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Baltariu IC, Enea V, de Jong PJ, Aan Het Rot M. Associations between alcohol consumption and empathy in a non-clinical sample: drinking motives as a moderator. Sci Rep 2024; 14:10993. [PMID: 38744834 PMCID: PMC11094050 DOI: 10.1038/s41598-024-59233-x] [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: 12/13/2023] [Accepted: 04/08/2024] [Indexed: 05/16/2024] Open
Abstract
People consume alcohol for multiple reasons. Negative motives are often associated with alcohol-related problems. These problems might be explained by negative effects of high alcohol consumption on empathy. Past studies have associated alcohol use disorder (AUD) with reduced cognitive and affective empathy. Few studies have focused on non-clinical samples and considered behavioral empathy. We examined the links between alcohol consumption and multiple aspects of empathy, and if these links were moderated by negative drinking motives. We collected online data of 520 unselected individuals. All completed the AUD Identification Test (AUDIT) and a Drinking Motives Questionnaire. Affective and cognitive empathy were assessed using the Empathy Quotient. Behavioral empathy was assessed by asking participants how likely they would help the person in each of 24 scenarios involving pain. Helping others in pain was positively predicted by affective and cognitive empathy. Higher AUDIT scores were associated with helping others less, particularly among participants who scored higher on drinking to cope with negative affect. People who drink more and do so to cope with negative affect appear to have less behavioral empathy. This supports the view that negative drinking motives contribute to AUD risk.
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Affiliation(s)
- Isabelle C Baltariu
- Department of Psychology, University of Groningen, Grote Kruisstraat 2/1, Groningen, The Netherlands.
- Department of Psychology, Alexandru Ioan Cuza University of Iași, Iași, Romania.
| | - Violeta Enea
- Department of Psychology, Alexandru Ioan Cuza University of Iași, Iași, Romania
| | - Peter J de Jong
- Department of Psychology, University of Groningen, Grote Kruisstraat 2/1, Groningen, The Netherlands
| | - Marije Aan Het Rot
- Department of Psychology, University of Groningen, Grote Kruisstraat 2/1, Groningen, The Netherlands
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Knopp M, Burghardt J, Oppenauer C, Meyer B, Moritz S, Sprung M. Affective and cognitive Theory of Mind in patients with alcohol use disorder: Associations with symptoms of depression, anxiety, and somatization. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 157:209227. [PMID: 37992810 DOI: 10.1016/j.josat.2023.209227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 08/23/2023] [Accepted: 11/14/2023] [Indexed: 11/24/2023]
Abstract
INTRODUCTION Theory of Mind (ToM) is the ability to ascribe thoughts (cognitive ToM) and feelings (affective ToM) to others. Ample evidence exists for impairments of affective and cognitive ToM in individuals with alcohol use disorder (AUD); however, evidence regarding changes of these impairments during AUD treatment and their possible relationship to comorbid symptoms is ambiguous. The current study analyzed changes in ToM during treatment and tested associations with comorbid symptoms of depression, anxiety, somatization, and social functioning. METHODS We analyzed data from 175 individuals with AUD. The study assessed ToM and comorbid symptoms of depression, anxiety, somatization, and social functioning at the time of admission and at the time of discharge from an approximately 60 days long abstinence-oriented inpatient treatment. We assessed affective and cognitive ToM using the Movie for the Assessment of Social Cognition, a measure with high ecological validity. RESULTS All symptoms, total and cognitive ToM improved following treatment; however, affective ToM did not improve. Moreover, cognitive ToM at the beginning of treatment was associated with improved symptoms of depression and somatization, while affective ToM was not. CONCLUSIONS Our study shows improvements in total and cognitive ToM as well as symptoms of depression, anxiety, somatization, and social functioning following long-term treatment. Furthermore, cognitive ToM was related to improvements in comorbid symptoms. This finding suggests that ToM may be an important treatment target in patients with AUD.
