Decision Making, Impulsivity, and Personality Traits in Alcohol-Dependent Subjects

Implications of Impulsivity on Criminal Behavior in Individuals With Substance Use Disorder

OBJECTIVE

Our aim was to analyze the association between criminal behavior and impulsivity in individuals with drug addiction and investigate whether impulsiveness mediates the relationship between drug use severity and legal problems.

METHODS

This cross-sectional study included 773 men diagnosed with addiction (295 alcohol users and 478 users of crack/polysubstance) while undergoing addiction treatment. The BIS-11 and ASI-6 were applied to assess impulsivity, criminal behavior, and drug use.

RESULTS

The prevalence of criminal behavior was 41.7% (n = 123) in alcohol users and 64.9% (n = 310) in users of crack/polysubstance. Earlier use of different substances and higher impulsivity scores were observed in individuals with criminal history. Mediation analyses revealed that impulsiveness acts as a mediator factor between substance use and criminal behavior, enhancing the severity of legal problems.

CONCLUSION

Our findings can help in deciding on tailored treatment strategies, focusing not only on substance use, but also on the prevention of social problems, criminality, and impulsivity.

Profiles and the impact of affective temperaments on alcohol use disorder: a cross-sectional study

AIMS

This study aimed to explore the profiles and impact of affective temperaments, together with social and clinical backgrounds, including affective symptoms, in patients with alcohol use disorder (AUD).

METHODS

This study included 314 low-risk drinkers and 257 patients with AUD. To assess affective temperament, we used the short version of the temperament evaluation of Memphis, Pisa, Paris, and San Diego. To evaluate depressive and mixed symptoms, the quick inventory of depressive symptomatology self-report Japanese version and 12-item questionnaire for the quantitative assessment of the depressive mixed state were used. We compared the profiles of affective temperaments as well as social and clinical backgrounds, including affective symptoms, between the two groups and further performed logistic regression analyses to explore the factors contributing to AUD.

RESULTS

Our analysis showed higher cyclothymic, hyperthymic, and irritable temperament scores and lower depressive temperament scores in patients with AUD than that in nonclinical drinkers. Regarding other social and clinical backgrounds, patients with AUD were less educated and employed and more experienced depressive and mixed symptoms. Logistic regression analysis identified hyperthymic temperament as a positive contributor and depressive temperament as a negative contributor to AUD.

CONCLUSIONS

Our findings indicated potential bipolarity in patients with AUD, as manifested by a more hyperthymic temperament in contrast to less depressive temperament. Despite their self-perceived adaptive temperament profiles, patients showed poorer social outcomes and more affective symptoms. This gap may be partly explained by a lack of insight unique to AUD psychology, which potentially disturbs problem recognition.

Predicting Alcohol-Related Memory Problems in Older Adults: A Machine Learning Study with Multi-Domain Features

Memory problems are common among older adults with a history of alcohol use disorder (AUD). Employing a machine learning framework, the current study investigates the use of multi-domain features to classify individuals with and without alcohol-induced memory problems. A group of 94 individuals (ages 50-81 years) with alcohol-induced memory problems (the memory group) were compared with a matched control group who did not have memory problems. The random forests model identified specific features from each domain that contributed to the classification of the memory group vs. the control group (AUC = 88.29%). Specifically, individuals from the memory group manifested a predominant pattern of hyperconnectivity across the default mode network regions except for some connections involving the anterior cingulate cortex, which were predominantly hypoconnected. Other significant contributing features were: (i) polygenic risk scores for AUD, (ii) alcohol consumption and related health consequences during the past five years, such as health problems, past negative experiences, withdrawal symptoms, and the largest number of drinks in a day during the past twelve months, and (iii) elevated neuroticism and increased harm avoidance, and fewer positive "uplift" life events. At the neural systems level, hyperconnectivity across the default mode network regions, including the connections across the hippocampal hub regions, in individuals with memory problems may indicate dysregulation in neural information processing. Overall, the study outlines the importance of utilizing multidomain features, consisting of resting-state brain connectivity data collected ~18 years ago, together with personality, life experiences, polygenic risk, and alcohol consumption and related consequences, to predict the alcohol-related memory problems that arise in later life.

