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Giannone F, Ebrahimi C, Endrass T, Hansson AC, Schlagenhauf F, Sommer WH. Bad habits-good goals? Meta-analysis and translation of the habit construct to alcoholism. Transl Psychiatry 2024; 14:298. [PMID: 39030169 PMCID: PMC11271507 DOI: 10.1038/s41398-024-02965-1] [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] [Received: 10/08/2023] [Revised: 05/19/2024] [Accepted: 05/24/2024] [Indexed: 07/21/2024] Open
Abstract
Excessive alcohol consumption remains a global public health crisis, with millions suffering from alcohol use disorder (AUD, or simply "alcoholism"), leading to significantly reduced life expectancy. This review examines the interplay between habitual and goal-directed behaviors and the associated neurobiological changes induced by chronic alcohol exposure. Contrary to a strict habit-goal dichotomy, our meta-analysis of the published animal experiments combined with a review of human studies reveals a nuanced transition between these behavioral control systems, emphasizing the need for refined terminology to capture the probabilistic nature of decision biases in individuals with a history of chronic alcohol exposure. Furthermore, we distinguish habitual responding from compulsivity, viewing them as separate entities with diverse roles throughout the stages of the addiction cycle. By addressing species-specific differences and translational challenges in habit research, we provide insights to enhance future investigations and inform strategies for combatting AUD.
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Affiliation(s)
- F Giannone
- Institute of Psychopharmacology, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159, Mannheim, Germany
| | - C Ebrahimi
- Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, 01062, Dresden, Germany
| | - T Endrass
- Faculty of Psychology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, 01062, Dresden, Germany
| | - A C Hansson
- Institute of Psychopharmacology, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159, Mannheim, Germany
| | - F Schlagenhauf
- Department of Psychotherapy, Campus Charité Mitte, Charité Universitätsmedizin Berlin & St. Hedwig Hospital, 10117, Berlin, Germany
| | - W H Sommer
- Institute of Psychopharmacology, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159, Mannheim, Germany.
- Bethania Hospital for Psychiatry, Psychosomatics and Psychotherapy, Greifswald, Germany.
- German Center for Mental Health (DZPG), Partner Site Mannheim-Heidelberg-Ulm, 68159, Mannheim, Germany.
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2
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Banca P, Herrojo Ruiz M, Gonzalez-Zalba MF, Biria M, Marzuki AA, Piercy T, Sule A, Fineberg NA, Robbins TW. Action sequence learning, habits, and automaticity in obsessive-compulsive disorder. eLife 2024; 12:RP87346. [PMID: 38722306 PMCID: PMC11081634 DOI: 10.7554/elife.87346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024] Open
Abstract
This study investigates the goal/habit imbalance theory of compulsion in obsessive-compulsive disorder (OCD), which postulates enhanced habit formation, increased automaticity, and impaired goal/habit arbitration. It directly tests these hypotheses using newly developed behavioral tasks. First, OCD patients and healthy participants were trained daily for a month using a smartphone app to perform chunked action sequences. Despite similar procedural learning and attainment of habitual performance (measured by an objective automaticity criterion) by both groups, OCD patients self-reported higher subjective habitual tendencies via a recently developed questionnaire. Subsequently, in a re-evaluation task assessing choices between established automatic and novel goal-directed actions, both groups were sensitive to re-evaluation based on monetary feedback. However, OCD patients, especially those with higher compulsive symptoms and habitual tendencies, showed a clear preference for trained/habitual sequences when choices were based on physical effort, possibly due to their higher attributed intrinsic value. These patients also used the habit-training app more extensively and reported symptom relief post-study. The tendency to attribute higher intrinsic value to familiar actions may be a potential mechanism leading to compulsions and an important addition to the goal/habit imbalance hypothesis in OCD. We also highlight the potential of smartphone app training as a habit reversal therapeutic tool.
