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Vaccaro AG, Lacadie CM, Potenza MN. Intrinsic connectivity demonstrates a shared role of the posterior cingulate for cue reactivity in both gambling and cocaine use disorders. Addict Behav 2024; 155:108027. [PMID: 38581751 DOI: 10.1016/j.addbeh.2024.108027] [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: 08/29/2023] [Revised: 03/25/2024] [Accepted: 04/03/2024] [Indexed: 04/08/2024]
Abstract
Cue reactivity is relevant across addictive disorders as a process relevant to maintenance, relapse, and craving. Understanding the neurobiological foundations of cue reactivity across substance and behavioral addictions has important implications for intervention development. The present study used intrinsic connectivity distribution methods to examine functional connectivity during a cue-exposure fMRI task involving gambling, cocaine and sad videos in 22 subjects with gambling disorder, 24 with cocaine use disorder, and 40 healthy comparison subjects. Intrinsic connectivity distribution implicated the posterior cingulate cortex (PCC) at a stringent whole-brain threshold. Post-hoc analyses investigating the nature of the findings indicated that individuals with gambling disorder and cocaine use disorder exhibited decreased connectivity in the posterior cingulate during gambling and cocaine cues, respectively, as compared to other cues and compared to other groups. Brain-related cue reactivity in substance and behavioral addictions involve PCC connectivity in a content-to-disorder specific fashion. The findings suggesting that PCC-related circuitry underlies cue reactivity across substance and behavioral addictions suggests a potential biomarker for targeting in intervention development.
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Affiliation(s)
- Anthony G Vaccaro
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Cheryl M Lacadie
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Child Study Center, Yale University School of Medicine, New Haven, CT, USA; Department of Neuroscience, 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, New Haven, CT, USA.
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2
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Noel JK, Rosenthal SR, Jacob S. Internet, App-Based, and Casino Gambling: Associations Between Modality, Problem Gambling, and Substance Use. J Gambl Stud 2024:10.1007/s10899-024-10284-9. [PMID: 38311694 DOI: 10.1007/s10899-024-10284-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2024] [Indexed: 02/06/2024]
Abstract
Technology-based gambling prevalence is not well understood since relevant questions are not included in health and disease surveillance studies. The current study sought to estimate the prevalence of internet-based and smartphone app-based gambling, along with casino gambling, in a sample of U.S. young adults and determine if gambling modality was associated with problem gambling symptoms or substance use. The 2022 Rhode Island Young Adult Survey included N = 1,022 students between the ages of 18 to 25 years old who had lived in Rhode Island, with n = 414 lifetime gamblers (40.5%) included in this study. Odds of gambling via a smartphone app and on the internet, respectively, were greater in heterosexual cis-males compared to heterosexual cis-females (OR[95%CI] = 3.14 [1.25,7.91]; OR[95%CI] = 6.30 [2.05,19.3]). Internet gambling amongst employed students was less common than among those who were not a student and not employed (OR[95%CI] = 0.25 [0.06,1.00]). Odds of problem gambling symptoms were higher among those who gambled via a smartphone app (OR[95%CI] = 3.23 [1.21,8.60]). All forms of gambling were associated with alcohol consumption, although the strength of the association was stronger in app and internet gamblers. Casino gamblers were more likely to be high risk marijuana and illicit drug users. The rising availability of app gambling coupled with its social, psychological, and cultural context may presents an alternative pathway to problem gambling. Bans on internet gambling and/or strict guidelines on the frequency of wagers and cash placed per wager, should be considered as viable methods to mitigate associated consequences.
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Affiliation(s)
- Jonathan K Noel
- Department of Health Science, College of Health & Wellness, Johnson & Wales University, 8 Abbott Park Place, Providence, RI, 02903, USA.
