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Kolokotroni KZ, Fozard TE, Selby DL, Harrison AA. Is impulsivity related to attentional bias in cigarette smokers? An exploration across levels of nicotine dependency and deprivation. Behav Pharmacol 2024; 35:172-184. [PMID: 38651685 DOI: 10.1097/fbp.0000000000000775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
Research has largely focused on how attentional bias to smoking-related cues and impulsivity independently influence the development and maintenance of cigarette smoking, with limited exploration of the relationship between these mechanisms. The current experiments systematically assessed relationships between multiple dimensions of impulsivity and attentional bias, at different stages of attention, in smokers varying in nicotine dependency and deprivation. Nonsmokers (NS; n = 26), light-satiated smokers (LS; n = 25), heavy-satiated smokers (HS; n = 23) and heavy 12-hour nicotine-deprived smokers (HD; n = 30) completed the Barratt Impulsivity Scale, delayed discounting task, stop-signal task, information sampling task and a visual dot-probe assessing initial orientation (200 ms) and sustained attention (2000 ms) toward smoking-related cues. Sustained attention to smoking-related cues was present in both HS and LS, while initial orientation bias was only evident in HS. HS and LS also had greater levels of trait motor and nonplanning impulsivity and heightened impulsive choice on the delay discounting task compared with NS, while heightened trait attentional impulsivity was only found in HS. In contrast, in HD, nicotine withdrawal was associated with no attentional bias but heightened reflection impulsivity, poorer inhibitory control and significantly lower levels of impulsive choice relative to satiated smokers. Trait and behavioral impulsivity were not related to the extent of attentional bias to smoking-related cues at any stage of attention, level of nicotine dependency or state of deprivation. Findings have both clinical and theoretical implications, highlighting the unique and independent roles impulsivity and attentional bias may play at different stages of the nicotine addiction cycle.
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Affiliation(s)
| | - Therese E Fozard
- School of Humanities and Social Sciences, Psychology, Leeds Beckett University
| | - Danielle L Selby
- School of Humanities and Social Sciences, Psychology, Leeds Beckett University
| | - Amanda A Harrison
- Faculty of Medicine & Health, School of Psychology, University of Leeds, Leeds, United Kingdom
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Avila Chauvet L, Mejía Cruz D. Computational modeling of decision-making in substance abusers: testing Bechara's hypotheses. Front Psychol 2024; 15:1281082. [PMID: 38882514 PMCID: PMC11178135 DOI: 10.3389/fpsyg.2024.1281082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 04/29/2024] [Indexed: 06/18/2024] Open
Abstract
One of the cognitive abilities most affected by substance abuse is decision-making. Behavioral tasks such as the Iowa Gambling Task (IGT) provide a means to measure the learning process involved in decision-making. To comprehend this process, three hypotheses have emerged: (1) participants prioritize gains over losses, (2) they exhibit insensitivity to losses, and (3) the capacity of operational storage or working memory comes into play. A dynamic model was developed to examine these hypotheses, simulating sensitivity to gains and losses. The Linear Operator model served as the learning rule, wherein net gains depend on the ratio of gains to losses, weighted by the sensitivity to both. The study further proposes a comparison between the performance of simulated agents and that of substance abusers (n = 20) and control adults (n = 20). The findings indicate that as the memory factor increases, along with high sensitivity to losses and low sensitivity to gains, agents prefer advantageous alternatives, particularly those with a lower frequency of punishments. Conversely, when sensitivity to gains increases and the memory factor decreases, agents prefer disadvantageous alternatives, especially those that result in larger losses. Human participants confirmed the agents' performance, particularly when contrasting optimal and sub-optimal outcomes. In conclusion, we emphasize the importance of evaluating the parameters of the linear operator model across diverse clinical and community samples.
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Affiliation(s)
| | - Diana Mejía Cruz
- Psychology Department, Sonora Institute of Technology, Obregon City, Sonora, Mexico
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Loreto BBL, Sordi AO, de Castro MN, Ornell F, Guarnieri EP, Roza TH, Schuch JB, Cima MDS, Pechansky F, Grevet EH, Grassi-Oliveira R, von Diemen L, Kessler FHP. Proposing an integrative, dynamic and transdiagnostic model for addictions: dysregulation phenomena of the three main modes of the predostatic mind. Front Psychiatry 2024; 14:1298002. [PMID: 38274436 PMCID: PMC10808830 DOI: 10.3389/fpsyt.2023.1298002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/28/2023] [Indexed: 01/27/2024] Open
Abstract
Several theories have been proposed to explain the complex diagnostic aspects related to addiction disorders and their development. Recent frameworks tend to focus on dimensional perspectives of symptoms rather than categorical systems, since substance use disorders are frequently comorbid with other psychiatric and especially personality disorders. However, useful transdiagnostic models that could integrate clinical evaluation derived from neuroscientific theories are lacking. In the present manuscript, the authors propose a model based on a new paradigm, in an attempt to better explain this complex, multifaceted phenomenon. The new paradigm presupposes that emotions and behavior are a response to risk prediction. Individuals make choices and engage in actions to manage potential risks/rewards in order to seek or maintain homeostasis in their internal and external environments - a mechanism that the authors call predostatic (predictive mechanism with homeostatic purpose). The model considers three main modes of the predostatic mind: (1) Alarm Mode, activated by high and/or imminent risk prediction; (2) Seek Mode, activated by long-term risk or reward prediction; and (3) Balance Mode, a self-regulating state of mind related to low risk prediction, a soothing system and a calm state. Addiction is seen as a chronic dysregulation of organism systems leading to internalizing or externalizing phenomena mainly related to the Seek and Alarm Modes, which are persistently activated by reward and risk prediction, respectively, thus hindering Balance. Addiction neuroscience research has shown that chronic drug use or engagement in addictive behaviors can lead to neuroadaptations in the brain reward circuitry, disrupting normal balance and the regulation of reward processes. This dysregulation can contribute to persistent drug-seeking/addictive behaviors despite negative consequences. This newly proposed dynamic and integrative model, named dysregulation based on externalizing and internalizing phenomena of the three main modes of the predostatic mind (DREXI3), proposes six dysregulation dimensions with basic emotional and behavioral symptoms, such as neurophysiological alterations, impulsivity, compulsion, cognitive impairment/psychosis, mood, and anxiety/anger. In this paper, the authors explain the rationale behind DREXI3 and present some hypothetical clinical examples to better illustrate the use of the model in clinical practice. The development of this innovative model could possibly guide tailored treatment interventions in the addiction field.
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Affiliation(s)
- Bibiana Bolten Lucion Loreto
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Anne Orgler Sordi
- Addiction and Forensic Psychiatry Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Melina Nogueira de Castro
- Addiction and Forensic Psychiatry Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Felipe Ornell
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Eduardo Pegoraro Guarnieri
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | | | - Jaqueline Bohrer Schuch
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Marcos da Silveira Cima
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Flavio Pechansky
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Eugênio Horácio Grevet
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Rodrigo Grassi-Oliveira
- Department of Clinical Medicine, Translational Neuropsychiatry Unit, Aarhus University, Aarhus, Denmark
| | - Lisia von Diemen
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Felix Henrique Paim Kessler
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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Xia X, Pi Y, Xia J, Li Y, Shi Q, Zhang J, Tan X. Bilateral motor cortex functional differences in left-handed approaching-avoiding behavior. Psychophysiology 2023; 60:e14194. [PMID: 36250797 DOI: 10.1111/psyp.14194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 08/14/2022] [Accepted: 09/25/2022] [Indexed: 01/25/2023]
Abstract
Automatic action tendencies occur at behavioral and neurophysiological levels during task performance with the dominant right hand, with shorter reaction times (RTs) and higher excitability of the contralateral primary motor cortex (M1) during automatic vs. regulated behavior. However, effects associated with the non-dominant left-hand in approaching-avoiding behavior remain unclear. Here, we used transcranial magnetic stimulation during the performance by 18 participants of an approaching-avoiding task using the non-dominant left hand. Single-pulse transcranial magnetic stimulation was applied over left or right M1 at 150 and 300 ms after the onset of an emotional stimulus. RTs and motor-evoked potentials (MEPs) were recorded. Significant automatic action tendencies were observed at the behavioral level. Higher MEP amplitudes were detected 150 ms after stimulus onset from the right hand (non-task hand, corresponding to left M1) during regulated behavior compared with during automatic behavior. However, no significant modulation was found for MEP amplitudes from the left hand (task hand, corresponding to right M1). These findings suggested that left M1 may play a principal role in the early phase of mediating left-handed movement toward an emotional stimulus.