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Affiliation(s)
- Paula Banca
- Department of Psychology, University of CambridgeCambridgeUnited Kingdom
- Behavioural and Clinical Neuroscience Institute, University of CambridgeCambridgeUnited Kingdom
| | - Maria Herrojo Ruiz
- Department of Psychology, Goldsmiths University of LondonLondonUnited Kingdom
| | | | - Marjan Biria
- Department of Psychology, University of CambridgeCambridgeUnited Kingdom
- Behavioural and Clinical Neuroscience Institute, University of CambridgeCambridgeUnited Kingdom
| | - Aleya A Marzuki
- Department of Psychology, University of CambridgeCambridgeUnited Kingdom
- Behavioural and Clinical Neuroscience Institute, University of CambridgeCambridgeUnited Kingdom
| | - Thomas Piercy
- Department of Psychiatry, School of Clinical Medicine, University of CambridgeCambridgeUnited Kingdom
| | - Akeem Sule
- Department of Psychiatry, School of Clinical Medicine, University of CambridgeCambridgeUnited Kingdom
| | - Naomi A Fineberg
- Hertfordshire Partnership University NHS Foundation TrustWelwyn Garden CityUnited Kingdom
- University of HertfordshireHatfieldUnited Kingdom
| | - Trevor W Robbins
- Department of Psychology, University of CambridgeCambridgeUnited Kingdom
- Behavioural and Clinical Neuroscience Institute, University of CambridgeCambridgeUnited Kingdom
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3
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Sandri E, Pardo J, Cantín Larumbe E, Cerdá Olmedo G, Falcó A. Analysis of the influence of educational level on the nutritional status and lifestyle habits of the young Spanish population. Front Public Health 2024; 12:1341420. [PMID: 38651128 PMCID: PMC11033505 DOI: 10.3389/fpubh.2024.1341420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 03/19/2024] [Indexed: 04/25/2024] Open
Abstract
Aim This study aims to analyze some nutrition and health habits of young people and the impact of educational attainment on health. Methods An observational, descriptive, and cross-sectional study was carried out using surveys. Using non-probabilistic snowball sampling, a previously validated questionnaire was disseminated through networks, collecting a sample of 9,681 people between 18 and 30 years old. Comparative analyses between groups were obtained by clustering and the corresponding statistical tests. Results The results showed how young people with higher education generally have a lower BMI, a higher healthy nutrition index, less frequent consumption of sugary drinks, and less smoking than their peers with basic education. These healthier habits are reflected in the higher self-perceived health status of the higher-educated group. While for all the educational levels analyzed, the minutes of physical activity practice are above the 150 min recommended by the WHO. Conclusion Our findings suggest that young people's education level is of fundamental importance for health, particularly for nutritional habits. In general, the lifestyle habits of the young Spanish population are healthy, but there is a need for improvement in those aspects related to nutrition and food.
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Affiliation(s)
- Elena Sandri
- Faculty of Medicine and Health Sciences, Catholic University of Valencia San Vicente Mártir, Valencia, Spain
- Doctoral School, Catholic University of Valencia San Vicente Mártir, Valencia, Spain
| | - Juan Pardo
- Embedded Systems and Artificial Intelligence Group, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Eva Cantín Larumbe
- Degree in Data Science, Polytechnical University of Valencia, Valencia, Spain
| | - Germán Cerdá Olmedo
- Faculty of Medicine and Health Sciences, Catholic University of Valencia San Vicente Mártir, Valencia, Spain
| | - Antonio Falcó
- Department of Mathematics, Physics and Technological Sciences, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
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4
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Zhou X, Meng Y, Li J, Shen X. Childhood adversity and mind wandering: the mediating role of cognitive flexibility and habitual tendencies. Eur J Psychotraumatol 2024; 15:2301844. [PMID: 38197454 PMCID: PMC10783837 DOI: 10.1080/20008066.2024.2301844] [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: 06/20/2023] [Accepted: 12/24/2023] [Indexed: 01/11/2024] Open
Abstract
ABSTRACTBackground: Initial evidence proposes that exposure to childhood adversity may induce avoidance or withdrawal behaviour. However, it remains unclear whether childhood adversity results in avoidance from externally directed thinking to both deliberate and spontaneous mind wandering, i.e. intentionally or unintentionally diverting attention from ongoing task to task-independent thoughts.Objective: To assess the associations between childhood adversity, and mind wandering, and to evaluate the mediating roles of cognitive flexibility, and habit tendencies.Methods: A total of 601 Chinese subjects (378 females, Mage = 19.37) participated in the current study. The participants completed a series of questionnaires including demographics, childhood maltreatment, cognitive flexibility, habitual tendencies, and mind wandering.Results: Hierarchical regression analyses showed childhood adversity, the control facet of cognitive flexibility, and the automaticity facet of habitual tendencies had significant contributions to deliberate mind wandering (β = 0.10, β = -0.40, and β = 0.06) and spontaneous mind wandering (β = 0.09, β = -0.28, and β = 0.07). Serial mediation analyses revealed that the control and automaticity partially mediated associations between childhood adversity and mind wandering (deliberate mind wandering: 95% CIs = [0.037 0.078], and spontaneous mind wandering: 95% CIs = [0.023, 0.062]).Conclusions: The findings underscore the pivotal role of mediators in delineating the relationship between childhood adversity and mind wandering in everyday life. Interventions geared toward augmenting the control component of cognitive flexibility and regulating the automatic component of habitual tendencies show the potential to ameliorate the propensity of individuals affected by childhood adversity to disengage cognitively from the present moment.