- Center for Student Research & Interdisciplinary Collaboration, Johnson & Wales University, Providence, RI, 02903, USA.
| | - Samantha R Rosenthal
- Department of Health Science, College of Health & Wellness, Johnson & Wales University, 8 Abbott Park Place, Providence, RI, 02903, USA
- Center for Student Research & Interdisciplinary Collaboration, Johnson & Wales University, Providence, RI, 02903, USA
- Department of Epidemiology, Brown School of Public Health, Providence, RI, 02903, USA
| | - Steve Jacob
- Department of Health Science, College of Health & Wellness, Johnson & Wales University, 8 Abbott Park Place, Providence, RI, 02903, USA
- Center for Student Research & Interdisciplinary Collaboration, Johnson & Wales University, Providence, RI, 02903, USA
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3
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Sakulsriprasert C, Thawornwutichat R, Phukao D, Guadamuz TE. Early maladaptive schemas and addictive behaviours: A systematic review and meta-analysis. Clin Psychol Psychother 2023; 30:1416-1432. [PMID: 37464912 DOI: 10.1002/cpp.2882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 06/08/2023] [Accepted: 06/26/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND Recently, early maladaptive schemas have been increasingly focused as the underlying factor of several psychopathologies. The primary objective is to systematically review and meta-analytically analyse the evidence on the relationship between early maladaptive schemas and types of addictive behaviours. Additionally, the secondary objective was to examine potential moderators of the effect sizes. METHODS The systematic search was conducted on three databases including 'Scopus', 'Web of Science' and 'PubMed'. They were searched for quantitative studies investigating the relationship between early maladaptive schemas and addictive behaviours. The studies that were non-English and had insufficient information to calculate effect sizes were excluded. The random-effect model was utilized to estimate the pool effect sizes, and the meta-regression was used for moderation analysis. RESULTS Thirty-three studies with 12,577 participants were included for analyses. Most of included studies were conducted in the United States (k = 12, 36.36%). The mean ages of participants varied from 13.32 to 46.09 years. The findings indicated that all of early maladaptive schemas and schema domains positively correlated with addictive behaviours. The disconnection and rejection, impaired limits and impaired autonomy were the domains with the highest association with substance addictions (pool r = 0.338, 3.26 and 3.16, respectively). Furthermore, disconnection and rejection and impaired autonomy were the schema domains with the highest association with behavioural addictions (0.310 and 0.304, respectively). The moderation analysis demonstrated that study design was the factor affecting the effect sizes between schema domain and addictive behaviours. LIMITATION All included studies were from peer-reviewed journals in English. Moreover, the number of research examining the relationship between early maladaptive schemas and behavioural addictions was limited. CONCLUSION The findings provide evidence supporting the idea that substance addictions and behavioural addictions have shared risk factors, supporting the validity of the schema model, which can be applied for targeting and preventing addictive behaviours.
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Affiliation(s)
- Chaiyun Sakulsriprasert
- Department of Psychology, Faculty of Humanities, Chiang Mai University, Chiang Mai, Thailand
| | - Ratipan Thawornwutichat
- Center of Excellence in Research on Gender, Sexuality and Health, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand
| | - Darunee Phukao
- Department of Health Social Science, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand
| | - Thomas E Guadamuz
- Center of Excellence in Research on Gender, Sexuality and Health, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand
- John F. Kennedy School of Government, Harvard University, Cambridge, Massachusetts, USA
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Pagano A, Le T, Fong T, Reid R, Delucchi K, Guydish J. Gambling, tobacco use, and health among individuals in substance use disorder treatment. Am J Addict 2023; 32:563-573. [PMID: 37543853 DOI: 10.1111/ajad.13458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 05/23/2023] [Accepted: 07/25/2023] [Indexed: 08/07/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Gambling is highly comorbid with disordered use of tobacco and other drugs, and may increase relapse risk among substance use disorder (SUD) patients. We investigated associations between gambling and tobacco use behaviors among SUD patients to inform clinical care. METHODS Patients (N = 651, 170 female) from 25 residential SUD treatment programs in California completed surveys about tobacco use, health, and gambling. Using multivariate regression, we examined associations between gambling, tobacco use behaviors, and mental and physical health. RESULTS Past-year gamblers were more likely than non-gamblers to be current smokers (adjusted odds ratio [AOR] = 1.44, 95% confidence interval [CI] = 1.03, 2.01). Smokers who gambled had higher mean Heaviness of Smoking Index (HSI) scores (mean difference = +0.32, 95% CI = 0.04, 0.60), and more often reported smokeless tobacco use (AOR = 1.73, 95% CI = 1.16, 2.58), compared to non-gambling smokers. Past-year problem gamblers were more likely than all others (non-gamblers and non-problem gamblers) to be current smokers (AOR = 1.44, 95% CI = 1.08, 1.90) and to report high psychosocial stress (AOR = 1.87, 95% CI = 1.34, 2.61). Smokers with problem gambling also had higher HSI scores (mean difference = +0.54, 95% CI = 0.14, 0.95) compared to smokers without problem gambling. DISCUSSION AND CONCLUSIONS Gambling and problem gambling were associated with tobacco use and heavier smoking. SUD patients with gambling comorbidity may be heavier smokers and may need concurrent treatment for tobacco use and problem gambling. SCIENTIFIC SIGNIFICANCE This study provides novel data regarding gambling and tobacco use behaviors among SUD patients.