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Affiliation(s)
- Xue Xia
- School of Psychology, Shanghai University of Sport, Shanghai, China.,Krembil Research Institute, University Health Network, Toronto, Canada
| | - Yanling Pi
- Shanghai Punan Hospital of Pudong New District, Shanghai, China
| | - Jing Xia
- School of Psychology, Shanghai University of Sport, Shanghai, China
| | - Yansong Li
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Qingde Shi
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao, China
| | - Jian Zhang
- School of Psychology, Shanghai University of Sport, Shanghai, China
| | - Xiaoying Tan
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao, China
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Martinez S, Brandt L, Comer SD, Levin FR, Jones JD. The subjective experience of heroin effects among individuals with chronic opioid use: Revisiting reinforcement in an exploratory study. ADDICTION NEUROSCIENCE 2022; 4:100034. [PMID: 36120106 PMCID: PMC9481059 DOI: 10.1016/j.addicn.2022.100034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Aims Consistent with the opponent process theory individuals with chronic opioid use should predominantly endorse the avoidance of aversive negative emotional and/or physiological states as the motivation for continued opioid use (source of reinforcement: reductions in negative states). The primary aim of this study was to explore whether this view is supported by the subjective effects of heroin reported by individuals with opioid use disorder (OUD). Methods Responses during in-person interviews of participants to the question "What do you like about heroin? " were categorized as positive, negative, or mixed (positive and negative) reinforcement. In addition, we examined differences between these "reinforcement groups" in sociodemographic and clinical variables. Results Participants (N = 307) with OUD were predominantly male (78.1%), with chronic heroin use (M = 15.8 years, SD = 11.5), and 46.1% currently used heroin and were not enrolled in treatment. Agreement between two raters concerning the categorization of participant-reported effects of heroin into reinforcement categories was high, κ= 0.924, p < .0005. Approximately half (49.8%) of participant-reported effects of heroin were categorized as attributable to positive reinforcement. About one-fourth (22.8%) were categorized as negative reinforcement and 9.0% as "mixed ". There were no statistically significant differences between the three reinforcement groups in any of the socio-demographic variables, duration of heroin use, or treatment status/interest. Conclusions The results of this study indicate marked heterogeneity of heroin effects experienced by individuals with OUD and their source of reinforcement, respectively. Better integration of how individuals construe their drug use is important to understand the psychological-and neurobiological-processes in the development and maintenance of OUD.
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Mengin AC, Rolling J, Porche C, Durpoix A, Lalanne L. The Intertwining of Posttraumatic Stress Symptoms, Alcohol, Tobacco or Nicotine Use, and the COVID-19 Pandemic: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14546. [PMID: 36361425 PMCID: PMC9658659 DOI: 10.3390/ijerph192114546] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/30/2022] [Accepted: 11/02/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Posttraumatic stress symptoms (PTSSs) and alcohol, tobacco, or nicotine use are frequently associated conditions. The COVID-19 pandemic has been a stressful situation globally and has worsened mental health conditions and addictions in the population. Our systematic review explores the links between PTSSs and (1) alcohol use and (2) tobacco or nicotine use during the COVID-19 pandemic. METHODS We searched the PubMed, PsycINFO, and Web of Science databases for studies published between January 2020 and 16 December 2021. We included studies published in English concerning adults or adolescents. Included articles dealt simultaneously with the COVID-19 pandemic, PTSSs, and alcohol, tobacco, or nicotine use. The reports included were cross-sectional, longitudinal, or cohort studies. We categorized the reports according to the population explored. Our main outcomes are the impacts of PTSSs on (1) alcohol use and (2) tobacco and nicotine use and their relation to COVID-19-related stressors (worries, exposure, lockdown, and infection, either of self or relatives). RESULTS Of the 503 reports identified, 44 were assessed for eligibility, and 16 were included in our review, encompassing 34,408 participants. The populations explored were the general population, healthcare workers, war veterans, patients with substance use disorders, and other vulnerable populations. Most studies were online surveys (14) with cross-sectional designs (11). Every study explored alcohol use, while only two assessed tobacco use. In most populations explored, a high level of PTSSs was associated with alcohol use increase. COVID-19-related stress was frequently correlated with either high PTSSs or alcohol use. In healthcare workers, PTSSs and alcohol use were not associated, while COVID-19 worries were related to both PTSSs and alcohol use. DISCUSSION 1. PTSSs and increased alcohol use are frequently associated, while COVID-19 worries might trigger both conditions and worsen their association. Alcohol use increase may represent either an inadequate way of coping with PTSSs or a vulnerability amid the COVID-19 pandemic, leading to PTSSs. As most studies were cross-sectional online surveys, longitudinal prospective studies are needed to ascertain the direction of the associations between these conditions. These studies need to be sufficiently powered and control for potential bias and confounders. 2. Our review highlighted that research about PTSSs and tobacco or nicotine use is scarce.
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Affiliation(s)
- Amaury C. Mengin
- Psychiatry, Mental Health and Addictology Department, Strasbourg University Hospital, 67000 Strasbourg, France
- Regional Center for Psychotrauma Great East, 67000 Strasbourg, France
- Institut National de la Santé et de la Recherche Médiale, Unité de Recherche 1114 (INSERM U1114), Cognitive Neuropsychology, and Pathophysiology of Schizophrenia, 67000 Strasbourg, France
| | - Julie Rolling
- Psychiatry, Mental Health and Addictology Department, Strasbourg University Hospital, 67000 Strasbourg, France
- Regional Center for Psychotrauma Great East, 67000 Strasbourg, France
- Centre National de la Recherche Scientifique Unité Propre de Recherche 3212 (CNRS UPR 3212), Institute for Cellular and Integrative Neurosciences (INCI), 67000 Strasbourg, France
| | - Christelle Porche
- Psychiatry, Mental Health and Addictology Department, Strasbourg University Hospital, 67000 Strasbourg, France
- Institut National de la Santé et de la Recherche Médiale, Unité de Recherche 1114 (INSERM U1114), Cognitive Neuropsychology, and Pathophysiology of Schizophrenia, 67000 Strasbourg, France
| | - Amaury Durpoix
- Psychiatry, Mental Health and Addictology Department, Strasbourg University Hospital, 67000 Strasbourg, France
- Faculty of Medicine, Strasbourg University, 67000 Strasbourg, France
| | - Laurence Lalanne
- Psychiatry, Mental Health and Addictology Department, Strasbourg University Hospital, 67000 Strasbourg, France
- Institut National de la Santé et de la Recherche Médiale, Unité de Recherche 1114 (INSERM U1114), Cognitive Neuropsychology, and Pathophysiology of Schizophrenia, 67000 Strasbourg, France
- Faculty of Medicine, Strasbourg University, 67000 Strasbourg, France
- Fédération de Médecine Translationnelle de Strasbourg, 67000 Strasbourg, France
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Dousset C, Chenut C, Kajosch H, Kornreich C, Campanella S. Comparison of Neural Correlates of Reactive Inhibition in Cocaine, Heroin, and Polydrug Users through a Contextual Go/No-Go Task Using Event-Related Potentials. BIOLOGY 2022; 11:biology11071029. [PMID: 36101410 PMCID: PMC9312501 DOI: 10.3390/biology11071029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/29/2022] [Accepted: 07/05/2022] [Indexed: 12/05/2022]
Abstract
Simple Summary Witnessing the current increase in the use of substances in society and considering the associated pervasive relapse rate, the management of addictions remains a significant challenge. The identification of biomarkers that are linked to specific profiles of consumption would allow a more targeted, and therefore, more effective care. In this view, the present study evaluates and compares the cognitive performance usually associated with substance use disorder—inhibitory control, attentional bias, and error detection—of heroin, cocaine, and polydrug users to matched healthy controls. Simultaneously, the addition of measurement of the modulation of brain activity during the task (event-related potentials technique) offers a reliable representation of the neuronal mechanisms underlying cognitive functioning. The results reveal substance-specific neural patterns of response, notably a more deleterious impact on polydrug use, and, despite nonsignificant results, suggest a more drastically affected cognitive functioning in cocaine users. Such evidence refines our knowledge of the specific mode of action of each substance. Ultimately, knowing their neural signature will lead to the implementation of more targeted interventions, thereby allowing specific needs to be addressed. Abstract Recent global data indicates a worldwide increase in polydrug use associated with a shift from recreational to productive habits of consumption. Such non-responsible abuse of substances (alcohol, cocaine, heroin, etc.) is likely to lead to addictive disorders that are characterized by various neuropsychopharmacological effects. A main cognitive function involved in the onset and long-term maintenance of addiction is reactive inhibition, i.e., the ability to withhold a prepotent motor dominant response. In the present study, 63 (poly)drug user patients who were undergoing a detoxification program, in addition to 19 healthy controls matched for gender, age, and education, were subjected to a “contextual Go/No-Go task” with concomitant electroencephalography. Stimuli were superimposed on three contextual backgrounds: control (black screen), drug-unrelated (neutral pictures), or drug-related (pictures related to drug consumption). Of these patients, 23 were cocaine users (CU), 21 were heroin users (HU), and 19 were polydrug users (PDU). The main results showed that (1) at the behavioral level, more commission errors occurred with the PDU patients compared to the healthy controls; (2) at the neurophysiological level, specific alterations were found on classical event-related potentials that index reactive inhibition. Indeed, the higher rate of errors in the PDU group was subtended by both reduced amplitude and latency on the ∆N2 component and increased ∆P3 latency compared to controls. These data clearly suggest a more deleterious impact of polydrug use on inhibitory functions. In addition, our results provide evidence of reduced ERN amplitude in cocaine users, suggesting that impaired performance monitoring and error-processing may support impaired awareness, thereby preventing these patients from changing their behaviors.