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Affiliation(s)
- Xinqi Zhou
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, People’s Republic of China
| | - Yayun Meng
- School of Psychology, Central China Normal University, Wuhan, People’s Republic of China
| | - Jiarui Li
- Sichuan Southwest Vocational College of Civil Aviation, Chengdu, People’s Republic of China
| | - Xi Shen
- Center for Mental Health Education, Faculty of Psychology, Southwest University, Chongqing, People’s Republic of China
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5
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Boog M, Tibboel H. Automaticity: schema modes in addiction. Front Psychiatry 2023; 14:1158067. [PMID: 37920537 PMCID: PMC10618344 DOI: 10.3389/fpsyt.2023.1158067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 10/03/2023] [Indexed: 11/04/2023] Open
Abstract
Automaticity is a hallmark of substance use disorder. In Schema Therapy (an evidence-based form of psychotherapy, that has also been applied to substance use disorders), automaticity appears to be a relevant variable. However, the role of automaticity in Schema Therapy has never been made explicit. In the present article, we investigate the role of automaticity in schema modes and its role in different phases in Schema Therapy for substance use disorders. In performing this investigation, we facilitate a better understanding of the working mechanisms of Schema Therapy, and, vice versa, suggest an alternative understanding of automaticity in substance use disorders. We suggest that the automatic use of substances is way of coping with schemas and, therefore, is the consequence of schema mode activity. In the article, four characteristics of automaticity (unconscious, uncontrollable/uncontrolled, efficient, fast) are translated to schema modes. Subsequently, a Schema Therapy case of a patient suffering from an alcohol use disorder and a narcissistic personality disorder is discussed, focusing on the four facets of automaticity. Last, implications for theory, clinical practice and future research are discussed.
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Affiliation(s)
- Michiel Boog
- Department of Addiction and Personality, Antes Mental Health Care, Rotterdam, Netherlands
- Erasmus School of Social and Behavioural Sciences – Clinical Psychology, Rotterdam, Netherlands
| | - Helen Tibboel
- Erasmus School of Social and Behavioural Sciences – Clinical Psychology, Rotterdam, Netherlands
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6
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Velazquez-Sanchez C, Muresan L, Marti-Prats L, Belin D. The development of compulsive coping behaviour is associated with a downregulation of Arc in a Locus Coeruleus neuronal ensemble. Neuropsychopharmacology 2023; 48:653-663. [PMID: 36635597 PMCID: PMC9938202 DOI: 10.1038/s41386-022-01522-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 01/14/2023]
Abstract
Some compulsive disorders have been considered to stem from the loss of control over coping strategies, such as displacement. However, the cellular mechanisms involved in the acquisition of coping behaviours and their subsequent compulsive manifestation in vulnerable individuals have not been elucidated. Considering the role of the locus coeruleus (LC) noradrenaline-dependent system in stress and related excessive behaviours, we hypothesised that neuroplastic changes in the LC may be associated with the acquisition of an adjunctive polydipsic water drinking, a prototypical displacement behaviour, and the ensuing development of compulsion in vulnerable individuals. Thus, male Sprague Dawley rats were characterised for their tendency, or not, to develop compulsive polydipsic drinking in a schedule-induced polydipsia (SIP) procedure before their fresh brains were harvested. A new quantification tool for RNAscope assays revealed that the development of compulsive adjunctive behaviour was associated with a low mRNA copy number of the plasticity marker Arc in the LC which appeared to be driven by specific adaptations in an ensemble of tyrosine hydroxylase (TH)+, zif268- neurons. This ensemble was specifically engaged by the expression of compulsive adjunctive behaviour, not by stress, because its functional recruitment was not observed in individuals that no longer had access to the water bottle before sacrifice, while it consistently correlated with the levels of polydipsic water drinking only when it had become compulsive. Together these findings suggest that downregulation of Arc mRNA levels in a population of a TH+/zif268- LC neurons represents a signature of the tendency to develop compulsive coping behaviours.
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Affiliation(s)
- Clara Velazquez-Sanchez
- CLIC (Cambridge Laboratory for research on Impulsive/Compulsive disorders), Department of Psychology, University of Cambridge, Downing Street, Cambridge, CB2 3EB, UK
| | - Leila Muresan
- Cambridge Advanced Imaging Centre, Department of Physiology Development and Neuroscience of the University of Cambridge, Downing Street, Cambridge, CB2 3DY, UK
| | - Lucia Marti-Prats
- CLIC (Cambridge Laboratory for research on Impulsive/Compulsive disorders), Department of Psychology, University of Cambridge, Downing Street, Cambridge, CB2 3EB, UK
| | - David Belin
- CLIC (Cambridge Laboratory for research on Impulsive/Compulsive disorders), Department of Psychology, University of Cambridge, Downing Street, Cambridge, CB2 3EB, UK.