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Affiliation(s)
- Magdalena Knopp
- Karl Landsteiner University of Health Sciences, Division of Clinical Psychology, Dr.-Karl-Dorrek-Straße 30, 3500 Krems an der Donau, Austria; Ludwig-Maximilians-Universität München, Faculty of Psychology and Educational Sciences, Department of Psychology, Leopoldstraße 13, 80802 München, Germany.
| | - Juliane Burghardt
- Karl Landsteiner University of Health Sciences, Division of Clinical Psychology, Dr.-Karl-Dorrek-Straße 30, 3500 Krems an der Donau, Austria
| | - Claudia Oppenauer
- Karl Landsteiner University of Health Sciences, Division of Clinical Psychology, Dr.-Karl-Dorrek-Straße 30, 3500 Krems an der Donau, Austria
| | - Bernhard Meyer
- Karl Landsteiner University of Health Sciences, Division of Clinical Psychology, Dr.-Karl-Dorrek-Straße 30, 3500 Krems an der Donau, Austria
| | - Steffen Moritz
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistrasse 52, 20246 Hamburg, Germany
| | - Manuel Sprung
- Karl Landsteiner University of Health Sciences, Division of Clinical Psychology, Dr.-Karl-Dorrek-Straße 30, 3500 Krems an der Donau, Austria; Ludwig-Maximilians-Universität München, Faculty of Psychology and Educational Sciences, Department of Psychology, Leopoldstraße 13, 80802 München, Germany; University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistrasse 52, 20246 Hamburg, Germany; Psychiatric Rehabilitation Clinic Gars am Kamp, Psychosomatisches Zentrum Waldviertel, Kremserstraße 656, 3571 Gars am Kamp, Austria
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Kumar L, Ringwald WR, Wright AGC, Creswell KG. Associations of state and trait empathy with daily alcohol use. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:951-962. [PMID: 37526597 PMCID: PMC10875975 DOI: 10.1111/acer.15056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 02/22/2023] [Accepted: 02/28/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND A growing literature documents associations between lower trait empathy and heavier alcohol use and more alcohol problems in adolescent and young adult samples. Prior work linking empathy and alcohol use/problems in these populations has thus far focused on trait rather than state empathy, and researchers often do not differentiate between cognitive and affective empathy. Further, no prior studies have examined associations between daily fluctuations in state empathy and alcohol use. The goal of the current study is to advance knowledge about the associations between state (vs. trait) and cognitive (vs. affective) empathy and alcohol use. METHODS Adult alcohol drinkers (n = 492; Mage = 22.89, SD = 5.53; 53.70% female) participated in ecological momentary assessment studies for 7 to 10 days (day n = 4683). Multilevel hurdle models were used to investigate associations between day-level state empathy and daily alcohol use at the within-person level, and associations between individual differences in trait empathy and alcohol use across days at the between-person level. RESULTS Higher day-level state affective empathy was not associated with the likelihood of drinking on a particular day, but it was significantly associated with a greater number of drinks consumed on alcohol-consuming days, with the latter associations remaining after controlling for day-level positive affect (PA) and negative affect (NA). No associations were found for day-level state cognitive empathy, or trait affective or cognitive empathy. CONCLUSIONS On drinking days, when individuals reported more affective empathy than is typical for them, they were more likely to consume a greater number of alcoholic drinks, results that remained when controlling for levels of PA and NA. Daily shifts in affective empathy may be important to consider in efforts to understand alcohol use.
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Affiliation(s)
- Lakshmi Kumar
- Department of Psychology, Carnegie Mellon University, Pittsburgh, Pennsylvania, USA
| | - Whitney R. Ringwald
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Aidan G. C. Wright
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kasey G. Creswell
- Department of Psychology, Carnegie Mellon University, Pittsburgh, Pennsylvania, USA
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Monk RL, Qureshi AW, Knibb G, McGale L, Nair L, Kelly J, Collins H, Heim D. In people who drink more, facets of theory of mind may be impaired by alcohol stimuli. Drug Alcohol Depend 2023; 245:109811. [PMID: 36871375 DOI: 10.1016/j.drugalcdep.2023.109811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 01/16/2023] [Accepted: 02/14/2023] [Indexed: 02/23/2023]
Abstract
BACKGROUND Theory of mind (ToM) - the ability to understand others' beliefs, mental states, and knowledge - is an important part of successful social interaction. There is a growing (albeit mixed) evidence base suggesting that individuals with substance use disorder or who are intoxicated (relative to sober controls) perform worse on a number of ToM tasks. The aim of this study was to explore the hitherto little explored notion that ToM-related capabilities such as the ability to see the world from another person's perspective (termed Visual Perspective Taking; VPT), may be impacted by alcohol-related stimuli. METHOD In this pre-registered study, 108 participants (M age = 25.75, SD age = 5.67) completed a revised version of the director task where they followed the instructions of an avatar to move both alcohol beverages and soft drinks that were mutually visible (target objects) while avoiding those only visible to the participant (distractor items). RESULTS Contrary to predictions, accuracy was lower when the target drink was alcohol and the distractor was a soft drink, although higher AUDIT scores were associated with significantly lower accuracy when alcohol drinks were the distractor items. CONCLUSIONS There may be some contexts when being able to see alcohol beverages makes it harder to take another person's perspective. It also appears that poorer VPT and perhaps ToM capacity may be evident in individuals who consume more alcohol. Future research is warranted to examine how alcohol beverages, alcohol consumption behaviours, and intoxication interact to impact VPT capacity.
