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Mora-Maltas B, Baenas I, Etxandi M, Lucas I, Granero R, Fernández-Aranda F, Tovar S, Solé-Morata N, Gómez-Peña M, Moragas L, Del Pino-Gutiérrez A, Tapia J, Diéguez C, Goudriaan AE, Jiménez-Murcia S. Association between endocrine and neuropsychological endophenotypes and gambling disorder severity. Addict Behav 2024; 153:107968. [PMID: 38447412 DOI: 10.1016/j.addbeh.2024.107968] [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: 09/25/2023] [Revised: 01/07/2024] [Accepted: 01/22/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Neurobiological characteristics have been identified regarding the severity of gambling disorder (GD). The aims of this study were: (1) to examine, through a path analysis, whether there was a relationship between neuroendocrine features, potentially mediational GD variables, and GD severity, and (2) to associate neuroendocrine variables, with GD severity-related variables according to gambling preferences. METHODS The sample included 297 outpatients with GD. We analyzed endocrine concentrations of different appetite-related hormones (ghrelin, liver antimicrobial peptide 2 [LEAP-2], leptin, adiponectin), and neuropsychological performance (working memory, cognitive flexibility, inhibition, decision making, premorbid intelligence). Path analysis assessed mechanisms between neuroendocrine features and GD severity, including mediational GD variables (impulsivity traits and gambling-related cognitive distortions). Partial correlations evaluated the associations between neuroendocrine variables, including impulsivity traits, and variables related to GD severity (DSM-5, South Oaks Gambling Screen, illness duration, and gambling-related cognitive distortions). RESULTS Lower adiponectin concentrations predicted greater GD severity, while higher LEAP-2 concentrations predicted more gambling-related cognitive distortions. Likewise, better neuropsychological performance directly predicted GD severity, but worse neuropsychological performance was associated with GD severity through the mediational variables of impulsivity traits and gambling-related cognitive distortions. Also, in non-strategic individuals with GD, poor working memory was associated with gambling expectancies and predictive control. In strategic individuals with GD, poor cognitive flexibility was associated with illusion of control, predictive control, and inability to stop gambling. CONCLUSIONS These results provide updated information about the comprehension of the interaction between neuroendocrine features, clinical variables, and severity of GD. Thus, neurobiological functions seem to be strongly related to GD severity.
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Affiliation(s)
- Bernat Mora-Maltas
- Clinical Psychology Department, Bellvitge University Hospital- Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Doctorate in Medicine and Traslational Research Programme, University of Barcelona (UB), Barcelona, Spain
| | - Isabel Baenas
- Clinical Psychology Department, Bellvitge University Hospital- Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Doctorate in Medicine and Traslational Research Programme, University of Barcelona (UB), Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Mikel Etxandi
- Clinical Psychology Department, Bellvitge University Hospital- Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Doctorate in Medicine and Traslational Research Programme, University of Barcelona (UB), Barcelona, Spain; Department of Psychiatry, Hospital Universitari Germans Trias i Pujol, IGTP Campus Can Ruti, Badalona, Spain
| | - Ignacio Lucas
- Clinical Psychology Department, Bellvitge University Hospital- Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Roser Granero
- Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Department of Psychobiology and Methodology, Autonomous University of Barcelona, Barcelona, Spain
| | - Fernando Fernández-Aranda
- Clinical Psychology Department, Bellvitge University Hospital- Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Sulay Tovar
- Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Physiology, CIMUS, University of Santiago de Compostela, Instituto de Investigación Sanitaria, Santiago de Compostela, Spain
| | - Neus Solé-Morata
- Clinical Psychology Department, Bellvitge University Hospital- Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Mónica Gómez-Peña
- Clinical Psychology Department, Bellvitge University Hospital- Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Laura Moragas
- Clinical Psychology Department, Bellvitge University Hospital- Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Amparo Del Pino-Gutiérrez
- Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Department of Public Health, Mental Health and Perinatal Nursing, School of Nursing, University of Barcelona, Barcelona, Spain
| | - Javier Tapia
- Doctorate in Medicine and Traslational Research Programme, University of Barcelona (UB), Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Medical Direction of Ambulatory Processes, South Metropolitan Territorial Management, Bellvitge University Hospital, Barcelona, Spain
| | - Carlos Diéguez
- Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Physiology, CIMUS, University of Santiago de Compostela, Instituto de Investigación Sanitaria, Santiago de Compostela, Spain
| | - Anna E Goudriaan
- Arkin Mental Health Care, Jellinek, Amsterdam Institute for Addiction Research, Amsterdam, the Netherlands; Amsterdam UMC, Department of Psychiatry, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Susana Jiménez-Murcia
- Clinical Psychology Department, Bellvitge University Hospital- Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain; Centre for Psychological Services, University of Barcelona, Spain.
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Wiehler A, Peters J. Decomposition of Reinforcement Learning Deficits in Disordered Gambling via Drift Diffusion Modeling and Functional Magnetic Resonance Imaging. COMPUTATIONAL PSYCHIATRY (CAMBRIDGE, MASS.) 2024; 8:23-45. [PMID: 38774428 PMCID: PMC11104325 DOI: 10.5334/cpsy.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 03/07/2024] [Indexed: 05/24/2024]
Abstract
Gambling disorder is associated with deficits in reward-based learning, but the underlying computational mechanisms are still poorly understood. Here, we examined this issue using a stationary reinforcement learning task in combination with computational modeling and functional resonance imaging (fMRI) in individuals that regular participate in gambling (n = 23, seven fulfilled one to three DSM 5 criteria for gambling disorder, sixteen fulfilled four or more) and matched controls (n = 23). As predicted, the gambling group exhibited substantially reduced accuracy, whereas overall response times (RTs) were not reliably different between groups. We then used comprehensive modeling using reinforcement learning drift diffusion models (RLDDMs) in combination with hierarchical Bayesian parameter estimation to shed light on the computational underpinnings of this performance deficit. In both groups, an RLDDM in which both non-decision time and decision threshold (boundary separation) changed over the course of the experiment accounted for the data best. The model showed good parameter and model recovery, and posterior predictive checks revealed that, in both groups, the model accurately reproduced the evolution of accuracies and RTs over time. Modeling revealed that, compared to controls, the learning impairment in the gambling group was linked to a more rapid reduction in decision thresholds over time, and a reduced impact of value-differences on the drift rate. The gambling group also showed shorter non-decision times. FMRI analyses replicated effects of prediction error coding in the ventral striatum and value coding in the ventro-medial prefrontal cortex, but there was no credible evidence for group differences in these effects. Taken together, our findings show that reinforcement learning impairments in disordered gambling are linked to both maladaptive decision threshold adjustments and a reduced consideration of option values in the choice process.
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Affiliation(s)
- Antonius Wiehler
- Department of Systems Neuroscience, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
- Institut du Cerveau et de la Moelle épinière (ICM), INSERM U 1127, CNRS UMR 7225, Sorbonne Universités Paris, France
| | - Jan Peters
- Department of Systems Neuroscience, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
- Department of Psychology, Biological Psychology, University of Cologne, Cologne, Germany
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Yan WS, Liu SJ, Zheng DH. Compulsivity and Inhibitory Control Deficits in Abstinent Individuals With Heroin Addiction and Their Biological Siblings Compared With Unrelated Healthy Control Participants. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024; 9:196-206. [PMID: 37995811 DOI: 10.1016/j.bpsc.2023.11.002] [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: 06/19/2023] [Revised: 09/20/2023] [Accepted: 11/08/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Compulsivity represents the performance of persistent and repetitive acts despite negative consequences and is considered one of the critical mechanisms for drug addiction. Although compulsivity-related neurocognitive impairments have been linked to addiction, it remains unclear whether these deficits might have predated drug abuse as potential familial susceptibilities. METHODS A large sample of 213 adult participants were recruited, including 70 abstinent individuals addicted to heroin (HAs), 69 unaffected biological siblings of the HAs (siblings), and 74 unrelated healthy control participants. Compulsivity-related neurocognitive functions were evaluated using the intradimensional/extradimensional set-shift task and a probabilistic reversal learning task. Compulsive traits were measured by the Obsessive-Compulsive Inventory-Revised. Inhibitory control was assessed using the stop signal task and Stroop Color and Word Test. Network models for group recognition were conducted using multilayer perceptron neural networks. RESULTS Data indicated that both HAs and siblings performed worse than healthy control participants on compulsivity-related aspects (i.e., shifting and reversal learning functions) and inhibitory control and had higher levels of self-reported compulsive traits. Furthermore, neural models revealed that a possible 3-facet clustering of neurocognitive deficits was linked to both HAs and siblings. CONCLUSIONS Our findings suggest that deficits in shift reversal and inhibitory control aspects and elevated compulsive traits, shared by HAs and their unaffected siblings, may putatively represent conceivable markers associated with familial vulnerabilities implicated in the development of heroin dependence.
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Affiliation(s)
- Wan-Sen Yan
- Department of Psychology, School of Medical Humanitarians, Guizhou Medical University, Guiyang, China; Guizhou Research Institute for Health Development, Guizhou Medical University, Guiyang, China.
| | - Su-Jiao Liu
- Department of Psychology, School of Medical Humanitarians, Guizhou Medical University, Guiyang, China
| | - Dan-Hui Zheng
- Department of Psychology, School of Medical Humanitarians, Guizhou Medical University, Guiyang, China
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Baenas I, Mora-Maltas B, Etxandi M, Lucas I, Granero R, Fernández-Aranda F, Tovar S, Solé-Morata N, Gómez-Peña M, Moragas L, Del Pino-Gutiérrez A, Tapia J, Diéguez C, Goudriaan AE, Jiménez-Murcia S. Cluster analysis in gambling disorder based on sociodemographic, neuropsychological, and neuroendocrine features regulating energy homeostasis. Compr Psychiatry 2024; 128:152435. [PMID: 37976998 DOI: 10.1016/j.comppsych.2023.152435] [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: 07/26/2023] [Revised: 10/12/2023] [Accepted: 10/26/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND The heterogeneity of gambling disorder (GD) has led to the identification of different subtypes, mostly including phenotypic features, with distinctive implications on the GD severity and treatment outcome. However, clustering analyses based on potential endophenotypic features, such as neuropsychological and neuroendocrine factors, are scarce so far. AIMS This study firstly aimed to identify empirical clusters in individuals with GD based on sociodemographic (i.e., age and sex), neuropsychological (i.e., cognitive flexibility, inhibitory control, decision making, working memory, attention, and set-shifting), and neuroendocrine factors regulating energy homeostasis (i.e., leptin, ghrelin, adiponectin, and liver-expressed antimicrobial peptide 2, LEAP-2). The second objective was to compare the profiles between clusters, considering the variables used for the clustering procedure and other different sociodemographic, clinical, and psychological features. METHODS 297 seeking-treatment adult outpatients with GD (93.6% males, mean age of 39.58 years old) were evaluated through a semi-structured clinical interview, self-reported psychometric assessments, and a protocolized neuropsychological battery. Plasma concentrations of neuroendocrine factors were assessed in peripheral blood after an overnight fast. Agglomerative hierarchical clustering was applied using sociodemographic, neuropsychological, and neuroendocrine variables as indicators for the grouping procedure. Comparisons between the empirical groups were performed using Chi-square tests (χ2) for categorical variables, and analysis of variance (ANOVA) for quantitative measures. RESULTS Three-mutually-exclusive groups were obtained, being neuropsychological features those with the greatest weight in differentiating groups. The largest cluster (Cluster 1, 65.3%) was composed by younger males with strategic and online gambling preferences, scoring higher on self-reported impulsivity traits, but with a lower cognitive impairment. Cluster 2 (18.2%) and 3 (16.5%) were characterized by a significantly higher proportion of females and older patients with non-strategic gambling preferences and a worse neuropsychological performance. Particularly, Cluster 3 had the poorest neuropsychological performance, especially in cognitive flexibility, while Cluster 2 reported the poorest inhibitory control. This latter cluster was also distinguished by a poorer self-reported emotion regulation, the highest prevalence of food addiction, as well as a metabolic profile characterized by the highest mean concentrations of leptin, adiponectin, and LEAP-2. CONCLUSIONS To the best of our knowledge, this is the first study to identify well-differentiated GD clusters using neuropsychological and neuroendocrine features. Our findings reinforce the heterogeneous nature of the disorder and emphasize a role of potential endophenotypic features in GD subtyping. This more comprehensive characterization of GD profiles could contribute to optimize therapeutic interventions based on a medicine of precision.
