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Brevers D, Billieux J, de Timary P, Desmedt O, Maurage P, Perales JC, Suárez-Suárez S, Bechara A. Physical Exercise to Redynamize Interoception in Substance use Disorders. Curr Neuropharmacol 2024; 22:1047-1063. [PMID: 36918784 PMCID: PMC10964100 DOI: 10.2174/1570159x21666230314143803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/19/2022] [Accepted: 12/23/2022] [Indexed: 03/16/2023] Open
Abstract
Physical exercise is considered a promising medication-free and cost-effective adjunct treatment for substance use disorders (SUD). Nevertheless, evidence regarding the effectiveness of these interventions is currently limited, thereby signaling the need to better understand the mechanisms underlying their impact on SUD, in order to reframe and optimize them. Here we advance that physical exercise could be re-conceptualized as an "interoception booster", namely as a way to help people with SUD to better decode and interpret bodily-related signals associated with transient states of homeostatic imbalances that usually trigger consumption. We first discuss how mismatches between current and desired bodily states influence the formation of reward-seeking states in SUD, in light of the insular cortex brain networks. Next, we detail effort perception during physical exercise and discuss how it can be used as a relevant framework for re-dynamizing interoception in SUD. We conclude by providing perspectives and methodological considerations for applying the proposed approach to mixed-design neurocognitive research on SUD.
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Affiliation(s)
- Damien Brevers
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Sciences Research Institute (IPSY), UCLouvain, Louvain-La-Neuve, Belgium
- Department of Behavioural and Cognitive Sciences, Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Joël Billieux
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
- Centre for Excessive Gambling, Addiction Medicine, Lausanne University Hospitals (CHUV), Lausanne, Switzerland
| | - Philippe de Timary
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Sciences Research Institute (IPSY), UCLouvain, Louvain-La-Neuve, Belgium
- Department of Adult Psychiatry, Cliniques universitaires Saint-Luc and Institute of Neuroscience (IoNS), UCLouvain, Brussels, Belgium
| | - Olivier Desmedt
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
| | - Pierre Maurage
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Sciences Research Institute (IPSY), UCLouvain, Louvain-La-Neuve, Belgium
| | - José Cesar Perales
- Mind, Brain, and Behavior Research Center (CIMCYC), Department of Experimental Psychology, University of Granada, Granada, Spain
| | - Samuel Suárez-Suárez
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Sciences Research Institute (IPSY), UCLouvain, Louvain-La-Neuve, Belgium
- Department of Clinical Psychology and Psychobiology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Antoine Bechara
- Department of Psychology, University of Southern California, Los Angeles, California, CA, USA
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Brown A, Kumar AT, Melamed O, Ahmed I, Wang YH, Deza A, Morcos M, Zhu L, Maslej M, Minian N, Sujaya V, Wolff J, Doggett O, Iantorno M, Ratto M, Selby P, Rose J. A Motivational Interviewing Chatbot With Generative Reflections for Increasing Readiness to Quit Smoking: Iterative Development Study. JMIR Ment Health 2023; 10:e49132. [PMID: 37847539 PMCID: PMC10618902 DOI: 10.2196/49132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/28/2023] [Accepted: 07/29/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND The motivational interviewing (MI) approach has been shown to help move ambivalent smokers toward the decision to quit smoking. There have been several attempts to broaden access to MI through text-based chatbots. These typically use scripted responses to client statements, but such nonspecific responses have been shown to reduce effectiveness. Recent advances in natural language processing provide a new way to create responses that are specific to a client's statements, using a generative language model. OBJECTIVE This study aimed to design, evolve, and measure the effectiveness of a chatbot system that can guide ambivalent people who smoke toward the decision to quit smoking with MI-style generative reflections. METHODS Over time, 4 different MI chatbot versions were evolved, and each version was tested with a separate group of ambivalent smokers. A total of 349 smokers were recruited through a web-based recruitment platform. The first chatbot version only asked questions without reflections on the answers. The second version asked the questions and provided reflections with an initial version of the reflection generator. The third version used an improved reflection generator, and the fourth version added extended interaction on some of the questions. Participants' readiness to quit was measured before the conversation and 1 week later using an 11-point scale that measured 3 attributes related to smoking cessation: readiness, confidence, and importance. The number of quit attempts made in the week before the conversation and the week after was surveyed; in addition, participants rated the perceived empathy of the chatbot. The main body of the conversation consists of 5 scripted questions, responses from participants, and (for 3 of the 4 versions) generated reflections. A pretrained transformer-based neural network was fine-tuned on examples of high-quality reflections to generate MI reflections. RESULTS The increase in average confidence using the nongenerative version was 1.0 (SD 2.0; P=.001), whereas for the 3 generative versions, the increases ranged from 1.2 to 1.3 (SD 2.0-2.3; P<.001). The extended conversation with improved generative reflections was the only version associated with a significant increase in average importance (0.7, SD 2.0; P<.001) and readiness (0.4, SD 1.7; P=.01). The enhanced reflection and extended conversations exhibited significantly better perceived empathy than the nongenerative conversation (P=.02 and P=.004, respectively). The number of quit attempts did not significantly change between the week before the conversation and the week after across all 4 conversations. CONCLUSIONS The results suggest that generative reflections increase the impact of a conversation on readiness to quit smoking 1 week later, although a significant portion of the impact seen so far can be achieved by only asking questions without the reflections. These results support further evolution of the chatbot conversation and can serve as a basis for comparison against more advanced versions.
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Affiliation(s)
- Andrew Brown
- The Edward S Rogers Sr Department of Electrical & Computer Engineering, University of Toronto, Toronto, ON, Canada
| | - Ash Tanuj Kumar
- The Edward S Rogers Sr Department of Electrical & Computer Engineering, University of Toronto, Toronto, ON, Canada
| | - Osnat Melamed
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Imtihan Ahmed
- The Edward S Rogers Sr Department of Electrical & Computer Engineering, University of Toronto, Toronto, ON, Canada
| | - Yu Hao Wang
- The Edward S Rogers Sr Department of Electrical & Computer Engineering, University of Toronto, Toronto, ON, Canada
| | - Arnaud Deza
- The Edward S Rogers Sr Department of Electrical & Computer Engineering, University of Toronto, Toronto, ON, Canada
| | - Marc Morcos
- The Edward S Rogers Sr Department of Electrical & Computer Engineering, University of Toronto, Toronto, ON, Canada
| | - Leon Zhu
- The Edward S Rogers Sr Department of Electrical & Computer Engineering, University of Toronto, Toronto, ON, Canada
| | - Marta Maslej
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Nadia Minian
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
| | - Vidya Sujaya
- The Edward S Rogers Sr Department of Electrical & Computer Engineering, University of Toronto, Toronto, ON, Canada
| | - Jodi Wolff
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Olivia Doggett
- Faculty of Information, University of Toronto, Toronto, ON, Canada
| | - Mathew Iantorno
- Faculty of Information, University of Toronto, Toronto, ON, Canada
| | - Matt Ratto
- Faculty of Information, University of Toronto, Toronto, ON, Canada
| | - Peter Selby
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Jonathan Rose
- The Edward S Rogers Sr Department of Electrical & Computer Engineering, University of Toronto, Toronto, ON, Canada
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
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Mohd Noordin Z, Neoh CF, Ibrahim@ Ghazali NH, Karuppannan M. "A person who do not smoke will not understand a person who smokes and trying to quit…" Insights From Quit Smoking Clinics' Defaulters: A Qualitative Study. J Patient Exp 2023; 10:23743735231184690. [PMID: 37424538 PMCID: PMC10328151 DOI: 10.1177/23743735231184690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023] Open
Abstract
This study explored the factors contributing to discontinuation of people who smoke (PWS) from quit smoking clinic prior to achieving 6-month abstinence. Fifteen active PWS were interviewed via telephone and face-to-face. Interviews were audio-recorded, transcribed and analysed using thematic analysis. At individual level, low intrinsic motivation including unreadiness to quit, low self-efficacy and ambivalence on smoking cessation were barriers to attain successful cessation. Influence of extrinsic factors such as work-related factors, social interaction and ill-health burden lead to poor commitment with QSC. At the clinic level, healthcare professional's competency, personal attributes, pharmacotherapy's efficacy, safety and availability were important components that may affect a participant's effort to quit. Working commitment was highlighted as the primary barrier for a successful cessation. Hence, effective intervention and collaborative effort between healthcare facilities and employers are essential to optimise cessation adherence among employees who smoke which subsequently will enhance their abstinence rates.