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Affiliation(s)
- Rebecca L Monk
- Edge Hill University, UK; Liverpool Centre for Alcohol Research, UK.
| | - Adam W Qureshi
- Edge Hill University, UK; Liverpool Centre for Alcohol Research, UK.
| | - Graeme Knibb
- Edge Hill University, UK; Liverpool Centre for Alcohol Research, UK.
| | - Lauren McGale
- Edge Hill University, UK; Liverpool Centre for Alcohol Research, UK.
| | - Leonie Nair
- Edge Hill University, UK; Liverpool Centre for Alcohol Research, UK
| | - Jordan Kelly
- Edge Hill University, UK; Liverpool Centre for Alcohol Research, UK
| | - Hope Collins
- Edge Hill University, UK; Liverpool Centre for Alcohol Research, UK
| | - Derek Heim
- Edge Hill University, UK; Liverpool Centre for Alcohol Research, UK.
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Li G, Zhang Z, Chen Y, Wang W, Bi J, Tang X, Li CSR. Cognitive Challenges Are Better in Distinguishing Binge From Nonbinge Drinkers: An Exploratory Deep-Learning Study of fMRI Data of Multiple Behavioral Tasks and Resting State. J Magn Reson Imaging 2023; 57:856-868. [PMID: 35808911 DOI: 10.1002/jmri.28336] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 06/13/2022] [Accepted: 06/16/2022] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Studies have identified imaging markers of binge drinking. Functional connectivity during both task challenges and resting state was shown to distinguish binge and nonbinge drinkers. However, no studies have compared the efficacy of task and resting data in the classification. HYPOTHESIS Task outperforms resting-state functional magnetic resonance imaging (fMRI) data in the differentiation of binge and nonbinge drinkers. We tested the hypothesis via multiple deep learning algorithms. STUDY TYPE Cross-sectional; retrospective. POPULATION A total of 149 binge (107 men) and 151 demographically matched, nonbinge (92 men) drinkers curated from the Human Connectome Project, with 80% randomly selected for model development and 20% for validation/test. FIELD STRENGTH/SEQUENCE A 3 T; fMRI with a blood oxygen level-dependent (BOLD) gradient-echo echo-planar sequence. ASSESSMENT FMRI data of resting state and seven behavioral tasks were acquired. Graph convolutional network (GCN), long short-term memory, convolutional, and recurrent neural network models were built to distinguish bingers and nonbingers using connectivity matrices of 8, 116, and 268 regions of interest (ROI). Nodal metrics including betweenness centrality, degree centrality, clustering coefficient, efficiency, local efficiency, and shortest path length were calculated from the GCN model. STATISTICAL TESTS Model performance was quantified by the area under the curve (AUC) in receiver operating characteristic analysis. A P value < 0.05 was considered statistically significant. RESULTS Task outperformed resting data in classification by approximately 8% by AUC in the test set. Across models and ROI sets, the gambling, motor, language and working memory tasks, each with AUC of 0.614, 0.612, 0.605, and 0.603, performed better than resting data (AUC = 0.548). Models with 116 ROIs (AUC = 0.602) consistently outperformed those with 8 ROIs (AUC = 0.569). Task data performed best with GCN (AUC = 0.619). Nodal metrics of left supplementary motor area and right cuneus showed significant group main effect across tasks. CONCLUSION Neural responses to cognitive challenges relative to resting state better characterize binge drinking. The performance of different network models may depend on behavioral tasks and the number of ROIs. EVIDENCE LEVEL 3 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Guangfei Li
- Department of Biomedical Engineering, Faculty of Environment and Life Sciences, Beijing University of Technology, Beijing, China.,Department of Biomedical Engineering, School of Life Sciences, Beijing Institute of technology, Beijing, China.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Zhao Zhang
- Department of Biomedical Engineering, School of Life Sciences, Beijing Institute of technology, Beijing, China
| | - Yu Chen
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Wuyi Wang
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Jinbo Bi
- Department of Computer Science and Engineering, University of Connecticut, Storrs, Connecticut, USA
| | - Xiaoying Tang