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Affiliation(s)
- Isabel Baenas
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Doctoral Program in Medicine and Translational Research, University of Barcelona (UB), Barcelona, Spain
| | - Bernat Mora-Maltas
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Doctoral Program in Medicine and Translational Research, University of Barcelona (UB), Barcelona, Spain
| | - Mikel Etxandi
- Doctoral Program in Medicine and Translational Research, University of Barcelona (UB), Barcelona, Spain; Department of Psychiatry, Hospital Universitari Germans Trias i Pujol, IGTP Campus Can Ruti, Badalona, Spain
| | - Ignacio Lucas
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain
| | - Roser Granero
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Psychobiology and Methodology, Autonomous University of Barcelona, Barcelona, Spain
| | - Fernando Fernández-Aranda
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Sulay Tovar
- Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Physiology, CIMUS, University of Santiago de Compostela, Instituto de Investigación Sanitaria (IDIS), Santiago de Compostela, Spain
| | - Neus Solé-Morata
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain
| | - Mónica Gómez-Peña
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Laura Moragas
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Amparo Del Pino-Gutiérrez
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Public Health, Mental Health and Perinatal Nursing, School of Nursing, University of Barcelona, Barcelona, Spain
| | - Javier Tapia
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Doctoral Program in Medicine and Translational Research, University of Barcelona (UB), Barcelona, Spain; Medical Direction of Ambulatory Processes, South Metropolitan Territorial Management, Bellvitge University Hospital, Barcelona, Spain
| | - Carlos Diéguez
- Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Physiology, CIMUS, University of Santiago de Compostela, Instituto de Investigación Sanitaria (IDIS), Santiago de Compostela, Spain
| | - Anna E Goudriaan
- Arkin Mental Health Care, Jellinek, Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands; Amsterdam UMC, Department of Psychiatry, University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Susana Jiménez-Murcia
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
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Zühlsdorff K, Verdejo-Román J, Clark L, Albein-Urios N, Soriano-Mas C, Cardinal RN, Robbins TW, Dalley JW, Verdejo-García A, Kanen JW. Computational modelling of reinforcement learning and functional neuroimaging of probabilistic reversal for dissociating compulsive behaviours in gambling and cocaine use disorders. BJPsych Open 2023; 10:e8. [PMID: 38073280 PMCID: PMC10755559 DOI: 10.1192/bjo.2023.611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 10/12/2023] [Accepted: 10/15/2023] [Indexed: 12/28/2023] Open
Abstract
BACKGROUND Individuals with cocaine use disorder or gambling disorder demonstrate impairments in cognitive flexibility: the ability to adapt to changes in the environment. Flexibility is commonly assessed in a laboratory setting using probabilistic reversal learning, which involves reinforcement learning, the process by which feedback from the environment is used to adjust behavior. AIMS It is poorly understood whether impairments in flexibility differ between individuals with cocaine use and gambling disorders, and how this is instantiated by the brain. We applied computational modelling methods to gain a deeper mechanistic explanation of the latent processes underlying cognitive flexibility across two disorders of compulsivity. METHOD We present a re-analysis of probabilistic reversal data from individuals with either gambling disorder (n = 18) or cocaine use disorder (n = 20) and control participants (n = 18), using a hierarchical Bayesian approach. Furthermore, we relate behavioural findings to their underlying neural substrates through an analysis of task-based functional magnetic resonanceimaging (fMRI) data. RESULTS We observed lower 'stimulus stickiness' in gambling disorder, and report differences in tracking expected values in individuals with gambling disorder compared to controls, with greater activity during reward expected value tracking in the cingulate gyrus and amygdala. In cocaine use disorder, we observed lower responses to positive punishment prediction errors and greater activity following negative punishment prediction errors in the superior frontal gyrus compared to controls. CONCLUSIONS Using a computational approach, we show that individuals with gambling disorder and cocaine use disorder differed in their perseverative tendencies and in how they tracked value neurally, which has implications for psychiatric classification.
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Affiliation(s)
- Katharina Zühlsdorff
- Department of Psychology, University of Cambridge, UK; Behavioural and Clinical Neuroscience Institute, University of Cambridge, UK; and the Alan Turing Institute, London, UK
| | - Juan Verdejo-Román
- Department of Personality, Assessment and Psychological Treatment, Universidad de Granada, Spain; and Mind, Brain and Behavior Research Center, Universidad de Granada, Spain
| | - Luke Clark
- Department of Psychology and Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Canada
| | | | - Carles Soriano-Mas
- Department of Psychiatry, Bellvitge Biomedical Research Institute-IDIBELL, Spain; Department of Social Psychology and Quantitative Psychology, University of Barcelona, Spain; and CIBERSAM, Carlos III Health Institute, Madrid, Spain
| | - Rudolf N. Cardinal
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, UK; Department of Psychiatry, University of Cambridge, UK; and Liaison Psychology, Cambridgeshire and Peterborough NHS Foundation Trust, UK
| | - Trevor W. Robbins
- Department of Psychology, University of Cambridge, UK; and Behavioural and Clinical Neuroscience Institute, University of Cambridge, UK
| | - Jeffrey W. Dalley
- Department of Psychology, University of Cambridge, UK; Behavioural and Clinical Neuroscience Institute, University of Cambridge, UK; and Department of Psychiatry, University of Cambridge, UK
| | - Antonio Verdejo-García
- School of Psychological Sciences, Monash University, Australia; and Turner Institute for Brain and Mental Health, Monash University, Australia
| | - Jonathan W. Kanen
- Department of Psychology, University of Cambridge, UK; and Behavioural and Clinical Neuroscience Institute, University of Cambridge, UK
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Grant JE, Chamberlain SR. Impaired cognitive flexibility across psychiatric disorders. CNS Spectr 2023; 28:688-692. [PMID: 37114560 DOI: 10.1017/s1092852923002237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
OBJECTIVE Problems with cognitive flexibility have been associated with multiple psychiatric disorders, but there has been little understanding of how cognitive flexibility compares across these disorders. This study examined problems of cognitive flexibility in young adults across a range of psychiatric disorders using a validated computerized trans-diagnostic flexibility paradigm. We hypothesized that obsessive-compulsive spectrum disorders (eg, obsessive-compulsive disorder, trichotillomania, and skin-picking disorder) would be associated with pronounced flexibility problems as they are most often associated with irrational or purposeless repetitive behaviors. METHODS A total of 576 nontreatment seeking participants (aged 18-29 years) were enrolled from general community settings, provided demographic information, and underwent structured clinical assessments. Each participant undertook the intra-extra-dimensional task, a validated computerized test measuring set-shifting ability. The specific measures of interest were total errors on the task and performance on the extra-dimensional (ED) shift, which reflects the ability to inhibit and shift attention away from one stimulus dimension to another. RESULTS Participants with depression and PTSD had elevated total errors on the task with moderate effect sizes; and those with the following had deficits of small effect size: generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), antisocial personality disorder, and binge-eating disorder. For ED errors, participants with PTSD, GAD, and binge-eating disorder exhibited deficits with medium effect sizes; those with the following had small effect size deficits: depression, social anxiety disorder, OCD, substance dependence, antisocial personality disorder, and gambling disorder. CONCLUSIONS These data indicate cognitive flexibility deficits occur across a range of mental disorders. Future work should explore whether these deficits can be ameliorated with novel treatment interventions.
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Affiliation(s)
- Jon E Grant
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Samuel R Chamberlain
- Department of Psychiatry, Faculty of Medicine, University of Southampton, Southampton, UK
- Southern Health NHS Foundation Trust, Southampton, UK
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Murayama K, Tomiyama H, Ohno A, Kato K, Matsuo A, Hasuzawa S, Sashikata K, Kang M, Nakao T. Decision-making deficits in obsessive-compulsive disorder are associated with abnormality of recency and response consistency parameter in prospect valence learning model. Front Psychiatry 2023; 14:1227057. [PMID: 37840793 PMCID: PMC10570432 DOI: 10.3389/fpsyt.2023.1227057] [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: 05/22/2023] [Accepted: 09/07/2023] [Indexed: 10/17/2023] Open
Abstract
Background Patients with obsessive-compulsive disorder (OCD) have deficits in decision-making in the Iowa Gambling Task (IGT). However, no study has investigated the parameters of the prospect valence learning (PVL) model in the IGT for OCD. Aims This study aimed to investigate deficits in decision-making in OCD using the PVL model and identify whether the parameters of the PVL model were associated with obsessive-compulsive severity. Methods Forty-seven medication-free patients with OCD were compared with 47 healthy controls (HCs). Decision-making was measured using the total net and block net scores of the IGT. A PVL model with a decay-reinforcement learning rule (PVL-DecayRI) was used to investigate the parameters of the model. Correlation analysis was conducted between each parameter of the PVL-DecayRL and obsessive-compulsive symptoms. Results The total net score of patients with OCD was significantly lower than that of the HCs. The block net scores of the OCD group did not differ across the five blocks, whereas in the HCs, the fifth block net score was significantly higher than the block net scores of the first and second blocks. The values of the recency and response consistency parameters of the PVL-DecayRI in patients with OCD were significantly lower than those in HCs. The recency parameter positively correlated with the Y-BOCS obsessive score. Meanwhile, there was no correlation between consistency parameter values and symptom severity in OCD. Conclusion Our detailed analysis of the decision-making deficit in OCD suggests that the most recent outcome has a small influence on the expectancy of prospect valence, as indicated by the lower recency parameter, and is characterized by more impulsive choices, as indicated by the lower consistency parameter.
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Affiliation(s)
- Keitaro Murayama
- Department of Neuropsychiatry, Kyushu University Hospital, Fukuoka, Japan
| | - Hirofumi Tomiyama
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Aikana Ohno
- Integrated Center for Educational Research and Development, Faculty of Education, Saga University, Saga, Japan
- Graduate School of Human-Environment Studies, Kyushu University, Fukuoka, Japan
| | - Kenta Kato
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Akira Matsuo
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Suguru Hasuzawa
- Center for Health Sciences and Counseling, Kyushu University, Fukuoka, Japan
| | - Kenta Sashikata
- Graduate School of Human-Environment Studies, Kyushu University, Fukuoka, Japan
| | - Mingi Kang
- Graduate School of Human-Environment Studies, Kyushu University, Fukuoka, Japan
| | - Tomohiro Nakao
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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van Timmeren T, Piray P, Goudriaan AE, van Holst RJ. Goal-directed and habitual decision making under stress in gambling disorder: An fMRI study. Addict Behav 2023; 140:107628. [PMID: 36716563 DOI: 10.1016/j.addbeh.2023.107628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 12/02/2022] [Accepted: 01/20/2023] [Indexed: 01/26/2023]
Abstract
The development of addictive behaviors has been suggested to be related to a transition from goal-directed to habitual decision making. Stress is a factor known to prompt habitual behavior and to increase the risk for addiction and relapse. In the current study, we therefore used functional MRI to investigate the balance between goal-directed 'model-based' and habitual 'model-free' control systems and whether acute stress would differentially shift this balance in gambling disorder (GD) patients compared to healthy controls (HCs). Using a within-subject design, 22 patients with GD and 20 HCs underwent stress induction or a control condition before performing a multistep decision-making task during fMRI. Salivary cortisol levels showed that the stress induction was successful. Contrary to our hypothesis, GD patients did not show impaired goal-directed 'model-based' decision making, which remained similar to HCs after stress induction. Bayes factors provided three times more evidence against a difference between the groups or a group-by-stress interaction on the balance between model-based and model-free decision making. Similarly, no differences were found between groups and conditions on the neural estimates of model-based or model-free decision making. These results challenge the notion that GD is related to an increased reliance on habitual (or decreased goal-directed) control, even during stress.