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Affiliation(s)
- Anna Pagano
- Institute for Health Policy Studies, University of California, San Francisco, California, USA
| | - Thao Le
- Institute for Health Policy Studies, University of California, San Francisco, California, USA
| | - Timothy Fong
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
| | - Rory Reid
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
| | - Kevin Delucchi
- UCSF Weill Institute for Neurosciences, University of California, San Francisco, California, USA
| | - Joseph Guydish
- Institute for Health Policy Studies, University of California, San Francisco, California, USA
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Farrar DC, Killiany RJ, Moss MB, Fink B, Budson AE. Event-related Potentials Corresponding to Decision-making Under Uncertain Conditions. Cogn Behav Neurol 2023; 36:166-177. [PMID: 37404132 DOI: 10.1097/wnn.0000000000000346] [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: 03/01/2022] [Accepted: 03/17/2023] [Indexed: 07/06/2023]
Abstract
BACKGROUND Decision-making is essential to human functioning, and resolving uncertainty is an essential part of decision-making. Impaired decision-making is present in many pathological conditions, and identifying markers of decision-making under uncertainty will provide a measure of clinical impact in future studies of therapeutic intervention for impaired decision-making. OBJECTIVE To describe EEG event-related potentials (ERPs) correlating with decision-making under uncertain conditions when compared with certain conditions. METHOD We used a novel card-matching task based on the Wisconsin Card Sorting Test to describe the neural correlates of uncertainty, as measured by EEG, in a group of 27 neurotypical individuals. We evaluated 500-ms intervals in the 2 seconds after card presentation to identify ERPs that are associated with maximal uncertainty compared with maximal certainty. RESULTS After correcting for multiple comparisons, we identified an ERP in the 500-1000-ms time frame (certain > uncertain, max amplitude 12.73 µV, latency 914 ms) in the left posterior inferior region of the scalp. We also found a P300-like ERP in the left frontal and parietal regions in the 0-500-ms time frame when the individuals received correct versus incorrect feedback (incorrect feedback > correct feedback, max amplitude 1.625 µV, latency 339 ms). CONCLUSION We identified an ERP in the 500-1000-ms time frame (certain > uncertain) that may reflect the resolution of uncertainty, as well as a P300-like ERP when feedback is presented (incorrect feedback > correct feedback). These findings can be used in future studies to improve decision-making and resolve uncertainty on the described markers.
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Affiliation(s)
- Danielle C Farrar
- Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque, New Mexico
| | - Ronald J Killiany
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts
| | - Mark B Moss
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts
| | - Brandi Fink
- Department of Psychiatry and Behavioral Sciences, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma
| | - Andrew E Budson
- Veterans Affairs Boston Healthcare System, Boston, Massachusetts
- Alzheimer's Disease Research Center, Boston University School of Medicine, Boston, Massachusetts
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Müller SM, Antons S. Decision making and executive functions in problematic pornography use. Front Psychiatry 2023; 14:1191297. [PMID: 37564242 PMCID: PMC10411905 DOI: 10.3389/fpsyt.2023.1191297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/14/2023] [Indexed: 08/12/2023] Open
Abstract
Introduction Previous research on cognitive functions in Compulsive Sexual Behavior Disorder (CSBD) and problematic pornography use (PPU) reported inconsistent findings and mostly included sexual pictures in the used tasks. The role of general executive functions and cognitive competences (without the presence of appetitive stimuli) in the context of PPU is largely unexplored. Methods This study investigated differences between individuals with high versus low problem severity of PPU regarding decision making and executive functions. The sample of the laboratory study consisted of N = 102 male adults. Besides measures of trait impulsivity, we used standard neuropsychological tests (Trail Making Test and three-back working memory task) and an intertemporal risky choice paradigm, the Cards & Lottery Task (CLT). Results The results show heightened impulsivity (urgency and deficits in perseverance) in individuals with high PPU, but no differences regarding performance in the CLT and executive function tasks. Discussion The findings indicate that PPU might be associated with impulsive behavior when experiencing strong emotions (urgency) and deficient cognitive performance especially in the presence of sexual stimuli but not in general.