- Department of Biomedical Engineering, School of Life Sciences, Beijing Institute of technology, Beijing, China
| | - Chiang-Shan R Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.,Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut, USA.,Interdepartmental Neuroscience Program, Yale University School of Medicine, New Haven, Connecticut, USA.,Wu Tsai Institute, Yale University, New Haven, Connecticut, USA
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Carbia C, Bastiaanssen TFS, Iannone LF, García-Cabrerizo R, Boscaini S, Berding K, Strain CR, Clarke G, Stanton C, Dinan TG, Cryan JF. The Microbiome-Gut-Brain axis regulates social cognition & craving in young binge drinkers. EBioMedicine 2023; 89:104442. [PMID: 36739238 PMCID: PMC10025767 DOI: 10.1016/j.ebiom.2023.104442] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 12/30/2022] [Accepted: 01/06/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Binge drinking is the consumption of an excessive amount of alcohol in a short period of time. This pattern of consumption is highly prevalent during the crucial developmental period of adolescence. Recently, the severity of alcohol use disorders (AUDs) has been linked with microbiome alterations suggesting a role for the gut microbiome in its development. Furthermore, a strong link has emerged too between microbiome composition and socio-emotional functioning across different disorders including AUD. The aim of this study was to investigate the potential link (and its predictive value) between alcohol-related altered microbial profile, social cognition, impulsivity and craving. METHODS Young people (N = 71) aged 18-25 reported their alcohol use and underwent a neuropsychological evaluation. Craving was measured at baseline and three months later. Diet was controlled for. Blood, saliva and hair samples were taken for inflammatory, kynurenine and cortisol analysis. Stool samples were provided for shotgun metagenomic sequencing and short-chain fatty acids (SCFAs) were measured. FINDINGS Binge drinking was associated with distinct microbiome alterations and emotional recognition difficulties. Associations were found for several microbiome species with emotional processing and impulsivity. Craving showed a strong link with alterations in microbiome composition and neuroactive potential over time. INTERPRETATION In conclusion, this research demonstrates alterations in the gut microbiome of young binge drinkers (BDs) and identifies early biomarkers of craving. Associations between emotional processing and microbiome composition further support the growing literature on the gut microbiome as a regulator of social cognition. These findings are of relevance for new gut-derived interventions directed at improving early alcohol-related alterations during the vulnerability period of adolescence. FUNDING C.C. and R.G-C. received funding from the European Union's Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant agreement No. 754535. APC Microbiome Ireland is a research centre funded by Science Foundation Ireland (SFI), through the Irish Government's National Development Plan [grant no. SFI/12/RC/2273_P2]. J.F.C has research support from Cremo, Pharmavite, DuPont and Nutricia. He has spoken at meetings sponsored by food and pharmaceutical companies. G.C. has received honoraria from Janssen, Probi, and Apsen as an invited speaker; is in receipt of research funding from Pharmavite, Fonterra, Nestle and Reckitt; and is a paid consultant for Yakult, Zentiva and Heel pharmaceuticals. All the authors declare no competing interests.
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Affiliation(s)
- Carina Carbia
- APC Microbiome Ireland, University College Cork, Cork, Ireland.
| | | | | | | | - Serena Boscaini
- APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Kirsten Berding
- APC Microbiome Ireland, University College Cork, Cork, Ireland
| | | | - Gerard Clarke
- APC Microbiome Ireland, University College Cork, Cork, Ireland; Department of Psychiatry and Neurobehavioural Science, University College Cork, Cork, Ireland
| | | | - Timothy G Dinan
- APC Microbiome Ireland, University College Cork, Cork, Ireland; Department of Psychiatry and Neurobehavioural Science, University College Cork, Cork, Ireland
| | - John F Cryan
- APC Microbiome Ireland, University College Cork, Cork, Ireland; Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland.
