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Kerver GA, Engel SG, Gunstad J, Crosby RD, Steffen KJ. Deficits in cognitive control during alcohol consumption after bariatric surgery. Surg Obes Relat Dis 2023; 19:344-349. [PMID: 36443210 PMCID: PMC10040420 DOI: 10.1016/j.soard.2022.10.014] [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: 08/10/2022] [Revised: 09/21/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND While bariatric surgery results in substantial weight loss, one negative side effect of surgery is that patients often experience more rapid and intense intoxication effects after consuming alcohol. OBJECTIVES Given that alcohol use has been associated with impaired cognitive functioning in the general population, this study examined whether acute alcohol consumption after bariatric surgery immediately led to impaired cognitive control, and whether this effect was impacted by baseline levels of cognitive control. SETTING Nonprofit teaching hospital, United States. METHODS Participants were 34 adults who attended a laboratory visit before and 1 year after Roux-en-Y gastric bypass surgery, wherein they consumed a weight-based dose of alcohol and completed cognitive testing over the course of 3 hours. RESULTS A series of generalized mixed-effect models demonstrated that performance on the cognitive task generally improved over time, likely due to practice effects. However, following bariatric surgery, individuals with impaired cognitive control before consuming alcohol experienced greater commission errors immediately afterward. CONCLUSIONS These findings suggest that alcohol use after bariatric surgery may produce immediate deficits in inhibitory control among individuals who are already vulnerable to impaired cognitive control. Clinicians should seek to educate bariatric surgery candidates on this possible effect, as deficits in inhibitory control may ultimately lead to risky behaviors and poor adherence with postsurgical medical recommendations.
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Affiliation(s)
- Gail A Kerver
- Sanford Center for Biobehavioral Research, Fargo, North Dakota; Department of Psychiatry and Behavioral Science, School of Medicine and Health Sciences, University of North Dakota, Fargo, North Dakota.
| | - Scott G Engel
- Sanford Center for Biobehavioral Research, Fargo, North Dakota; Department of Psychiatry and Behavioral Science, School of Medicine and Health Sciences, University of North Dakota, Fargo, North Dakota
| | - John Gunstad
- Department of Psychological Sciences, Kent State University, Kent, Ohio
| | - Ross D Crosby
- Sanford Center for Biobehavioral Research, Fargo, North Dakota; Department of Psychiatry and Behavioral Science, School of Medicine and Health Sciences, University of North Dakota, Fargo, North Dakota
| | - Kristine J Steffen
- Sanford Center for Biobehavioral Research, Fargo, North Dakota; Department of Pharmaceutical Sciences, North Dakota State University, Fargo, North Dakota
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From phone use to speeding and driving under influence: Identifying clusters of driving risk behaviors as an opportunity for targeted interventions. J Psychiatr Res 2021; 143:556-562. [PMID: 33218750 DOI: 10.1016/j.jpsychires.2020.11.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 10/16/2020] [Accepted: 11/09/2020] [Indexed: 11/24/2022]
Abstract
Identifying the profile of risky behaviors among drivers is central to propose effective interventions. Due to the multidimensional and overlapping aspects of risky driving behaviors, cluster analysis can provide additional insights in order to identify specific subgroups of risk. This study aimed to identify clusters of driving risk behavior (DRB) among car drivers, and to verify intra-cluster differences concerning clinical and sociodemographic variables. We approached a total of 12,231 drivers and we included 6392 car drivers. A cluster algorithm was used to identify groups of car drivers in relation to the DRB: driving without a seat belt (SB), exceeding the speed limit (SPD), using a cell phone while driving (CELL), and driving after drinking alcohol (DUI). The algorithm classified drivers within five different DRB profiles. In cluster 1 (20.1%), subjects with a history of CELL. In cluster 2 (41.4%), drivers presented no DRB. In cluster 3 (9.3%), all drivers presented SPD. In cluster 4 (12.5%), drivers presented all DRB. In cluster 5 (16.6%), all drivers presented DUI. Clusters with DUI-related offenses (4 and 5) comprised more men (81.9 and 78.8%, respectively) than the overall sample (63.4%), with more binge drinking (50.9 and 45.7%) and drug use in the previous year (13.5 and 8.6%). Cluster 1 had a high years of education (14.4 ± 3.4) and the highest personal income (Md = 3000 IQR [2000-5000]). Cluster 2 had older drivers (46.6 ± 15), and fewer bingers (10.9%). Cluster 4 had the youngest drivers (34.4 ± 11.4) of all groups. Besides reinforcing previous literature data, our study identified five unprecedented clusters with different profiles of drivers regarding DRB. We identified an original and heterogeneous group of drivers with only CELL misuse, as well as other significant differences among clusters. Hence, our findings show that targeted interventions must be developed for each subgroup in order to effectively produce safe behavior in traffic.