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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
| | - Stephanie Antons
- 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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Wolfschlag M, Håkansson A. Drug-Induced Gambling Disorder: Epidemiology, Neurobiology, and Management. Pharmaceut Med 2023; 37:37-52. [PMID: 36611111 PMCID: PMC9825131 DOI: 10.1007/s40290-022-00453-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2022] [Indexed: 01/09/2023]
Abstract
Problematic gambling has been suggested to be a possible consequence of dopaminergic medications used mainly in neurological conditions, i.e. pramipexole and ropinirole, and possibly by one antipsychotic compound, aripiprazole. Patients with Parkinson's disease, restless legs syndrome and other conditions potentially treated with dopamine agonists, as well as patients treated for psychotic disorders, are vulnerable patient groups with theoretically increased risk of developing gambling disorder (GD), for example due to higher rates of mental ill-health in these groups. The aim of the present paper is to review the epidemiological, clinical, and neurobiological evidence of the association between dopaminergic medications and GD, and to describe risk groups and treatment options. The neurobiology of GD involves the reward and reinforcement system, based mainly on mesocorticolimbic dopamine projections, with the nucleus accumbens being a crucial area for developing addictions to substances and behaviors. The addictive properties of gambling can perhaps be explained by the reward uncertainty that activates dopamine signaling in a pathological manner. Since reward-related learning is mediated by dopamine, it can be altered by dopaminergic medications, possibly leading to increased gambling behavior and a decreased impulse control. A causal relationship between the medications and GD seems likely, but the molecular mechanisms behind this association have not been fully described yet. More research is needed in order to fully outline the clinical picture of GD developing in patient groups with dopaminergic medications, and data are needed on the differentiation of risk in different compounds. In addition, very few interventional studies are available on the management of GD induced by dopaminergic medications. While GD overall can be treated, there is need for treatment studies testing the effectiveness of tapering of the medication or other gambling-specific treatment modalities in these patient groups.
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Affiliation(s)
- Mirjam Wolfschlag
- Malmö-Trelleborg Addiction Center, Competence Center Addiction, Region Skåne, Södra Förstadsgatan 35, plan 4, S-205 02 Malmö, Sweden ,Faculty of Medicine, Dept of Clinical Sciences Lund, Lund University, Psychiatry, Lund, Sweden
| | - Anders Håkansson
- Malmö-Trelleborg Addiction Center, Competence Center Addiction, Region Skåne, Södra Förstadsgatan 35, plan 4, S-205 02, Malmö, Sweden. .,Faculty of Medicine, Dept of Clinical Sciences Lund, Lund University, Psychiatry, Lund, Sweden.