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Affiliation(s)
- Tim van Timmeren
- Amsterdam Institute for Addiction Research, Amsterdam UMC, Department of Psychiatry, University of Amsterdam, The Netherlands; Habit Lab, Department of Clinical Psychology, University of Amsterdam, The Netherlands; Department of Social Health and Organizational Psychology, Utrecht University, The Netherlands.
| | - Payam Piray
- Department of Psychology, University of Southern California, USA
| | - Anna E Goudriaan
- Amsterdam Institute for Addiction Research, Amsterdam UMC, Department of Psychiatry, University of Amsterdam, The Netherlands; Arkin Mental Health, The Netherlands
| | - Ruth J van Holst
- Amsterdam Institute for Addiction Research, Amsterdam UMC, Department of Psychiatry, University of Amsterdam, The Netherlands
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9
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Hales CA, Clark L, Winstanley CA. Computational approaches to modeling gambling behaviour: Opportunities for understanding disordered gambling. Neurosci Biobehav Rev 2023; 147:105083. [PMID: 36758827 DOI: 10.1016/j.neubiorev.2023.105083] [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: 10/13/2022] [Revised: 01/05/2023] [Accepted: 02/06/2023] [Indexed: 02/10/2023]
Abstract
Computational modeling has become an important tool in neuroscience and psychiatry research to provide insight into the cognitive processes underlying normal and pathological behavior. There are two modeling frameworks, reinforcement learning (RL) and drift diffusion modeling (DDM), that are well-developed in cognitive science, and have begun to be applied to Gambling Disorder. RL models focus on explaining how an agent uses reward to learn about the environment and make decisions based on outcomes. The DDM is a binary choice framework that breaks down decision making into psychologically meaningful components based on choice reaction time analyses. Both approaches have begun to yield insight into aspects of cognition that are important for, but not unique to, gambling, and thus relevant to the development of Gambling Disorder. However, these approaches also oversimplify or neglect various aspects of decision making seen in real-world gambling behavior. Gambling Disorder presents an opportunity for 'bespoke' modeling approaches to consider these neglected components. In this review, we discuss studies that have used RL and DDM frameworks to investigate some of the key cognitive components in gambling and Gambling Disorder. We also include an overview of Bayesian models, a methodology that could be useful for more tailored modeling approaches. We highlight areas in which computational modeling could enable progression in the investigation of the cognitive mechanisms relevant to gambling.
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Affiliation(s)
- C A Hales
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada; Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada.
| | - L Clark
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada; Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - C A Winstanley
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada; Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
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10
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Mestre-Bach G, Granero R, Fernández-Aranda F, Potenza MN, Jiménez-Murcia S. Obsessive-compulsive, harm-avoidance and persistence tendencies in patients with gambling, gaming, compulsive sexual behavior and compulsive buying-shopping disorders/concerns. Addict Behav 2023; 139:107591. [PMID: 36587418 DOI: 10.1016/j.addbeh.2022.107591] [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: 07/11/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND AIMS There is a growing interest in determining the specific role of obsessive-compulsive features in different behavioral addictions. However, more studies comparing sizable clinical populations with different addictions are needed.Therefore, a main aim of the present study was to explore the presence of obsessive-compulsive features among people with different behavioral addictions (gambling disorder, internet gaming disorder, compulsive sexual behavior disorder and compulsive buying-shopping concerns). Through a clustering procedure, the existence of empirical clusters among treatment-seeking patients based on obsessive-compulsive measures was explored. MATERIALS AND METHODS The Symptom Checklist-Revised, and the Temperament and Character Inventory-Revised were obtained from 4,010 treatment-seeking patients. Obsessive-compulsive features were measured with the obsessive-compulsive subscale of the Symptom Checklist-Revised and the harm avoidance and persistence dimensions of the Temperament and Character Inventory-Revised. Cluster analysis was applied to explore the existence of empirical groups based on obsessive-compulsive features. RESULTS Patients with compulsive sexual behavior disorder and compulsive buying-shopping disorder reported the highest scores on the obsessive-compulsive subscale, while patients with gambling disorder showed the lowest scores on harm avoidance, and patients with internet gaming disorder the lowest scores on persistence. Two mutually exclusive clusters were identified. Cluster 1 exhibited a more maladaptive psychopathological and personality profile than cluster. DISCUSSION AND CONCLUSIONS These results provide new evidence regarding obsessive-compulsive features in specific behavioral addictions. Therapeutic approaches should consider that different addictions may present distinct levels of obsessive-compulsive features.
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Affiliation(s)
| | - Roser Granero
- Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Fernando Fernández-Aranda
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Department of Neuroscience, Yale University School of Medicine, New Haven, CT, USA; Child Study Center, Yale University School of Medicine, New Haven, CT, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA; Connecticut Mental Health Center, New Haven, CT, USA; Wu Tsai Institute, Yale University School of Medicine, New Haven, CT, USA.
| | - Susana Jiménez-Murcia
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.
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11
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Suzuki S, Zhang X, Dezfouli A, Braganza L, Fulcher BD, Parkes L, Fontenelle LF, Harrison BJ, Murawski C, Yücel M, Suo C. Individuals with problem gambling and obsessive-compulsive disorder learn through distinct reinforcement mechanisms. PLoS Biol 2023; 21:e3002031. [PMID: 36917567 PMCID: PMC10013903 DOI: 10.1371/journal.pbio.3002031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 02/08/2023] [Indexed: 03/16/2023] Open
Abstract
Obsessive-compulsive disorder (OCD) and pathological gambling (PG) are accompanied by deficits in behavioural flexibility. In reinforcement learning, this inflexibility can reflect asymmetric learning from outcomes above and below expectations. In alternative frameworks, it reflects perseveration independent of learning. Here, we examine evidence for asymmetric reward-learning in OCD and PG by leveraging model-based functional magnetic resonance imaging (fMRI). Compared with healthy controls (HC), OCD patients exhibited a lower learning rate for worse-than-expected outcomes, which was associated with the attenuated encoding of negative reward prediction errors in the dorsomedial prefrontal cortex and the dorsal striatum. PG patients showed higher and lower learning rates for better- and worse-than-expected outcomes, respectively, accompanied by higher encoding of positive reward prediction errors in the anterior insula than HC. Perseveration did not differ considerably between the patient groups and HC. These findings elucidate the neural computations of reward-learning that are altered in OCD and PG, providing a potential account of behavioural inflexibility in those mental disorders.
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Affiliation(s)
- Shinsuke Suzuki
- Centre for Brain, Mind and Markets, The University of Melbourne, Carlton, Australia
- Center for the Promotion of Social Data Science Education and Research, Hitotsubashi University, Tokyo, Japan
- * E-mail:
| | - Xiaoliu Zhang
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
| | - Amir Dezfouli
- Data61, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Sydney, Australia
| | - Leah Braganza
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
| | - Ben D. Fulcher
- School of Physics, The University of Sydney, Sydney, Australia
| | - Linden Parkes
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
- Department of Bioengineering, School of Engineering & Applied Science, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Leonardo F. Fontenelle
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
| | - Ben J. Harrison
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Carlton, Australia
| | - Carsten Murawski
- Centre for Brain, Mind and Markets, The University of Melbourne, Carlton, Australia
| | - Murat Yücel
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
| | - Chao Suo
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
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12
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Grant JE, Chamberlain SR. Illegal behaviors as a consequence of gambling disorder. Am J Addict 2023; 32:40-46. [PMID: 36398436 PMCID: PMC10098700 DOI: 10.1111/ajad.13360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 10/03/2022] [Accepted: 10/24/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Gambling disorder has been associated with illegal behaviors; however, research using validated scales and in-person assessments has been less common. METHODS Four hundred and twenty-seven people with gambling disorders taking part in clinical trials completed multiple instruments and select cognitive tasks. Two groups were identified: those with illegal behaviors linked to gambling disorder and those without. Differences between the groups were examined. RESULTS 43.3% of people with gambling disorders reported gambling-related illegal behaviors. Illegal behaviors were associated with earlier gambling symptom onset, higher levels of depressive symptoms, worse quality of life, and higher non-planning impulsivity. In those with illegal behaviors, the most common activities reported were writing bad checks/paying bills from accounts that no longer had funds (75.1%), and theft (9.6%). People with illegal gambling-related behaviors did not differ from those without, in terms of levels of symptom severity, or likelihood of responding to treatment in the subsequent clinical trials. DISCUSSION AND CONCLUSIONS Illegal behaviors are commonplace in people with gambling disorders and linked to worse quality of life, but people with gambling-related illegal behaviors respond to core treatments to the same extent as people without these behaviors. SCIENTIFIC SIGNIFICANCE The findings from this study extend previous research and support the novel notion that rather than more intensive treatment being indicated for gambling disorders linked to illegal activities, it may be prudent to consider illegal behaviors as part of a wider profile of gambling-related harms that merit interventions in their own right.
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Affiliation(s)
- Jon E Grant
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, Illinois, USA
| | - Samuel R Chamberlain
- Department of Psychiatry, Faculty of Medicine, University of Southampton, Southampton, UK.,Southern Health NHS Foundation Trust, Southampton, UK
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13
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Etxandi M, Baenas I, Mora-Maltas B, Granero R, Fernández-Aranda F, Tovar S, Solé-Morata N, Lucas I, Casado S, Gómez-Peña M, Moragas L, del Pino-Gutiérrez A, Codina E, Valenciano-Mendoza E, Potenza MN, Diéguez C, Jiménez-Murcia S. Are Signals Regulating Energy Homeostasis Related to Neuropsychological and Clinical Features of Gambling Disorder? A Case-Control Study. Nutrients 2022; 14:nu14235084. [PMID: 36501114 PMCID: PMC9736671 DOI: 10.3390/nu14235084] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/04/2022] [Accepted: 11/24/2022] [Indexed: 12/04/2022] Open
Abstract
Gambling disorder (GD) is a modestly prevalent and severe condition for which neurobiology is not yet fully understood. Although alterations in signals involved in energy homeostasis have been studied in substance use disorders, they have yet to be examined in detail in GD. The aims of the present study were to compare different endocrine and neuropsychological factors between individuals with GD and healthy controls (HC) and to explore endocrine interactions with neuropsychological and clinical variables. A case−control design was performed in 297 individuals with GD and 41 individuals without (healthy controls; HCs), assessed through a semi-structured clinical interview and a psychometric battery. For the evaluation of endocrine and anthropometric variables, 38 HCs were added to the 41 HCs initially evaluated. Individuals with GD presented higher fasting plasma ghrelin (p < 0.001) and lower LEAP2 and adiponectin concentrations (p < 0.001) than HCs, after adjusting for body mass index (BMI). The GD group reported higher cognitive impairment regarding cognitive flexibility and decision-making strategies, a worse psychological state, higher impulsivity levels, and a more dysfunctional personality profile. Despite failing to find significant associations between endocrine factors and either neuropsychological or clinical aspects in the GD group, some impaired cognitive dimensions (i.e., WAIS Vocabulary test and WCST Perseverative errors) and lower LEAP2 concentrations statistically predicted GD presence. The findings from the present study suggest that distinctive neuropsychological and endocrine dysfunctions may operate in individuals with GD and predict GD presence. Further exploration of endophenotypic vulnerability pathways in GD appear warranted, especially with respect to etiological and therapeutic potentials.