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Scherer JN, Schuch JB, Rocha MR, Assunção V, Silvestrin RB, Roglio VS, Limberger RP, Sousa TRV, Pechansky F. Drug use and driving behaviors among drivers with and without alcohol-related infractions. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2020; 42:230-238. [PMID: 33084800 PMCID: PMC7879079 DOI: 10.1590/2237-6089-2019-0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 12/12/2019] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Brazil is one of the countries with the highest rates of alcohol-related traffic infractions, but little is known about the profile of the drivers who commit them. Identifying the characteristics of impaired drivers is essential for planning preventive actions. OBJECTIVE To compare drug use and driving behavior profiles of drivers with and without alcohol-related infractions. METHODS 178 drivers stopped at routine roadblocks were assessed by traffic agents who conducted standard roadblock procedures (document verification; request of a breathalyzer test [BT]). Drug use and driving behavior data were collected through semi-structured interviews. Subjects were divided into three groups: drivers who refused the BT (RDs, n = 72), drivers who tested positive on the BT (PDs, n = 34), and drivers who had committed other infractions (ODs, n = 72). RESULTS The proportion of alcohol use in the last year was higher among RDs (100%) than in the PD and OD groups (97.1% and 72.2% respectively, p < 0.001). Lifetime prevalence of cannabis and cocaine use for the overall sample was 44.3% and 18.2%, respectively. Fewer individuals in the OD group (31.5%) reported having been stopped at roadblocks in the previous year compared to the PDs (55.9%) and RDs (48.6%, p = 0.03). However, a higher proportion of RDs reported drunk driving in the same period (87.5%; PD 69.7%; OD 26.9%; p < 0.001). CONCLUSION Essential differences among groups were observed. RDs had a higher proportion of alcohol use and drunk driving in the previous year; drivers who fit into this particular group may be unresponsive or less responsive to social deterrence and enforcement actions.