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8
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Myers CE, Interian A, Moustafa AA. A practical introduction to using the drift diffusion model of decision-making in cognitive psychology, neuroscience, and health sciences. Front Psychol 2022; 13:1039172. [PMID: 36571016 PMCID: PMC9784241 DOI: 10.3389/fpsyg.2022.1039172] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 10/27/2022] [Indexed: 12/14/2022] Open
Abstract
Recent years have seen a rapid increase in the number of studies using evidence-accumulation models (such as the drift diffusion model, DDM) in the fields of psychology and neuroscience. These models go beyond observed behavior to extract descriptions of latent cognitive processes that have been linked to different brain substrates. Accordingly, it is important for psychology and neuroscience researchers to be able to understand published findings based on these models. However, many articles using (and explaining) these models assume that the reader already has a fairly deep understanding of (and interest in) the computational and mathematical underpinnings, which may limit many readers' ability to understand the results and appreciate the implications. The goal of this article is therefore to provide a practical introduction to the DDM and its application to behavioral data - without requiring a deep background in mathematics or computational modeling. The article discusses the basic ideas underpinning the DDM, and explains the way that DDM results are normally presented and evaluated. It also provides a step-by-step example of how the DDM is implemented and used on an example dataset, and discusses methods for model validation and for presenting (and evaluating) model results. Supplementary material provides R code for all examples, along with the sample dataset described in the text, to allow interested readers to replicate the examples themselves. The article is primarily targeted at psychologists, neuroscientists, and health professionals with a background in experimental cognitive psychology and/or cognitive neuroscience, who are interested in understanding how DDMs are used in the literature, as well as some who may to go on to apply these approaches in their own work.
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Affiliation(s)
- Catherine E. Myers
- Research and Development Service, VA New Jersey Health Care System, East Orange, NJ, United States
- Department of Pharmacology, Physiology and Neuroscience, New Jersey Medical School, Rutgers University, Newark, NJ, United States
| | - Alejandro Interian
- Mental Health and Behavioral Sciences, VA New Jersey Health Care System, Lyons, NJ, United States
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ, United States
| | - Ahmed A. Moustafa
- Department of Human Anatomy and Physiology, The Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
- School of Psychology, Faculty of Society and Design, Bond University, Robina, QLD, Australia
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Wagner B, Mathar D, Peters J. Gambling Environment Exposure Increases Temporal Discounting but Improves Model-Based Control in Regular Slot-Machine Gamblers. COMPUTATIONAL PSYCHIATRY (CAMBRIDGE, MASS.) 2022; 6:142-165. [PMID: 38774777 PMCID: PMC11104401 DOI: 10.5334/cpsy.84] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 05/26/2022] [Indexed: 11/20/2022]
Abstract
Gambling disorder is a behavioral addiction that negatively impacts personal finances, work, relationships and mental health. In this pre-registered study (https://osf.io/5ptz9/) we investigated the impact of real-life gambling environments on two computational markers of addiction, temporal discounting and model-based reinforcement learning. Gambling disorder is associated with increased temporal discounting and reduced model-based learning. Regular gamblers (n = 30, DSM-5 score range 3-9) performed both tasks in a neutral (café) and a gambling-related environment (slot-machine venue) in counterbalanced order. Data were modeled using drift diffusion models for temporal discounting and reinforcement learning via hierarchical Bayesian estimation. Replicating previous findings, gamblers discounted rewards more steeply in the gambling-related context. This effect was positively correlated with gambling related cognitive distortions (pre-registered analysis). In contrast to our pre-registered hypothesis, model-based reinforcement learning was improved in the gambling context. Here we show that temporal discounting and model-based reinforcement learning are modulated in opposite ways by real-life gambling cue exposure. Results challenge aspects of habit theories of addiction, and reveal that laboratory-based computational markers of psychopathology are under substantial contextual control.
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Affiliation(s)
- Ben Wagner
- Department of Psychology, Biological Psychology, University of Cologne, Cologne, Germany
- Faculty of Psychology, Chair of Neuroimaging, Technical University of Dresden, Dresden, Germany
| | - David Mathar
- Department of Psychology, Biological Psychology, University of Cologne, Cologne, Germany
| | - Jan Peters
- Department of Psychology, Biological Psychology, University of Cologne, Cologne, Germany
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10
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Kim HS, Ritchie EV, Sears CR, Hodgins DC, Kowatch KR, McGrath DS. Affective impulsivity moderates the relationship between disordered gambling severity and attentional bias in electronic gaming machine (EGM) players. J Behav Addict 2022; 11:386-395. [PMID: 35895477 PMCID: PMC9295233 DOI: 10.1556/2006.2022.00043] [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: 10/19/2021] [Revised: 03/06/2022] [Accepted: 05/20/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND AND AIMS Attentional bias to gambling-related stimuli is associated with increased severity of gambling disorder. However, the addiction-related moderators of attentional bias among those who gamble are largely unknown. Impulsivity is associated with attentional bias among those who abuse substances, and we hypothesized that impulsivity would moderate the relationship between disordered electronic gaming machine (EGM) gambling and attentional bias. METHODS We tested whether facets of impulsivity, as measured by the UPPS-P (positive urgency, negative urgency, sensation seeking, lack of perseverance, lack of premeditation) and the Barratt Impulsiveness Scale-11 (cognitive, motor, non-planning) moderated the relationship between increased severity of gambling disorder, as measured by the Problem Gambling Severity Index (PGSI), and attentional bias. Seventy-five EGM players participated in a free-viewing eye-tracking paradigm to measure attentional bias to EGM images. RESULTS Attentional bias was significantly correlated with Barratt Impulsiveness Scale-11 (BIS-11) motor, positive urgency, and negative urgency. Only positive and negative urgency moderated the relationship between PGSI scores and attentional bias. For participants with high PGSI scores, higher positive and negative urgency were associated with larger attentional biases to EGM stimuli. DISCUSSION The results indicate that affective impulsivity is an important contributor to the association between gambling disorder and attentional bias.