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Affiliation(s)
- Mikel Etxandi
- Department of Psychiatry, Bellvitge University Hospital-Bellvitge Institute for Biomedical Research (IDIBELL), 08907 Barcelona, Spain
- Department of Psychiatry, Hospital Universitari Germans Trias i Pujol, IGTP Campus Can Ruti, 08916 Badalona, Spain
| | - Isabel Baenas
- Department of Psychiatry, Bellvitge University Hospital-Bellvitge Institute for Biomedical Research (IDIBELL), 08907 Barcelona, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Institute for Biomedical Research (IDIBELL), 08908 Barcelona, Spain
| | - Bernat Mora-Maltas
- Department of Psychiatry, Bellvitge University Hospital-Bellvitge Institute for Biomedical Research (IDIBELL), 08907 Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Institute for Biomedical Research (IDIBELL), 08908 Barcelona, Spain
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Institute for Biomedical Research (IDIBELL), 08908 Barcelona, Spain
- Department of Psychobiology and Methodology, Autonomous University of Barcelona, 08193 Barcelona, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry, Bellvitge University Hospital-Bellvitge Institute for Biomedical Research (IDIBELL), 08907 Barcelona, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Institute for Biomedical Research (IDIBELL), 08908 Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, 08907 Barcelona, Spain
| | - Sulay Tovar
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Physiology, CIMUS, Instituto de Investigación Sanitaria, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Neus Solé-Morata
- Department of Psychiatry, Bellvitge University Hospital-Bellvitge Institute for Biomedical Research (IDIBELL), 08907 Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Institute for Biomedical Research (IDIBELL), 08908 Barcelona, Spain
| | - Ignacio Lucas
- Department of Psychiatry, Bellvitge University Hospital-Bellvitge Institute for Biomedical Research (IDIBELL), 08907 Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Institute for Biomedical Research (IDIBELL), 08908 Barcelona, Spain
| | - Sabela Casado
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Physiology, CIMUS, Instituto de Investigación Sanitaria, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Mónica Gómez-Peña
- Department of Psychiatry, Bellvitge University Hospital-Bellvitge Institute for Biomedical Research (IDIBELL), 08907 Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Institute for Biomedical Research (IDIBELL), 08908 Barcelona, Spain
| | - Laura Moragas
- Department of Psychiatry, Bellvitge University Hospital-Bellvitge Institute for Biomedical Research (IDIBELL), 08907 Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Institute for Biomedical Research (IDIBELL), 08908 Barcelona, Spain
| | - Amparo del Pino-Gutiérrez
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Institute for Biomedical Research (IDIBELL), 08908 Barcelona, Spain
- Department of Public Health, Mental Health and Perinatal Nursing, School of Nursing, University of Barcelona, 08907 Barcelona, Spain
| | - Ester Codina
- Department of Psychiatry, Bellvitge University Hospital-Bellvitge Institute for Biomedical Research (IDIBELL), 08907 Barcelona, Spain
| | - Eduardo Valenciano-Mendoza
- Department of Psychiatry, Bellvitge University Hospital-Bellvitge Institute for Biomedical Research (IDIBELL), 08907 Barcelona, Spain
| | - Marc N. Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA
- Child Study Center, Yale University School of Medicine, New Haven, CT 06510, USA
- Connecticut Mental Health Center, New Haven, CT 06519, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT 06106, USA
- Department of Neuroscience, Yale University, New Haven, CT 06520, USA
| | - Carlos Diéguez
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Physiology, CIMUS, Instituto de Investigación Sanitaria, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital-Bellvitge Institute for Biomedical Research (IDIBELL), 08907 Barcelona, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Institute for Biomedical Research (IDIBELL), 08908 Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, 08907 Barcelona, Spain
- Correspondence:
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14
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Muela I, Navas JF, Ventura-Lucena JM, Perales JC. How to pin a compulsive behavior down: A systematic review and conceptual synthesis of compulsivity-sensitive items in measures of behavioral addiction. Addict Behav 2022; 134:107410. [PMID: 35780595 DOI: 10.1016/j.addbeh.2022.107410] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 06/08/2022] [Accepted: 06/11/2022] [Indexed: 12/15/2022]
Abstract
Experimental models identify the transition from choice to compulsivity as the main mechanism underlying addiction. In behavioral addictions research, however, the adjective compulsive is used to describe virtually any kind of excessive or dysregulated behavior, which hinders the connection between experimental and clinical models. In this systematic review, we adopted a preliminary definition of compulsive behavior based on previous theoretical work. Subsequently, a systematic review following PRISMA guidelines was conducted (a) to identify the validated instruments, currently used in behavioral addictions research, that include items that are sensitive (intendedly or not) to compulsivity, and (b) to categorize those items into differentiable operationalizations of compulsivity. Six operationalizations of compulsivity emerged from item content analysis: 1. Automatic or habitual behavior occurring in absence of conscious instrumental goals; 2. Behavior insensitive to negative consequences despite conscious awareness of them; 3. Overwhelming urge or desire that impels the individual to initiate the activity and jeopardizes control attempts; 4. Bingeing, or inability to stop or interrupt the activity once initiated, resulting in an episode substantially longer or more intense than intended; 5. Attentional capture and cognitive hijacking; and 6. Inflexible rules, stereotyped behaviors, and rituals related to task completion or execution. Subsequently, a list of 15 representative items per operationalization was elaborated for independent assessment and identification of delimitation problems. A high degree of agreement was reached in assessing them as instantiating compulsivity, as well as in their assignment to the corresponding categories. However, many of them were also considered overinclusive, i.e., uncapable of distinguishing compulsivity from value-based momentary choice. To increase their discriminative value, items in future compulsivity scales should be refined to explicitly mention disconnection between behavior and declarative goals. Further research on factorial structure of a pool of items derived from these operational definitions is warranted. Such a factorial structure could be used as an intermediate link between specific behavioral items and explanatory psychobiological, learning, and cognitive mechanisms.
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Affiliation(s)
- Ismael Muela
- Department of Experimental Psychology, Mind, Brain and Behavior Research Center (CIMCYC), Universidad de Granada, Spain.
| | - Juan F Navas
- Department of Personality, Assessment, and Clinical Psychology, Universidad Complutense de Madrid, Spain
| | - José M Ventura-Lucena
- Department of Experimental Psychology, Mind, Brain and Behavior Research Center (CIMCYC), Universidad de Granada, Spain
| | - José C Perales
- Department of Experimental Psychology, Mind, Brain and Behavior Research Center (CIMCYC), Universidad de Granada, Spain
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15
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Crivelli D, Balena A, Losasso D, Balconi M. Screening Executive Functions in Substance-Use Disorder: First Evidence from Testing of the Battery for Executive Functions in Addiction (BFE-A). Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00928-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/10/2022] Open
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16
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MacLaren V, McDonald V, Hollett KB, Harris N. Gambling Associated Risk-taking Behaviors Correlate with Emotional Regulation and the Iowa Gambling Task but not Wisconsin Card Sorting. J Gambl Stud 2022; 39:829-841. [PMID: 36064998 DOI: 10.1007/s10899-022-10157-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/09/2022] [Accepted: 08/14/2022] [Indexed: 11/24/2022]
Abstract
It is not known why some novice gamblers eventually develop Gambling Disorder while most do not. This study tested predictions from two competing models of Gambling Disorder etiology: the Pathways Model of Problem and Pathological Gambling (Blaszczynski & Nower, 2002) and the Allostatic Model of addictions (Koob & Schulkin, 2019) applied to Gambling Disorder. Participants were drawn from introductory psychology courses and screened as non-gamblers (N = 91). They completed computerized versions of the Iowa Gambling Task (IGT-2), Wisconsin Sorting Task (WCST-64), and a Difficulties with Emotional Regulation Scale (DERS). Risk-taking tendencies were observed by having participants play a typical electronic slots game for up to 15 min. Higher betting on the slots game was correlated with the frequency of Deck A selections on the IGT-2 and lower total DERS scores. There were no significant correlations involving slots betting and the WCST-64. Greater risk-taking on the slots game was correlated with more frequent wins, partial losses that were disguised as wins, bonus game features, and the largest nominal amount won on a single spin. However, there were no significant correlations between betting behaviors and the 'payback percentage', defined as total winnings as a proportion of total wagers made throughout the session. Post-game ratings were positively correlated with frequency of reinforcing outcomes. These findings suggest that novice gamblers' likelihood of further gambling participation may be elevated by high sensitivity to immediate rewards and low difficulty self-regulating negative emotions. These findings are consistent with the Allostatic Model; they are not consistent with Pathways Model.
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Affiliation(s)
- Vance MacLaren
- Department of Psychology, Memorial University of Newfoundland, P.O. Box 4200, A1C-5S7, St. John's, NL, Canada.
| | - Valerie McDonald
- Department of Psychology, Memorial University of Newfoundland, P.O. Box 4200, A1C-5S7, St. John's, NL, Canada
| | - Kayla B Hollett
- Department of Psychology, Memorial University of Newfoundland, P.O. Box 4200, A1C-5S7, St. John's, NL, Canada
| | - Nick Harris
- Department of Psychology, Memorial University of Newfoundland, P.O. Box 4200, A1C-5S7, St. John's, NL, Canada
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17
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Hoven M, de Boer NS, Goudriaan AE, Denys D, Lebreton M, van Holst RJ, Luigjes J. Metacognition and the effect of incentive motivation in two compulsive disorders: Gambling disorder and obsessive-compulsive disorder. Psychiatry Clin Neurosci 2022; 76:437-449. [PMID: 35674699 PMCID: PMC9541950 DOI: 10.1111/pcn.13434] [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: 03/21/2022] [Revised: 05/30/2022] [Accepted: 06/01/2022] [Indexed: 12/12/2022]
Abstract
AIMS Compulsivity is a common phenotype among psychiatric disorders, such as obsessive-compulsive disorder (OCD) and gambling disorder (GD). Deficiencies in metacognition, such as the inability to estimate one's performance via confidence judgments could contribute to pathological decision-making. Earlier research has shown that patients with OCD exhibit underconfidence, while patients with GD exhibit overconfidence. Moreover, it is known that motivational states (e.g. monetary incentives) influence metacognition, with gain (respectively loss) prospects increasing (respectively decreasing) confidence. Here, we reasoned that OCD and GD symptoms might correspond to an exacerbation of this interaction between metacognition and motivation. METHODS We hypothesized GD's overconfidence to be exaggerated during gain prospects, while OCD's underconfidence to be worsened in loss context, which we expected to see represented in ventromedial prefrontal cortex (VMPFC) blood-oxygen-level-dependent activity. We tested those hypotheses in a task-based functional magnetic resonance imaging (fMRI) design (27 patients with GD, 28 patients with OCD, 55 controls). The trial is registered in the Dutch Trial Register (NL6171). RESULTS We showed increased confidence for patients with GD versus patients with OCD, which could partly be explained by sex and IQ. Although our primary analyses did not support the hypothesized interaction between incentives and groups, exploratory analyses did show increased confidence in patients with GD specifically in gain context. fMRI analyses confirmed a central role for VMPFC in the processing of confidence and incentives, but no differences between the groups. CONCLUSION Patients with OCD and those with GD reside at opposite ends of the confidence spectrum, while no interaction with incentives was found, nor group differences in neuronal processing of confidence.
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Affiliation(s)
- Monja Hoven
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Nina S de Boer
- Department of Philosophy, Radboud University, Nijmegen, The Netherlands
| | - Anna E Goudriaan
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Arkin and Jellinek, Mental Health Care, and Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands
| | - Damiaan Denys
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Maël Lebreton
- Paris School of Economics, Paris, France.,Swiss Center for Affective Science, University of Geneva, Geneva, Switzerland.,Laboratory for Behavioral Neurology and Imaging of Cognition, Department of Fundamental Neurosciences, University of Geneva, Geneva, Switzerland
| | - Ruth J van Holst
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Judy Luigjes
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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18
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Ferrari MA, Limbrick-Oldfield EH, Clark L. Behavioral analysis of habit formation in modern slot machine gambling. INTERNATIONAL GAMBLING STUDIES 2022. [DOI: 10.1080/14459795.2022.2088822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Mario A. Ferrari
- Centre for Gambling Research at UBC, Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Eve H. Limbrick-Oldfield
- Centre for Gambling Research at UBC, Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Luke Clark
- Centre for Gambling Research at UBC, Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
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19
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Bowden-Jones H, Hook RW, Grant JE, Ioannidis K, Corazza O, Fineberg NA, Singer BF, Roberts A, Bethlehem R, Dymond S, Romero-Garcia R, Robbins TW, Cortese S, Thomas SA, Sahakian BJ, Dowling NA, Chamberlain SR. Gambling disorder in the UK: key research priorities and the urgent need for independent research funding. Lancet Psychiatry 2022; 9:321-329. [PMID: 35180386 PMCID: PMC7612512 DOI: 10.1016/s2215-0366(21)00356-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 07/31/2021] [Accepted: 08/10/2021] [Indexed: 12/24/2022]
Abstract
Gambling in the modern era is pervasive owing to the variety of gambling opportunities available, including those that use technology (eg, online applications on smartphones). Although many people gamble recreationally without undue negative effects, a sizeable subset of individuals develop disordered gambling, which is associated with marked functional impairment including other mental health problems, relationship problems, bankruptcy, suicidality, and criminality. The National UK Research Network for Behavioural Addictions (NUK-BA) was established to promote understanding of, research into, and treatments for behavioural addictions including gambling disorder, which is the only formally recognised behavioural addiction. In this Health Policy paper, we outline the status of research and treatment for disordered gambling in the UK (including funding issues) and key research that should be conducted to establish the magnitude of the problem, vulnerability and resilience factors, the underlying neurobiology, long-term consequences, and treatment opportunities. In particular, we emphasise the need to: (1) conduct independent longitudinal research into the prevalence of disordered gambling (including gambling disorder and at-risk gambling), and gambling harms, including in vulnerable and minoritised groups; (2) select and refine the most suitable pragmatic measurement tools; (3) identify predictors (eg, vulnerability and resilience markers) of disordered gambling in people who gamble recreationally, including in vulnerable and minoritised groups; (4) conduct randomised controlled trials on psychological interventions and pharmacotherapy for gambling disorder; (5) improve understanding of the neurobiological basis of gambling disorder, including impulsivity and compulsivity, genetics, and biomarkers; and (6) develop clinical guidelines based on the best contemporary research evidence to guide effective clinical interventions. We also highlight the need to consider what can be learnt from approaches towards mitigating gambling-related harm in other countries.