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Affiliation(s)
- Juliana N Scherer
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Jaqueline B Schuch
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil
| | - Marcelo R Rocha
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Vanessa Assunção
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Roberta B Silvestrin
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Vinícius S Roglio
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Renata P Limberger
- Programa de Pós-Graduação em Ciências Farmacêuticas, UFRGS, Porto Alegre, RS, Brazil
| | - Tanara R V Sousa
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Flavio Pechansky
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
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Scherer JN, Silvello D, Volpato VL, Roglio VS, Fara L, Ornell F, von Diemen L, Kessler FP, Pechansky F. Predictive factors associated with driving under the influence among Brazilian drug-using drivers. ACCIDENT; ANALYSIS AND PREVENTION 2019; 123:256-262. [PMID: 30553128 DOI: 10.1016/j.aap.2018.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 12/04/2018] [Accepted: 12/05/2018] [Indexed: 06/09/2023]
Abstract
The incidence of driving under the influence of psychoactive substances (DUI) and its recidivism can be curtailed by the proper identification of specific and predictive characteristics among drug users. In this sense, interpersonal violence (IV), psychiatric comorbidity and impulsivity seem to play an important role in DUI engagement according to previous studies. There are, however, limited data originated from low and middle income countries. In the present study, drug-using Brazilian drivers reporting DUI (n = 75) presented a higher prevalence of bipolar disorders (BD; DUI: 8% vs. non-DUI: 0%, p < 0.001), lower prevalence of obsessive-compulsive disorder (OCD; DUI: 0% vs. non-DUI: 12.6%, p < 0.001), and higher prevalence of childhood trauma (DUI: 65.3% vs. non-DUI: 46.8%, p = 0.022) than those not reporting DUI (n = 79). The evaluation of impulsivity though the Barratt Impulsivity Scale, which give impulsivity scores ranging from 30 to 120, showed higher impulsivity scores in the DUI group (80.4 ± 8) than in the non-DUI group (77.2 ± 10, p = 0.045). In general, subjects were young adults (mean age of 36 ± 9 years), Caucasians (58.4%), not married (61.0%), and with elementary schooling (40.3%) with no significant differences in demographic characteristics between drivers with and without DUI behavior. A multiple Poisson regression model showed that individuals reporting IV as perpetrators and history of childhood trauma were more likely to report DUI (PR: 1.66, 95%CI 1.22-2.7; PR: 1.57, 95%CI 1.02-2.42, respectively). The overlapping of violent situations (childhood trauma, IV and DUI) in some individuals presented here corroborates literature data suggesting that DUI can be an externalizing expression of a range of risky behavior, such as impulsiveness and aggressiveness. Moreover, while BD and higher impulsivity scores seem to act as risk factors for DUI, OCD was shown as a protective factor. These results corroborate the hypothesis that individuals with high risk for DUI could probably be identified by multidimensional assessment of cognitive, risky taking, and personality traits, which perhaps could facilitate the development of focused interventions.
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Affiliation(s)
- Juliana N Scherer
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil.
| | - Daiane Silvello
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil
| | - Vanessa L Volpato
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil
| | - Vinícius S Roglio
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil
| | - Letícia Fara
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil
| | - Felipe Ornell
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil
| | - Lisia von Diemen
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil
| | - Felix Paim Kessler
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil
| | - Flavio Pechansky
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Rua Professor Álvaro Alvim, 400, 90420-020, Porto Alegre, RS, Brazil
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Acupuncture for Alcohol Use Disorder: A Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 2017:7823278. [PMID: 28167975 PMCID: PMC5266803 DOI: 10.1155/2017/7823278] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 12/25/2016] [Indexed: 01/04/2023]
Abstract
Empirical research has produced mixed results regarding the effects of acupuncture on the treatment of alcohol use disorder in humans. Few studies have provided a comprehensive review or a systematic overview of the magnitude of the treatment effect of acupuncture on alcoholism. This study investigated the effects of acupuncture on alcohol-related symptoms and behaviors in patients with this disorder. The PubMed database was searched until 23 August 2016, and reference lists from review studies were also reviewed. Seventeen studies were identified for a full-text inspection, and seven (243 patients) of these met our inclusion criteria. The outcomes assessed at the last posttreatment point and any available follow-up data were extracted from each of the studies. Our meta-analysis demonstrated that an acupuncture intervention had a stronger effect on reducing alcohol-related symptoms and behaviors than did the control intervention (g = 0.67). A beneficial but weak effect of acupuncture treatment was also found in the follow-up data (g = 0.29). Although our analysis showed a significant difference between acupuncture and the control intervention in patients with alcohol use disorder, this meta-analysis is limited by the small number of studies included. Thus, a larger cohort study is required to provide a firm conclusion.