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Affiliation(s)
- Clémence Dousset
- Laboratoire de Psychologie Médicale et d’Addictologie, ULB Neuroscience Institute (UNI), CHU Brugmann-Université Libre de Bruxelles (ULB), 4 Place Vangehuchten, 1020 Brussels, Belgium; (C.D.); (H.K.); (C.K.)
| | - Christie Chenut
- Substance Abuse Unit 73, CHU Brugmann, 4 Place Vangehuchten, 1020 Brussels, Belgium;
| | - Hendrik Kajosch
- Laboratoire de Psychologie Médicale et d’Addictologie, ULB Neuroscience Institute (UNI), CHU Brugmann-Université Libre de Bruxelles (ULB), 4 Place Vangehuchten, 1020 Brussels, Belgium; (C.D.); (H.K.); (C.K.)
| | - Charles Kornreich
- Laboratoire de Psychologie Médicale et d’Addictologie, ULB Neuroscience Institute (UNI), CHU Brugmann-Université Libre de Bruxelles (ULB), 4 Place Vangehuchten, 1020 Brussels, Belgium; (C.D.); (H.K.); (C.K.)
| | - Salvatore Campanella
- Laboratoire de Psychologie Médicale et d’Addictologie, ULB Neuroscience Institute (UNI), CHU Brugmann-Université Libre de Bruxelles (ULB), 4 Place Vangehuchten, 1020 Brussels, Belgium; (C.D.); (H.K.); (C.K.)
- Correspondence: or ; Tel.: +32-477-28-51
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He H, Zhou S, Peng C, Ran W, Tong S, Hong L, Cai F, Jin W, Jiang Y, Li M, Wang X, Luo M, Wang W, Zhao K. Effects of resilience on impulsivity, cognition and depression during protracted withdrawal among Chinese male methamphetamine users. BMC Psychiatry 2022; 22:414. [PMID: 35729547 PMCID: PMC9215047 DOI: 10.1186/s12888-022-04041-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 06/02/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Methamphetamine (METH) dependence is a complex and dynamic public health problem. Long-term abuse of METH can increase numerous risks of mental and physical problems. Currently, the methods to reduce METH dependence and improve the withdrawal symptoms are limited and ineffective. Resilience is seen as a multidimensional and dynamic capability to recover or bounce back from stressful events and is also generally considered as a protective factor against mental dysfunction. METHODS One hundred thirty-four males with METH dependence were consecutively recruited from Huanglong Compulsory Isolated Detoxification Center between 2019 and 2021, of whom 112 were into the group. The Connor-Davidson Resilience Scale (CD-RISC), Self-rating depression scale (SDS), Self-rating anxiety scale (SAS), Barratt Impulsiveness Scale-11(BIS-11), and the Repeatable Battery for the Assessment of Neuropsychological Status (Rbans) were used to evaluate resilience, depression, anxiety, impulsivity, and cognition respectively. RESULTS The results mainly indicated that high resilience group showed lower SDS, SAS and BIS-11 scores than low resilience group (all p < 0.05). Besides, the total scores of Rbans were higher in high resilience groups than low resilience group (both p < 0.05). Moreover, linear regression results showed that resilience may be influenced by the scores of SDS and SAS. CONCLUSIONS Resilience is negatively correlated with impulsivity and depression. Besides, it is also positively associated with cognitive function. Drug users with higher resilience may have a strong ability to mobilize psychological resources to create a good psychological environment, which may have a positive effect on the relief or improvement of symptoms.
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Affiliation(s)
- He He
- grid.268099.c0000 0001 0348 3990School of Mental Health, Wenzhou Medical University, Chashan Higher Education Park, Ouhai District, Wenzhou, 325000 China
| | - Siyao Zhou
- grid.268099.c0000 0001 0348 3990School of Mental Health, Wenzhou Medical University, Chashan Higher Education Park, Ouhai District, Wenzhou, 325000 China
| | - Chenhui Peng
- grid.268099.c0000 0001 0348 3990School of Mental Health, Wenzhou Medical University, Chashan Higher Education Park, Ouhai District, Wenzhou, 325000 China
| | - Wang Ran
- grid.13402.340000 0004 1759 700XThe Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Siyu Tong
- grid.268099.c0000 0001 0348 3990School of Mental Health, Wenzhou Medical University, Chashan Higher Education Park, Ouhai District, Wenzhou, 325000 China
| | - Lan Hong
- grid.268099.c0000 0001 0348 3990School of Mental Health, Wenzhou Medical University, Chashan Higher Education Park, Ouhai District, Wenzhou, 325000 China
| | - Fangfang Cai
- grid.268099.c0000 0001 0348 3990School of Mental Health, Wenzhou Medical University, Chashan Higher Education Park, Ouhai District, Wenzhou, 325000 China
| | - Wei Jin
- grid.268099.c0000 0001 0348 3990School of Mental Health, Wenzhou Medical University, Chashan Higher Education Park, Ouhai District, Wenzhou, 325000 China
| | - Yile Jiang
- grid.268099.c0000 0001 0348 3990School of Mental Health, Wenzhou Medical University, Chashan Higher Education Park, Ouhai District, Wenzhou, 325000 China
| | - Mengjia Li
- grid.268099.c0000 0001 0348 3990School of Mental Health, Wenzhou Medical University, Chashan Higher Education Park, Ouhai District, Wenzhou, 325000 China
| | - Xuanping Wang
- grid.268099.c0000 0001 0348 3990School of Mental Health, Wenzhou Medical University, Chashan Higher Education Park, Ouhai District, Wenzhou, 325000 China
| | - Mengdan Luo
- grid.268099.c0000 0001 0348 3990School of Mental Health, Wenzhou Medical University, Chashan Higher Education Park, Ouhai District, Wenzhou, 325000 China
| | - Wei Wang
- School of Mental Health, Wenzhou Medical University, Chashan Higher Education Park, Ouhai District, Wenzhou, 325000, China. .,The Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou, China.
| | - Ke Zhao
- School of Mental Health, Wenzhou Medical University, Chashan Higher Education Park, Ouhai District, Wenzhou, 325000, China. .,The Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou, China. .,School of Mental Health, Key Laboratory of Alzheimer's Disease of Zhejiang Province, Wenzhou Medical University, Wenzhou, China.