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Affiliation(s)
- Henrietta Bowden-Jones
- National Problem Gambling Clinic & National Centre for Gaming Disorders, London, UK; Department of Psychiatry, University of Cambridge, Cambridge, UK; Faculty of Brain Sciences, University of Sussex, Brighton, UK
| | - Roxanne W Hook
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Jon E Grant
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, IL, USA
| | - Konstantinos Ioannidis
- Department of Psychiatry, University of Cambridge, Cambridge, UK; Department of International Health, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Ornella Corazza
- Department of Clinical, Pharmacological and Biological Sciences, University of Hertfordshire, Hatfield, UK
| | - Naomi A Fineberg
- Department of Psychiatry, University of Cambridge, Cambridge, UK; School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK; Hertforshire Partnership University NHS Foundation Trust, Welwyn Garden City, UK
| | - Bryan F Singer
- School of Psychology, University of Sussex, Brighton, UK; Sussex Addiction Research and Intervention Centre, University of Sussex, Brighton, UK; Sussex Neuroscience, University of Sussex, Brighton, UK
| | - Amanda Roberts
- School of Psychology, College of Social Science, University of Lincoln, Lincoln, UK
| | | | - Simon Dymond
- Department of Psychology, Swansea University, Swansea, UK; Department of Psychology, Reykjavík University, Reykjavík, Iceland
| | - Rafa Romero-Garcia
- Department of Psychiatry, University of Cambridge, Cambridge, UK; Departamento de Fisiología Médica y Biofísica, Instituto de Biomedicina de Sevilla, Universidad de Sevilla, Seville, Spain
| | - Trevor W Robbins
- Department of Psychology and Behavioural and Clinical Neuroscience Institute, University of Cambridge, UK
| | - Samuele Cortese
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK; Solent NHS Trust, Southampton, UK; Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York City, NY, USA; Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Shane A Thomas
- School of Health, Federation University, Ballarat, VIC Australia
| | | | - Nicki A Dowling
- School of Psychology, Deakin University, Geelong, VIC, Australia; Melbourne Graduate School of Education, University of Melbourne, VIC, Australia
| | - Samuel R Chamberlain
- Department of Psychiatry, Faculty of Medicine, University of Southampton, Southampton, UK; Southern Health NHS Foundation Trust, Southampton, UK.
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20
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Den Ouden L, Suo C, Albertella L, Greenwood LM, Lee RSC, Fontenelle LF, Parkes L, Tiego J, Chamberlain SR, Richardson K, Segrave R, Yücel M. Transdiagnostic phenotypes of compulsive behavior and associations with psychological, cognitive, and neurobiological affective processing. Transl Psychiatry 2022; 12:10. [PMID: 35013101 PMCID: PMC8748429 DOI: 10.1038/s41398-021-01773-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 12/02/2021] [Accepted: 12/16/2021] [Indexed: 01/10/2023] Open
Abstract
Compulsivity is a poorly understood transdiagnostic construct thought to underlie multiple disorders, including obsessive-compulsive disorder, addictions, and binge eating. Our current understanding of the causes of compulsive behavior remains primarily based on investigations into specific diagnostic categories or findings relying on one or two laboratory measures to explain complex phenotypic variance. This proof-of-concept study drew on a heterogeneous sample of community-based individuals (N = 45; 18-45 years; 25 female) exhibiting compulsive behavioral patterns in alcohol use, eating, cleaning, checking, or symmetry. Data-driven statistical modeling of multidimensional markers was utilized to identify homogeneous subtypes that were independent of traditional clinical phenomenology. Markers were based on well-defined measures of affective processing and included psychological assessment of compulsivity, behavioral avoidance, and stress, neurocognitive assessment of reward vs. punishment learning, and biological assessment of the cortisol awakening response. The neurobiological validity of the subtypes was assessed using functional magnetic resonance imaging. Statistical modeling identified three stable, distinct subtypes of compulsivity and affective processing, which we labeled "Compulsive Non-Avoidant", "Compulsive Reactive" and "Compulsive Stressed". They differed meaningfully on validation measures of mood, intolerance of uncertainty, and urgency. Most importantly, subtypes captured neurobiological variance on amygdala-based resting-state functional connectivity, suggesting they were valid representations of underlying neurobiology and highlighting the relevance of emotion-related brain networks in compulsive behavior. Although independent larger samples are needed to confirm the stability of subtypes, these data offer an integrated understanding of how different systems may interact in compulsive behavior and provide new considerations for guiding tailored intervention decisions.
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Affiliation(s)
- Lauren Den Ouden
- BrainPark, The Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia.
| | - Chao Suo
- BrainPark, The Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
| | - Lucy Albertella
- BrainPark, The Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
| | - Lisa-Marie Greenwood
- BrainPark, The Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
- Research School of Psychology, ANU College of Health and Medicine, The Australian National University, Canberra, Australia
| | - Rico S C Lee
- BrainPark, The Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
| | - Leonardo F Fontenelle
- BrainPark, The Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
- D'Or Institute for Research and Education and Anxiety, Obsessive, Compulsive Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Linden Parkes
- BrainPark, The Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
- Department of Bioengineering, School of Engineering & Applied Science, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Jeggan Tiego
- Neural Systems and Behaviour Lab, The Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
| | - Samuel R Chamberlain
- Department of Psychiatry, University of Southampton, Southampton, UK
- Southern Health NHS Foundation Trust, Southampton, UK
| | - Karyn Richardson
- BrainPark, The Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
| | - Rebecca Segrave
- BrainPark, The Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
| | - Murat Yücel
- BrainPark, The Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
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21
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Demetrovics Z, van den Brink W, Paksi B, Horváth Z, Maraz A. Relating Compulsivity and Impulsivity With Severity of Behavioral Addictions: A Dynamic Interpretation of Large-Scale Cross-Sectional Findings. Front Psychiatry 2022; 13:831992. [PMID: 35782446 PMCID: PMC9248365 DOI: 10.3389/fpsyt.2022.831992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 04/08/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND AIM Impulsivity and compulsivity are two key temperament traits involved in behavior regulation. The aim of this study was to test several existing theories in explaining the role of impulsivity and compulsivity in symptom severity in various behavioral addictions. METHODS Data were collected from a (representative) general population sample (N = 2,710, mean age:39.8 years (SD:13.6), 51% woman), and from people who are at increased risk of having a behavioral addiction (N = 9,528 in total, mean age: 28.11 (SD:8.3), 34.3% woman), including people with problematic gaming and internet use, pathological gambling, exercise dependence, compulsive buying and work addiction. Symptom severity, reward driven impulsivity and relief driven compulsivity were assessed. RESULTS For non-problematic groups, impulsivity is present to about the same extent as compulsivity, whereas for problematic groups, compulsivity dominates over impulsivity in all groups (except for gambling). The strength of the correlation between impulsivity and compulsivity is higher in more severe forms of the disorders (from r = 0.18 to r = 0.59 in the representative population). DISCUSSION Based on these data, it appears that relief-driven behavior (negative reinforcement) dominates over reward-driven behavior (positive reinforcement) in more severe cases of a behavioral addiction. CONCLUSION This is the first large-scale study to find empirical support for the neuroscientific theory on the dominance of compulsivity ("needing") over impulsivity ("wanting") in more severe cases of a behavioral addiction. Although longitudinal research is needed, a possible shift from impulsivity to compulsivity takes place, similar to substance use addictions, which maintains the circle of addiction.
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Affiliation(s)
- Zsolt Demetrovics
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar.,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Wim van den Brink
- Amsterdam Institute of Addiction Research (AIAR), Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Borbála Paksi
- Institute of Education, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Zsolt Horváth
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Aniko Maraz
- Institut Für Psychologie, Humboldt-Universität zu Berlin, Berlin, Germany
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22
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Balconi M, Losasso D, Balena A, Crivelli D. Neurocognitive impairment in addiction: A digital tool for executive function assessment. Front Psychiatry 2022; 13:955277. [PMID: 36276307 PMCID: PMC9579426 DOI: 10.3389/fpsyt.2022.955277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 09/12/2022] [Indexed: 12/04/2022] Open
Affiliation(s)
- Michela Balconi
- International Research Center for Cognitive Applied Neuroscience (IrcCAN), Catholic University of the Sacred Heart, Milan, Italy.,Research Unit in Affective and Social Neuroscience, Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Doriana Losasso
- SerD Canzio, Department of Mental Health and Dependence, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Alessandra Balena
- SerD Canzio, Department of Mental Health and Dependence, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Davide Crivelli
- International Research Center for Cognitive Applied Neuroscience (IrcCAN), Catholic University of the Sacred Heart, Milan, Italy.,Research Unit in Affective and Social Neuroscience, Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
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23
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Carr MM, Wiedemann AA, Macdonald-Gagnon G, Potenza MN. Impulsivity and compulsivity in binge eating disorder: A systematic review of behavioral studies. Prog Neuropsychopharmacol Biol Psychiatry 2021; 110:110318. [PMID: 33794320 PMCID: PMC8222068 DOI: 10.1016/j.pnpbp.2021.110318] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 01/15/2021] [Accepted: 03/25/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Binge eating disorder (BED) often includes impulsive and compulsive behaviors related to eating behavior and food. Impulsivity and compulsivity generally may contribute to the etiology and maintenance of multiple psychiatric disorders including BED. This review aimed to identify and synthesize available behavioral studies of impulsivity and compulsivity among individuals with BED. METHOD A systematic search was performed focusing on BED and specific facets of impulsivity (rapid response and choice) and compulsivity (set-shifting, cognitive flexibility, and/or habit learning). All case-control studies comparing adults with either full-threshold or subthreshold BED to individuals with normal weight, overweight/obesity, or other eating disorders (e.g., bulimia nervosa) were included. RESULTS Thirty-two studies representing 29 unique samples met inclusion criteria. Increased choice impulsivity was observed among individuals with BED relative to individuals with normal weight. There were mixed findings and/or a lack of available evidence regarding rapid response impulsivity and compulsivity. The presence of between-group differences was not dependent on sample characteristics (e.g., full or sub threshold BED diagnosis, or treatment-seeking status). Heterogeneity relating to covariates, task methodologies, and power limited conclusions. CONCLUSIONS Literature supports a postive association between choice impulsivity and BED. More research is needed to determine if individuals with BED demonstrate elevated levels of either rapid response impulsivity or types of compulsivity. Careful selection of covariates and consideration of task methodologies and power would aid future research.
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Affiliation(s)
- Meagan M Carr
- Department of Psychiatry, Yale School of Medicine, 300 George St., New Haven, CT 06511, United States of America
| | - Ashley A Wiedemann
- Department of Psychiatry, Yale School of Medicine, 300 George St., New Haven, CT 06511, United States of America
| | - Grace Macdonald-Gagnon
- Department of Psychiatry, Yale School of Medicine, 300 George St., New Haven, CT 06511, United States of America
| | - Marc N Potenza
- Department of Psychiatry, Yale School of Medicine, 300 George St., New Haven, CT 06511, United States of America; Connecticut Mental Health Center, 34 Park St., New Haven, CT 06511, United States of America; Connecticut Council on Problem Gambling, 100 Great Meadow Rd, Wethersfield, CT 06109, United States of America; Child Study Center, Yale School of Medicine, 230 S Frontage Rd., New Haven, CT 06519, United States of America; Department of Neuroscience, Yale University, One Church Street, New Haven, CT 06510, United States of America.
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24
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Legault MCB, Liu HZ, Balodis IM. Neuropsychological Constructs in Gaming Disorders: a Systematic Review. Curr Behav Neurosci Rep 2021. [DOI: 10.1007/s40473-021-00230-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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25
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Müller SM, Wegmann E, García Arias M, Bernabéu Brotóns E, Marchena Giráldez C, Brand M. Deficits in executive functions but not in decision making under risk in individuals with problematic social-network use. Compr Psychiatry 2021; 106:152228. [PMID: 33581450 DOI: 10.1016/j.comppsych.2021.152228] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 12/04/2020] [Accepted: 01/15/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The tendency to strive for immediate gratification by neglecting potential negative long-term outcomes characterizes addictive behaviors, such as substance use or gaming disorder. Problematic social-network use is currently discussed as another potential addictive behavior, which is considered to result from an imbalance between affective and cognitive processes, indicated by traits such as increased impulsivity and/or decreased executive functions and decision-making abilities. METHODS This study investigates the respective functions in social-network users by use of the Cards and Lottery Task (CLT) - a decision-making task under risk conditions in which options contain conflicting immediate and long-term outcomes at the same time. A sample of German and Spanish participants (N = 290) performed the CLT as well as the Modified Card Sorting Test (MCST), Barratt Impulsiveness Scale (BIS), the short Internet Addiction Test specified for social-networking (sIAT-SNS), and screeners on other potentially problematic behaviors. RESULTS Comparing extreme groups based on sIAT-SNS scores (1SD above/below mean), individuals with problematic social-network use (n = 56), as compared to those with non-problematic social-network use (n = 50), showed increased attentional impulsivity and reduced executive functions. No differences were observed in decision-making performance. CONCLUSION The findings indicate that problematic social-network use is related to attentional rather than general decision-making deficits. Furthermore, problematic social-network use is likely to co-occur with other problematic Internet-use behaviors, particularly gaming or shopping.