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Affiliation(s)
- Zakiah Mohd Noordin
- Department of Clinical Pharmacy, Faculty of Pharmacy, Universiti Teknologi MARA Selangor Branch, Puncak Alam Campus, Selangor, Malaysia
- Cardiology Therapeutics Research Group, Faculty of Pharmacy, Universiti Teknologi MARA Selangor Branch, Puncak Alam Campus, Selangor, Malaysia
| | - Chin Fen Neoh
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | | | - Mahmathi Karuppannan
- Department of Clinical Pharmacy, Faculty of Pharmacy, Universiti Teknologi MARA Selangor Branch, Puncak Alam Campus, Selangor, Malaysia
- Cardiology Therapeutics Research Group, Faculty of Pharmacy, Universiti Teknologi MARA Selangor Branch, Puncak Alam Campus, Selangor, Malaysia
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Brevers D, Baeken C, De Smet S, Catoira B, De Witte S, He Q, Maurage P, Schulze-Steinen L, Sescousse G, Verde CV, Vögele C, Billieux J. Stimulation of the dorsolateral prefrontal cortex modulates brain cue reactivity to reward (un)availability. Cortex 2023; 164:51-62. [PMID: 37172533 DOI: 10.1016/j.cortex.2023.03.008] [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: 08/11/2022] [Revised: 10/13/2022] [Accepted: 03/23/2023] [Indexed: 05/15/2023]
Abstract
Brain imaging studies have shown that stimulation of the left dorsolateral prefrontal cortex (dlPFC), which plays a pivotal role in high-order cognitive control processes, modulates brain reactivity to reward-related cues. Nevertheless, the impact of contextual factors such as reward availability (the reward that is depicted in the cue exposure task) on such modulation effect remains unclear. Here we tested whether a single session of high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) over the left dlPFC differently impacts brain reactivity to cues signalling either availability or unavailability of a sports betting opportunity. Employing a within-subject design (verum versus sham HF-rTMS) among thirty-two frequent sports bettors, we first observed that, as compared to the sham condition, verum HF-rTMS modulated brain reactivity to game cues prior to being made (un)available for betting, through simultaneous increases (posterior insula and caudate nucleus) and decreases (occipital pole) in brain activation. Second, verum HF-rTMS led to increased ventral striatal activity towards cues available for betting but did not modulate brain response to cues unavailable for betting. Taken together, these findings demonstrate that transient stimulation of the left dlPFC led to a general modulation in brain activity in responses to cues, and that this effect is only partly dependent on cues signalling for reward (un)availability.
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Affiliation(s)
- Damien Brevers
- Louvain for Experimental Psychopathology Research Group (LEP), Psychological Sciences Research Institute (IPSY), UCLouvain, Louvain-la-Neuve, Belgium; Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg.
| | - Chris Baeken
- Department of Psychiatry University Hospital (UZBrussel), Brussels, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium; Department of Head and Skin, Ghent University Hospital, Ghent University, Ghent, Belgium; Eindhoven University of Technology, Department of Electrical Engineering, Eindhoven, the Netherlands
| | | | - Beatriz Catoira
- Department of Psychiatry University Hospital (UZBrussel), Brussels, Belgium
| | - Sara De Witte
- Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium
| | - Qinghua He
- Faculty of Psychology, Southwest University, 2 Tiansheng Rd, Chongqing, China
| | - Pierre Maurage
- Louvain for Experimental Psychopathology Research Group (LEP), Psychological Sciences Research Institute (IPSY), UCLouvain, Louvain-la-Neuve, Belgium
| | - Laimi Schulze-Steinen
- Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Guillaume Sescousse
- Lyon Neuroscience Research Center - INSERM U1028 - CNRS UMR5292, PSYR2 Team, University of Lyon, Lyon, France
| | - Claudia Vila Verde
- Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Claus Vögele
- Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Joël Billieux
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland; Centre for Excessive Gambling, Addiction Medicine, Lausanne University Hospitals (CHUV), Lausanne, Switzerland
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5
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Indexing Quit-Smoking Interest among Norwegian Smokers 2019-2021. J Smok Cessat 2023; 2023:9536270. [PMID: 36814442 PMCID: PMC9940954 DOI: 10.1155/2023/9536270] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 12/20/2022] [Accepted: 01/12/2023] [Indexed: 02/16/2023] Open
Abstract
Even if smoking prevalence is declining in several western countries, continued smoking cessation is required to reduce tobacco-related harms and to achieve future goals of smoke-free societies or the tobacco endgame. But how many of the current smokers want to quit? Estimates vary and depend on the type of question asked. We investigate how a pooled sample of Norwegian smokers (N = 1321) is distributed over four indicators of interest in quitting: (i) degree of desire to quit, (ii) prediction of future smoking status, (iii) reported plan for quitting smoking, and (iv) statements on previous attempts to quit. Based on these variables, we constructed an index. One-third of the smokers (32.6%) was categorized as having a high or very high interest in quitting. However, nearly half of the smokers (47.8%) had low or very low interest in quitting. Like several other countries, Norway has legislated a vision of a smoke-free society and, under the government's plans; this goal will be achieved by intensified use of structural measures such as tax hikes, tighter restrictions on outdoor smoking, and reduced availability of cigarettes. For the third who want to quit smoking, such constraints on their behaviour may help them to pursue their desire to quit. However, for the half who want to continue smoking, these measures may not be helpful but instead be experienced as a loss of welfare, less freedom to act, and increased social disqualification.