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Affiliation(s)
- Hyoun S. Kim
- Department of Psychology, Toronto Metropolitan University (Formerly Ryerson University), Toronto, Canada
| | | | | | - David C. Hodgins
- Department of Psychology, University of Calgary, Calgary, Canada
| | | | - Daniel S. McGrath
- Department of Psychology, University of Calgary, Calgary, Canada,Corresponding author. E-mail:
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11
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Pechtel P, Harris J, Karl A, Clunies-Ross C, Bower S, Moberly NJ, Pizzagalli DA, Watkins ER. Emerging ecophenotype: reward anticipation is linked to high-risk behaviours after sexual abuse. Soc Cogn Affect Neurosci 2022; 17:1035-1043. [PMID: 35438797 PMCID: PMC9629466 DOI: 10.1093/scan/nsac030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 02/28/2022] [Accepted: 04/19/2022] [Indexed: 01/12/2023] Open
Abstract
Adolescents frequently engage in high-risk behaviours (HRB) following childhood sexual abuse (CSA). Aberrant reward processes are implicated in HRB, and their underlying fronto-striatal networks are vulnerable to neurodevelopmental changes during adversity representing a promising candidate for understanding links between CSA and HRB. We examined whether fronto-striatal responses during reward anticipation and feedback (i) are altered in depressed adolescents with CSA compared to depressed, non-abused peers and (ii) moderate the relationship between CSA and HRB irrespective of depression. Forty-eight female adolescents {14 with CSA and depression [CSA + major depressive disorder (MDD)]; 17 with MDD but no CSA (MDD); 17 healthy, non-abused controls} completed a monetary reward task during functional magnetic resonance imaging. No differences in fronto-striatal response to reward emerged between CSA + MDD and MDD. Critically, high left nucleus accumbens activation during reward anticipation was associated with greater HRB in CSA + MDD compared to MDD and controls. Low left putamen activation during reward feedback was associated with the absence of HRB in CSA + MDD compared to MDD. Striatal reward responses appear to play a key role in HRB for adolescents with CSA irrespective of depression, providing initial support for a CSA ecophenotype. Such information is pivotal to identify at-risk youth and prevent HRB in adolescents after CSA.