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7
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Yatan G, Lim LW, Aquili L. Routine behaviour, a putative dopamine marker, predicts cognitive flexibility by tDCS of the dlPFC. Brain Stimul 2023; 16:108-110. [PMID: 36731769 DOI: 10.1016/j.brs.2023.01.1676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 01/26/2023] [Accepted: 01/27/2023] [Indexed: 02/03/2023] Open
Affiliation(s)
- Gibson Yatan
- College of Science, Health, Engineering and Education, Discipline of Psychology, Murdoch University, Perth, Australia
| | - Lee Wei Lim
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, SAR, China
| | - Luca Aquili
- College of Science, Health, Engineering and Education, Discipline of Psychology, Murdoch University, Perth, Australia; School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, SAR, China.
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8
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Olsen JR, Nicholls N, Caryl F, Mendoza JO, Panis LI, Dons E, Laeremans M, Standaert A, Lee D, Avila-Palencia I, de Nazelle A, Nieuwenhuijsen M, Mitchell R. Day-to-day intrapersonal variability in mobility patterns and association with perceived stress: A cross-sectional study using GPS from 122 individuals in three European cities. SSM Popul Health 2022; 19:101172. [PMID: 35865800 PMCID: PMC9294330 DOI: 10.1016/j.ssmph.2022.101172] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/08/2022] [Accepted: 07/11/2022] [Indexed: 02/09/2023] Open
Abstract
Many aspects of our life are related to our mobility patterns and individuals can exhibit strong tendencies towards routine in their daily lives. Intrapersonal day-to-day variability in mobility patterns has been associated with mental health outcomes. The study aims were: (a) calculate intrapersonal day-to-day variability in mobility metrics for three cities; (b) explore interpersonal variability in mobility metrics by sex, season and city, and (c) describe intrapersonal variability in mobility and their association with perceived stress. Data came from the Physical Activity through Sustainable Transport Approaches (PASTA) project, 122 eligible adults wore location measurement devices over 7-consecutive days, on three occasions during 2015 (Antwerp: 41, Barcelona: 41, London: 40). Participants completed the Short Form Perceived Stress Scale (PSS-4). Day-to-day variability in mobility was explored via six mobility metrics using distance of GPS point from home (meters:m), distance travelled between consecutive GPS points (m) and energy expenditure (metabolic equivalents:METs) of each GPS point collected (n = 3,372,919). A Kruskal-Wallis H test determined whether the median daily mobility metrics differed by city, sex and season. Variance in correlation quantified day-to-day intrapersonal variability in mobility. Levene's tests or Kruskal-Wallis tests were applied to assess intrapersonal variability in mobility and perceived stress. There were differences in daily distance travelled, maximum distance from home and METS between individuals by sex, season and, for proportion of time at home also, by city. Intrapersonal variability across all mobility metrics were highly correlated; individuals had daily routines and largely stuck to them. We did not observe any association between stress and mobility. Individuals are habitual in their daily mobility patterns. This is useful for estimating environmental exposures and in fuelling simulation studies.
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Affiliation(s)
- Jonathan R Olsen
- MRC/CSO Social and Public Health Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Natalie Nicholls
- MRC/CSO Social and Public Health Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Fiona Caryl
- MRC/CSO Social and Public Health Sciences, University of Glasgow, Glasgow, United Kingdom
| | | | - Luc Int Panis
- Hasselt University, Centre for Environmental Sciences (CMK), Hasselt, Belgium.,Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Evi Dons
- Hasselt University, Centre for Environmental Sciences (CMK), Hasselt, Belgium.,Flemish Institute for Technological Research (VITO), Mol, Belgium
| | | | - Arnout Standaert
- Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Duncan Lee
- School of Mathematics and Statistics, University of Glasgow, Glasgow, United Kingdom
| | | | - Audrey de Nazelle
- Centre for Environmental Policy, Imperial College London, London, United Kingdom.,MRC-PHE Centre for Environment and Health, Imperial College London, United Kingdom
| | - Mark Nieuwenhuijsen
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain.,Universität Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Richard Mitchell
- MRC/CSO Social and Public Health Sciences, University of Glasgow, Glasgow, United Kingdom
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Ramakrishnan S, Robbins TW, Zmigrod L. The Habitual Tendencies Questionnaire: A tool for psychometric individual differences research. Personal Ment Health 2022; 16:30-46. [PMID: 34196130 DOI: 10.1002/pmh.1524] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 05/31/2021] [Accepted: 06/08/2021] [Indexed: 01/06/2023]
Abstract
Habits are automatic responses to learned stimuli or contextual cues that are insensitive to goals. Although habits may allow for automated behaviours that increase efficiency in our daily lives, an over-reliance on habits has been suggested to contribute to disorders such as obsessive-compulsive disorder (OCD). There are currently few established measures of individual differences in habitual tendencies. To fill this gap, the present study generated and validated a novel 11-item scale, the Habitual Tendencies Questionnaire (HTQ), to measure individual differences in habitual tendencies in the general population. In Study 1, factor analysis revealed three underlying subcomponents of the HTQ: Compulsivity, Preference for Regularity, and Aversion to Novelty, with Compulsivity showing the strongest association with subclinical OCD symptomatology. Study 2 validated the HTQ and replicated the findings of Study 1 in a larger sample, and explored relationships with other personality traits. The results emphasise the importance of measuring individual variation in habitual thinking styles, illustrating that different facets of habitual tendencies may contribute to diverse behavioural and clinical outcomes. The present investigation provides a new, reliable way of measuring habitual tendencies and has important implications for future explorations into the nature of individual differences from a dimensional perspective to psychiatry.