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Cai Z, Wang P, Liu B, Zou Y, Wu S, Tian J, Dan G, Ma J, Wu G, Zhang J, Huang B. To explore the mechanism of tobacco addiction using structural and functional MRI: a preliminary study of the role of the cerebellum-striatum circuit. Brain Imaging Behav 2022; 16:834-842. [PMID: 34606038 DOI: 10.1007/s11682-021-00546-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2021] [Indexed: 10/20/2022]
Abstract
Previous studies have found that the striatum and the cerebellum played important roles in nicotine dependence, respectively. In heavy smokers, however, the effect of resting-state functional connectivity of cerebellum-striatum circuits in nicotine dependence remained unknown. This study aimed to explore the role of the circuit between the striatum and the cerebellum in addiction in heavy smokers using structural and functional magnetic resonance imaging. The grey matter volume differences and the resting-state functional connectivity differences in cerebellum-striatum circuits were investigated between 23 heavy smokers and 23 healthy controls. The cigarette dependence in heavy smokers and healthy controls were evaluated by using Fagerström Test. Then, we applied mediation analysis to test whether the resting-state functional connectivity between the striatum and the cerebellum mediates the relationship between the striatum morphometry and the nicotine dependence in heavy smokers. Compared with healthy controls, the heavy smokers' grey matter volumes decreased significantly in the cerebrum (bilateral), and increased significantly in the caudate (bilateral). Seed-based resting-state functional connectivity analysis showed significantly higher resting-state functional connectivity among the bilateral caudate, the left cerebellum, and the right middle temporal gyrus in heavy smokers. The cerebellum-striatum resting-state functional connectivity fully mediated the relationship between the striatum morphometry and the nicotine dependence in heavy smokers. Heavy smokers showed abnormal interactions and functional connectivity between the striatum and the cerebellum, which were associated with the striatum morphometry and nicotine dependence. Such findings could provide new insights into the neural correlates of nicotine dependence in heavy smokers.
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Affiliation(s)
- Zongyou Cai
- Medical AI Lab, School of Biomedical Engineering, Health Science Center, Shenzhen University, Room 508, Shenzhen, China
- Shenzhen University General Hospital Clinical Research Center for Neurological Diseases, Shenzhen, China
| | - Panying Wang
- Radiology Department, Shenzhen University General Hospital and Shenzhen University Clinical Medical Academy, Shenzhen, 518055, People's Republic of China
- Shenzhen University International Cancer Center, Shenzhen, China
| | - Bihua Liu
- Medical AI Lab, School of Biomedical Engineering, Health Science Center, Shenzhen University, Room 508, Shenzhen, China
- Radiology Department, Shenzhen University General Hospital and Shenzhen University Clinical Medical Academy, Shenzhen, 518055, People's Republic of China
| | - Yujian Zou
- Medical AI Lab, School of Biomedical Engineering, Health Science Center, Shenzhen University, Room 508, Shenzhen, China
- Shenzhen University General Hospital Clinical Research Center for Neurological Diseases, Shenzhen, China
| | - Songxiong Wu
- Radiology Department, Dongguan People's Hospital, Dongguan, China
| | - Junru Tian
- Radiology Department, Dongguan People's Hospital, Dongguan, China
| | - Guo Dan
- Shenzhen University General Hospital Clinical Research Center for Neurological Diseases, Shenzhen, China
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Jinting Ma
- Medical AI Lab, School of Biomedical Engineering, Health Science Center, Shenzhen University, Room 508, Shenzhen, China
- Shenzhen University General Hospital Clinical Research Center for Neurological Diseases, Shenzhen, China
| | - Guangyao Wu
- Radiology Department, Shenzhen University General Hospital and Shenzhen University Clinical Medical Academy, Shenzhen, 518055, People's Republic of China.
- Shenzhen University International Cancer Center, Shenzhen, China.
| | - Jian Zhang
- Shenzhen University General Hospital Clinical Research Center for Neurological Diseases, Shenzhen, China.
- Health Science Center, Shenzhen University, Shenzhen, China.
| | - Bingsheng Huang
- Medical AI Lab, School of Biomedical Engineering, Health Science Center, Shenzhen University, Room 508, Shenzhen, China.
- Shenzhen University General Hospital Clinical Research Center for Neurological Diseases, Shenzhen, China.
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Creswell KG, Sayette MA. How laboratory studies of cigarette craving can inform the experimental alcohol craving literature. Alcohol Clin Exp Res 2022; 46:344-358. [PMID: 35037262 PMCID: PMC8920775 DOI: 10.1111/acer.14773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 01/03/2022] [Accepted: 01/05/2022] [Indexed: 11/28/2022]
Abstract
Interest in alcohol and other drug craving has flourished over the past two decades, and evidence has accumulated showing that craving can be meaningfully linked to both drug use and relapse. Considerable human experimental alcohol craving research since 2000 has focused on craving as a clinical phenomenon. Self-reported craving to drink typically has served as a catch-all for the craving construct in these studies, whereas few studies have considered craving as a process (or hypothetical construct) that interacts with other phenomena to affect use. In contrast to alcohol, we believe that recently there has been more mechanistic work targeting cigarette craving-related processes. Here, we briefly present a narrative review of studies of acute alcohol craving in humans that have been conducted during the past two decades. We then specify important ways in which alcohol and tobacco differ (e.g., the role of withdrawal), and we note the unique challenges in inducing robust alcohol craving states in the laboratory. Finally, we offer recommendations for how the alcohol field might advance its conceptual understanding of craving by adopting ideas and methods drawn from the smoking research literature. Specifically, we suggest that researchers extend their studies to not only examine the link between alcohol craving and relapse but also to focus on why and, in some instances, how alcohol cravings matter clinically, and the circumstances under which craving especially matters. We propose research to investigate the shifts in alcohol-related cognitive and affective processing that occur during alcohol craving states. Furthermore, we highlight the value of research examining the level of insight that individuals with varying levels of alcohol involvement possess about their own craving-related processing shifts. We believe that laboratory studies can provide rich opportunities to examine conceptual questions about alcohol craving that are central to addiction.
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Affiliation(s)
- Kasey G. Creswell
- Department of PsychologyCarnegie Mellon UniversityPittsburghPennsylvaniaUSA
| | - Michael A. Sayette
- Department of PsychologyUniversity of PittsburghPittsburghPennsylvaniaUSA
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8
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Creswell KG, Skrzynski CJ. The Influence of Smoking Motivation on the Associations Among Cigarette Craving, Attentional Bias to Smoking Cues, and Smoking Behavior. Nicotine Tob Res 2021; 23:1727-1734. [PMID: 33599777 DOI: 10.1093/ntr/ntab028] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 02/10/2021] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Theory and data suggest that attentional bias (AB) to drug-related cues should be associated with craving when smoking motivation is high, and that AB should be predictive of drug use when immediate use is possible. The current study is the first to test these propositions in smokers in a controlled laboratory environment. AIMS AND METHODS Ninety daily smokers were randomly assigned to a high smoking motivation (nicotine-deprived and/or smoking cue exposure) or low smoking motivation (non-deprived and/or control cue exposure) condition. Participants engaged in an AB task in which they viewed smoking and matched control pictures while their eye movements were continuously monitored. Participants were then given the option to smoke, and latency to first puff and number of puffs were coded. RESULTS High motivation smokers had significantly higher urges to smoke (p < .001) and shorter latencies to smoke (p = .001) than low motivation smokers, but AB measures (ie, dwell time and initial fixation bias scores) and number of puffs did not differ across groups (ps > .45). As predicted, the association between dwell time bias scores and urge to smoke was stronger in the high (r = .47) than low (r = .18) smoking motivation condition, but this difference failed to reach significance (p = .068). Contrary to predictions, neither AB measure was significantly associated with smoking behavior (SB). Internal reliability was excellent for dwell time bias scores (alpha = .90) but very low for initial fixation bias scores (alpha = .20). CONCLUSIONS Maintenance of attention on drug-related cues may be a valid index of incentive motivation. Importantly, however, these dwell time bias scores were not predictive of actual SB. IMPLICATIONS This study tested key predictions made by theoretical accounts of addiction that emphasize AB to drug-related cues as fundamental components of the development and maintenance of drug use. Namely, this is the first experimental study in smokers to test whether AB to smoking-related cues is associated with craving when smoking motivation is high and whether AB predicts SB assessed immediately after the AB task. As predicted, the association between AB and craving was stronger in smokers randomly assigned to a high rather than a low smoking motivation condition. Contrary to predictions, AB did not predict SB.