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Affiliation(s)
- Silke M Müller
- Department of General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
| | - Elisa Wegmann
- Department of General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany
| | - María García Arias
- Faculty of Education and Psychology, Universidad Francisco de Vitoria, Madrid, Spain
| | | | | | - Matthias Brand
- Department of General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany.
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26
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Haynos AF, Camchong J, Pearson CM, Lavender JM, Mueller BA, Peterson CB, Specker S, Raymond N, Lim KO. Resting State Hypoconnectivity of Reward Networks in Binge Eating Disorder. Cereb Cortex 2021; 31:2494-2504. [PMID: 33415334 DOI: 10.1093/cercor/bhaa369] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 11/10/2020] [Accepted: 11/11/2020] [Indexed: 12/21/2022] Open
Abstract
The clinical presentation of binge eating disorder (BED) and data emerging from task-based functional neuroimaging research suggests that this disorder may be associated with alterations in reward processing. However, there is a dearth of research investigating the functional organization of brain networks that mediate reward in BED. To address this gap, 27 adults with BED and 21 weight-matched healthy controls (WMC) completed a multimodel assessment consisting of a resting functional magnetic resonance imaging scan, behavioral tasks measuring reward-based decision-making (i.e., delay discounting and reversal learning), and self-report assessing clinical symptoms. A seed-based approach was employed to examine the resting state functional connectivity (rsFC) of the striatum (nucleus accumbens [NAcc] and ventral and dorsal caudate), a collection of regions implicated in reward processing. Compared with WMC, the BED group exhibited lower rsFC of striatal seeds, with frontal regions mediating executive functioning (e.g., superior frontal gyrus [SFG]) and posterior, parietal, and temporal regions implicated in emotional processing. Lower NAcc-SFG rsFC was associated with more difficulties with reversal learning and binge eating frequency in the BED group. Results suggest that hypoconnectivity of striatal networks that integrate self-regulation and reward processing may promote the clinical phenomenology of BED. Interventions for BED may benefit from targeting these circuit-based disturbances.
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Affiliation(s)
- Ann F Haynos
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, 55454 MN, USA
| | - Jazmin Camchong
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, 55454 MN, USA
| | - Carolyn M Pearson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, 55454 MN, USA
| | - Jason M Lavender
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, 20814 MD, USA.,Metis Foundation, San Antonio, 78205 TX, USA
| | - Bryon A Mueller
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, 55454 MN, USA
| | - Carol B Peterson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, 55454 MN, USA
| | - Sheila Specker
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, 55454 MN, USA
| | - Nancy Raymond
- Department of Psychiatry, University of Wisconsin, Madison, 53719 WI, USA
| | - Kelvin O Lim
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, 55454 MN, USA.,Minneapolis VA Health Care System, Minneapolis, 55417 MN, USA
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27
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Abstract
Abstract
Old age constitutes a vulnerable stage for developing gambling-related problems. The aims of the study were to identify patterns of gambling habits in elderly participants from the general population, and to assess socio-demographic and clinical variables related to the severity of the gambling behaviours. The sample included N = 361 participants aged in the 50–90 years range. A broad assessment included socio-demographic variables, gambling profile and psychopathological state. The percentage of participants who reported an absence of gambling activities was 35.5 per cent, while 46.0 per cent reported only non-strategic gambling, 2.2 per cent only strategic gambling and 16.3 per cent both non-strategic plus strategic gambling. Gambling form with highest prevalence was lotteries (60.4%), followed by pools (13.9%) and bingo (11.9%). The prevalence of gambling disorder was 1.4 per cent, and 8.0 per cent of participants were at a problematic gambling level. Onset of gambling activities was younger for men, and male participants also reached a higher mean for the bets per gambling-episode and the number of total gambling activities. Risk factors for gambling severity in the sample were not being born in Spain and a higher number of cumulative lifetime life events, and gambling severity was associated with a higher prevalence of tobacco and alcohol abuse and with worse psychopathological state. Results are particularly useful for the development of reliable screening tools and for the design of effective prevention programmes.
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28
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Wiehler A, Chakroun K, Peters J. Attenuated Directed Exploration during Reinforcement Learning in Gambling Disorder. J Neurosci 2021; 41:2512-2522. [PMID: 33531415 PMCID: PMC7984586 DOI: 10.1523/jneurosci.1607-20.2021] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 01/18/2021] [Accepted: 01/22/2021] [Indexed: 12/30/2022] Open
Abstract
Gambling disorder (GD) is a behavioral addiction associated with impairments in value-based decision-making and behavioral flexibility and might be linked to changes in the dopamine system. Maximizing long-term rewards requires a flexible trade-off between the exploitation of known options and the exploration of novel options for information gain. This exploration-exploitation trade-off is thought to depend on dopamine neurotransmission. We hypothesized that human gamblers would show a reduction in directed (uncertainty-based) exploration, accompanied by changes in brain activity in a fronto-parietal exploration-related network. Twenty-three frequent, non-treatment seeking gamblers and twenty-three healthy matched controls (all male) performed a four-armed bandit task during functional magnetic resonance imaging (fMRI). Computational modeling using hierarchical Bayesian parameter estimation revealed signatures of directed exploration, random exploration, and perseveration in both groups. Gamblers showed a reduction in directed exploration, whereas random exploration and perseveration were similar between groups. Neuroimaging revealed no evidence for group differences in neural representations of basic task variables (expected value, prediction errors). Our hypothesis of reduced frontal pole (FP) recruitment in gamblers was not supported. Exploratory analyses showed that during directed exploration, gamblers showed reduced parietal cortex and substantia-nigra/ventral-tegmental-area activity. Cross-validated classification analyses revealed that connectivity in an exploration-related network was predictive of group status, suggesting that connectivity patterns might be more predictive of problem gambling than univariate effects. Findings reveal specific reductions of strategic exploration in gamblers that might be linked to altered processing in a fronto-parietal network and/or changes in dopamine neurotransmission implicated in GD.SIGNIFICANCE STATEMENT Wiehler et al. (2021) report that gamblers rely less on the strategic exploration of unknown, but potentially better rewards during reward learning. This is reflected in a related network of brain activity. Parameters of this network can be used to predict the presence of problem gambling behavior in participants.
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Affiliation(s)
- A Wiehler
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany
- Université de Paris, Paris F-75006, France
- Department of Psychiatry, Service Hospitalo-Universitaire, Groupe Hospitalier Universitaire Paris Psychiatrie & Neurosciences, Paris F-75014, France
| | - K Chakroun
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany
| | - J Peters
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany
- Department of Psychology, Biological Psychology, University of Cologne, Cologne 50923, Germany
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Gender and gambling disorder: Differences in compulsivity-related neurocognitive domains. Addict Behav 2021; 113:106683. [PMID: 33038679 DOI: 10.1016/j.addbeh.2020.106683] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 09/23/2020] [Accepted: 09/25/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND AIMS It has been suggested that compulsivity has an essential role in gambling disorder (GD), yet there is a lack of literature exploring the link between GD, compulsivity and gender. Our main aim was to explore gender differences between two of the neurocognitive domains of compulsivity (attentional set-shifting and attentional bias and disengagement) in patients with GD and compare them with healthy controls (HCs). METHODS The sample included 57 treatment-seeking adults with GD and 60 HCs recruited from the general population. RESULTS The pairwise comparisons showed a worse attentional set-shifting performance in women with GD than in men (total trials (p = 0.042, |d| = 0.56), perseverative responses (p = 0.001, |d| = 0.89), trails to complete the first category (p = 0.001, |d| = 0.78) and categories completed (p = 0.001, |d| = 0.98. Also, men with GD presented higher difficulties than HC men in the two assessed compulsivity domains (attentional bias and disengagement and attentional set-shifting; Stroop interference (p = 0.015, |d| = 0.11), TMT-B (p = 0.041, |d| = 1.96) and lower scores for the WCST perseverative responses (p = 0.007, |d| = 0.78), whereas the differences observed in women with GD and HCs were most significantly in attentional set-shifting. CONCLUSIONS This study provides the first evidence of gender compulsivity differences in GD. The results are relevant for improving current treatments by targeting specific compulsivity domains that can lead to more successful treatment options.
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The effect of non-invasive brain stimulation on executive functioning in healthy controls: A systematic review and meta-analysis. Neurosci Biobehav Rev 2021; 125:122-147. [PMID: 33503477 DOI: 10.1016/j.neubiorev.2021.01.013] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 12/07/2020] [Accepted: 01/11/2021] [Indexed: 01/01/2023]
Abstract
In recent years, there has been a heightened interest in the effect of non-invasive brain stimulation on executive functioning. However, there is no comprehensive overview of its effects on different executive functioning domains in healthy individuals. Here, we assessed the state of the field by conducting a systematic review and meta-analysis on the effectiveness of non-invasive brain stimulation (i.e. repetitive transcranial magnetic stimulation and transcranial direct current stimulation) over prefrontal regions on tasks assessing working memory, inhibition, flexibility, planning and initiation performance. Our search yielded 63 studies (n = 1537), and the effectiveness of excitatory and inhibitory non-invasive brain stimulation were assessed per executive functioning task. Our analyses showed that excitatory non-invasive brain stimulation had a small but positive effect on Stop Signal Task and Go/No-Go Task performance, and that inhibitory stimulation had a small negative effect on Flanker Task performance. Non-invasive brain stimulation did not affect performance on working memory and flexibility tasks, and effects on planning tasks were inconclusive.
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31
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Perandrés-Gómez A, Navas JF, van Timmeren T, Perales JC. Decision-making (in)flexibility in gambling disorder. Addict Behav 2021; 112:106534. [PMID: 32890912 DOI: 10.1016/j.addbeh.2020.106534] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 06/26/2020] [Accepted: 06/29/2020] [Indexed: 01/26/2023]
Abstract
BACKGROUND Behavioral flexibility -the ability to dynamically readjust our behavior in response to reward contingency changes- is often investigated using probabilistic reversal learning tasks (PRLT). Poor PRLT performance has been proposed as a proxy for compulsivity, and theorized to be related to perseverative gambling. Previous attempts to measure inflexibility with the PRLT in patients with gambling disorder have, however, used a variety of indices that may conflate inflexibility with more general aspects of performance in the task. METHODS Trial-by-trial PRLT acquisition and reacquisition curves in 84 treatment-seeking patients with gambling disorder and 64 controls (non-gamblers and non-problem recreational gamblers) were analyzed to distinguish between (a) variability in acquisition learning, and (b) reacquisition learning in reversed contingency phases. Complementarily, stay/switch responses throughout the task were analyzed to identify (c) premature switching, and (d) sensitivity to accumulated negative feedback. RESULTS AND INTERPRETATION Even after controlling for differences in acquisition learning, patients were slower to readjust their behavior in reversed contingency phases, and were more prone to maintain their decisions despite accumulated negative feedback. Inflexibility in patients with gambling disorder is thus a robust phenomenon that could predate gambling escalation, or result from massive exposure to gambling activities.
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Affiliation(s)
- Ana Perandrés-Gómez
- Department of Experimental Psychology, Mind, Brain and Research Center (CIMCYC), Universidad de Granada, Spain
| | - Juan F Navas
- Department of Clinical Psychology, Universidad Complutense de Madrid, Spain; Universitat Oberta de Catalunya, Spain
| | - Tim van Timmeren
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, the Netherlands
| | - José C Perales
- Department of Experimental Psychology, Mind, Brain and Research Center (CIMCYC), Universidad de Granada, Spain.