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Bollen Z, Field M, Billaux P, Maurage P. Attentional bias in alcohol drinkers: A systematic review of its link with consumption variables. Neurosci Biobehav Rev 2022; 139:104703. [PMID: 35643118 DOI: 10.1016/j.neubiorev.2022.104703] [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: 12/04/2021] [Revised: 03/29/2022] [Accepted: 05/14/2022] [Indexed: 12/01/2022]
Abstract
In severe alcohol use disorder (SAUD), attentional bias refers to the preferential allocation of attentional resources toward alcohol-related cues. Dominant models consider that this bias plays a key role in the emergence and maintenance of SAUD. We evaluate the available experimental support for this assumption through a systematic literature review, providing a critical synthesis of studies exploring the links between alcohol consumption and attentional bias. Using PRISMA guidelines, we explored three databases (PsycINFO, PubMed, Scopus) and extracted 95 papers. We assessed their methodological quality and categorized them based on the population targeted, namely patients with SAUD or subclinical populations with various drinking patterns. We also classified papers according to the measures used (i.e., behavioral or eye-tracking measures). Overall, subclinical populations present an alcohol-related bias, but many studies in SAUD did not find such bias, nor approach/avoidance patterns. Moreover, attentional bias fluctuates alongside motivational states rather than according to alcohol use severity, which questions its stability. We provide recommendations to develop further theoretical knowledge and overcome methodological shortcomings.
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Affiliation(s)
- Zoé Bollen
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Science Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Matt Field
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
| | - Pauline Billaux
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
| | - Pierre Maurage
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Science Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium.
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Wittekind CE, Takano K, Sckopke P, Winkler MH, Werner GG, Ehring T, Rüther T. Efficacy of approach bias modification as an add-on to smoking cessation treatment: study protocol for a randomized-controlled double-blind trial. Trials 2022; 23:223. [PMID: 35313949 PMCID: PMC8935694 DOI: 10.1186/s13063-022-06155-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 03/07/2022] [Indexed: 11/18/2022] Open
Abstract
Background Although effective treatments for smoking cessation are available, long-term abstinence is the exception rather than the norm. Accordingly, there is a need for novel interventions that potentially improve clinical outcome. Although implicit information processing biases, for example approach biases for smoking-related stimuli, are ascribed a dominant role in the maintenance of tobacco dependence, these biases are hardly targeted in current treatment. Past research has shown that so-called Approach Bias Modification (AppBM) trainings, aiming to modify this bias, lead to improved long-term abstinence in abstinent alcoholic inpatients when delivered as an add-on to treatment-as-usual. Findings on the efficacy of AppBM in smoking have been inconsistent. The present large-scale clinical trial pursues two goals. First, it aims to investigate the efficacy of AppBM as an add-on to treatment-as-usual in a representative sample of adult smokers. Second, possible mechanisms of change are investigated. Methods The study is a randomized-controlled, double-blind, parallel-group superiority trial. We aim at a final sample of at least 336 adult smokers. Participants are allocated with a 1:1:1 allocation ratio to one of the following conditions: (1) treatment-as-usual + AppBM, (2) treatment-as-usual + Sham, (3) treatment-as-usual only. During the add-on training, participants are presented smoking-related and positive pictures and are instructed to respond by either pushing or pulling a joystick, depending on the tilt of the pictures (5○ to the left/right). During AppBM, all smoking-related pictures are tilted in the direction that is associated with pushing, thereby aiming to train an avoidance bias for smoking. All positive pictures are tilted in the direction associated with pulling. During Sham, the contingency is 50/50. Participants are assessed before and after the intervention and at a 6-month follow-up. The primary outcome is prolonged abstinence, and secondary outcomes include smoking-related variables and psychological distress. Additionally, the motivational significance of smoking-related stimuli (i.e., approach bias, valence) is assessed with different experimental tasks (Approach-Avoidance Task; Single Target Implicit Association Test) and psychophysiological measures. Discussion This is the first large-scale clinical trial investigating the efficacy of AppBM as an add-on in smokers including a TAU only condition. Additionally, it is the first study to systematically investigate potential mechanisms mediating the effects of treatment on clinical outcome. Trial registration German Clinical Trials Register, DRKS00019221, 11/11/2019 Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06155-6.
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Anderson AC, Youssef GJ, Robinson AH, Lubman DI, Verdejo-Garcia A. Cognitive boosting interventions for impulsivity in addiction: a systematic review and meta-analysis of cognitive training, remediation and pharmacological enhancement. Addiction 2021; 116:3304-3319. [PMID: 33751683 DOI: 10.1111/add.15469] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 12/09/2020] [Accepted: 02/24/2021] [Indexed: 01/05/2023]
Abstract
AIMS To evaluate and compare the effects of three cognitive boosting intervention approaches (computerised cognitive training, cognitive remediation and pharmacological cognitive enhancers) on measures of impulsive action and impulsive choice. DESIGN Systematic review and meta-analysis of publications that reported original controlled trials of cognitive boosting interventions. SETTING Studies conducted anywhere in the world. No language restrictions were applied. PARTICIPANTS Treatment-seeking adults with substance use disorder or gambling disorder. MEASUREMENTS Our primary outcome was a reduction in impulsive action or choice on a validated cognitive measure post-intervention. We assessed risk of bias using the Cochrane Collaboration tool and determined pooled estimates from published reports. We performed random-effects analyses for impulsive action and impulsive choice outcomes and planned moderator analyses. FINDINGS Of 2204 unique studies identified, 60 were included in the full-text review. Twenty-three articles were considered eligible for inclusion in the qualitative synthesis and 16 articles were included in our meta-analysis. Articles eligible for pooled analyses included five working memory training (computerised cognitive training) studies with 236 participants, three goal management training (cognitive remediation) studies with 99 participants, four modafinil (cognitive enhancer) studies with 160 participants and four galantamine (cognitive enhancer) studies with 131 participants. Study duration ranged from 5 days to 13 weeks, with immediate follow-up assessments. There were no studies identified that specifically targeted gambling disorder. We only found evidence for a benefit on impulsive choice of goal management training, although only in two studies involving 66 participants (standardised mean difference (SMD) = 0.86; 95% CI = 0.49-1.23; P = 0.02; I2 = 0%, P = 0.95). CONCLUSION Cognitive remediation, and specifically goal management training, may be an effective treatment for addressing impulsive choice in addiction. Preliminary evidence does not support the use of computerised cognitive training or pharmacological enhancers to boost impulse control in addiction.
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Affiliation(s)
- Alexandra C Anderson
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia.,Monash Addiction Research Centre, Monash University, Melbourne, Victoria, Australia
| | - George J Youssef
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia.,Centre for Adolescent Health, Population Health Theme, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Alex H Robinson
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia.,Monash Addiction Research Centre, Monash University, Melbourne, Victoria, Australia
| | - Dan I Lubman
- Turning Point, Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia.,Monash Addiction Research Centre, Monash University, Melbourne, Victoria, Australia
| | - Antonio Verdejo-Garcia
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia.,Monash Addiction Research Centre, Monash University, Melbourne, Victoria, Australia
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12
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Sliedrecht W, Roozen HG, Witkiewitz K, de Waart R, Dom G. The Association Between Impulsivity and Relapse in Patients With Alcohol Use Disorder: A Literature Review. Alcohol Alcohol 2021; 56:637-650. [PMID: 33382416 DOI: 10.1093/alcalc/agaa132] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 10/13/2020] [Accepted: 11/07/2020] [Indexed: 01/14/2023] Open
Abstract
AIM Impulsivity has been identified as a key relapse risk factor in patients with alcohol use disorder (AUD); however, the inherent characteristics of this relationship have been largely understudied. The heterogeneity of AUD and variation in impulsivity constructs require careful consideration to inform future work examining the relationship. This study sought to review empirical findings examining facets of impulsivity and AUD relapse. METHODS A systematic search strategy was employed to capture studies on impulsivity measures related to AUD relapse. Impulsivity measures were qualitatively organized in terms of 'trait impulsivity'-typically measured by self-report questionnaires-and 'behavioural impulsivity', i.e. 'motor impulsivity', 'impulsive choice' and 'reflection impulsivity, assessed with cognitive-behavioural tasks. RESULTS Seventeen peer-reviewed papers were identified. Relapse outcomes varied substantially in relation to impulsivity measures. Twelve papers included aspects of 'trait impulsivity', and nine studies included 'behavioural impulsivity' measures, from which five studies dealt with the 'impulsive choice' subcategory. The Barratt Impulsivity Scale was the self-report questionnaire that was most frequently used. CONCLUSIONS All three included facets of impulsivity ('trait-, motor- and impulsive choice impulsivity') were associated with AUD relapse, but none seemed to be superior to another. This study confirmed that research on the relation between impulsivity and AUD relapse is relatively scarce. Future research and treatment options are proposed.