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Affiliation(s)
- Pia Pechtel
- Correspondence should be addressed to Pia Pechtel, Department of Psychology, University of Exeter, Sir Henry Wellcome Building for Mood Disorders Research, Perry Road, Exeter EX4 4QQ, UK. E-mail:
| | - Jennifer Harris
- Department of Psychology, College of Life and Environmental Sciences (CLES), University of Exeter, Exeter EX4 4QG, UK
| | - Anke Karl
- Department of Psychology, College of Life and Environmental Sciences (CLES), University of Exeter, Exeter EX4 4QG, UK
| | - Caroline Clunies-Ross
- Child and Adolescent Mental Health Services, Children and Family Health Devon, Exeter EX2 4NU, UK
| | - Susie Bower
- Child and Adolescent Mental Health Services, Children and Family Health Devon, Exeter EX2 4NU, UK
| | - Nicholas J Moberly
- Department of Psychology, College of Life and Environmental Sciences (CLES), University of Exeter, Exeter EX4 4QG, UK
| | - Diego A Pizzagalli
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont MA 02478, USA,Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA,McLean Imaging Center, McLean Hospital, Belmont, MA 02478 USA
| | - Edward R Watkins
- Department of Psychology, College of Life and Environmental Sciences (CLES), University of Exeter, Exeter EX4 4QG, UK
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Witkiewitz K, Pfund RA, Tucker JA. Mechanisms of Behavior Change in Substance Use Disorder With and Without Formal Treatment. Annu Rev Clin Psychol 2022; 18:497-525. [PMID: 35138868 DOI: 10.1146/annurev-clinpsy-072720-014802] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This article provides a narrative review of studies that examined mechanisms of behavior change in substance use disorder. Several mechanisms have some support, including self-efficacy, craving, protective behavioral strategies, and increasing substance-free rewards, whereas others have minimal support (e.g., motivation, identity). The review provides recommendations for expanding the research agenda for studying mechanisms of change, including designs to manipulate putative change mechanisms, measurement approaches that expand the temporal units of analysis during change efforts, more studies of change outside of treatment, and analytic approaches that move beyond mediation tests. The dominant causal inference approach that focuses on treatment and individuals as change agents could be expanded to include a molar behavioral approach that focuses on patterns of behavior in temporally extended environmental contexts. Molar behavioral approaches may advance understanding of how recovery from substance use disorder is influenced by broader contextual features, community-level variables, and social determinants of health. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 18 is May 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Katie Witkiewitz
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico, USA; .,Center on Alcohol, Substance Use and Addictions, University of New Mexico, Albuquerque, New Mexico, USA
| | - Rory A Pfund
- Center on Alcohol, Substance Use and Addictions, University of New Mexico, Albuquerque, New Mexico, USA
| | - Jalie A Tucker
- Department of Health Education & Behavior and Center for Behavioral Economic Health Research, University of Florida, Gainesville, Florida, USA
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Increased risk for developing gambling disorder under the treatment with pramipexole, ropinirole, and aripiprazole: A nationwide register study in Sweden. PLoS One 2021; 16:e0252516. [PMID: 34061895 PMCID: PMC8168838 DOI: 10.1371/journal.pone.0252516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 05/17/2021] [Indexed: 11/24/2022] Open
Abstract
Gambling Disorder (GD) has recently been reclassified from an impulse-control disorder to a behavioural addiction and, as in other addictive disorders, the dopaminergic reward system is involved. According to neuroimaging studies, alterations within the striatal dopaminergic signalling can occur in GD. However, the findings to date are controversial and there has been no agreement yet on how the reward system is affected on a molecular basis. Within the last 20 years, there has been growing evidence for a higher risk to develop GD in response to certain dopaminergic medication. Especially the dopamine agonists pramipexole and ropinirole, and the dopamine modulator aripiprazole seem to increase the likelihood for GD. The goal of this study was to examine the association between a prescription for either of the three pharmaceuticals and a GD diagnosis in a large cross-sectional study of the Swedish population. Compared to patients with any other dopaminergic drug prescription (38.7% with GD), the diagnosis was more common in patients with a dopamine agonist prescription (69.8% with GD), resulting in an odds ratio of 3.2. A similar association was found between aripiprazole prescriptions and GD diagnoses, which were analysed within the subgroup of all patients with schizophrenia or a schizotypal, delusional, or another non-mood psychotic disorder. An aripiprazole prescription increased the likelihood of GD (88.8%) in comparison to patients without an aripiprazole prescription (71.2%) with an odds ratio of 3.4. This study contributes to the increasingly reliable evidence for an association between several dopaminergic drugs and a higher risk for developing GD. Therefore, one future research goal should be a better understanding of the neurobiology in GD to be able to design more selective dopaminergic medication with less severe side effects. Additionally, this knowledge could enable the development of pharmacotherapy in GD and other addictive disorders.