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Kumar L, Zhou A, Sanov B, Beitler S, Skrzynski CJ, Creswell KG. Indirect effects of theory of mind on alcohol use and problems in underage drinkers: The role of peer pressure to drink. Addict Behav Rep 2022; 16:100468. [DOI: 10.1016/j.abrep.2022.100468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/15/2022] [Accepted: 10/30/2022] [Indexed: 11/09/2022] Open
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Kumar L, Skrzynski CJ, Creswell KG. Meta-analysis of associations between empathy and alcohol use and problems in clinical and non-clinical samples. Addiction 2022; 117:2793-2804. [PMID: 35546448 PMCID: PMC9796795 DOI: 10.1111/add.15941] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 04/13/2022] [Indexed: 01/07/2023]
Abstract
AIMS To (1) measure the aggregated effect size of empathy deficits in individuals with alcohol use disorder (AUD) compared with healthy controls, (2) measure the aggregated effect sizes for associations between lower empathy and heavier alcohol consumption and more alcohol problems in non-clinical samples and (3) identify potential moderators on the variability of effect sizes across studies in these meta-analyses. METHOD PsycINFO, PubMed and Google Scholar were searched following a pre-registered International Prospective Register of Systematic Reviews (PROSPERO) protocol (CRD42021225392) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. We meta-analyzed (using random-effects models) mean differences in empathy between individuals with AUD compared with healthy controls and associations between empathy and alcohol consumption and alcohol problems in non-clinical samples. A total of 714 participants were included in the meta-analysis on clinical samples; 3955 were included in the meta-analyses on non-clinical samples. RESULTS Individuals with AUD reported significantly lower empathy than healthy controls [Hedges' g = -0.53, 95% confidence interval (CI) = -0.91, -0.16, k = 9, P < 0.01, Q = 40.09, I2 = 80.04]. Study quality [Q = 1.88, degrees of freedom (d.f.) = 1, P = 0.17] and gender (β = -0.006, Z = -0.60, P = 0.55) were not moderators. Increases in age corresponded to an increase in effect size (β = 0.095, Z = 3.34, P < 0.001). Individuals with AUD (versus healthy controls) had significantly lower cognitive (Hedges' g = -0.44, CI = -0.79, -0.10, P < 0.05), but not affective empathy (Hedges' g = -0.19, CI = -0.51, 0.14, P = 0.27), and the difference between these was significant (Z = 2.34, k = 6, P < 0.01). In non-clinical samples, individuals with lower (versus higher) empathy reported heavier alcohol consumption (r = -0.12, CI = -0.15, -0.09, k = 11, P < 0.001, Q = 9.68, I2 = 0.00) and more alcohol problems (r = -0.08, CI = -0.14, -0.01, k = 7, P = 0.021, Q = 6.55, I2 = 8.34). There was no significant heterogeneity across studies. CONCLUSION Individuals with alcohol use disorder appear to show deficits in empathy compared with healthy controls. Deficits are particularly pronounced for older individuals and for cognitive (versus affective) empathy. In non-clinical samples, lower empathy appears to be associated with heavier alcohol consumption and more alcohol problems.
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Affiliation(s)
- Lakshmi Kumar
- Department of PsychologyCarnegie Mellon UniversityPittsburghPA
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Kumar L, Skrzynski CJ, Creswell KG. Systematic review and meta-analysis on the association between theory of mind and alcohol problems in non-clinical samples. Alcohol Clin Exp Res 2022; 46:1944-1952. [PMID: 36117380 PMCID: PMC9722547 DOI: 10.1111/acer.14943] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 08/08/2022] [Accepted: 09/12/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Deficits in theory of mind (ToM) found in individuals with alcohol use disorder (AUD) are often thought to result from prolonged heavy alcohol use. However, links between deficits in ToM and greater alcohol problems are often also present in non-clinical samples (e.g., adolescents and young adults) who may not have a similar long-lasting history of alcohol consumption as individuals with AUD. The current study is the first to systematically review and meta-analyze results from studies examining associations between lower ToM and greater alcohol problems in non-clinical samples. Evidence of reliable associations in these non-clinical samples would support the idea that deficits in ToM might also precede the emergence of AUD. METHODS PsycINFO, PubMed, and Google Scholar were searched according to our preregistered International Prospective Register of Systematic Reviews (PROSPERO) protocol (CRD42021225392) and following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. We systematically reviewed sample characteristics and ToM measures in identified articles. We then meta-analyzed the findings of association between ToM and alcohol problems in non-clinical samples using random effects models. RESULTS Nearly all studies used a measure of ToM that assessed the ability to infer the mental states of others based on eye region cues. Meta-analytic results demonstrated that lower ToM was associated with more alcohol problems (r = -0.16, k = 6, CI = [-0.26, -0.04], p < 0.01, Q = 15.55, I2 = 67.85), and there was significant heterogeneity across studies. Gender (ß = 0.0003, CI = [-0.006, 0.007], z = 0.09, p = 0.93), age (ß = -0.008, CI = [-0.03, 0.01], z = -0.82, p = 0.42), and study quality (ß = -0.10, CI = [-0.35, 0.15], z = -0.82, p = 0.41) did not explain the heterogeneity. CONCLUSION In non-clinical samples, lower ToM is associated with more alcohol problems, indicative of a small effect size. Future longitudinal studies are needed to explore whether socio-cognitive deficits may also serve as a risk factor for alcohol misuse.