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Hook RW, Grant JE, Ioannidis K, Tiego J, Yücel M, Wilkinson P, Chamberlain SR. Trans-diagnostic measurement of impulsivity and compulsivity: A review of self-report tools. Neurosci Biobehav Rev 2021; 120:455-469. [PMID: 33115636 PMCID: PMC7116678 DOI: 10.1016/j.neubiorev.2020.10.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 08/15/2020] [Accepted: 10/14/2020] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Impulsivity and compulsivity are important constructs, relevant to understanding behaviour in the general population, as well as in particular mental disorders (e.g. attention deficit hyperactivity disorder, obsessive-compulsive disorder). The current paper provides a narrative review of self-report impulsivity and compulsivity scales. METHODS A literature search was conducted using the following terms: ("impulsivity" OR "compulsivity") AND ("self-report" OR "questionnaire" OR "psychometric" OR "scale"). RESULTS 25 impulsive and 11 compulsive scales were identified, which varied considerably in psychometric properties, convenience, and validity. For impulsivity, the most commonly used scales were the BIS and the UPPS-P, whilst for compulsivity, the Padua Inventory was commonly used. The majority of compulsivity scales measured OCD symptoms (obsessions and compulsions) rather than being trans-diagnostic or specific to compulsivity (as opposed to obsessions). Scales capable of overcoming these limitations were highlighted. DISCUSSION This review provides clarity regarding relative advantages and disadvantages of different scales relevant to the measurement of impulsivity and compulsivity in many contexts. Areas for further research and refinement are highlighted.
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Affiliation(s)
- Roxanne W Hook
- Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB2 0SZ, United Kingdom.
| | - Jon E Grant
- Department of Psychiatry, University of Chicago, Pritzker School of Medicine, USA
| | - Konstantinos Ioannidis
- Cambridge and Peterborough NHS Foundation Trust and Department of Psychiatry, University of Cambridge, UK
| | - Jeggan Tiego
- Neural Systems and Behaviour Lab, Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Australia
| | - Murat Yücel
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Australia
| | - Paul Wilkinson
- Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB2 0SZ, United Kingdom; Cambridge and Peterborough NHS Foundation Trust and Department of Psychiatry, University of Cambridge, UK
| | - Samuel R Chamberlain
- Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB2 0SZ, United Kingdom; Cambridge and Peterborough NHS Foundation Trust and Department of Psychiatry, University of Cambridge, UK
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Mestre-Bach G, Steward T, Balodis IM, DeVito EE, Yip SW, George TP, Reynolds BA, Granero R, Fernandez-Aranda F, Jimenez-Murcia S, Potenza MN. Discrete Roles for Impulsivity and Compulsivity in Gambling Disorder. Front Psychiatry 2021; 12:789940. [PMID: 34950074 PMCID: PMC8689001 DOI: 10.3389/fpsyt.2021.789940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 11/15/2021] [Indexed: 11/25/2022] Open
Abstract
Background and Objective: Complex associations between gambling disorder (GD) and impulsivity have been identified. However, little is known regarding how compulsivity associates with different impulsivity domains in GD. In this study, we examined associations between self-reported and behavioral measures of impulsivity-assessed through the Barratt Impulsiveness Scale (BIS-11) and the Experiential Discounting Task (EDT), respectively- and compulsivity-measured using the Padua Inventory and the Wisconsin Card Sorting Test (WCST), respectively-, in an adult sample with GD (N = 132, 94 men and 38 women, ages ranging from 18 to 69 years). GD severity was assessed using the South Oaks Gambling Screen. Methods: Structural Equation Modeling was used to examine relationships between impulsivity and compulsivity measures, age, and GD severity. Results: BIS-11 non-planning and BIS-11 total scores positively correlated with GD severity. The standardized coefficients for the SEM showed direct positive contributions of BIS-11 non-planning, Padua and EDT scores to GD severity. Only participants' ages directly contributed to WCST perseverative errors, and no direct or indirect effects were found with respect to GD severity. Conclusion: The findings suggest that specific aspects of impulsivity and compulsivity contribute to GD severity. Interventions specifically targeting domains that are most relevant to GD severity may improve treatment outcomes.
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Affiliation(s)
- Gemma Mestre-Bach
- Health Sciences School, Universidad Internacional de La Rioja, La Rioja, Spain
| | - Trevor Steward
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Iris M Balodis
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Elise E DeVito
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Sarah W Yip
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States.,Yale Child Study Center, Yale University School of Medicine, New Haven, CT, United States
| | - Tony P George
- Addictions Division, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada.,Division of Brain and Therapeutics, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Brady A Reynolds
- Department of Behavioral Science, University of Kentucky, Lexington, KY, United States
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain.,Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Fernando Fernandez-Aranda
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain.,Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Susana Jimenez-Murcia
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain.,Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States.,Yale Child Study Center, Yale University School of Medicine, New Haven, CT, United States.,Department of Neuroscience, Yale University School of Medicine, New Haven, CT, United States.,The National Center on Addiction and Substance Abuse, Yale University School of Medicine, New Haven, CT, United States.,Connecticut Mental Health Center, New Haven, CT, United States
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Chamberlain SR, Solly JE, Hook RW, Vaghi MM, Robbins TW. Cognitive Inflexibility in OCD and Related Disorders. Curr Top Behav Neurosci 2021; 49:125-145. [PMID: 33547598 DOI: 10.1007/7854_2020_198] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Cognitive inflexibility is suggested by the hallmark symptoms of obsessive-compulsive disorder (OCD), namely the occurrence of repetitive thoughts and/or behaviours that persist despite being functionally impairing and egodystonic to the individual. As well as being implied by the top-level symptoms, cognitive inflexibility in OCD, and some related conditions, has also been objectively quantified in case-control studies using computerised cognitive tasks. This chapter begins by considering the objective measurement of different aspects of cognitive flexibility using neuropsychological paradigms, with a focus on neural and neurochemical substrates. It moves on to conduct a systematic review and meta-analysis of findings from a widely deployed flexibility task: the Intra-Dimensional/Extra-Dimensional Set-Shift Task (IDED). By pooling data from 11 studies (335 OCD patients and 311 controls), we show that Extra-Dimensional (ED) shift deficits are a robust and reproducible finding (effect size medium-large) in OCD across the literature, and that this deficit is not attributable to group differences in age or IQ. The OCD ED deficit is then discussed in terms of dysfunction of fronto-striatal pathways (as exemplified, for example, by functional connectivity data), and the putative role of different neurotransmitters. We consider evidence that impaired ED shifting constitutes a candidate vulnerability marker (or 'endophenotype') for OCD. The available literature is then surveyed as to ED findings in other obsessive-compulsive (OC) related disorders (e.g. hoarding, body-dysmorphic disorder, and trichotillomania), as well as in non-OC disorders (schizophrenia and anxiety symptoms in general). Lastly, we consider more recent, emerging developments in the quantification of compulsivity using cognitive tasks and questionnaires, as well as key directions for future research, including the need to refine compulsivity and its composite cognitive processes.
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Affiliation(s)
- Samuel R Chamberlain
- Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK. .,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK.
| | - Jeremy E Solly
- Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Roxanne W Hook
- Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Matilde M Vaghi
- Max Planck University College London (UCL) Centre for Computational Psychiatry and Ageing Research, London, UK
| | - Trevor W Robbins
- Department of Psychology, University of Cambridge, Cambridge, UK
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Jara-Rizzo MF, Navas JF, Rodas JA, Perales JC. Decision-making inflexibility in a reversal learning task is associated with severity of problem gambling symptoms but not with a diagnosis of substance use disorder. BMC Psychol 2020; 8:120. [PMID: 33168098 PMCID: PMC7654010 DOI: 10.1186/s40359-020-00482-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 10/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Decisions made by individuals with disordered gambling are markedly inflexible. However, whether anomalies in learning from feedback are gambling-specific, or extend beyond gambling contexts, remains an open question. More generally, addictive disorders-including gambling disorder-have been proposed to be facilitated by individual differences in feedback-driven decision-making inflexibility, which has been studied in the lab with the Probabilistic Reversal Learning Task (PRLT). In this task, participants are first asked to learn which of two choice options is more advantageous, on the basis of trial-by-trial feedback, but, once preferences are established, reward contingencies are reversed, so that the advantageous option becomes disadvantageous and vice versa. Inflexibility is revealed by a less effective reacquisition of preferences after reversal, which can be distinguished from more generalized learning deficits. METHODS In the present study, we compared PRLT performance across two groups of 25 treatment-seeking patients diagnosed with an addictive disorder and who reported gambling problems, and 25 matched controls [18 Males/7 Females in both groups, Mage(SDage) = 25.24 (8.42) and 24.96 (7.90), for patients and controls, respectively]. Beyond testing for differences in the shape of PRLT learning curves across groups, the specific effect of problematic gambling symptoms' severity was also assessed independently of group assignment. In order to surpass previous methodological problems, full acquisition and reacquisition curves were fitted using generalized mixed-effect models. RESULTS Results showed that (1) controls did not significantly differ from patients in global PRLT performance nor showed specific signs of decision-making inflexibility; and (2) regardless of whether group affiliation was controlled for or not, gambling severity was specifically associated with more inefficient learning in phases with reversed contingencies. CONCLUSION Decision-making inflexibility, as revealed by difficulty to reacquire decisional preferences based on feedback after contingency reversals, seems to be associated with gambling problems, but not necessarily with a substance-use disorder diagnosis. This result aligns with gambling disorder models in which domain-general compulsivity is linked to vulnerability to develop gambling-specific problems with exposure to gambling opportunities.
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Affiliation(s)
| | - Juan F Navas
- Department of Clinical Psychology, Complutense University of Madrid, Madrid, Spain
| | - Jose A Rodas
- Faculty of Psychology, University of Guayaquil, Guayaquil, Ecuador
- School of Psychology, University College Dublin, Dublin, Ireland
| | - José C Perales
- Department of Experimental Psychology; Mind, Brain and Behavior Research Centre (CIMCYC), University of Granada, Granada, Spain
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Jauregui P, Estevez A, Macía L, López-González H. Gambling motives: Association with addictive disorders and negative and positive mood in youth. Addict Behav 2020; 110:106482. [PMID: 32535485 DOI: 10.1016/j.addbeh.2020.106482] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 03/27/2020] [Accepted: 05/19/2020] [Indexed: 12/20/2022]
Abstract
Gambling disorder and other comorbid addictive disorders may have similar underlying affective and motivational patterns. This study aims at examining the association between gambling disorder, comorbid addictive disorders (i.e., alcohol, drugs, spending, and videogames), positive and affective mood, and gambling motives in a community sample. A sample of 1099 adolescents and young adults was recruited from educational centres, from which 569 (51.7%) scored as non-problem gamblers, 42 (3.8%) as at-risk gamblers, and 53 (4.8%) as problem gamblers. Results suggest that enhancement, social, and coping motives are greater among problem gamblers and at-risk gamblers as compared to non-problem gamblers. Problem gamblers scored higher in gambling and comorbid disorders than at-risk gamblers, and also higher in gambling motives and negative mood when compared to non-problem gamblers. Likewise, gambling severity was significantly associated to gambling motives, negative mood, and other addictive disorders. Finally, enhancement motives were predictive of gambling, alcohol, drugs, and spending while controlling for the effect of age, sex, and positive and negative mood. These results shed light into the nature of the relationship between gambling and other comorbid addictions and can be used to tailor prevention and treatment strategies.
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Affiliation(s)
| | | | - L Macía
- Universidad de Deusto, Spain
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37
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Kildahl N, Hansen S, Brevers D, Skewes J. Individual differences in learning during decision-making may predict specific harms associated with gambling. Addict Behav 2020; 110:106496. [PMID: 32563860 DOI: 10.1016/j.addbeh.2020.106496] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 04/30/2020] [Accepted: 06/01/2020] [Indexed: 01/06/2023]
Abstract
Problem gambling has been linked to impairments in decision-making under uncertainty. Problem gamblers are more likely to favor high-risk, high-reward, and short-term gains over more advantageous choice alternatives, and this preference has been linked to impaired learning about decision outcomes. In this paper we link specific learning processes in decision-making to specific harms related to problem gambling. We asked a group of 140 casual gamblers to 1) perform a canonical decision-making task (the Iowa Gambling Task) online, and 2) to complete a self-report survey (the GamTest) designed to measure self-perceived harm caused by their gambling. We used a reinforcement learning model to explain individual differences in the decision task, and related individuals' model parameters to the specific problem areas reported using the questionnaire. We found that people who learned more from gains than from losses on the task were more likely to report overall gambling problems, and problems specifically related to money. We also found that people whose learning was more driven by the frequency of rewards were more likely to report problems related to the amount of time spent gambling, as well as social problems. We discuss possible psychological and neural processes mediating learning and gambling related harms, and we discuss the relevance of our approach to the diagnosis of problem gambling and its consequences.