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Sobngwi-Tambekou JL, Brown TG, Bhatti JA. Driving under the influence of alcohol in professional drivers in Cameroon. TRAFFIC INJURY PREVENTION 2016; 17 Suppl 1:73-78. [PMID: 27586106 DOI: 10.1080/15389588.2016.1199867] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 06/05/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Professional drivers play a pivotal role in transporting people and goods in Cameroon. Alcohol misuse is frequent in Cameroon, but its impact on professional drivers has never been studied. This study assessed driving under the influence of alcohol and its correlates in professional drivers in Cameroon. METHODS A cross-sectional study was conducted at 4 sites on the Yaoundé-Douala highway during a 10-day period in 2014. At each site, professional drivers were randomly stopped during a 24-h window and their breath was sampled for alcohol use. The prevalence of driving under the influence (the equivalent of blood alcohol level ≥ 1 mg/100 mL) and impaired driving (blood alcohol level ≥ 40 mg/100 mL) was computed for all drivers. The correlates of driving under the influence were assessed using logistic regression analysis. RESULTS Of the 807 professional drivers stopped, complete data for 783 were available. Almost all were men (n = 781). The mean age of drivers was 38.3 years (SD = 8.9). About one in 10 drivers (n = 77, 9.8%) tested positive for driving under the influence. About 2.8% (n = 22) had blood alcohol levels ≥ 40 mg/100 mL (legal limit in the United States) and 1.4% (n = 11) had blood alcohol levels ≥ 80 mg/100 mL. The likelihood of driving under the influence increased in drivers scoring 8 or more on Alcohol Use Disorder Identification Test (adjusted odds ratio [aOR] = 3.60; 95% confidence interval [CI], 2.14-6.07) and in those having a nighttime driving schedule (aOR = 4.43; 95% CI, 1.33-14.77). CONCLUSION These findings suggest that increasing enforcement to counter impaired driving in professional drivers in Cameroon is needed. Interventions might include screening for alcohol misuse and hazardous occupational practices.
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Affiliation(s)
| | - Thomas G Brown
- c Douglas Mental Health University Institute , Montreal , QC , Canada
| | - Junaid Ahmad Bhatti
- d Sunnybrook Research Institute , Toronto , ON , Canada
- e University of Toronto , Department of Surgery , Toronto , ON , Canada
- f Institute for Clinical Evaluative Sciences , Toronto , ON , Canada
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Du A, Jiang H, Xu L, An N, Liu H, Li Y, Zhang R. Damage of hippocampal neurons in rats with chronic alcoholism. Neural Regen Res 2014; 9:1610-5. [PMID: 25368648 PMCID: PMC4211203 DOI: 10.4103/1673-5374.141787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2014] [Indexed: 01/08/2023] Open
Abstract
Chronic alcoholism can damage the cytoskeleton and aggravate neurological deficits. However, the effect of chronic alcoholism on hippocampal neurons remains unclear. In this study, a model of chronic alcoholism was established in rats that were fed with 6% alcohol for 42 days. Endogenous hydrogen sulfide content and cystathionine-beta-synthase activity in the hippocampus of rats with chronic alcoholism were significantly increased, while F-actin expression was decreased. Hippocampal neurons in rats with chronic alcoholism appeared to have a fuzzy nuclear membrane, mitochondrial edema, and ruptured mitochondrial crista. These findings suggest that chronic alcoholism can cause learning and memory decline in rats, which may be associated with the hydrogen sulfide/cystathionine-beta-synthase system, mitochondrial damage and reduced expression of F-actin.
