Digits Backward (DB), Stroop Color Word Test (SCWT), the Wisconsin Card Sorting Test (WCST), and the Frontal Assessment Battery (FAB). DSM-IV criteria for ADHD were used for diagnosis and previous ADHD symptoms (in the childhood) were retrospectively assessed by the Wender-Utah Rating Scale (WURS).

RESULTS

There were no significant differences between CDI + ADHD, CDI, and controls in estimated intellectual quotient (IQ), socioeconomic background, education (in years), and pre-morbid IQ (p > 0.05). SCWT and WCST scores did not differ across groups (p > 0.05). Nevertheless, CDI and CDI + ADHD performed more poorly than controls in total score of the FAB (p < 0.05). Also, CDI + ADHD did worse than CDI on DF (F = 4.756, p = 0.011), DB (F = 8.037, p = 0.001), Conceptualization/FAB (F = 4.635, p = 0.012), and Mental flexibility/FAB (F = 3.678, p = 0.029). We did not find correlations between cocaine-use variables and neuropsychological functioning, but previous ADHD symptoms assessed by WURS were negatively associated with DF (p = 0.016) and with the total score of the FAB (p = 0.017).

CONCLUSION

CDI + ADHD presented more pronounced executive alterations than CDI and CDI exhibited poorer cognitive functioning than controls. Pre-existing ADHD symptoms may have a significant negative impact on executive dysfunction in CDI. It remains to be investigated by future studies if symptoms such as impulsivity or a pre-existing ECF dysfunction could represent underlying cognitive endophenotypes that would substantially increase the risk for acquiring addictive disorders.

Secondary Psychopathy, but not Primary Psychopathy, is Associated with Risky Decision-Making in Noninstitutionalized Young Adults

Although risky decision-making has been posited to contribute to the maladaptive behavior of individuals with psychopathic tendencies, the performance of psychopathic groups on a common task of risky decision-making, the Iowa Gambling Task (IGT; Bechara, Damasio, Damasio, & Anderson, 1994), has been equivocal. Different aspects of psychopathy (personality traits, antisocial deviance) and/or moderating variables may help to explain these inconsistent findings. In a sample of college students (N = 129, age 18 to 27), we examined the relationship between primary and secondary psychopathic features and IGT performance. A measure of impulsivity was included to investigate its potential as a moderator. In a joint model including main effects and interactions between primary psychopathy, secondary psychopathy and impulsivity, only secondary psychopathy was significantly related to risky IGT performance, and this effect was not moderated by the other variables. This finding supports the growing literature suggesting that secondary psychopathy is a better predictor of decision-making problems than the primary psychopathic personality traits of lack of empathy and remorselessness.

Rash impulsiveness and reward sensitivity in relation to risky drinking by university students: potential roles of frontal systems

BACKGROUND

Two forms of impulsivity, rash impulsiveness and reward sensitivity, have been proposed to reflect aspects of frontal lobe functioning and promote substance use. The present study examined these two forms of impulsivity as well as frontal lobe symptoms in relation to risky drinking by university students.

METHODS

University undergraduates aged 18-26years completed the Alcohol Use Disorders Identification Test (AUDIT), Barratt Impulsiveness Scale (BIS-11), Sensitivity to Punishment and Sensitivity to Reward Questionnaire (SPSRQ), Frontal Systems Behavior Scale (FrSBe), and a demographics questionnaire assessing age, gender, and age of onset of weekly drinking (AOD).

RESULTS

AUDIT-defined harmful drinkers reported earlier AOD and scored higher on BIS-11, the Sensitivity to Reward (SR) scale of the SPSRQ, and the Disinhibition and Executive Dysfunction scales of the FrSBe compared to lower risk groups. Differences remained significant after controlling for duration of alcohol exposure. Path analyses indicated that the influence of SR on AUDIT was mediated by FrSBe Disinhibition, whereas the influence of BIS-11 on AUDIT was mediated by both Disinhibition and Executive Dysfunction scales of the FrSBe.

CONCLUSIONS

Findings tentatively suggest that the influence of rash impulsiveness on drinking may reflect dysfunction in dorsolateral prefrontal and orbitofrontal systems, whereas the influence of reward sensitivity on drinking may primarily reflect orbitofrontal dysfunction. Irrespective of the underlying functional brain systems involved, results appear to be more consistent with a pre-drinking trait interpretation than effects of alcohol exposure.

Characterizing the anomalous cognition-emotion interactions in externalizing

Externalizing traits are characterized by exaggerated emotional (e.g., frustration, anger) and behavioral (e.g., drug seeking, reactive aggression) reactions to motivationally significant stimuli. Explanations for this exaggerated reactivity emphasize attention, executive function, and affective processes, but the associations among these processes are rarely investigated. To examine these interactions, we measure fear potentiated startle (FPS; Experiment 1) and neural activation (Experiment 2) in an instructed fear paradigm that manipulates attentional focus, demands on executive functioning, and emotion. In both studies, exaggerated emotional reactivity associated with externalizing was specific to conditions that focused attention on threat information and placed minimal demands on executive functioning. Results suggest that a crucial cognition-emotion interaction affecting externalizing is the over-prioritization and over-allocation of attention to motivationally significant information, which in turn, may impair executive functions and affective regulation.