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Affiliation(s)
| | - Trevor W Robbins
- Department of Psychology, University of Cambridge, Cambridge, UK.,Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Leor Zmigrod
- Department of Psychology, University of Cambridge, Cambridge, UK.,Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
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10
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Fernando J, Stochl J, Ersche KD. Drug Use in Night Owls May Increase the Risk for Mental Health Problems. Front Neurosci 2022; 15:819566. [PMID: 35087376 PMCID: PMC8787192 DOI: 10.3389/fnins.2021.819566] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 12/21/2021] [Indexed: 12/12/2022] Open
Abstract
Drugs of abuse are widely known to worsen mental health problems, but this relationship may not be a simple causational one. Whether or not a person is susceptible to the negative effects of drugs of abuse may not only be determined by their addictive properties, but also the users’ chronotype, which determines their daily activity patterns. The present study investigates the relationship between chronotype, drug use and mental health problems in a cross-sectional community sample. Participants (n = 209) completed a selection of questionnaires online, including the Munich Chronotype Questionnaire, the Depression Anxiety Stress Scale, the Alcohol Use Disorder Identification Test, the Cannabis Use Disorder Identification Test and the Fagerström Test for Nicotine Dependence. We conducted multiple regression models to determine relationships between participants’ chronotype and their reported mental health symptoms and then estimated mediation models to investigate the extent to which their drug consumption accounted for the identified associations. Chronotype was significantly associated with participants’ overall mental health (β = 0.16, p = 0.022) and their anxiety levels (β = 0.18, p = 0.009) but not with levels of depression or stress. However, both relationships were fully mediated by participants’ overall drug consumption. Thus, late chronotypes, so-called “night owls”, not only use more drugs but consequently have an increased risk for developing anxiety and deteriorating mental health status. This group may be particularly vulnerable to the negative psychological effects of drugs. Our results point toward the importance of considering chronotype in designing preventative and therapeutic innovations, specifically for anxiety, which at present has been largely neglected.
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Affiliation(s)
- Jeevan Fernando
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Jan Stochl
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
- Department of Kinanthropology and Humanities, Charles University, Prague, Czechia
| | - Karen D. Ersche
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- *Correspondence: Karen D. Ersche,
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11
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Martinez MC, Zold CL, Coletti MA, Murer MG, Belluscio MA. Dorsal striatum coding for the timely execution of action sequences. eLife 2022; 11:74929. [PMID: 36426715 PMCID: PMC9699698 DOI: 10.7554/elife.74929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 10/27/2022] [Indexed: 11/27/2022] Open
Abstract
The automatic initiation of actions can be highly functional. But occasionally these actions cannot be withheld and are released at inappropriate times, impulsively. Striatal activity has been shown to participate in the timing of action sequence initiation and it has been linked to impulsivity. Using a self-initiated task, we trained adult male rats to withhold a rewarded action sequence until a waiting time interval has elapsed. By analyzing neuronal activity we show that the striatal response preceding the initiation of the learned sequence is strongly modulated by the time subjects wait before eliciting the sequence. Interestingly, the modulation is steeper in adolescent rats, which show a strong prevalence of impulsive responses compared to adults. We hypothesize this anticipatory striatal activity reflects the animals’ subjective reward expectation, based on the elapsed waiting time, while the steeper waiting modulation in adolescence reflects age-related differences in temporal discounting, internal urgency states, or explore–exploit balance.