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Affiliation(s)
- Wilco Sliedrecht
- De Hoop GGZ, Provincialeweg 70, 3329 KP Dordrecht, The Netherlands
| | - Hendrik G Roozen
- Center on Alcoholism, Substance Abuse, and Addictions (CASAA), The University of New Mexico (UNM), MSC 11 6280, Albuquerque, NM 87106, USA
| | - Katie Witkiewitz
- The University of New Mexico, MSC 03-2220, Albuquerque, NM 87131, USA
| | - Ranne de Waart
- Mentrum/Arkin, Domselaerstraat 126, 1093 MB Amsterdam, The Netherlands
| | - Geert Dom
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), Antwerp University, Universiteitsplein 1, 2610 Antwerp, Belgium
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Elevated ad libitum alcohol consumption following continuous theta burst stimulation to the left-dorsolateral prefrontal cortex is partially mediated by changes in craving. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2021; 22:160-170. [PMID: 34410618 PMCID: PMC8791868 DOI: 10.3758/s13415-021-00940-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/28/2021] [Indexed: 01/19/2023]
Abstract
Previous research indicates that following alcohol intoxication, activity in prefrontal cortices is reduced, linking to changes in associated cognitive processes, such as inhibitory control, attentional bias (AB), and craving. While these changes have been implicated in alcohol consumption behaviour, it has yet to be fully illuminated how these frontal regions and cognitive processes interact to govern alcohol consumption behaviour. The current preregistered study applied continuous theta burst transcranial magnetic stimulation (cTBS) to examine directly these relationships while removing the wider pharmacological effects of alcohol. A mixed design was implemented, with cTBS stimulation to right and left dorsolateral prefrontal cortex (DLPFC), the medial orbital frontal cortex (mOFC) and Vertex, with measures of inhibitory control, AB, and craving taken both pre- and post-stimulation. Ad libitum consumption was measured using a bogus taste task. Results suggest that rDLPFC stimulation impaired inhibitory control but did not significantly increase ad libitum consumption. However, lDLPFC stimulation heightened craving and increased consumption, with findings indicating that changes in craving partially mediated the relationship between cTBS stimulation of prefrontal regions and ad libitum consumption. Medial OFC stimulation and AB findings were inconclusive. Overall, results implicate the left DLPFC in the regulation of craving, which appears to be a prepotent cognitive mechanism by which alcohol consumption is driven and maintained.
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14
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Xia X, Li Y, Wang Y, Xia J, Lin Y, Zhang X, Liu Y, Zhang J. Functional role of dorsolateral prefrontal cortex in the modulation of cognitive bias. Psychophysiology 2021; 58:e13894. [PMID: 34227119 DOI: 10.1111/psyp.13894] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 05/31/2021] [Accepted: 06/18/2021] [Indexed: 12/11/2022]
Abstract
Human cognition is often biased. It is a fundamental question in psychology how cognitive bias is modulated in the human brain. Automatic action tendency is a typical cognitive bias. The dorsolateral prefrontal cortex (DLPFC) is a crucial area for processing various behavioral tasks. We investigated the functional role of DLPFC in the modulation of cognitive bias by testing the automatic action tendency during automatic and regulated behavioral tasks. Unilateral intermittent or continuous theta burst stimulation (excitatory iTBS or inhibitory cTBS) was used to manipulate the left or right DLPFC excitability and assess the changes in automatic action tendency during a manikin task. An approaching behavior with positive stimulus and avoiding behavior with negative stimulus were performed in an automatic task. An approaching behavior with negative stimulus and avoiding behavior with positive stimulus were performed in a regulated task. Reaction time was measured. We confirmed the automatic action tendency that reaction time for performing an automatic task was shorter than that for performing a regulated task. The automatic action tendency was enhanced after left DLPFC excitatory iTBS and was abolished after left DLPFC inhibitory cTBS stimulation. On the other hand, right DLPFC excitatory iTBS accelerated the avoiding behaviors and right DLPFC inhibitory cTBS accelerated approaching behaviors. The results suggest that left DLPFC modulates the automatic action tendency while the right DLPFC modulates the direction of behavioral tasks. We conclude that left DLPFC and right DLPFC are key nodes in modulating the cognitive bias while their functional roles are different.
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Affiliation(s)
- Xue Xia
- School of Psychology, Shanghai University of Sport, Shanghai, China
| | - Yansong Li
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Yanqiu Wang
- School of Psychology, Shanghai University of Sport, Shanghai, China
| | - Jing Xia
- School of Psychology, Shanghai University of Sport, Shanghai, China
| | - Yitong Lin
- School of Psychology, Shanghai University of Sport, Shanghai, China
| | - Xiaoxiao Zhang
- School of Psychology, Shanghai University of Sport, Shanghai, China
| | - Yu Liu
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Jian Zhang
- School of Psychology, Shanghai University of Sport, Shanghai, China
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Yarborough BJH, Stumbo SP, Ahmedani B, Rossom R, Coleman K, Boggs JM, Simon GE. Suicide Behavior Following PHQ-9 Screening Among Individuals With Substance Use Disorders. J Addict Med 2021; 15:55-60. [PMID: 32657957 DOI: 10.1097/adm.0000000000000696] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Individuals with substance use disorders (SUD) are at risk for suicide, but no studies have assessed whether routinely administered screeners for suicidal ideation accurately identify outpatients with SUD who are at risk for suicide attempt or death. METHODS Data from more than 186,000 visits by over 55,000 patients with mental health and SUD diagnoses receiving care in 7 health systems were analyzed to determine whether responses to item 9 of the 9-item Patient Health Questionnaire, which assesses frequency of thoughts of death and self-harm, are associated with suicide outcomes after an outpatient visit. Odds of suicide attempt or death were computed using generalized estimating equations. RESULTS In bivariate analyses, a nearly 5-fold risk was observed for patients answering "nearly every day" relative to "not at all" among individuals who made a suicide attempt within 90 days (4.9% vs 1.1%; χ2 = 1151, P < 0.0001). At nearly half of visits (46%) followed by a suicide attempt within 90 days, patients responded "not at all." In logistic models, compared to "not at all," all other responses were associated with higher odds of suicide attempt or death within 90 days. Fully adjusted models attenuated results but odds of suicide attempt (AOR = 3.24, CI: 2.69-3.91) and suicide death (AOR = 5.67, CI: 2.0-16.1) remained high for those reporting "nearly every day." CONCLUSIONS In people with SUD, increasing Patient Health Questionnaire item 9 response predicts increased risk of subsequent suicidal behavior and should prompt intervention. However, clinicians should realize that those reporting "not at all" are not immune from subsequent suicide risk.
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Affiliation(s)
- Bobbi Jo H Yarborough
- Kaiser Permanente Northwest, Center for Health Research, Portland, OR (BJHY, SPS); Henry Ford Health System, Center for Health Services Research, Detroit, MI (BA); Health Partners Institute, Minneapolis, MN (RR); Kaiser Permanente Southern California, Department of Research and Evaluation, Pasadena, CA (KC); Kaiser Permanente Colorado, Institute for Health Research, Denver, CO (JMB); Kaiser Permanente Washington Health Research Institute, Seattle, WA (GES)
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Abstract
Increased motivation towards alcohol use and suboptimal behavioral control are suggested to predispose adolescents to alcohol use disorders (AUDs). Paradoxically however, most adolescent AUDs resolve over time without any formal intervention, suggesting adolescent resilience to AUDs. Importantly, studies directly comparing adolescent and adult alcohol use are largely missing. We therefore aimed to unravel the moderating role of age in the relation between alcohol use and motivational and control-related cognitive processes in 45 adolescent drinkers compared to 45 adults. We found that enhancement drinking motives and impulsivity related positively to alcohol use. Although enhancement drinking motives and impulsivity were higher in adolescents, the strength of the relation between these measures and alcohol use did not differ between age groups. None of the alcohol use-related motivational measures (i.e., craving, attentional bias, and approach bias) and behavioral control measures (i.e., interference control, risky decision making, and working-memory) were associated with alcohol use or differed between age groups. These findings support the role of impulsivity and affective sensitivity in adolescent drinking but question the moderating role of age therein. The current study contributes towards understanding the role of age in the relation between alcohol use and cognition.