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Affiliation(s)
- Ailin Du
- Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan Province, China ; Department of Physiology and Neurobiology, Xinxiang Medical University, Xinxiang, Henan Province, China
| | - Hongbo Jiang
- Department of Physiology and Neurobiology, Xinxiang Medical University, Xinxiang, Henan Province, China ; Department of Neurology, the Third Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan Province, China
| | - Lei Xu
- Department of Physiology and Neurobiology, Xinxiang Medical University, Xinxiang, Henan Province, China
| | - Na An
- Department of Physiology and Neurobiology, Xinxiang Medical University, Xinxiang, Henan Province, China
| | - Hui Liu
- Department of Physiology and Neurobiology, Xinxiang Medical University, Xinxiang, Henan Province, China ; Department of Neurology, the Third Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan Province, China
| | - Yinsheng Li
- Department of Physiology and Neurobiology, Xinxiang Medical University, Xinxiang, Henan Province, China
| | - Ruiling Zhang
- Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan Province, China ; Department of Physiology and Neurobiology, Xinxiang Medical University, Xinxiang, Henan Province, China ; Henan Provincial Key Laboratory of Bio-psychiatry, Xinxiang, Henan Province, China
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Ouimet MC, Brown TG, Guo F, Klauer SG, Simons-Morton BG, Fang Y, Lee SE, Gianoulakis C, Dingus TA. Higher crash and near-crash rates in teenaged drivers with lower cortisol response: an 18-month longitudinal, naturalistic study. JAMA Pediatr 2014; 168:517-22. [PMID: 24710522 PMCID: PMC4139916 DOI: 10.1001/jamapediatrics.2013.5387] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Road traffic crashes are one of the leading causes of injury and death among teenagers worldwide. Better understanding of the individual pathways to driving risk may lead to better-targeted intervention in this vulnerable group. OBJECTIVE To examine the relationship between cortisol, a neurobiological marker of stress regulation linked to risky behavior, and driving risk. DESIGN, SETTING, AND PARTICIPANTS The Naturalistic Teenage Driving Study was designed to continuously monitor the driving behavior of teenagers by instrumenting vehicles with kinematic sensors, cameras, and a global positioning system. During 2006-2008, a community sample of 42 newly licensed 16-year-old volunteer participants in the United States was recruited and driving behavior monitored. It was hypothesized in teenagers that higher cortisol response to stress is associated with (1) lower crash and near-crash (CNC) rates during their first 18 months of licensure and (2) faster reduction in CNC rates over time. MAIN OUTCOMES AND MEASURES Participants' cortisol response during a stress-inducing task was assessed at baseline, followed by measurement of their involvement in CNCs and driving exposure during their first 18 months of licensure. Mixed-effect Poisson longitudinal regression models were used to examine the association between baseline cortisol response and CNC rates during the follow-up period. RESULTS Participants with a higher baseline cortisol response had lower CNC rates during the follow-up period (exponential of the regression coefficient, 0.93; 95% CI, 0.88-0.98) and faster decrease in CNC rates over time (exponential of the regression coefficient, 0.98; 95%, CI, 0.96-0.99). CONCLUSIONS AND RELEVANCE Cortisol is a neurobiological marker associated with teenaged-driving risk. As in other problem-behavior fields, identification of an objective marker of teenaged-driving risk promises the development of more personalized intervention approaches.