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Affiliation(s)
- Kasey G Creswell
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, USA
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9
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Abstract
The impact of tobacco smoking treatment is determined by its reach into the smoking population and the effectiveness of its interventions. This review evaluates the reach and effectiveness of pharmacotherapy and psychosocial interventions for smoking. Historically, the reach of smoking treatment has been low, and therefore its impact has been limited, but new reach strategies such as digital interventions and health care system changes offer great promise. Pharmacotherapy tends to be more effective than psychosocial intervention when used clinically, and newer pharmacotherapy strategies hold great promise of further enhancing effectiveness. However, new approaches are needed to advance psychosocial interventions; progress has stagnated because research and dissemination efforts have focused too narrowly on skill training despite evidence that its core content may be inconsequential and the fact that its mechanisms are either unknown or inconsistent with supporting theory. Identifying effective psychosocial content and its mechanisms of action could greatly enhance the effectiveness of counseling, digital, and web interventions.
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Affiliation(s)
- Timothy B Baker
- Department of Medicine, University of Wisconsin-Madison, Madison, Wisconsin 53711, USA;
| | - Danielle E McCarthy
- Department of Medicine, University of Wisconsin-Madison, Madison, Wisconsin 53711, USA;
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10
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Schulte EM, Yokum S, Jahn A, Gearhardt AN. Food cue reactivity in food addiction: A functional magnetic resonance imaging study. Physiol Behav 2019; 208:112574. [PMID: 31181233 PMCID: PMC6620138 DOI: 10.1016/j.physbeh.2019.112574] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 05/21/2019] [Accepted: 06/05/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND While neuroimaging studies have revealed that reward dysfunction may similarly contribute to obesity and addiction, no prior studies have examined neural responses in individuals who meet the "clinical" food addiction phenotype. METHODS Women (n = 44) with overweight and obesity, nearly half of whom (n = 20) met criteria for moderate-to-severe Yale Food Addiction Scale 2.0 (YFAS 2.0) food addiction, participated in a functional magnetic resonance imaging cue reactivity task. Participants viewed images of highly processed foods, minimally processed foods, and household objects while thinking about how much they wanted each item. Differences in neural responses by YFAS 2.0 food addiction to highly processed and minimally processed food cues were investigated. RESULTS There was a significant interaction between participant group and neural response in the right superior frontal gyrus to highly versus minimally processed food cues (r = 0.57). Individuals with YFAS 2.0 food addiction exhibited modest, elevated responses in the superior frontal gyrus for highly processed food images and more robust, decreased activations for minimally processed food cues, whereas participants in the control group showed the opposite responses in this region. Across all participants, the household items elicited greater activation than the food cues in regions associated with interoceptive awareness and visuospatial attention (e.g., insula, inferior frontal gyrus, inferior parietal lobe). CONCLUSIONS Women with overweight or obesity and YFAS 2.0 food addiction, compared to those with only overweight or obesity, exhibited differential responses to highly and minimally processed food cues in a region previously associated with cue-induced craving in persons with a substance-use disorder. Overall, the present work provides further support for the utility of the food addiction phenotype within overweight and obesity.
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Affiliation(s)
- Erica M Schulte
- Department of Psychology, University of Michigan, United States.
| | | | - Andrew Jahn
- Functional MRI Laboratory, University of Michigan, United States
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11
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Lack of conflict during food choice is associated with the failure of restrained eating. Eat Behav 2019; 34:101309. [PMID: 31325801 DOI: 10.1016/j.eatbeh.2019.101309] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 06/20/2019] [Accepted: 07/05/2019] [Indexed: 12/18/2022]
Abstract
Restrained eaters tend to sustain a restriction in caloric intake to lose or maintain body weight; however, only a few restrained eaters can achieve the goal of restricting their caloric intake to lose or maintain body weight. Those who are effective restrained eaters habitually adhere to their intentions to avoid eating certain palatable foods, whereas those who are ineffective restrained eaters are generally unable to translate their intentions into behavior. To restrain eating regardless of temptation, an individual must first identify potential conflicts between achieving restrained eating and temptation to eat. Regarding food selections, the association between a lack of conflict between temptation, eating enjoyment, and weight loss or maintenance goals and the failure of restriction of caloric intake remains unknown. The present study used an eye-tracking technique to assess the degree of conflict experienced by effective and ineffective restrained eaters during food choice. Participants were required to choose between pairs of high- and low-calorie foods. The results showed that choosing the low-calorie food was associated with the experience of more conflict, measured by longer response times and more gaze switches, than choosing the high-calorie food. Ineffective restrained eaters experienced less conflict, exhibiting shorter response times and fewer gaze switches, than did effective restrained eaters, which suggests that a failure to restrain eating might be associated with a lack of experience of conflict.
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Ramdave S, Dawson A, Carter A, Dissanayaka NNW. Unmasking neurobiological commonalities between addictive disorders and impulse control disorders in Parkinson’s disease. Brain Imaging Behav 2019; 14:2785-2798. [PMID: 30707344 DOI: 10.1007/s11682-019-00041-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Changes in reward circuitry have been studied extensively in substance and behavioural addictions. However, comparatively little is known about the neurobiology underlying impulse control disorders (ICDs) in Parkinson's disease, which show roughly similar risk factors and behavioural presentations to both stimulant and behavioural addictions. ICDs occur in a subset of susceptible patients with Parkinson's disease (PD) following intake of dopamine replacement therapy (DRT). These behavioural disorders often have debilitating effects on a patient's quality of life and increase caregiver burden. This comprehensive review examined findings of 40 neuroimaging studies of ICDs in PD to determine (a) whether there are putative neurobiological commonalities between traditional substance and behavioural addictions and DRT-induced ICD in PD and (b) opportunities for future studies to advance current neurobiological understanding of the phenomenon. Results revealed that strikingly similar (a) deficits in dopaminergic receptor expression, (b) connectivity changes in corticostriatal circuitry and (c) neural responses to cue exposure are observed in both ICDs in PD and addictive disorders. These findings point to the value of adopting a transdiagnostic approach when studying addicted populations and pave the way for demystifying this peculiar, often-devastating phenomenon in PD that has so far proven extremely difficult to treat and predict with any precision.
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Affiliation(s)
- Swathi Ramdave
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia.