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Edemann-Callesen H, Barak S, Hadar R, Winter C. Choosing the Optimal Brain Target for Neuromodulation Therapies as Alcohol Addiction Progresses—Insights From Pre-Clinical Studies. CURRENT ADDICTION REPORTS 2020. [DOI: 10.1007/s40429-020-00316-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Abstract
Purpose of the Review
Development of addiction involves a transition from reward-driven to habitual behavior, mediated by neuroplastic changes. Based on preclinical findings, this article article reviews the current knowledge on the use of neuromodulation therapies to target alcohol addiction and essentially reduce relapse.
Recent Findings
To date, only a limited number of preclinical studies have investigated the use of neuromodulation in alcohol addiction, with the focus being on targeting the brain reward system. However, as addiction develops, additional circuits are recruited. Therefore, a differential setup may be required when seeking to alter the chronic alcohol-dependent brain, as opposed to treating earlier phases of alcohol addiction.
Summary
To promote enduring relapse prevention, the choice of brain target should match the stage of the disorder. Further studies are needed to investigate which brain areas should be targeted by neuromodulating strategies, in order to sufficiently alter the behavior and pathophysiology as alcohol addiction progresses.
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Lueck JA, Costantini R, Knobloch M. The Making of an Addiction: Examining Psychological Determinants of Prescription Stimulant Abuse among College Students. HEALTH COMMUNICATION 2020; 35:946-954. [PMID: 30987453 DOI: 10.1080/10410236.2019.1598743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Diagnoses of attention-deficit-disorders and stimulant prescriptions to treat these disorders (e.g., Adderall) are on the rise. The non-medical use of such stimulants (NUPS) as 'study drugs' has increased among college students, which aggravates the worsening prescription drug crisis in the U.S. This research examined the underlying psychological determinants of NUPS in order to inform effective health communication intervention efforts. It also tested potential individual-level characteristics that could influence such determinants in order to determine at-risk groups. This research utilized the reasoned action framework in a mixed-methods, two-study approach. Study 1 explored the underlying beliefs associated with intentions to engage in NUPS in an open-ended belief elicitation survey (N = 121), study 2 (N = 312) tested the psychological determinants of intentions and influencing individual-level characteristics in a quantitative survey. Results revealed (1) the top three unique attitudinal, normative, and control beliefs about NUPS; (2) instrumental attitude as strongest determinant of NUPS; (3) expectations of improved productivity, approval from friends and peers, access and financial means, peer pressure, and health risks as effective targets for effective health communication interventions; and (4) poor mental health, high levels of stress, and characteristics of perfectionism and sensation-seeking as aggravating risk factors among college students. Further implications and directions are discussed.
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Granero R, Fernández-Aranda F, Valero-Solís S, del Pino-Gutiérrez A, Mestre-Bach G, Baenas I, Contaldo SF, Gómez-Peña M, Aymamí N, Moragas L, Vintró C, Mena-Moreno T, Valenciano-Mendoza E, Mora-Maltas B, Menchón JM, Jiménez-Murcia S. The influence of chronological age on cognitive biases and impulsivity levels in male patients with gambling disorder. J Behav Addict 2020; 9:383-400. [PMID: 32573467 PMCID: PMC8939415 DOI: 10.1556/2006.2020.00028] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 04/04/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND AND AIMS Due to the contribution of age to the etiology of gambling disorder (GD), there is a need to assess the moderator effect of the aging process with other features that are highly related with the clinical profile. The objective of this study is to examine the role of the chronological age into the relationships between cognitive biases, impulsivity levels and gambling preference with the GD profile during adulthood. METHODS Sample included n = 209 patients aged 18-77 years-old recruited from a Pathological Gambling Outpatients Unit. Orthogonal contrasts explored polynomial patterns in data, and path analysis implemented through structural equation modeling assessed the underlying mechanisms between the study variables. RESULTS Compared to middle-age patients, younger and older age groups reported more impairing irrational beliefs (P = 0.005 for interpretative control and P = 0.043 for interpretative bias). A linear trend showed that as people get older sensation seeking (P = 0.006) and inability to stop gambling (P = 0.018) increase. Path analysis showed a direct effect between the cognitive bias and measures of gambling severity (standardized effects [SE] between 0.12 and 0.17) and a direct effect between impulsivity levels and cumulated debts due to gambling (SE = 0.22). CONCLUSION Screening tools and intervention plans should consider the aging process. Specific programs should be developed for younger and older age groups, since these are highly vulnerable to the consequences of gambling activities and impairment levels of impulsivity and cognitive biases.
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Affiliation(s)
- Roser Granero
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Department of Psychobiology and Methodology, Autonomous University of Barcelona, Barcelona, Spain
| | - Fernando Fernández-Aranda
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Susana Valero-Solís
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Amparo del Pino-Gutiérrez
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain,Department of Public Health, Mental Health and Perinatal Nursing, School of Nursing, University of Barcelona, Barcelona, Spain
| | - Gemma Mestre-Bach
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Isabel Baenas
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - S. Fabrizio Contaldo
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Mónica Gómez-Peña
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Neus Aymamí
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Laura Moragas
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Cristina Vintró
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Teresa Mena-Moreno
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Eduardo Valenciano-Mendoza
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain,CIBER Salud Mental (CIBERSam), Instituto de Salud Carlos III, Madrid, Spain
| | - Bernat Mora-Maltas
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - José M. Menchón
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain,CIBER Salud Mental (CIBERSam), Instituto de Salud Carlos III, Madrid, Spain
| | - Susana Jiménez-Murcia
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain,Corresponding author. Department of Psychiatry, Bellvitge University Hospital, c/ Feixa Llarga s/n, Hospitalet de Llobregat, Barcelona, 08907, Spain. Tel.: +34 93 260 79 88; fax: +34 93 260 76 58. E-mail:
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Abstract
In this targeted review, we summarize current knowledge on substance-use disorder
(SUD)-related cognitive deficits, the link between these deficits and clinical outcomes,
and the cognitive training, remediation, and pharmacological approaches that have the
potential to rescue cognition. We conclude that: (i) people with SUDs have moderate
deficits in memory, attention, executive functions, and decision-making (including
reward expectancy, valuation, and learning); (ii) deficits in higher-order executive
functions and decision-making are significant predictors of relapse; (iii) cognitive
training programs targeting reward-related appetitive biases, cognitive remediation
strategies targeting goal-based decision-making, and pharmacotherapies targeting memory,
attention, and impulsivity have potential to rescue SUD-related cognitive deficits. We
suggest avenues for future research, including developing brief, clinically oriented
harmonized cognitive testing suites to improve individualized prediction of treatment
outcomes; computational modeling that can achieve deep phenotyping of cognitive subtypes
likely to respond to different interventions; and phenotype-targeted cognitive,
pharmacological, and combined interventions. We conclude with a tentative model of
neuroscience-informed precision medicine.
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Affiliation(s)
| | - Gloria Garcia-Fernandez
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia; Department of Psychology, University of Oviedo, Spain
| | - Geert Dom
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), Antwerp University (UA), Antwerp, Belgium
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Wold EA, Wild CT, Cunningham KA, Zhou J. Targeting the 5-HT2C Receptor in Biological Context and the Current State of 5-HT2C Receptor Ligand Development. Curr Top Med Chem 2019; 19:1381-1398. [PMID: 31288724 DOI: 10.2174/1568026619666190709101449] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 05/14/2019] [Accepted: 05/16/2019] [Indexed: 12/19/2022]
Abstract
Serotonin (5-HT) 5-HT2C receptor (5-HT2CR) is recognized as a critical mediator of diseaserelated pathways and behaviors based upon actions in the central nervous system (CNS). Since 5-HT2CR is a class A G protein-coupled receptor (GPCR), drug discovery efforts have traditionally pursued the activation of the receptor through synthetic ligands with agonists proposed for the treatment of obesity, substance use disorders and impulse control disorders while antagonists may add value for the treatment of anxiety, depression and schizophrenia. The most significant agonist discovery to date is the FDAapproved anti-obesity medication lorcaserin. In recent years, efforts towards developing other mechanisms to enhance receptor function have resulted in the discovery of Positive Allosteric Modulators (PAMs) for the 5-HT2CR, with several molecule series now reported. The biological significance and context for signaling and function of the 5-HT2CR, and the current status of 5-HT2CR agonists and PAMs are discussed in this review.