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Affiliation(s)
- Lakshmi Kumar
- Department of Psychology, Carnegie Mellon University, 5000 Forbes Avenue, Pittsburgh, PA, 15213, USA
| | - Carillon J. Skrzynski
- Department of Psychology and Neuroscience, University of Colorado Boulder, 1600 Pleasant St., Boulder, CO, 80309, USA
| | - Kasey G. Creswell
- Department of Psychology, Carnegie Mellon University, 5000 Forbes Avenue, Pittsburgh, PA, 15213, USA
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Nestor BA, Sutherland S, Garber J. Theory of mind performance in depression: A meta-analysis. J Affect Disord 2022; 303:233-244. [PMID: 35176344 PMCID: PMC8961451 DOI: 10.1016/j.jad.2022.02.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 02/04/2022] [Accepted: 02/12/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Theory of mind (ToM) is a social-cognitive skill that involves the ability to understand the thoughts and feelings of others. Evidence is mixed regarding the extent of ToM ability in individuals with depression. METHODS We conducted a meta-analysis of 43 studies to investigate the strength of the association between ToM and depression. RESULTS Results indicated significant, small- to moderate impairment in ToM with a medium overall effect size (g = -0.398) in individuals with depression. Moderator analyses compared effect sizes across groups for the following variables: ToM content, process, and sample type. Additionally, meta-regression analyses tested age and gender as continuous moderators. LIMITATIONS The cross-sectional nature of included studies limits this meta-analysis from clarifying temporal or bidirectional relations. CONCLUSIONS We discuss findings in the context of the extant developmental, cognitive, social, and clinical literatures. We also suggest several possible explanations for these findings and offer implications for intervention.
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Affiliation(s)
- Bridget A. Nestor
- Vanderbilt University, Department of Psychology and Human Development, Peabody #552, 230 Appleton Place, Nashville, TN 37203, United States of America
| | - Susanna Sutherland
- Vanderbilt University, Department of Psychology and Human Development, Peabody #552, 230 Appleton Place, Nashville, TN 37203, United States of America
| | - Judy Garber
- Vanderbilt University, Department of Psychology and Human Development, Peabody #552, 230 Appleton Place, Nashville, TN 37203, United States of America
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A biological framework for emotional dysregulation in alcohol misuse: from gut to brain. Mol Psychiatry 2021; 26:1098-1118. [PMID: 33288871 DOI: 10.1038/s41380-020-00970-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 10/21/2020] [Accepted: 11/20/2020] [Indexed: 02/08/2023]
Abstract
Alcohol use disorder (AUD) has been associated with impairments in social and emotional cognition that play a crucial role in the development and maintenance of addiction. Repeated alcohol intoxications trigger inflammatory processes and sensitise the immune system. In addition, emerging data point to perturbations in the gut microbiome as a key regulator of the inflammatory cascade in AUD. Inflammation and social cognition are potent modulators of one another. At the same time, accumulating evidence implicates the gut microbiome in shaping emotional and social cognition, suggesting the possibility of a common underlying loop of crucial importance for addiction. Here we propose an integrative microbiome neuro-immuno-affective framework of how emotional dysregulation and alcohol-related microbiome dysbiosis could accelerate the cycle of addiction. We outline the overlapping effects of chronic alcohol use, inflammation and microbiome alterations on the fronto-limbic circuitry as a convergence hub for emotional dysregulation. We discuss the interdependent relationship of social cognition, immunity and the microbiome in relation to alcohol misuse- from binge drinking to addiction. In addition, we emphasise adolescence as a sensitive period for the confluence of alcohol harmful effects and emotional dysregulation in the developing gut-brain axis.