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Calluso C, Pettorruso M, Tosoni A, Carenti ML, Cannito L, Martinotti G, di Giannantonio M, Committeri G. Cognitive dynamics of intertemporal choice in gambling disorder. Addict Behav 2020; 109:106463. [PMID: 32454227 DOI: 10.1016/j.addbeh.2020.106463] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 03/10/2020] [Accepted: 04/30/2020] [Indexed: 12/18/2022]
Abstract
Gambling Disorder (GD) is a behavioral addiction characterized by the persistence of recurrent gambling behaviors despite serious adverse consequences. One of the key features of GD is a marked inability to delay gratification and an overall impairment of decision-making mechanisms. Indeed, in intertemporal choice (ITC) tasks, GD patients usually display a marked tendency to prefer smaller-sooner over larger-later rewards (temporal discounting, TD). However, ITC represents a highly verbal/explicit measure, and as such it might not be sensitive to implicit decision biases. Here we sought to uncover the implicit mechanisms underlying the ITC impairment in GD by employing the process-tracing method of mouse kinematics. To this aim, we collected and analyzed ITCs and kinematics measures from 24 GD patients and 23 matched healthy control participants (HC). In line with the relevant literature, the results showed that GD patients discounted future rewards more steeply compared to HCs. Additionally, the results of kinematics analyses showed that patients were characterized by a strong bias toward the immediate option, which was associated with straight-line trajectories. Conversely, the delayed option was selected with edge-curved trajectories, indicating a bias toward the immediate option which was revised in later stages of processing. Interestingly, kinematics indices were also found to be predictive of individual discounting preferences (i.e., discount rates) across the two groups. Taken together, these results suggest that kinematics indices, by revealing hidden and implicit patterns of attraction toward the unselected choice option, may represent reliable behavioral markers of TD in gambling disorder.
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Mestre-Bach G, Fernández-Aranda F, Jiménez-Murcia S, Potenza MN. WITHDRAWN: Emotional regulation in gambling disorder. Curr Opin Behav Sci 2020. [DOI: 10.1016/j.cobeha.2019.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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40
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Goghari VM, Shakeel MK, Swan JL, Kim HS, Sharif-Razi M, Hodgins DC. A Family Study of Trauma and Coping Strategies in Gambling Disorder. J Gambl Stud 2020; 36:767-782. [PMID: 32666373 DOI: 10.1007/s10899-020-09963-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Family studies can provide a wealth of information regarding risk factors in psychological disorders. No studies have compared the trauma experiences and coping strategies of problem gamblers with those of their first-degree relatives. Therefore, in this study, childhood trauma and coping strategies were investigated among participants with gambling disorder, their first-degree biological relatives, and community controls. Participants completed diagnostic interviews and symptom severity assessments. Participants also completed the Childhood Trauma Questionnaire (CTQ) which assesses history of abuse and neglect, and the Coping Inventory for Stressful Situations (CISS) which assesses task, emotion, and avoidance oriented coping strategies. Analysis of variance showed that there was a significant effect for group, but not gender, on the CTQ. Multivariate analysis of variance revealed a significant effect for group on coping style. Post-hoc tests showed that probands and relatives were less likely to use task-oriented coping compared to controls, but probands and relatives did not differ from each other on task-oriented coping. Mediation analysis showed that task-oriented coping did not mediate the relation between childhood trauma and gambling severity. By using a family study design, this study was able for the first time to delineate familial and disease-specific effects associated with childhood trauma and coping strategies in gambling disorder.
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Affiliation(s)
- Vina M Goghari
- Department of Psychology, University of Toronto Scarborough, 1265 Military Trail, Toronto, ON, M1C 1A4, Canada. .,Department of Psychiatry, University of Toronto Scarborough, 1265 Military Trail, Toronto, ON, M1C 1A4, Canada.
| | - Mohammed K Shakeel
- Department of Psychiatry, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - Jennifer L Swan
- Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - Hyoun S Kim
- Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - Maryam Sharif-Razi
- Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - David C Hodgins
- Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
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Grant JE, Chamberlain SR. Autistic traits in young adults who gamble. CNS Spectr 2020; 21:1-6. [PMID: 32641183 PMCID: PMC7612193 DOI: 10.1017/s1092852920001571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND. Little is known about the relationship between autistic traits and addictive behaviors such as problem gambling. Thus, the present study examined clinical characteristics and multiple facets of cognition in young adults who gamble and have autistic traits. METHODS. A total of 102 young adults who gamble were recruited from two Mid-Western university communities in the United States using media advertisements. Autistic traits were examined using the brief Autism-Spectrum Quotient (AQ-10). Clinician rating scales, questionnaires, and cognitive tests were completed. Relationships between AQ10 scores and demographic, gambling symptom, and neurocognitive measures were evaluated. RESULTS. Autistic traits were correlated with disordered gambling symptoms, attention-deficit/hyperactivity disorder (ADHD) symptoms, trait impulsivity, and some types of obsessive-compulsive symptoms. In regression, ADHD no longer significantly related to autistic traits once disordered gambling symptoms were accounted for; whereas the link between autistic traits and disordered gambling symptoms was robust even controlling for ADHD. CONCLUSIONS. These data suggest a particularly strong relationship between autistic traits and problem gambling symptoms, as well as certain aspects of impulsivity and compulsivity. The link between ADHD and autistic traits in some prior studies may have been attributable to disordered gambling symptoms, which was likely not screened for, and since individuals may endorse ADHD instruments due to other impulsive/compulsive symptom types (eg, gambling). The contribution of autistic traits to the emergence and chronicity of disordered gambling now requires further scrutiny, not only in community samples (such as this) but also in clinical settings.
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Affiliation(s)
- Jon E Grant
- Department of Psychiatry & Behavioral Neuroscience, Pritzker School of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Samuel R Chamberlain
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
- Cambridge and Peterborough NHS Foundation Trust, Cambridge, United Kingdom
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Grant JE, Chamberlain SR. Family history of substance use disorders: Significance for mental health in young adults who gamble. J Behav Addict 2020; 9:289-297. [PMID: 32516117 PMCID: PMC7115917 DOI: 10.1556/2006.2020.00017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 04/18/2020] [Accepted: 04/22/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Although family history of psychiatric disorders has often been considered potentially useful in understanding clinical presentations in patients, it is less clear what a positive family history means for people who gamble in the general community. We sought to understand the clinical and cognitive impact of having a first-degree relative with a substance use disorder (SUD) in a sample of non-treatment seeking young adults. METHODS 576 participants (aged 18-29 years) who gambled at least five times in the preceding year undertook clinical and neurocognitive evaluations. Those with a first-degree relative with a SUD were compared to those without on a number of demographic, clinical and cognitive measures. We used Partial Least Squares (PLS) regression to identify which variables (if any) were significantly associated with family history of SUDs, controlling for the influence of other variables on each other. RESULTS 180 (31.3%) participants had a first-degree family member with a SUD. In terms of clinical variables, family history of SUD was significantly associated with higher rates of substance use (alcohol, nicotine), higher rates of problem gambling, and higher occurrence of mental health disorders. Family history of SUD was also associated with more set-shifting problems (plus higher rates of obsessive-compulsive tendencies), lower quality of decision-making, and more spatial working memory errors. CONCLUSIONS These results indicate that gamblers with a first-degree family member with a SUD may have a unique clinical and cognition presentation. Understanding these differences may be relevant to developing more individualized treatment approaches for disordered gambling. Compulsivity may be important as a proxy of vulnerability towards addiction.
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Affiliation(s)
- Jon E. Grant
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, IL, USA,Corresponding author. Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Pritzker School of Medicine, 5841 S. Maryland Avenue, MC-3077, Chicago, IL, 60637, USA. Tel.: +1 773 834 1325; fax: +1 773 834 6761 E-mail:
| | - Samuel R. Chamberlain
- Department of Psychiatry, University of Cambridge, Cambridge, UK,Cambridge and Peterborough NHS Foundation Trust (CPFT), Cambridge, UK
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Stehmann J. Identifying research streams in online gambling and gaming literature: A bibliometric analysis. COMPUTERS IN HUMAN BEHAVIOR 2020. [DOI: 10.1016/j.chb.2019.106219] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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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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Balodis IM, Potenza MN. Common neurobiological and psychological underpinnings of gambling and substance-use disorders. Prog Neuropsychopharmacol Biol Psychiatry 2020; 99:109847. [PMID: 31862419 DOI: 10.1016/j.pnpbp.2019.109847] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 12/11/2019] [Accepted: 12/16/2019] [Indexed: 12/20/2022]
Abstract
Both psychological and neurobiological studies in gambling disorder have increased in the past 10-15 years. This review examines the current state of the literature, with a focus on recent magnetic resonance imaging (MRI) studies in gambling disorder. The review compares and contrasts findings across gambling and substance-use disorders. Additionally, features with arguably particular relevance to gambling disorder (e.g., "near-miss" processing) are described, as well as their relationship to choice behaviors. More broadly, the review informs on how these studies advance our understanding of brain-behavior relationships relating to decision-making and key features of addictive disorders.
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Affiliation(s)
- Iris M Balodis
- Peter Boris Centre for Addictions Research, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
| | - Marc N Potenza
- Departments of Psychiatry, Neuroscience and Child Study, Yale University School of Medicine, New Haven, CT, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA; Connecticut Mental Health Center, New Haven, CT, USA
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Interactions of impulsivity, general executive functions, and specific inhibitory control explain symptoms of social-networks-use disorder: An experimental study. Sci Rep 2020; 10:3866. [PMID: 32123268 PMCID: PMC7052241 DOI: 10.1038/s41598-020-60819-4] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 02/13/2020] [Indexed: 01/23/2023] Open
Abstract
While the use of social media and online-communication applications has become an integral part of everyday life, some individuals suffer from an excessive, uncontrolled use of social media despite experiencing negative consequences. In accordance with neuropsychological models of addiction, we assume the tendency of a social-networks-use disorder to be related to an interplay of predisposing personality traits (e.g., impulsivity), and reductions in cognitive functions (e.g., executive functions, inhibitory control). The current study makes first strides towards examining this interplay. In addition to a newly developed social-networks-specific auditory Go-NoGo paradigm, other neuropsychological paradigms were used. Impulsivity and social-networks-use-disorder symptoms were assessed by standardized questionnaires. The results show that the symptom severity of a social-networks-use disorder is mainly associated with attentional impulsivity. General executive functions and specific inhibitory control of social-networks-related cues have no direct effect on symptom severity. However, moderated regression analyses emphasize that increased symptom severity is associated with higher attentional impulsivity, especially if there are additionally reductions in executive functions or specific inhibitory control. The results complement previous findings and inform future research on social-networks-use disorder. The findings support the applicability of theoretical models of addictive behaviors to the social-networks-use disorder and point to social-networks-related specificities regarding attention-related facets.
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Nweze T, Agu E, Lange F. Risky decision making and cognitive flexibility among online sports bettors in Nigeria. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2020; 55:995-1002. [PMID: 32017062 PMCID: PMC7754305 DOI: 10.1002/ijop.12663] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 01/19/2020] [Indexed: 01/07/2023]
Abstract
Online sports betting is a popular recreational activity in Nigeria. Like other forms of gambling, risk of pathological progression exists for gamblers who continue betting despite severe financial and psychosocial consequences. In the present study, we examined whether this population of gamblers shows deficits in decision making and cognitive flexibility that have been documented in Western gambling populations. Thirty‐six online sports bettors and 42 non‐gambling participants completed a version of the Iowa gambling task (IGT) and an established set‐shifting task for the assessment of cognitive flexibility. The two groups did not differ significantly in the selection of disadvantageous decks on the IGT. In contrast, sports bettors committed significantly more errors on the set‐shifting task than non‐gambling control participants. As this performance deficit was not specific to trials requiring a set shift, it most likely resulted from gambling‐related changes in general cognitive or motivational abilities that are required to successfully complete challenging mental tasks. While our results illustrate that findings from Western populations cannot automatically be generalised to other contexts, it should be noted that we focused on only one particular type of gambling and included mostly participants with mild gambling‐related problems.
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Affiliation(s)
- Tochukwu Nweze
- Department of Psychology, University of Nigeria, Nsukka, Nigeria.,MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
| | - Ethelbert Agu
- Department of Psychology, University of Nigeria, Nsukka, Nigeria
| | - Florian Lange
- Behavioral Engineering Group, KU Leuven, Leuven, Belgium
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Balodis IM. Neuropsychology in GD: old and new directions. Curr Opin Behav Sci 2020. [DOI: 10.1016/j.cobeha.2019.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Mestre-Bach G, Fernández-Aranda F, Jiménez-Murcia S, Potenza MN. Emotional regulation in gambling disorder. Curr Opin Behav Sci 2020. [DOI: 10.1016/j.cobeha.2020.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Zhang K, Clark L. Loss-chasing in gambling behaviour: neurocognitive and behavioural economic perspectives. Curr Opin Behav Sci 2020. [DOI: 10.1016/j.cobeha.2019.10.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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