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Affiliation(s)
- Maria Cecilia Martinez
- Universidad de Buenos Aires, Facultad de Ciencias Exactas y Naturales, Departamento de Fisiología, Biología Molecular y Celular “Dr. Héctor Maldonado”Buenos AiresArgentina,Universidad de Buenos Aires - CONICET, Instituto de Fisiología y Biofísica “Dr. Bernardo Houssay” (IFIBIO-Houssay), Grupo de Neurociencia de SistemasBuenos AiresArgentina
| | - Camila Lidia Zold
- Universidad de Buenos Aires - CONICET, Instituto de Fisiología y Biofísica “Dr. Bernardo Houssay” (IFIBIO-Houssay), Grupo de Neurociencia de SistemasBuenos AiresArgentina,Universidad de Buenos Aires, Facultad de Ciencias Médicas, Departamento de FisiologíaBuenos AiresArgentina
| | - Marcos Antonio Coletti
- Universidad de Buenos Aires - CONICET, Instituto de Fisiología y Biofísica “Dr. Bernardo Houssay” (IFIBIO-Houssay), Grupo de Neurociencia de SistemasBuenos AiresArgentina,Universidad de Buenos Aires, Facultad de Ciencias Médicas, Departamento de FisiologíaBuenos AiresArgentina
| | - Mario Gustavo Murer
- Universidad de Buenos Aires - CONICET, Instituto de Fisiología y Biofísica “Dr. Bernardo Houssay” (IFIBIO-Houssay), Grupo de Neurociencia de SistemasBuenos AiresArgentina,Universidad de Buenos Aires, Facultad de Ciencias Médicas, Departamento de FisiologíaBuenos AiresArgentina
| | - Mariano Andrés Belluscio
- Universidad de Buenos Aires - CONICET, Instituto de Fisiología y Biofísica “Dr. Bernardo Houssay” (IFIBIO-Houssay), Grupo de Neurociencia de SistemasBuenos AiresArgentina,Universidad de Buenos Aires, Facultad de Ciencias Médicas, Departamento de FisiologíaBuenos AiresArgentina
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Ali F, Ali A, Iqbal A, Ullah Zafar A. How socially anxious people become compulsive social media users: The role of fear of negative evaluation and rejection. TELEMATICS AND INFORMATICS 2021. [DOI: 10.1016/j.tele.2021.101658] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Metacognition and Self-determination, Impulsivity and Emotional intelligence, and its relation with wellbeing and health indicators in young adults. INTERACCIONES: REVISTA DE AVANCES EN PSICOLOGÍA 2021. [DOI: 10.24016/2021.v7.216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: From the evidence, it is inferred the influence of cognitive or motivational variables over the emotional ones and from these on the perception and self-reported wellbeing and health, with direct implications for health promotion and prevention. Method: a quantitative approach, descriptive, correlational cross-sectional with statistical explanatory analysis investigation was conducted, analyzing the data through path modeling of the partial least squares approach of the structural equations model, by using the Smart PLS software 3.3.2 version, analyzing consequently the convergent and discriminant validity of the model. A total 223 undergraduate university young adult students was evaluated, 41 men (18,4%) and 182 women (81,6%) with ages between 18 and 30 years old (µ= 24,26 y σ=±3,30), from Bogotá Colombia participated. Results: The results allowed to significant relations between the self – determination with the impulsivity and emotional intelligence, and from these with the psychological well-being and healthy habits. There were not identified significant relations between the metacognition and the impulsivity, although there are between metacognition and emotional intelligence. Conclusions: The proposed model about the significant relations between metacognition and self-determination with impulsivity and emotional intelligence and between these and the psychological well-being and healthy habits was confirmed. The specific result related to the absence of significant relations between metacognition and the impulsivity suggest for futures research, to emphasize on the metacognitive process implicated on the emotional components. The results are discussed, its implications and the necessity to be considered more determinants for the promotion of health.
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Ersche KD, Lim TV, Murley AG, Rua C, Vaghi MM, White TL, Williams GB, Robbins TW. Reduced Glutamate Turnover in the Putamen Is Linked With Automatic Habits in Human Cocaine Addiction. Biol Psychiatry 2021; 89:970-979. [PMID: 33581835 PMCID: PMC8083107 DOI: 10.1016/j.biopsych.2020.12.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 12/09/2020] [Accepted: 12/14/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND The balance between goal-directed behavior and habits has been hypothesized to be biased toward the latter in individuals with cocaine use disorder (CUD), suggesting possible neurochemical changes in the putamen, which may contribute to their compulsive behavior. METHODS We assessed habitual behavior in 48 patients with CUD and 42 healthy control participants using a contingency degradation paradigm and the Creature of Habit Scale. In a subgroup of this sample (CUD: n = 21; control participants: n = 22), we also measured glutamate and glutamine concentrations in the left putamen using ultra-high-field (7T) magnetic resonance spectroscopy. We hypothesized that increased habitual tendencies in patients with CUD would be associated with abnormal glutamatergic metabolites in the putamen. RESULTS Compared with their non-drug-using peers, patients with CUD exhibited greater habitual tendencies during contingency degradation, which correlated with increased levels of self-reported daily habits. We further identified a significant reduction in glutamate concentration and glutamate turnover (glutamate-to-glutamine ratio) in the putamen in patients with CUD, which was significantly related to the level of self-reported daily habits. CONCLUSIONS Patients with CUD exhibit enhanced habitual behavior, as assessed both by questionnaire and by a laboratory paradigm of contingency degradation. This automatic habitual tendency is related to a reduced glutamate turnover in the putamen, suggesting a dysregulation of habits caused by chronic cocaine use.