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Affiliation(s)
- Marie Claude Ouimet
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Longueuil, Quebec, Canada,Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Thomas G. Brown
- Douglas Hospital Research Centre, McGill University, Montreal, Quebec, Canada
| | - Feng Guo
- Virginia Tech Transportation Institute, Blacksburg, Virginia,Department of Statistics, Virginia Tech, Blacksburg, Virginia
| | | | - Bruce G. Simons-Morton
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Youjia Fang
- Department of Statistics, Virginia Tech, Blacksburg, Virginia
| | - Suzanne E. Lee
- Virginia Tech Transportation Institute, Blacksburg, Virginia
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Liao DL, Huang CY, Hu S, Fang SC, Wu CS, Chen WT, Lee TSH, Chen PC, Li CSR. Cognitive control in opioid dependence and methadone maintenance treatment. PLoS One 2014; 9:e94589. [PMID: 24727743 PMCID: PMC3984179 DOI: 10.1371/journal.pone.0094589] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 03/18/2014] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Substance misuse is associated with cognitive dysfunction. We used a stop signal task to examine deficits in cognitive control in individuals with opioid dependence (OD). We examined how response inhibition and post-error slowing are compromised and whether methadone maintenance treatment (MMT), abstinence duration, and psychiatric comorbidity are related to these measures in individuals with OD. METHODS Two-hundred-and-sixty-four men with OD who were incarcerated at a detention center and abstinent for up to 2 months (n = 108) or at a correctional facility and abstinent for approximately 6 months (n = 156), 65 OD men under MMT at a psychiatric clinic, and 64 age and education matched healthy control (HC) participants were assessed. We computed the stop signal reaction time (SSRT) to index the capacity of response inhibition and post-error slowing (PES) to represent error-related behavioral adjustment, as in our previous work. We examined group effects with analyses of variance and covariance analyses, followed by planned comparisons. Specifically, we compared OD and HC participants to examine the effects of opioid dependence and MMT and compared OD sub-groups to examine the effects of abstinence duration and psychiatric comorbidity. RESULTS The SSRT was significantly prolonged in OD but not MMT individuals, as compared to HC. The extent of post-error slowing diminished in OD and MMT, as compared to HC (trend; p = 0.061), and there was no difference between the OD and MMT groups. Individuals in longer abstinence were no less impaired in these measures. Furthermore, these results remained when psychiatric comorbidities including misuse of other substances were accounted for. CONCLUSIONS Methadone treatment appears to be associated with relatively intact cognitive control in opioid dependent individuals. MMT may facilitate public health by augmenting cognitive control and thereby mitigating risky behaviors in heroin addicts.
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Affiliation(s)
- Ding-Lieh Liao
- Department of Addiction Psychiatry, Bali Psychiatric Center, Department of Health, New Taipei City, Taiwan
- Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan
- * E-mail: (DLL); (CSRL)
| | - Cheng-Yi Huang
- Department of Addiction Psychiatry, Bali Psychiatric Center, Department of Health, New Taipei City, Taiwan
| | - Sien Hu
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Su-Chen Fang
- Department of Nursing, Oriental Institute of Technology, New Taipei City, Taiwan
| | - Chi-Shin Wu
- Department of Psychiatry, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Wei-Ti Chen
- School of Nursing, Yale University, New Haven, Connecticut, United States of America
| | - Tony Szu-Hsien Lee
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
| | - Pau-Chung Chen
- Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chiang-shan R. Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, United States of America
- * E-mail: (DLL); (CSRL)
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Bouchard SM, Brown TG, Nadeau L. Decision-making capacities and affective reward anticipation in DWI recidivists compared to non-offenders: a preliminary study. ACCIDENT; ANALYSIS AND PREVENTION 2012; 45:580-587. [PMID: 22269545 DOI: 10.1016/j.aap.2011.09.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2011] [Revised: 09/06/2011] [Accepted: 09/11/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVES Impaired decision making is seen in several problem behaviours including alcoholism and problem gambling. Decision-making style may contribute to driving while impaired with alcohol (DWI) in some offenders as well. The Somatic Marker Framework theorizes that decision making is the product of two interacting affective neural systems, an impulsive, rapid, amygdala-dependent process for emotionally signalling the immediate negative or positive consequences of an option, and a reflective, longer-lasting, ventral medial prefrontal cortex dependent system for emotionally signalling the future negative or positive prospects of an option. This study tested the hypothesis that offenders who showed disadvantageous decision-making would be at higher risk for recidivism than those who showed more advantageous decision-making. In addition, in line with the Somatic Marker Hypothesis, offenders who showed disadvantageous decision-making would exhibit a distinct pattern of somatic activation compared to offenders who showed more advantageous decision-making. METHODS A sample of 21 DWI offenders with from 2 to 7 past DWI convictions and a reference group consisting of 19 non-offender (N-O) drivers were recruited and administered the Iowa Gambling Task (IGT), as well as evaluated on sociodemographic, driving and alcohol use dimensions. In addition, anticipatory skin conductance response (aSCR) was measured in the 5s prior to each of a 100 card draws on the IGT. RESULTS Median split of the DWI offender sample based upon overall performance on the IGT yielded two subgroups (IGT-R Hi and IGT-R Lo). Hypothesis 1 was supported, as the IGT-R Lo group possessed significantly greater frequency of past DWI convictions and severity of past drinking. Descriptive analyses revealed that on the IGT, IGT-R Hi group performed similarly to the N-O reference group while the IGT-R Lo group performed significantly worse. Hypothesis 2 was not supported. CONCLUSIONS Decision making is a plausible explanatory neurocognitive pathway to severer forms of DWI. The role of emotional processing in DWI risk is uncertain. Subtyping DWI offenders using neurocognitive criteria seems a promising avenue for improving clinically meaningful methods of DWI risk assessment and intervention.