- School of Psychology, The University of Queensland, Brisbane, Australia.
| | - Andrew Dawson
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Australia
| | - Adrian Carter
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Australia
| | - Nadeeka N W Dissanayaka
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- School of Psychology, The University of Queensland, Brisbane, Australia
- Department of Neurology, Royal Brisbane & Woman's Hospital, Brisbane, Australia
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Monteiro Mantovani V, Rodríguez Acelas AL, Klockner Boaz S, Cañon-Montañez W, Lucena ADF, Echer IC. Evaluation of Patients in a Smoking Cessation Support Group Using the Nursing Outcomes Classification. Int J Nurs Knowl 2018; 30:125-130. [PMID: 29847016 DOI: 10.1111/2047-3095.12213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE To evaluate patients in a smoking cessation support group using the Nursing Outcomes Classification (NOC). METHODS Prospective observational cohort study conducted with 21 patients participating in a smoking cessation support group. Data were collected using an instrument consisting of 2 NOC outcomes and 20 indicators, applied during each of the six support group meetings. FINDINGS The two NOC outcomes, Smoking Cessation Behavior (1625) and Substance Withdrawal Severity (2108), showed statistically significant differences over time in many of their indicators. CONCLUSIONS The NOC outcomes demonstrated the clinical evolution and behavioral improvement of patients during the smoking cessation process. IMPLICATIONS FOR NURSING PRACTICE The findings highlight important elements of the evaluation of behavioral change and severity of withdrawal symptoms.
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Affiliation(s)
- Vanessa Monteiro Mantovani
- School of Nursing, Universidade Federal do Rio Grande do Sul (UFRGS), Nurse at the Hospital São Lucas, Member of the Nursing Research Group on the Care of Adults and the Elderly (GEPECADI-CNPq), Porto Alegre, RS, Brazil
| | | | | | | | - Amália de Fátima Lucena
- School of Nursing, UFRGS, Coordinator of the Committee of Nursing Process, HCPA, Researcher at the GEPECADI-CNPq, Porto Alegre, RS, Brazil
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14
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MacLean RR, Martino S, Carroll KM, Smyth JM, Pincus AL, Wilson SJ. Momentary Associations Between Reported Craving and Valuing Health in Daily Smokers. Nicotine Tob Res 2017; 19:716-722. [PMID: 28486711 DOI: 10.1093/ntr/ntw253] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 09/28/2016] [Indexed: 12/20/2022]
Abstract
Introduction Research suggests that a blunted response to nondrug rewards, especially under conditions associated with strong cigarette cravings, is associated with reduced abstinence motivation in daily smokers. One limitation of previous studies is that they have largely focused on monetary rewards as broad representative of nondrug rewards. It remains unclear whether craving dampens responses to more abstract nondrug rewards, such as personal values. Personal values often have a positive valence and are frequently assumed to remain stable across time and situations. However, there may be time-varying and contextual influences on smokers' appraisal of values in daily life. Characterizing fluctuations in value importance in relation to relapse precipitants (eg, craving) may inform interventions that leverage personal values as motivation for cessation. Methods Daily smokers (n = 18) completed ecological momentary assessment surveys measuring the importance of specific personal values and smoking-related variables during 8 days of monetarily reinforced cigarette abstinence. We hypothesized that value ratings would demonstrate adequate within-person heterogeneity for multilevel modeling and that within-person fluctuations in craving would be negatively related to valuing personal health. Results All values demonstrated adequate within-person variability for multilevel modeling. Within-person craving was negatively related to health valuation (p = .012) and a cross-level interaction (p > .0001) suggested this effect is stronger for individuals who report greater overall craving. Conclusions Greater craving is associated with decreased importance of personal health in the moment, particularly for those with high average levels of craving. Timely interventions that bolster importance of health during moments of elevated craving can potentially improve cessation outcomes. Implications This study builds on research highlighting the positive influence of personal values in motivating behavior change. Values are an often used, but poorly studied, construct that has considerable utility in smoking cessation. Valuing personal health is frequently reported as a primary motivator for a quit attempt. Inasmuch as personal health is a distal nondrug reward used to motivate smoking abstinence, naturalistic evaluation of health importance, and motivators for continued smoking (ie, craving) could inform the timing and content of smoking treatment. This study is among the first to evaluate momentary assessment of personal values and craving within daily life.
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Affiliation(s)
- Robert Ross MacLean
- Department of Psychology, Pennsylvania State University, University Park, PA.,Department of Psychiatry, VA Connecticut Healthcare System, West Haven, CT.,Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Steve Martino
- Department of Psychiatry, VA Connecticut Healthcare System, West Haven, CT.,Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Kathleen M Carroll
- Department of Psychiatry, VA Connecticut Healthcare System, West Haven, CT.,Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Joshua M Smyth
- Department of Biobehavioral Health and Medicine, Pennsylvania State University, University Park, PA
| | - Aaron L Pincus
- Department of Psychology, Pennsylvania State University, University Park, PA
| | - Stephen J Wilson
- Department of Psychology, Pennsylvania State University, University Park, PA
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15
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Feldstein Ewing SW, Apodaca TR, Gaume J. Ambivalence: Prerequisite for success in motivational interviewing with adolescents? Addiction 2016; 111:1900-1907. [PMID: 26814983 PMCID: PMC4963310 DOI: 10.1111/add.13286] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 08/05/2015] [Accepted: 12/07/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS The exploration and resolution of ambivalence play an essential role in motivational interviewing (MI) theory. However, most adolescent MI studies have not examined ambivalence as a contributor to behaviour change. This paper reviewed research findings on the role of ambivalence in the adolescent change process. METHODS AND RESULTS We undertook a narrative review of the published empirical and theoretical literature on ambivalence and mechanisms of change in MI for adolescents and found that current MI evaluations appear not to have access to reliable and valid measures of ambivalence in adolescence or neuroimaging methods to evaluate the mechanisms of treatment response. CONCLUSIONS Improved instrumentation is needed to assess adolescents' ambivalence in clinical and research settings. Innovative methodology, including neuroimaging, may help identify factors mediating relationships between adolescents' ambivalence and treatment response.
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Affiliation(s)
- S. W. Feldstein Ewing
- Oregon Health & Science University, Department of Child & Adolescent Psychiatry, Portland, OR USA
| | - T. R. Apodaca
- Children’s Mercy Kansas City, Kansas City, MO USA,University of Missouri-Kansas City School of Medicine, Department of Pediatrics, Kansas City, MO USA
| | - J. Gaume
- Lausanne University Hospital, Department of Community Health and Medicine, Alcohol Treatment Center, Lausanne, Switzerland
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Markus W, de Weert-van Oene GH, Woud ML, Becker ES, DeJong CAJ. Are addiction-related memories malleable by working memory competition? Transient effects on memory vividness and nicotine craving in a randomized lab experiment. J Behav Ther Exp Psychiatry 2016; 52:83-91. [PMID: 27038191 DOI: 10.1016/j.jbtep.2016.03.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 02/29/2016] [Accepted: 03/14/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND OBJECTIVES Experimental research suggests that working memory (WM) taxation reduces craving momentarily. Using a modified Eye Movement Desensitization and Reprocessing (EMDR) procedure, prolonged reductions in craving and relapse rates in alcohol dependence have been demonstrated. Modified EMDR-procedures may also hold promise in smoking cessation attempts. A proof-of-concept study was conducted to narrow the gap between WM-taxation experiments and clinical EMDR studies. To this end the clinical EMDR-procedure was modified for use in a laboratory experiment. METHODS Daily smokers (n = 47), abstaining overnight, were allocated (by minimization randomization) to one of two groups using a parallel design. In both cases a modified EMDR-procedure was used. In the experimental group (n = 24) eye movements (EM) were induced while control group participants (n = 23) fixed their gaze (not taxing WM). During 6 min trials, craving-inducing memories were recalled. Craving, vividness of target memories, and smoking behavior were assessed at several variable-specific time-points between baseline (one week pre-intervention) and one week follow-up. RESULTS The experimental group showed significant immediate reductions of craving and vividness of targeted memories. However, these effects were lost during a one-week follow-up period. CONCLUSIONS A limited dose of WM-taxation, in the form of EM in a modified EMDR-procedure, resulted in transient effects on memory vividness and nicotine craving. EM provide a valuable way of coping with the acute effects of craving during smoking cessation attempts. Other aspects of the EMDR-procedure may provide additional effects. Component and dose-response studies are needed to establish the potential of EMDR-therapy in smoking cessation.