Decreased inter-brain synchronization in the right middle frontal cortex in alcohol use disorder during social interaction: An fNIRS hyperscanning study

BACKGROUND

Alcohol use disorder (AUD) is a widespread mental disorder and has thrust a heavy burden on the health system all over the world. Social cognition and function are reported to be impaired in AUD, but its neural mechanism is rarely investigated. The current study attempts to fill this gap.

METHODS

28 subjects with AUD and 36 healthy controls (HC) were recruited in this study and were paired into 14 AUD dyads and 18 HC dyads. The drinking problems, depression, anxiety, and impulsivity of subjects were measured. Each dyad completed cooperation and competition tasks with simultaneous frontal functional near-infrared spectroscopy (fNIRS) hyperscanning recording. The inter-brain synchronization (IBS) in the frontal cortex was calculated for each dyad and compared between AUD and HC. The significantly altered IBS in AUD was correlated with clinical measures to explore possible influencing factors.

RESULTS

The IBS in the right middle frontal cortex was significantly decreased in AUD under both cooperation (t = -2.257, P = 0.028) and competition (t = -2.488, P = 0.016) task. The IBS during the cooperation task in the right middle frontal cortex in AUD was negatively correlated with non-planning impulsivity (r = -0.673, P = 0.006).

LIMITATIONS

This study used cross-sectional data, which limited the causal inference. The synchronization between other brain regions besides the frontal cortex should be further explored in patients with AUD.

CONCLUSION

The current study could provide new insights into the neural mechanism of social dysfunction in AUD and facilitate clinical intervention in future practice.

Risky Decision-Making in Adults with Alcohol Use Disorder-A Systematic and Meta-Analytic Review

Alcohol use disorder (AUD) forms a major health concern and is the most common substance use disorder worldwide. The behavioural and cognitive deficits associated with AUD have often been related to impairments in risky decision-making. The aim of this study was to examine the magnitude and type of risky decision-making deficits of adults with AUD, as well as to explore the potential mechanisms behind these deficits. To this end, existing literature comparing risky decision-making task performance of an AUD group to a control group (CG) was systematically searched and analysed. A meta-analysis was performed to address overall effects. In total, 56 studies were included. In the majority of studies (i.e., 68%), the performance of the AUD group(s) deviated from the CG(s) on one or more of the adopted tasks, which was confirmed by a small to medium pooled effect size (Hedges' g = 0.45). This review therefore provides evidence of increased risk taking in adults with AUD as compared to CGs. The increased risk taking may be due to deficits in affective and deliberative decision-making. Making use of ecologically valid tasks, future research should investigate whether risky decision-making deficits predate and/or are consequential to the addiction of adults with AUD.

Personality-Related Factors and Depressive Symptomatology Predict Behavioral Control in Patients With Alcohol Use Disorders

In the face of increasing social, economic, and health consequences of alcohol use disorders (AUDs) and limited effects of available treatment options, the search for novel prevention and management methods continues to remain a timely and valid endeavor. This, however, requires a better grasp of the theoretical framework underlying addiction mechanisms. With the goal to extend the existing body of evidence on AUDs, we set out to investigate the effect of personality-related factors and depressive symptomatology on (i) impulsivity, (ii) cognitive response inhibition, and (iii) the links between the two measures of behavioral control (different facets of impulsivity and response inhibition) in a treatment-seeking AUD sample. To this end, 53 male (n = 45) and female (n = 8) inpatients at an alcohol rehabilitation center completed three self-report questionnaires: the International Personality Item Pool (IPIP-50), the Beck Depression Inventory Second Edition (BDI-II) and the Barratt Impulsiveness Scale (BIS-11) and performed one behavioral task-an alcohol go/no go task. Regression analyses revealed conscientiousness, intellect, and depression level to be important potential predictors of self-report impulsivity and processing speed in recovering drinkers. No significant links were observed between the two measures of behavioral control, thus complementing evidence that while they both encompass behavioral under-regulation, they may indeed represent distinct psychological constructs.