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Affiliation(s)
- Eric A Wold
- Center for Addiction Research and Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, Texas 77555, United States
| | - Christopher T Wild
- Center for Addiction Research and Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, Texas 77555, United States
| | - Kathryn A Cunningham
- Center for Addiction Research and Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, Texas 77555, United States
| | - Jia Zhou
- Center for Addiction Research and Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, Texas 77555, United States
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Hamza CA, Willoughby T. Impulsivity and nonsuicidal self-injury: A longitudinal examination among emerging adults. J Adolesc 2019; 75:37-46. [DOI: 10.1016/j.adolescence.2019.07.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 07/06/2019] [Accepted: 07/09/2019] [Indexed: 01/06/2023]
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Rolland B, D'Hondt F, Montègue S, Brion M, Peyron E, D'Aviau de Ternay J, de Timary P, Nourredine M, Maurage P. A Patient-Tailored Evidence-Based Approach for Developing Early Neuropsychological Training Programs in Addiction Settings. Neuropsychol Rev 2019; 29:103-115. [PMID: 30607658 DOI: 10.1007/s11065-018-9395-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Accepted: 11/16/2018] [Indexed: 12/22/2022]
Abstract
Substance use disorders (SUDs) are associated with impairments of cognitive functions, and cognitive training programs are thus rapidly developing in SUD treatment. However, neuropsychological impairments observed early after withdrawal (i.e., early impairments), that is, approximately in the first six months, may be widespread. Consequently, it might not be possible to train all the identified early impairments. In these situations, we propose that the priority of cognitive training should be given to the early impairments found to be associated with early dropout or relapse (i.e., relapse-related impairments). However, substance-specific relapse-related impairments have not been singled out among all early impairments so far. Using a systematic literature search, we identified the types of established early impairments for all SUDs, and we assessed the extent to which these early impairments were found to be associated with relapse-related impairments. All cognitive functions were investigated according to a classification based on current neuropsychological models, distinguishing classical cognitive, substance-bias, and social cognition systems. According to the current evidence, demonstrated relapse-related impairments in alcohol use disorder comprised impulsivity, long-term memory, and higher-order executive functions. For cannabis use disorder, the identified relapse-related impairments were impulsivity and working memory. For stimulant use disorder, the identified relapse-related impairments were attentional abilities and higher-order executive functions. For opioid use disorder, the only identified relapse-related impairments were higher executive functions. However, many early impairments were not explored with respect to dropout/relapse, particularly for stimulant and opioid use disorders. The current literature reveals substance-specific relapse-related impairments, which supports a pragmatic patient-tailored approach for defining which early impairments should be prioritized in terms of training among patients with SUDs.
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Affiliation(s)
- Benjamin Rolland
- Univ Lyon; UCBL ; INSERM U1028 ; CNRS UMR5292, Centre de Recherche en Neuroscience de Lyon (CRNL), F-69678, Bron, France.,Service Universitaire d'Addictologie de Lyon (SUAL), Pôle UP-MOPHA, F-69500, Bron, CH Le Vinatier, France
| | - Fabien D'Hondt
- Univ. Lille, CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, F-59000, Lille, France.,Clinique de Psychiatrie, CHU Lille, CURE, F-59000, Lille, France
| | - Solène Montègue
- Service Universitaire d'Addictologie de Lyon (SUAL), Pôle UP-MOPHA, F-69500, Bron, CH Le Vinatier, France
| | - Mélanie Brion
- Laboratory for Experimental Psychopathology (LEP), Psychological Science Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | | | - Julia D'Aviau de Ternay
- Service Universitaire d'Addictologie de Lyon (SUAL), Pôle UP-MOPHA, F-69500, Bron, CH Le Vinatier, France
| | - Philippe de Timary
- Laboratory for Experimental Psychopathology (LEP), Psychological Science Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium.,Cliniques Universitaires Saint-Luc, B-1060, Brussels, Belgium
| | - Mikaïl Nourredine
- Service Universitaire d'Addictologie de Lyon (SUAL), Pôle UP-MOPHA, F-69500, Bron, CH Le Vinatier, France
| | - Pierre Maurage
- Laboratory for Experimental Psychopathology (LEP), Psychological Science Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium.
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24
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Sholler DJ, Stutz SJ, Fox RG, Boone EL, Wang Q, Rice KC, Moeller FG, Anastasio NC, Cunningham KA. The 5-HT 2A Receptor (5-HT 2AR) Regulates Impulsive Action and Cocaine Cue Reactivity in Male Sprague-Dawley Rats. J Pharmacol Exp Ther 2019; 368:41-49. [PMID: 30373886 PMCID: PMC6290084 DOI: 10.1124/jpet.118.251199] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 10/25/2018] [Indexed: 01/25/2023] Open
Abstract
Impulsivity and the attentional orienting response to cocaine-associated cues (cue reactivity) promote relapse in cocaine-use disorder (CUD). A time-dependent escalation of cue reactivity (incubation) occurs during extended, forced abstinence from cocaine self-administration in rats. The investigational serotonin (5-HT) 5-HT2A receptor (5-HT2AR) antagonist/inverse agonist M100907 suppresses impulsive action, or the inability to withhold premature responses, and cocaine-seeking behaviors. The present preclinical study was designed to establish the potential for repurposing the Food and Drug Administration-approved selective 5-HT2AR antagonist/inverse agonist pimavanserin as a therapeutic agent to forestall relapse vulnerability in CUD. In male Sprague-Dawley rats, pimavanserin suppressed impulsive action (premature responses) measured in the 1-choice serial reaction time (1-CSRT) task, similarly to M100907. We also used the 1-CSRT task to establish baseline levels of impulsive action before cocaine self-administration and evaluation of cue reactivity (lever presses reinforced by the discrete cue complex previously paired with cocaine delivery). We observed an incubation of cocaine cue reactivity between day 1 and day 30 of forced abstinence from cocaine self-administration. Baseline levels of impulsive action predicted incubated levels of cocaine cue reactivity in late abstinence. We also found that baseline impulsive action predicted the effectiveness of pimavanserin to suppress incubated cue reactivity in late abstinence from cocaine self-administration at doses that were ineffective in early abstinence. These data suggest that integration of clinical measures of impulsive action may inform refined, personalized pharmacotherapeutic intervention for the treatment of relapse vulnerability in CUD.
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Affiliation(s)
- Dennis J Sholler
- Center for Addiction Research and Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, Texas (D.J.S., S.J.S., R.G.F., N.C.A., K.A.C.); Department of Statistical Sciences and Operations Research, Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia (E.L.B., Q.W.); Drug Design and Synthesis Section, Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse, Bethesda, Maryland (K.C.R.); and Department of Psychiatry, Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia (F.G.M.)
| | - Sonja J Stutz
- Center for Addiction Research and Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, Texas (D.J.S., S.J.S., R.G.F., N.C.A., K.A.C.); Department of Statistical Sciences and Operations Research, Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia (E.L.B., Q.W.); Drug Design and Synthesis Section, Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse, Bethesda, Maryland (K.C.R.); and Department of Psychiatry, Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia (F.G.M.)
| | - Robert G Fox
- Center for Addiction Research and Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, Texas (D.J.S., S.J.S., R.G.F., N.C.A., K.A.C.); Department of Statistical Sciences and Operations Research, Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia (E.L.B., Q.W.); Drug Design and Synthesis Section, Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse, Bethesda, Maryland (K.C.R.); and Department of Psychiatry, Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia (F.G.M.)
| | - Edward L Boone
- Center for Addiction Research and Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, Texas (D.J.S., S.J.S., R.G.F., N.C.A., K.A.C.); Department of Statistical Sciences and Operations Research, Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia (E.L.B., Q.W.); Drug Design and Synthesis Section, Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse, Bethesda, Maryland (K.C.R.); and Department of Psychiatry, Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia (F.G.M.)
| | - Qin Wang
- Center for Addiction Research and Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, Texas (D.J.S., S.J.S., R.G.F., N.C.A., K.A.C.); Department of Statistical Sciences and Operations Research, Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia (E.L.B., Q.W.); Drug Design and Synthesis Section, Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse, Bethesda, Maryland (K.C.R.); and Department of Psychiatry, Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia (F.G.M.)