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Rae CL, Gierski F, Smith KW, Nikolaou K, Davies A, Critchley HD, Naassila M, Duka T. Differential brain responses for perception of pain during empathic response in binge drinkers compared to non-binge drinkers. NEUROIMAGE-CLINICAL 2020; 27:102322. [PMID: 32645662 PMCID: PMC7338615 DOI: 10.1016/j.nicl.2020.102322] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 06/19/2020] [Accepted: 06/21/2020] [Indexed: 12/21/2022]
Abstract
We measure empathic responses to imagery pain while adopting a ‘self’ vs ‘other’ perspective. Social drinkers who binge drink respond more slowly to imagery pain than those who do not. Binge drinkers show also stronger activation in fusiform body area to imagery pain ‘other’ Differences between binge and non-binge drinkers relate to ‘self’ vs. ‘other’ distinction.
Individuals who engage in binge drinking behaviors may show evidence of impaired cognitive function and emotional dysregulation. Impaired empathy, characterized by a reduced ability to understand and respond appropriately to feelings of others, is increasingly recognized for its role in Alcohol Use Disorders (AUD). The present study examined a population of young adult social drinkers to compare individuals who show binge drinking behavior to those who do not on measures of empathic processing and associated neural responses. A secondary aim explored similarities and differences between binge drinkers living in the UK and France. Alcohol drinking history and impulsivity ratings were recorded from seventy-one participants [(37 UK (Binge drinkers N = 19); 34 France (Binge drinkers N = 17)], who then underwent a neuroimaging study. During functional magnetic resonance imaging, participants viewed images of bodily pain (vs. no-pain), while adopting the perspective of self (pain recipient) or other (observer of someone else experiencing pain). Anterior midcingulate cortex (aMCC) and insula activation distinguished pain from no-pain conditions. Binge drinkers showed stronger regional neural activation than non-binge drinkers within a cluster spanning fusiform gyrus and inferior temporal gyrus, encompassing the Fusiform Body Area. Binge drinkers compared to non-binge drinkers also took longer to respond when viewing pictures depicting pain, in particular when adopting the perspective of self. Relationships between changes in brain activation and behavioural responses in pain versus no pain conditions (self or other perspective) indicated that whereas non-binge drinkers engage areas supporting self to other distinction, binge drinkers do not. Our findings suggest that alcohol binge drinking is associated with different empathy-related behavioral and brain responses, consistent with the proposed importance of empathy in the development of AUD.
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Affiliation(s)
- Charlotte L Rae
- Behavioural and Clinical Neuroscience, School of Psychology, University of Sussex, United Kingdom; Clinical Imaging Sciences Centre, Brighton and Sussex Medical School, University of Sussex, United Kingdom; Sackler Centre for Consciousness Science, University of Sussex, United Kingdom
| | - Fabien Gierski
- Cognition, Health, Society Laboratory (C2S, EA6291), University of Reims Champagne Ardenne, Reims, France; Groupe de Recherche sur l'Alcool et les Pharmacodépendances, Equipe Région INSERM 24, Université de Picardie Jules Verne, Amiens, France
| | - Kathleen W Smith
- Behavioural and Clinical Neuroscience, School of Psychology, University of Sussex, United Kingdom; Groupe de Recherche sur l'Alcool et les Pharmacodépendances, Equipe Région INSERM 24, Université de Picardie Jules Verne, Amiens, France
| | - Kyriaki Nikolaou
- Behavioural and Clinical Neuroscience, School of Psychology, University of Sussex, United Kingdom; Clinical Imaging Sciences Centre, Brighton and Sussex Medical School, University of Sussex, United Kingdom
| | - Amy Davies
- Behavioural and Clinical Neuroscience, School of Psychology, University of Sussex, United Kingdom; Clinical Imaging Sciences Centre, Brighton and Sussex Medical School, University of Sussex, United Kingdom
| | - Hugo D Critchley
- Clinical Imaging Sciences Centre, Brighton and Sussex Medical School, University of Sussex, United Kingdom; Sackler Centre for Consciousness Science, University of Sussex, United Kingdom; Psychiatry, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Mickaël Naassila
- Groupe de Recherche sur l'Alcool et les Pharmacodépendances, Equipe Région INSERM 24, Université de Picardie Jules Verne, Amiens, France
| | - Theodora Duka
- Behavioural and Clinical Neuroscience, School of Psychology, University of Sussex, United Kingdom; Clinical Imaging Sciences Centre, Brighton and Sussex Medical School, University of Sussex, United Kingdom.
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