Direct comparison of the cognitive effects of acute alcohol with the morning after a normal night's drinking

OBJECTIVE

The aim of this study was to compare performance measures after acute alcohol consumption (intoxication) with the performance the day after a normal night's drinking (hangover).

METHODS

Eighty-four social drinkers took part in two studies that followed a counterbalanced repeated measure design. Fifteen men and 33 women were tested the morning (09:00, 11:00 or 13:00 h) following normal/usual alcohol consumption and the morning after no alcohol consumption; the order of testing was counterbalanced. In a second study, 36 participants (18 men and 18 women) were tested after receiving alcohol to attain a blood alcohol concentration of 0.08%, and after no alcohol administration, the order of testing was counterbalanced. In both studies, participants completed a task battery of memory, reaction time and attention tasks.

RESULTS

Alcohol had no effect on the free recall task and the spatial attention task. Alcohol consumption, either acute or the next day, significantly affected reaction time, divided attention, selective attention and Stroop interference. The impairments during intoxication and hangover were of comparable magnitude. Performance on tasks of delayed recognition and irregular interstimulus reaction time was worse during hangover when compared with intoxication.

CONCLUSION

It is evident that awareness needs to be raised that performance the morning after alcohol consumption is at the same level if not worse than when participants are at the legal limit for driving (0.08% blood alcohol concentration).

Preliminary evidence for an impulsivity-based thrifty eating phenotype

INTRODUCTION

Low birth weight is associated with obesity and an increased risk for metabolic/cardiovascular diseases in later life.

RESULTS

The results of the snack delay test, which encompassed four distinct trials, indicated that the gender × intrauterine growth restriction (IUGR) × trial interaction was a predictor of the ability to delay the food reward (P = 0.002). Among children with normal birth weights, girls showed a greater ability to delay food rewards than did boys (P = 0.014).In contrast, among children with IUGR, there was no such differential ability between girls and boys. Furthermore, in girls, impulsive responding predicted both increased consumption of palatable fat (P = 0.007) and higher BMIs (P = 0.020) at 48 mo of age, although there was no such association with BMI at 36 mo.

DISCUSSION

In girls, the quality of fetal growth may contribute to impulsive eating, which may promote an increased intake of fats and consequently higher BMIs. As with the original thrifty phenotype, such a mechanism would be adaptive when food supplies are sparse, but would be problematic in societies with ample access to calorically rich foods.

METHODS

We examined whether the quality of intrauterine growth programs obesogenic eating behaviors, by investigating (i) the relationship between birth weight and impulsive eating in 3-year-old children (using the snack delay test), and (ii) whether impulsive eating predicts fat intake and/or BMI at 4 years of age (using a laboratory-based test meal).

Alcoholics Anonymous attendance, decreases in impulsivity and drinking and psychosocial outcomes over 16 years: moderated-mediation from a developmental perspective

AIMS

To examine whether decreases in impulsivity account for links between Alcoholics Anonymous (AA) attendance and better drinking and psychosocial outcomes, and whether these mediational 'effects' are conditional on age.

DESIGN

A naturalistic study in which individuals were assessed at baseline, and 1, 8 and 16 years later.

SETTING

Participants initiated help-seeking through the alcohol intervention system (detoxification programs, information and referral centers).

PARTICIPANTS

Individuals with alcohol use disorders and no prior history of substance abuse treatment at baseline [n=628; 47% women; mean age=34.7 years (standard deviation=9.4)].

MEASUREMENTS

Self-reports of impulsivity and drinking pattern at baseline and year 1, duration of AA (number of weeks) in year 1 and drinking (alcohol use problems, self-efficacy to resist drinking) and psychosocial outcomes (emotional discharge coping, social support) at baseline and follow-ups.

FINDINGS

Controlling for changes in drinking pattern, decreases in impulsivity were associated with fewer alcohol use problems, better coping and greater social support and self-efficacy at year 1, and better coping and greater social support at year 8. Decreases in impulsivity statistically mediated associations between longer AA duration and improvements on all year 1 outcomes and indirect effects were moderated by participant age (significant only for individuals 25 years of age or younger).

CONCLUSIONS

Decreased impulsivity appears to mediate reductions in alcohol-related problems over 8 years in people attending Alcoholics Anonymous.

Selected impulsivity facets with alcohol use/problems: the mediating role of drinking motives

Impulsivity is associated with alcohol use and related problems, yet limited research has examined the different facets of impulsivity with these outcomes. This study aimed to examine whether sensation seeking, positive urgency, and negative urgency, as separate constructs, would differentially predict alcohol use/problems, and to investigate whether specific drinking motives would mediate these relationships. Self-reported data from an online survey of undergraduate drinkers (n=317) was used in the current study. Findings indicate that sensation seeking and the urgency traits represent unique personality constructs in the prediction of alcohol use/problems, and should be considered separately in future research and when designing prevention and intervention strategies.