| | - Kenner C Rice
- Center for Addiction Research and Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, Texas (D.J.S., S.J.S., R.G.F., N.C.A., K.A.C.); Department of Statistical Sciences and Operations Research, Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia (E.L.B., Q.W.); Drug Design and Synthesis Section, Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse, Bethesda, Maryland (K.C.R.); and Department of Psychiatry, Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia (F.G.M.)
| | - F Gerard Moeller
- Center for Addiction Research and Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, Texas (D.J.S., S.J.S., R.G.F., N.C.A., K.A.C.); Department of Statistical Sciences and Operations Research, Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia (E.L.B., Q.W.); Drug Design and Synthesis Section, Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse, Bethesda, Maryland (K.C.R.); and Department of Psychiatry, Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia (F.G.M.)
| | - Noelle C Anastasio
- Center for Addiction Research and Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, Texas (D.J.S., S.J.S., R.G.F., N.C.A., K.A.C.); Department of Statistical Sciences and Operations Research, Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia (E.L.B., Q.W.); Drug Design and Synthesis Section, Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse, Bethesda, Maryland (K.C.R.); and Department of Psychiatry, Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia (F.G.M.)
| | - Kathryn A Cunningham
- Center for Addiction Research and Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, Texas (D.J.S., S.J.S., R.G.F., N.C.A., K.A.C.); Department of Statistical Sciences and Operations Research, Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia (E.L.B., Q.W.); Drug Design and Synthesis Section, Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse, Bethesda, Maryland (K.C.R.); and Department of Psychiatry, Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia (F.G.M.)
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25
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Carbia C, Corral M, Doallo S, Caamaño-Isorna F. The dual-process model in young adults with a consistent binge drinking trajectory into adulthood. Drug Alcohol Depend 2018; 186:113-119. [PMID: 29567625 DOI: 10.1016/j.drugalcdep.2018.01.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 01/18/2018] [Accepted: 01/19/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND Binge Drinking (BD) generally declines once students have left university. However, many individuals continue to partake in BD into adulthood, constituting a scarcely investigated high-risk group towards whom interventions should be prioritized. Following the dual-process model, we examined the relationship between BD and both the reflective system (executive functions) and the affective system (alcohol bias) in young adults with a consistent BD trajectory. We considered impulsivity as a moderator in the relationship between BD and alcohol bias. METHODS A cohort of 63 (31♀) young adults were followed for eleven years (18-29 years old). In the last assessment, participants, with high and low drinking trajectories underwent neuropsychological assessment of executive functions (working memory [SOPT], cognitive flexibility [TMT -Verbal Fluency], inhibition [Stroop]) and alcohol bias (Addiction Stroop). The Barratt Impulsivity Scale measured impulsivity. Generalized linear mixed models and regression-based moderation models were applied. RESULTS BD was associated with weak inhibitory control, poor working memory and greater alcohol bias moderated by non-planning impulsivity. At moderate levels of non-planning impulsivity, BD was associated with greater alcohol bias. This association was not found at high levels of impulsivity. These deficits were related to loss of control over drinking and severity of alcohol use. CONCLUSIONS The imbalance between poor cognitive control and greater alcohol bias may contribute to the persistence of BD into adulthood. The findings highlight the complexities of the dual-process model, with intervention implications.
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Affiliation(s)
- Carina Carbia
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Galicia, Spain.
| | - Montserrat Corral
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Galicia, Spain
| | - Sonia Doallo
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Galicia, Spain
| | - Francisco Caamaño-Isorna
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Department of Preventive Medicine, University of Santiago de Compostela, Galicia, Spain
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26
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Sensation seeking moderates television's cultivation of alcohol and tobacco beliefs: Evidence from a national study of French adolescents. Drug Alcohol Depend 2018; 186:193-200. [PMID: 29604527 DOI: 10.1016/j.drugalcdep.2018.01.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 01/07/2018] [Accepted: 01/30/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND Television (TV) is a key socialization agent, especially amongst youth. According to cultivation theory, youth heavily exposed to TV content, where positive images of smoking and drinking abound, should hold more positive beliefs concerning drinking and smoking outcomes. This research investigates the role of the sensation-seeking personality trait in moderating this TV cultivation effect. METHODS A French national research company contacted its panel members with children aged 13-17. Parents completed a short survey and were asked for consent for their child to participate in a study. The children were then contacted, informed, and asked for assent. Assenters completed a survey that included measures of TV exposure, personality traits, drinking and smoking behaviors, and beliefs about the outcomes associated with drinking and smoking (expectancies). Parental drinking, smoking, and strictness were included as controls. RESULTS Survey data from 1040 adolescents (54.2% males) and their parents reveal that the relationship between cumulative TV exposure and drinking and smoking behavior, mediated through expectancies, is strongest amongst high sensation seeking adolescents. The moderated mediation analysis shows that sensation seeking trait moderates the relationship between TV exposure and the beliefs adolescents hold about the consequences of alcohol and tobacco use, which themselves are related to greater likelihood to engage in substance use. CONCLUSION Key personality traits and TV exposure levels must be accounted for to identify youth at risk of using substances at a time when many lifelong maladaptive behaviors and beliefs form.
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27
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Perkins FN, Freeman KB. Pharmacotherapies for decreasing maladaptive choice in drug addiction: Targeting the behavior and the drug. Pharmacol Biochem Behav 2018; 164:40-49. [PMID: 28666892 PMCID: PMC5745300 DOI: 10.1016/j.pbb.2017.06.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 06/06/2017] [Accepted: 06/26/2017] [Indexed: 12/23/2022]
Abstract
Drug addiction can be conceptualized as a disorder of maladaptive decision making in which drugs are chosen at the expense of pro-social, nondrug alternatives. The study of decision making in drug addiction has focused largely on the role of impulsivity as a facilitator of addiction, in particular the tendency for drug abusers to choose small, immediate gains over larger but delayed outcomes (i.e., delay discounting). A parallel line of work, also focused on decision making in drug addiction, has focused on identifying the determinants underlying the choice to take drugs over nondrug alternatives (i.e., drug vs. nondrug choice). Both tracks of research have been valuable tools in the development of pharmacotherapies for treating maladaptive decision making in drug addiction, and a number of common drugs have been studied in both designs. However, we have observed that there is little uniformity in the administration regimens of potential treatments between the designs, which hinders congruence in the development of single treatment strategies to reduce both impulsive behavior and drug choice. The current review provides an overview of the drugs that have been tested in both delay-discounting and drug-choice designs, and focuses on drugs that reduced the maladaptive choice in both designs. Suggestions to enhance congruence between the findings in future studies are provided. Finally, we propose the use of a hybridized, experimental approach that may enable researchers to test the effectiveness of therapeutics at decreasing impulsive and drug choice in a single design.
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Affiliation(s)
- Frank N Perkins
- Division of Neurobiology and Behavior Research, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS 39216, United States
| | - Kevin B Freeman
- Division of Neurobiology and Behavior Research, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS 39216, United States.
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28
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George O, Hope BT. Cortical and amygdalar neuronal ensembles in alcohol seeking, drinking and withdrawal. Neuropharmacology 2017; 122:107-114. [PMID: 28435008 DOI: 10.1016/j.neuropharm.2017.04.031] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 04/17/2017] [Accepted: 04/19/2017] [Indexed: 01/06/2023]
Abstract
Alcohol induces many alterations in the brain that are thought to contribute to alcohol addiction. Most of the known alterations are induced in all neurons of a brain area or all neurons of a given cell type, regardless of whether they were activated during behavior. While these alterations can have important modulatory effects on behavior, they cannot explain why animals respond specifically to alcohol-paired cues as opposed to all other non-paired cues and evoke highly specific goal-directed learned responses in models of drug craving. As an alternative, we hypothesize another class of alterations that are induced only within sparsely distributed patterns of neurons, called neuronal ensembles, that are selectively activated by alcohol-specific cues during behavior and encode the long-term memories underlying these learned behaviors in animal models of alcohol addiction. Here we review recent studies and techniques used to identify the role of neuronal ensembles in animal models of different phases of the alcohol addiction cycle. This article is part of the Special Issue entitled "Alcoholism".
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Affiliation(s)
- Olivier George
- Department of Neuroscience, The Scripps Research Institute, La Jolla, CA 92037, USA.
| | - Bruce T Hope
- National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD 21224, USA
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