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Affiliation(s)
- Karen D Ersche
- Departments of Psychiatry, Psychology, and Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom.
| | - Tsen Vei Lim
- Departments of Psychiatry, Psychology, and Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Alexander G Murley
- Departments of Psychiatry, Psychology, and Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Catarina Rua
- Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, United Kingdom
| | - Matilde M Vaghi
- Departments of Psychiatry, Psychology, and Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom; Department of Psychology, Stanford University, Stanford, California
| | - Tara L White
- Department of Behavioral and Social Sciences, Brown University, Providence, Rhode Island
| | - Guy B Williams
- Departments of Psychiatry, Psychology, and Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom; Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, United Kingdom
| | - Trevor W Robbins
- Departments of Psychiatry, Psychology, and Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
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Albertella L, Rotaru K, Christensen E, Lowe A, Brierley ME, Richardson K, Chamberlain SR, Lee RSC, Kayayan E, Grant JE, Schluter-Hughes S, Ince C, Fontenelle LF, Segrave R, Yücel M. The Influence of Trait Compulsivity and Impulsivity on Addictive and Compulsive Behaviors During COVID-19. Front Psychiatry 2021; 12:634583. [PMID: 33708147 PMCID: PMC7940765 DOI: 10.3389/fpsyt.2021.634583] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 01/29/2021] [Indexed: 12/11/2022] Open
Abstract
Background: The COVID-19 pandemic has resulted in high levels of psychological distress worldwide, with experts expressing concern that this could result in corresponding increases in addictive behaviors as individuals seek to cope with their distress. Further, some individuals may be at greater risk than others for developing problematic addictive behaviors during times of high stress, such as individuals with high trait impulsivity and compulsivity. Despite the potential of such knowledge to inform early detection of risk, no study to date has examined the influence of trait impulsivity and compulsivity on addictive behaviors during COVID-19. Toward this aim, the current study examined the association between impulsive and compulsive traits and problematic addictive and compulsive behaviors during the first COVID-19 lockdown in Australia. Methods: Eight hundred seventy-eight adults completed a cross-sectional online survey during the first lockdown, between late May to June 2020. Participants completed scales for addictive and compulsive behaviors for the period prior to and during lockdown for problematic eating, pornography, internet use, gambling, drinking, and obsessive-compulsive behaviors. Negative binomial regressions examined the associations between impulsivity, compulsivity, and their interaction with problematic behaviors during lockdown, controlling for age, gender, sample, psychological distress, exposure to COVID-related stressors, and pre-COVID problems. Results: Greater trait compulsivity was associated with more problematic obsessive-compulsive behaviors (p < 0.001) and less problematic drinking (p = 0.038) during lockdown. Further, trait compulsivity interacted with trait impulsivity in relation to problematic eating behaviors (p = 0.014) such that greater trait compulsivity was associated with more problems among individuals with low impulsivity only (p = 0.030). Finally, psychological distress and/or exposure to COVID-related stressors were associated with greater problems across all addictive and compulsive behaviors, as was severity of pre-COVID problems. Discussion: Trait compulsivity was associated with addictive and compulsive behaviors in different ways. Further, the finding that stress-related variables (psychological distress and COVID-related stressors) were associated with greater problems across all lockdown behaviors supports the idea that stress may facilitate, or otherwise be associated with, problematic behaviors. These findings highlight the need for interventions that enhance resilience to stress, which in turn may reduce risk for addictive and compulsive disorders.
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Affiliation(s)
- Lucy Albertella
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Kristian Rotaru
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
- Monash Business School, Monash University, Caulfield, VIC, Australia
| | - Erynn Christensen
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Amelia Lowe
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Mary-Ellen Brierley
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Karyn Richardson
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | | | - Rico S. C. Lee
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Edouard Kayayan
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Jon E. Grant
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, United States
| | - Sam Schluter-Hughes
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Campbell Ince
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Leonardo F. Fontenelle
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ), D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil
| | - Rebecca Segrave
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Murat Yücel
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
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16
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Wyckmans F, Chatard A, Saeremans M, Kornreich C, Jaafari N, Fantini-Hauwel C, Noël X. Habitual Routines and Automatic Tendencies Differential Roles in Alcohol Misuse Among Undergraduates. Front Psychol 2021; 11:607866. [PMID: 33408673 PMCID: PMC7779402 DOI: 10.3389/fpsyg.2020.607866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 11/26/2020] [Indexed: 11/13/2022] Open
Abstract
There is a debate over whether actions that resist devaluation (i.e., compulsive alcohol consumption) are primarily habit- or goal-directed. The incentive habit account of compulsive actions has received support from behavioral paradigms and brain imaging. In addition, the self-reported Creature of Habit Scale (COHS) has been proposed to capture inter-individual differences in habitual tendencies. It is subdivided into two dimensions: routine and automaticity. We first considered a French version of this questionnaire for validation, based on a sample of 386 undergraduates. The relationship between two dimensions of habit and the risk of substance use disorder and impulsive personality traits was also investigated. COHS has good psychometric properties with both features of habits positively associated with an Obsessive-Compulsive Inventory score. Besides, the propensity to rely more on routines was associated with lower levels of alcohol abuse and nicotine use, suggesting that some degree of routine might act as a protective factor against substance use. In contrast, a high automaticity score was associated with an increased risk of harmful alcohol use. These results demonstrate that the COHS is a valid measure of habitual tendencies and represents a useful tool for capturing inter-individual variations in drug use problems in undergraduates.