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14
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Pettorruso M, Testa G, Granero R, Martinotti G, d'Andrea G, di Giannantonio M, Fernández-Aranda F, Mena-Moreno T, Gómez-Peña M, Moragas L, Baenas I, Del Pino-Gutierrez A, Codina E, Valenciano-Mendoza E, Mora-Maltas B, Zoratto F, Valero-Solís S, Guillen-Guzmán E, Menchón JM, Jiménez-Murcia S. The transition time to gambling disorder: The roles that age, gambling preference and personality traits play. Addict Behav 2021; 116:106813. [PMID: 33453584 DOI: 10.1016/j.addbeh.2020.106813] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 12/20/2020] [Accepted: 12/28/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND AIMS Gambling Disorder (GD) is considered a heterogeneous, multidimensional pathology with high personal and social consequences. The transition time (TT) between problematic gaming and pathological gambling, which varies significantly across patients, may predict the disorder's severity. As only limited studies have investigated the factors implicated in the TT, the current study set out to identify its predictors and their relationships with GD severity. METHODS Correlation were performed in 725 male GD patients to identify factors associated to TT and GD severity, including: age of onset of gambling behaviors, alcohol/drug use, personality traits and gambling preferences (i.e., strategic, non-strategic, and mixed). Then a regression analysis was performed to identify predictors of TT to GD. RESULTS Longer TT correlated with higher GD severity, early age of onset of problematic gambling, substance use and a non-strategic gambling preference. Personality traits including low self-directedness, high novelty seeking, and low cooperativeness were also related with longer TT. The strongest associations with GD severity were substance use, and some of the personality traits (i.e., low self-directedness and cooperativeness, high harm avoidance and self-transcendence). Factors significantly predicting longer transition to GD were older ages, low self-directedness, and non-strategic gambling. CONCLUSIONS A clinical profile characterized by a longer TT and more severe GD symptoms pertains to older patients with low self-directedness, and preference for non-strategic gambling. Other relevant factors associated with this profile of patients included early age of onset problematic gambling, substance consumption, high novelty seeking and low cooperativeness.
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15
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Mestre-Bach G, Fernández-Aranda F, Jiménez-Murcia S, Potenza MN. Decision-Making in Gambling Disorder, Problematic Pornography Use, and Binge-Eating Disorder: Similarities and Differences. Curr Behav Neurosci Rep 2021; 7:97-108. [PMID: 33585161 DOI: 10.1007/s40473-020-00212-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Purpose of Review The present review attempts to provide a comprehensive and critical overview of the neurocognitive mechanisms of gambling disorder (GD), problematic pornography use (PPU) and binge-eating disorder (BED), focusing specifically on decision-making processes. Recent findings GD, PPU and BED have been associated with decision-making impairments both under risk and ambiguity. Features such as intelligence, emotions, social variables, cognitive distortions, comorbidities, or arousal may condition decision-making processes in these individuals. Summary Impairments in decision-making seem to be a shared transdiagnostic feature of these disorders We also hypothesized the EG relative to the NEG group would demonstrate weaker relationships between problem-gambling severity and health/functioning measures (e.g., substance use) and gambling behaviors (e.g., more time spent gambling) given that EG would account for some of the variance in the relationships between ARPG and these measures. However, there is varying support for the degree to which different features may affect decision-making. Therefore, the study of decision-making processes can provide crucial evidence for understanding addictions and other disorders with addiction-like symptomatology.
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Affiliation(s)
- Gemma Mestre-Bach
- Universidad Internacional de La Rioja, La Rioja, Spain.,Department of Psychiatry. Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry. Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry. Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Marc N Potenza
- Yale University School of Medicine, Department of Psychiatry, New Haven, CT, USA.,Yale University School of Medicine, Department of Neuroscience, New Haven, CT, USA.,Yale University School of Medicine, Yale Child Study Center, New Haven, CT, USA.,Connecticut Mental Health Center, New Haven, CT, USA
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16
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Singer BF, Anselme P, Robinson MJF, Vezina P. An overview of commonalities in the mechanisms underlying gambling and substance use disorders. Prog Neuropsychopharmacol Biol Psychiatry 2020; 101:109944. [PMID: 32289336 DOI: 10.1016/j.pnpbp.2020.109944] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Bryan F Singer
- School of Psychology, University of Sussex, Brighton, UK
| | - Patrick Anselme
- Department of Biopsychology, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
| | | | - Paul Vezina
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL, USA.
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