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Couture S, Brown TG, Tremblay J, Ng Ying Kin NMK, Ouimet MC, Nadeau L. Are biomarkers of chronic alcohol misuse useful in the assessment of DWI recidivism status? ACCIDENT; ANALYSIS AND PREVENTION 2010; 42:307-312. [PMID: 19887172 DOI: 10.1016/j.aap.2009.08.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2009] [Revised: 08/04/2009] [Accepted: 08/09/2009] [Indexed: 05/28/2023]
Abstract
UNLABELLED A first driving while impaired by alcohol (DWI) conviction is a key opportunity to identify offenders who are at high risk for recidivism. Detection of alcohol use disorder (AUD) is a major target of current DWI assessments. However, offenders frequently underreport their alcohol consumption, and use of biomarkers has been proposed as a more objective indicator. Among the best established are aspartate aminotranferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), mean corpuscular red blood cell volume (MCV), carbohydrate-deficient transferrin (CDT), and thiamine. To our knowledge, no research has directly verified whether AUD biomarkers predict DWI recidivism status. Using a cross-sectional design, this study tested three hypotheses related to the utility of biomarkers in DWI assessment. HYPOTHESES (1) DWI recidivists possess biomarkers indicative of greater prevalence of AUD compared to first-time offenders; (2) multiple biomarkers better differentiate first-time offenders from recidivists compared to individual biomarkers; and (3) biomarkers add significantly to the prediction of recidivism over and above psychosocial questionnaires. METHODS First-time offenders (n = 49) and recidivists (n = 95) participated in the study. In addition to self-reported information on sociodemographic and driving characteristics, data from several AUD questionnaires were gathered: Michigan Alcoholism Screening Test, Alcohol Use Disorders Identification Test, Composite International Diagnostic Interview, and Timeline Follow-Back. Blood samples were collected to measure AST, ALT, GGT, MCV, CDT, and thiamine. RESULTS AUD biomarkers, taken individually or in combination, did not indicate that recidivists had more frequent AUD compared to first-time offenders. Also, they failed to significantly differentiate first-time offenders from recidivists or predict recidivism status. Finally, the superiority of biomarkers over psychosocial AUD questionnaires was not supported in the laboratory setting. CONCLUSION The present findings suggest that biomarkers of chronic patterns of heavy drinking may not be adequate to capture the multiple processes that appear to promote recidivism (e.g., binge drinking, other risky behavioural and personality features). Despite their objectivity, caution is warranted in the interpretation of a positive score on these biomarkers in DWI assessment. Longitudinal research is needed to more comprehensively explore the relationship between positive biomarkers in first-time offenders and their risk of becoming recidivists.
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Affiliation(s)
- Sophie Couture
- Addiction Research Program, Douglas Mental Health University Institute, Perry Pavilion, Fourth Floor, Rm. E-4118, 6875 LaSalle Blvd., Verdun, Québec, Canada H4H 1R3
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