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Affiliation(s)
- Wiebren Markus
- IrisZorg, Institute for Addiction Care, Sheltered Housing and Social Support Services, Kronenburgsingel 545, P.O. Box 351, 6800 AJ, Arnhem, Netherlands; Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Radboud Universiteit Nijmegen/ACSW, P.O. Box 9104, 6500 HE, Nijmegen, Netherlands.
| | | | - Marcella L Woud
- Mental Health Research and Treatment Center, Department of Psychology, University of Bochum, P.O. Box, 44801 Bochum, Germany.
| | - Eni S Becker
- Behavioral Science Institute (BSI), Radboud University Nijmegen, P.O. Box 9104, 6500 HE, Nijmegen, Netherlands.
| | - Cornelis A J DeJong
- Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Radboud Universiteit Nijmegen/ACSW, P.O. Box 9104, 6500 HE, Nijmegen, Netherlands.
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Monteiro Mantovani V, Rodríguez Acelas AL, Lucena ADF, de Abreu Almeida M, Paz da Silva Heldt E, Klockner Boaz S, Echer IC. Nursing Outcomes for the Evaluation of Patients During Smoking Cessation. Int J Nurs Knowl 2016; 28:204-210. [DOI: 10.1111/2047-3095.12138] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 02/26/2016] [Accepted: 02/28/2016] [Indexed: 01/03/2023]
Affiliation(s)
- Vanessa Monteiro Mantovani
- Vanessa Monteiro Mantovani, RN, MSc, is a Nurse at Hospital São Lucas, Porto Alegre, Rio Grande do Sul, Brazil, and member of the Nursing Research Group on the Care of Adults and the Elderly (GEPECADI-CNPq)
| | - Alba Luz Rodríguez Acelas
- Alba Luz Rodríguez Acelas, RN, MSc, is a PhD student at the Graduate School of Nursing, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil, and member of the GEPECADI-CNPq
| | - Amália de Fátima Lucena
- Amália de Fátima Lucena, RN, PhD, an Associate Professor at the Nursing School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil, and Researcher of the GEPECADI-CNPq
| | - Miriam de Abreu Almeida
- Miriam de Abreu Almeida, RN, PhD, is an Associate Professor at the Nursing School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil, and Researcher of the GEPECADI-CNPq
| | - Elizeth Paz da Silva Heldt
- Elizeth Paz da Silva Heldt, RN, PhD, is an Associate Professor at the Nursing School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Solange Klockner Boaz
- Solange Klockner Boaz, RN, is a Nurse at Hospital de Clínicas de Porto Alegre, Rio Grande do Sul, Brazil
| | - Isabel Cristina Echer
- Isabel Cristina Echer, RN, PhD, is an Associate Professor at the Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil, and Researcher of the GEPECADI-CNPq
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The first day is always the hardest: Functional connectivity during cue exposure and the ability to resist smoking in the initial hours of a quit attempt. Neuroimage 2016; 151:24-32. [PMID: 26975550 DOI: 10.1016/j.neuroimage.2016.03.015] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 02/25/2016] [Accepted: 03/04/2016] [Indexed: 12/29/2022] Open
Abstract
Quitting smoking is the single best change in behavior that smokers can make to improve their health and extend their lives. Although most smokers express a strong desire to stop using cigarettes, the vast majority of quit attempts end in relapse. Relapse is particularly likely when smokers encounter cigarette cues. A striking number of relapses occur very quickly, with many occurring within as little as 24h. Characterizing what distinguishes successful quit attempts from unsuccessful ones, particularly just after cessation is initiated, is a research priority. We addressed this significant issue by examining the association between functional connectivity during cigarette cue exposure and smoking behavior during the first 24h of a quit attempt. Functional MRI was used to measure brain activity during cue exposure in nicotine-deprived daily smokers during the first day of a quit attempt. Participants were then given the opportunity to smoke. Using data collected in two parent studies, we identified a subset of participants who chose to smoke and a matched subset who declined (n=38). Smokers who were able to resist smoking displayed significant functional connectivity between the left anterior insula and the dorsolateral prefrontal cortex, whereas there was no such connectivity for those who chose to smoke. Notably, there were no differences in mean levels of activation in brain regions of interest, underscoring the importance of assessing interregional connectivity when investigating the links between cue-related neural responses and overt behavior. To our knowledge, this is the first study to link patterns of functional connectivity and actual cigarette use during the pivotal first hours of attempt to change smoking behavior.
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19
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Foster DW, Schmidt NB, Zvolensky MJ. Influences of barriers to cessation and reasons for quitting on substance use among treatment-seeking smokers who report heavy drinking. ACTA ACUST UNITED AC 2016; 6. [PMID: 26949566 DOI: 10.4172/2155-6105.1000246] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES We examined behavioral and cognitively-based quit processes among concurrent alcohol and tobacco users and assessed whether smoking and drinking were differentially influenced. METHODS Participants were 200 treatment-seeking smokers (37.50% female; Mage = 30.72; SD = 12.68) who reported smoking an average of 10 or more cigarettes daily for at least one year. RESULTS Barriers to cessation (BCS) and reasons for quitting (RFQ) were generally correlated with substance use. BCS moderated the relationship between quit methods and cigarette use such that quit methods were negatively associated with smoking, particularly among those with more BCS. RFQ moderated the association between quit methods and cigarette use such that quit methods were negatively linked with smoking among those with fewer RFQ, but positively linked with smoking among those with more RFQ. Two 3-way interactions emerged. The first 3-way indicated that among individuals with fewer RFQ, quit methods was negatively associated with smoking, and this was strongest among those with more BCS. However, among those with more RFQ, smoking and quit methods were positively associated, particularly among those with more BCS. The second 3-way showed that among those with fewer RFQ, quit methods was negatively linked with drinking frequency, and this was strongest among those with more BCS. However, among those with fewer BCS, drinking and quit methods were positively linked. CONCLUSIONS The relationship between behavioral and cognitively-based quit processes and substance use is not straightforward. There may be concurrent substance-using individuals for whom these processes might be associated with increased substance use.