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Affiliation(s)
- Florent Wyckmans
- Laboratoire de Psychologie Médicale, Faculté de Médecine, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Armand Chatard
- Faculty of Psychology, University of Poitiers, Poitiers, France
| | - Mélanie Saeremans
- Psychiatric Institute, Universitary Hospital Brugmann, Bruxelles, Belgium
| | - Charles Kornreich
- Laboratoire de Psychologie Médicale, Faculté de Médecine, Université Libre de Bruxelles, Bruxelles, Belgium.,Psychiatric Institute, Universitary Hospital Brugmann, Bruxelles, Belgium
| | - Nemat Jaafari
- Faculty of Medicine, University of Poitiers, Poitiers, France
| | - Carole Fantini-Hauwel
- Research Centre of Clinical Psychology, Psychopathology and Psychosomatic, Université libre de Bruxelles, Brussels, Belgium
| | - Xavier Noël
- Laboratoire de Psychologie Médicale, Faculté de Médecine, Université Libre de Bruxelles, Bruxelles, Belgium
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17
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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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18
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Zhou X, Meng Y, Schmitt HS, Montag C, Kendrick KM, Becker B. Cognitive flexibility mediates the association between early life stress and habitual behavior. PERSONALITY AND INDIVIDUAL DIFFERENCES 2020. [DOI: 10.1016/j.paid.2020.110231] [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: 10/23/2022]
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19
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Darevsky D, Hopf FW. Behavioral indicators of succeeding and failing under higher-challenge compulsion-like alcohol drinking in rat. Behav Brain Res 2020; 393:112768. [PMID: 32544510 PMCID: PMC7444822 DOI: 10.1016/j.bbr.2020.112768] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 06/05/2020] [Accepted: 06/07/2020] [Indexed: 01/04/2023]
Abstract
Intake despite negative consequences (compulsivity) contributes strongly to the harm of alcohol use disorder, making the underlying psychological and circuit mechanisms of great importance. To gain insight into possible underlying action strategies, we compared rat licking microstructure across compulsion-like and non-compulsive conditions. We previously showed that drinking under a moderate-challenge, quinine-alcohol model (Alc-ModQ) shows less variable responding in many measures, suggesting a more automatic strategy to overcome challenge. Here, we reanalyzed our original data, newly focusing on the behavioral profile of higher-challenge intake (100 mg/L quinine in alcohol, Alc-HighQ). Alc-HighQ greatly dropped consumption, yet retained aspects of greater automaticity and drive seen with Alc-ModQ, including earlier bout initiation and measures suggesting more stereotyped tongue control. In contrast, Alc-HighQ disordered bout generation and timing. Importantly, only fast-starting bouts persisted under Alc-HighQ, and while there were many fewer longer Alc-HighQ bouts, they still contributed >50 % of consumption. Also, longer bouts under Alc-HighQ had an early, several-second period with greater chance of stopping, but afterwards showed similar persistence and recovery from slow licking as other drinking conditions. Together, our findings elucidate novel behavioral indicators of successful and unsuccessful epochs of Alc-HighQ, compulsion-like intake. We also relate findings to congruent human and animal work implicating anterior insula and medial prefrontal cortices as critical for compulsion-like alcohol responding, and where ventral frontal cortex has been more associated with overall action plan and tongue control (retained under Alc-HighQ), with medial cortex more related to proximal action timing (disrupted under Alc-HighQ except after faster bout initiation).
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Affiliation(s)
- David Darevsky
- University of California at Berkeley, University of California at San Francisco (UCSF), Graduate Program in Bioengineering, United States; UCSF Medical Scientist Training Program, San Francisco, CA, United States; Department of Neurology, UCSF, United States
| | - Frederic W Hopf
- Department of Neurology, UCSF, United States; Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States.
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20
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Overmeyer R, Fürtjes S, Ersche KD, Ehrlich S, Endrass T. Self-regulation is negatively associated with habit tendencies: A validation of the German Creature of Habit Scale. PERSONALITY AND INDIVIDUAL DIFFERENCES 2020. [DOI: 10.1016/j.paid.2020.110029] [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: 10/24/2022]
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