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Affiliation(s)
| | | | - Michael J Zvolensky
- The University of Texas MD Anderson Cancer Center, Department of Behavioral Science; University of Houston, Department of Psychology
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20
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Moeller SJ, Stoops WW. Cocaine choice procedures in animals, humans, and treatment-seekers: Can we bridge the divide? Pharmacol Biochem Behav 2015; 138:133-41. [PMID: 26432174 DOI: 10.1016/j.pbb.2015.09.020] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 09/22/2015] [Accepted: 09/27/2015] [Indexed: 10/23/2022]
Abstract
Individuals with cocaine use disorder chronically self-administer cocaine to the detriment of other rewarding activities, a phenomenon best modeled in laboratory drug-choice procedures. These procedures can evaluate the reinforcing effects of drugs versus comparably valuable alternatives under multiple behavioral arrangements and schedules of reinforcement. However, assessing drug-choice in treatment-seeking or abstaining humans poses unique challenges: for ethical reasons, these populations typically cannot receive active drugs during research studies. Researchers have thus needed to rely on alternative approaches that approximate drug-choice behavior or assess more general forms of decision-making, but whether these alternatives have relevance to real-world drug-taking that can inform clinical trials is not well-understood. In this mini-review, we (A) summarize several important modulatory variables that influence cocaine choice in nonhuman animals and non-treatment seeking humans; (B) discuss some of the ethical considerations that could arise if treatment-seekers are enrolled in drug-choice studies; (C) consider the efficacy of alternative procedures, including non-drug-related decision-making and 'simulated' drug-choice (a choice is made, but no drug is administered) to approximate drug choice; and (D) suggest opportunities for new translational work to bridge the current divide between preclinical and clinical research.
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Affiliation(s)
- Scott J Moeller
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
| | - William W Stoops
- Department of Behavioral Science and Center on Drug and Alcohol Research, University of Kentucky College of Medicine, Lexington, KY, United States; Department of Psychiatry, University of Kentucky College of Medicine, Lexington, KY, United States; Department of Psychology, University of Kentucky College of Arts and Sciences, Lexington, KY, United States.
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Ran W, Yamamoto M. Attitudinal Ambivalence as a Protective Factor Against Junk Food Advertisements: A Moderated Mediation Model of Behavioral Intention. JOURNAL OF HEALTH COMMUNICATION 2015; 20:893-902. [PMID: 26020423 DOI: 10.1080/10810730.2015.1018598] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This study investigates the role of attitudinal ambivalence in moderating the effects of junk food advertisements on behavioral intentions by tapping different facets of this construct-felt ambivalence, potential ambivalence, and affective-cognitive ambivalence. Results based on an online survey of college students indicate that attention to junk food advertisements has an indirect positive effect on intentions to eat junk food through its positive effect on attitudes toward junk food. A moderated mediation model reveals that this indirect effect of junk food advertisements is weakened as respondents' levels of felt ambivalence increase. This moderating role is not observed for the measures of potential ambivalence and affective-cognitive ambivalence. Implications are discussed for health interventions.
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Affiliation(s)
- Weina Ran
- a Department of Management , University of Wisconsin-La Crosse, La Crosse , Wisconsin , USA
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Murray RJ, Debbané M, Fox PT, Bzdok D, Eickhoff SB. Functional connectivity mapping of regions associated with self- and other-processing. Hum Brain Mapp 2014; 36:1304-24. [PMID: 25482016 DOI: 10.1002/hbm.22703] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Revised: 10/16/2014] [Accepted: 11/17/2014] [Indexed: 12/12/2022] Open
Abstract
Neuroscience literature increasingly suggests a conceptual self composed of interacting neural regions, rather than independent local activations, yet such claims have yet to be investigated. We, thus, combined task-dependent meta-analytic connectivity modeling (MACM) with task-independent resting-state (RS) connectivity analysis to delineate the neural network of the self, across both states. Given psychological evidence implicating the self's interdependence on social information, we also delineated the neural network underlying conceptual other-processing. To elucidate the relation between the self-/other-networks and their function, we mined the MACM metadata to generate a cognitive-behavioral profile for an empirically identified region specific to conceptual self, the pregenual anterior cingulate (pACC), and conceptual other, posterior cingulate/precuneus (PCC/PC). Mining of 7,200 published, task-dependent, neuroimaging studies, using healthy human subjects, yielded 193 studies activating the self-related seed and were conjoined with RS connectivity analysis to delineate a differentiated self-network composed of the pACC (seed) and anterior insula, relative to other functional connectivity. Additionally, 106 studies activating the other-related seed were conjoined with RS connectivity analysis to delineate a differentiated other-network of PCC/PC (seed) and angular gyrus/temporoparietal junction, relative to self-functional connectivity. The self-network seed related to emotional conflict resolution and motivational processing, whereas the other-network seed related to socially oriented processing and contextual information integration. Notably, our findings revealed shared RS connectivity between ensuing self-/other-networks within the ventromedial prefrontal cortex and medial orbitofrontal cortex, suggesting self-updating via integration of self-relevant social information. We, therefore, present initial neurobiological evidence corroborating the increasing claims of an intricate self-network, the architecture of which may promote social value processing.
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Affiliation(s)
- Ryan J Murray
- Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland; Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
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Lee S, Cho S, Lee JH. Approach-avoidance pattern of visual attention in hazardous drinkers with ambivalence. Addict Behav 2014; 39:669-76. [PMID: 24368001 DOI: 10.1016/j.addbeh.2013.12.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Revised: 11/24/2013] [Accepted: 12/02/2013] [Indexed: 11/19/2022]
Abstract
Ambivalence toward alcohol often develops when hazardous drinkers try to quit or to control their drinking. The purpose of this study was to investigate the differences between hazardous drinkers with and without ambivalence toward alcohol in terms of their visual attention to alcohol-related pictures over time using an eye-tracker. The study included 20 hazardous drinkers with ambivalence and 21 hazardous drinkers without ambivalence. The eye movements of the participants were monitored while the participants conducted a free-viewing task in which 20 pairs of alcohol-related pictures and matched control pictures were presented. The results showed that the hazardous drinkers with ambivalence were more attentive to the alcohol-related pictures at first and were more attentive to the control pictures toward the end of the task. On the other hand, the hazardous drinkers without ambivalence were more attentive to the alcohol-related pictures from beginning to end. The findings of this study indicated that ambivalence toward alcohol resulted in the inclination to approach and then avoid alcohol in a consecutive sequence. The present results could be helpful in distinguishing hazardous drinkers who may have ambivalence toward alcohol and identifying the pattern of ambivalence more concretely. Additionally, further studies need to consider the time that is important to measure ambivalence toward alcohol.
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Affiliation(s)
- Saerom Lee
- Chung-Ang University, Department of Psychology, 84 Heukseok-ro, Dongjak-gu, Seoul 156-756, Republic of Korea.
| | - Sungkun Cho
- Chung-Ang University, Department of Psychology, 84 Heukseok-ro, Dongjak-gu, Seoul 156-756, Republic of Korea.
| | - Jang-Han Lee
- Chung-Ang University, Department of Psychology, 84 Heukseok-ro, Dongjak-gu, Seoul 156-756, Republic of Korea.
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Martin LE, Cox LS, Brooks WM, Savage CR. Winning and losing: differences in reward and punishment sensitivity between smokers and nonsmokers. Brain Behav 2014; 4:915-24. [PMID: 25365800 PMCID: PMC4178298 DOI: 10.1002/brb3.285] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 08/19/2014] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Smokers show increased brain activation in reward processing regions in response to smoking-related cues, yet few studies have examined secondary rewards not associated with smoking (i.e., money). Inconsistencies exist in the studies that do examine secondary rewards with some studies showing increased brain activation in reward processing brain regions, while others show decreased activation or no difference in activation between smokers and nonsmokers. AIMS The goal of the current study is to see if smokers process the evaluation and delivery of equally salient real world rewards similarly or differently than nonsmokers. METHODS The current study employed functional magnetic resonance imaging (fMRI) to examine brain responses in smokers and nonsmokers during the evaluation and delivery of monetary gains and losses. RESULTS In comparison to nonsmokers, smokers showed increased activation in the ventromedial prefrontal cortex to the evaluation of anticipated monetary losses and the brain response. Moreover, smokers compared to nonsmokers showed decreased activation in the inferior frontal gyrus to the delivery of expected monetary gains. Brain activations to both the evaluation of anticipated monetary losses and the delivery of expected monetary gains correlated with increased self-reported smoking craving to relieve negative withdrawal symptoms and craving related to positive aspects of smoking, respectively. DISCUSSION Together these results indicate that smokers are hyperresponsive to the evaluation of anticipated punishment and hyporesponsive to the delivery of expected rewards. Although further research is needed, this hypersensitivity to punishments coupled with increased craving may negatively impact quit attempts as smokers anticipate the negative withdrawal symptoms associated with quitting.
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Affiliation(s)
- Laura E Martin
- Hoglund Brain Imaging Center, University of Kansas Medical Center Kansas City, Kansas ; Department of Preventive Medicine and Public Health, University of Kansas Medical Center Kansas City, Kansas
| | - Lisa S Cox
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center Kansas City, Kansas
| | - William M Brooks
- Hoglund Brain Imaging Center, University of Kansas Medical Center Kansas City, Kansas ; Department of Neurology, University of Kansas Medical Center Kansas City, Kansas
| | - Cary R Savage
- Center for Health Behavior Neuroscience, University of Kansas Medical Center Kansas City, Kansas ; Department of Psychiatry and Behavioral Sciences, University of Kansas Medical Center Kansas City, Kansas
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Jasinska AJ, Stein EA, Kaiser J, Naumer MJ, Yalachkov Y. Factors modulating neural reactivity to drug cues in addiction: a survey of human neuroimaging studies. Neurosci Biobehav Rev 2013; 38:1-16. [PMID: 24211373 DOI: 10.1016/j.neubiorev.2013.10.013] [Citation(s) in RCA: 360] [Impact Index Per Article: 32.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Revised: 10/04/2013] [Accepted: 10/29/2013] [Indexed: 12/16/2022]
Abstract
Human neuroimaging studies suggest that neural cue reactivity is strongly associated with indices of drug use, including addiction severity and treatment success. However, little is known about factors that modulate cue reactivity. The goal of this review, in which we survey published fMRI and PET studies on drug cue reactivity in cocaine, alcohol, and tobacco cigarette users, is to highlight major factors that modulate brain reactivity to drug cues. First, we describe cue reactivity paradigms used in neuroimaging research and outline the brain circuits that underlie cue reactivity. We then discuss major factors that have been shown to modulate cue reactivity and review specific evidence as well as outstanding questions related to each factor. Building on previous model-building reviews on the topic, we then outline a simplified model that includes the key modulatory factors and a tentative ranking of their relative impact. We conclude with a discussion of outstanding challenges and future research directions, which can inform future neuroimaging studies as well as the design of treatment and prevention programs.
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Affiliation(s)
- Agnes J Jasinska
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, Baltimore, MD, USA.
| | - Elliot A Stein
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, Baltimore, MD, USA
| | - Jochen Kaiser
- Institute of Medical Psychology, Goethe-University, Frankfurt am Main, Germany
| | - Marcus J Naumer
- Institute of Medical Psychology, Goethe-University, Frankfurt am Main, Germany
| | - Yavor Yalachkov
- Institute of Medical Psychology, Goethe-University, Frankfurt am Main, Germany.
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Sensory modality of smoking cues modulates neural cue reactivity. Psychopharmacology (Berl) 2013; 225:461-71. [PMID: 22890475 DOI: 10.1007/s00213-012-2830-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Accepted: 07/27/2012] [Indexed: 01/19/2023]
Abstract
RATIONALE Behavioral experiments have demonstrated that the sensory modality of presentation modulates drug cue reactivity. OBJECTIVES The present study on nicotine addiction tested whether neural responses to smoking cues are modulated by the sensory modality of stimulus presentation. METHODS We measured brain activation using functional magnetic resonance imaging (fMRI) in 15 smokers and 15 nonsmokers while they viewed images of smoking paraphernalia and control objects and while they touched the same objects without seeing them. RESULTS Haptically presented, smoking-related stimuli induced more pronounced neural cue reactivity than visual cues in the left dorsal striatum in smokers compared to nonsmokers. The severity of nicotine dependence correlated positively with the preference for haptically explored smoking cues in the left inferior parietal lobule/somatosensory cortex, right fusiform gyrus/inferior temporal cortex/cerebellum, hippocampus/parahippocampal gyrus, posterior cingulate cortex, and supplementary motor area. CONCLUSIONS These observations are in line with the hypothesized role of the dorsal striatum for the expression of drug habits and the well-established concept of drug-related automatized schemata, since haptic perception is more closely linked to the corresponding object-specific action pattern than visual perception. Moreover, our findings demonstrate that with the growing severity of nicotine dependence, brain regions involved in object perception, memory, self-processing, and motor control exhibit an increasing preference for haptic over visual smoking cues. This difference was not found for control stimuli. Considering the sensory modality of the presented cues could serve to develop more reliable fMRI-specific biomarkers, more ecologically valid experimental designs, and more effective cue-exposure therapies of addiction.
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Fraser PE, Rosen AC. Transcranial direct current stimulation and behavioral models of smoking addiction. Front Psychiatry 2012; 3:79. [PMID: 22969733 PMCID: PMC3431716 DOI: 10.3389/fpsyt.2012.00079] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Accepted: 08/15/2012] [Indexed: 11/24/2022] Open
Abstract
While few studies have applied transcranial direct current stimulation (tDCS) to smoking addiction, existing work suggests that the intervention holds promise for altering the complex system by which environmental cues interact with cravings to drive behavior. Imaging and repetitive transcranial magnetic stimulation studies suggest that increased dorsolateral prefrontal cortex (DLPFC) activation and integrity may be associated with increased resistance to smoking cues. Anodal tDCS of the DLPFC, believed to boost activation, reduces cravings in response to these cues. The finding that noninvasive stimulation modifies cue induced cravings has profound implications for understanding the processes underlying addiction and relapse. tDCS can also be applied to probe mechanisms underlying and supporting nicotine addiction, as was done in a pharmacologic study that applied nicotine, tDCS, and TMS paired associative stimulation to find that stopping nicotine after chronic use induces a reduction in plasticity, causing difficulty in breaking free from association between cues and cravings. This mini-review will place studies that apply tDCS to smokers in the context of research involving the neural substrates of nicotine addiction.
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Affiliation(s)
- Paige E Fraser
- Psychiatry, Palo Alto Veterans Affairs Health Care System Palo Alto, CA, USA
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