Common Features in Compulsive Sexual Behavior, Substance Use Disorders, Personality, Temperament, and Attachment-A Narrative Review

Do addictions share common traits of an “addictive personality” or do different addictions have distinct personality profiles? This narrative review examines the differences in the associations between substance use disorder (SUD) and compulsive sexual behavior disorder (CSBD), on the one hand, and personality traits, attachment dispositions, and temperament, on the other hand. We found that both people with a SUD and people with CSBD tended to be more spontaneous, careless, and less reliable, to place self-interest above getting along with others, to show emotional instability and experience negative emotions such as anger, anxiety, and/or depression, to be less able to control their attention and/or behavior, and to be engulfed with a constant sensation of “wanting”. Only people with CSBD, but not SUD, noted concerns with their social ties, fear of losing close others, and/or trusting others around them. Results also suggested that people with a SUD and people with CSBD share high commonalities in personality traits and temperament, yet there are noted differences in their social tendencies, especially with close others. People with CSBD reported more concerns with possible relationship losses compared to people with SUD issues, who may be more worried about losing their source of escapism.

Alcohol Consumption during Adulthood Does Not Impair Later Go/No-Go Reversal Learning in Male Rats

Reversal learning tasks are used to model flexible decision-making in laboratory animals, and exposure to drugs of abuse can cause long-term impairments in reversal learning. However, the long-term effects of alcohol on reversal learning have varied. We evaluated whether six weeks of voluntary alcohol consumption through chronic intermittent alcohol access (elevated by food restriction) in adult male rats would impair rats in a go/no-go reversal learning task when tested at an interval beyond acute withdrawal. In our go/no-go task, rats were reinforced for pressing one lever or withholding from pressing another lever, and the identities of the two levers were switched twice (once rats reached an accuracy criterion). We found no evidence that prior alcohol consumption altered discrimination or reversal learning in our task. This replicates previous patterns from our laboratory that higher alcohol consumption in food-restricted rats did not impair discrimination or reversal learning in a different go/no-go task and that alcohol consumption in free-fed adolescent/early adult rats did not impair go/no-go discrimination or reversal learning in the same task. It is unclear whether this represents an insensitivity of this task to alcohol exposure generally or whether an alcohol exposure procedure that leads to higher blood ethanol concentration (BEC) levels would impair learning. More research is needed to investigate these possibilities.

Multiscale Free Energy Analysis of Human Ecosystem Engineering

Unlike ecosystem engineering by other living things, which brings a relatively limited range of sensations that are connected to a few enduring survival preferences, human ecosystem engineering brings an increasing variety and frequency of novel sensations. Many of these novel sensations can quickly become preferences as they indicate that human life will be less strenuous and more stimulating. Furthermore, they can soon become addictive. By contrast, unwanted surprise from these novel sensations may become apparent decades later. This recognition can come after the survival of millions of humans and other species has been undermined. In this paper, it is explained that, while multiscale free energy provides a useful hypothesis for framing human ecosystem engineering, disconnects between preferences and survival from human ecosystem engineering limit the application of current assumptions that underlie continuous state-space and discrete state-space modelling of active inference.

Individual associations of adolescent alcohol use disorder versus cannabis use disorder symptoms in neural prediction error signaling and the response to novelty

Two of the most commonly used illegal substances by adolescents are alcohol and cannabis. Alcohol use disorder (AUD) and cannabis use disorder (CUD) are associated with poorer decision-making in adolescents. In adolescents, level of AUD symptomatology has been negatively associated with striatal reward responsivity. However, little work has explored the relationship with striatal reward prediction error (RPE) representation and the extent to which any augmentation of RPE by novel stimuli is impacted. One-hundred fifty-one adolescents participated in the Novelty Task while undergoing functional magnetic resonance imaging (fMRI). In this task, participants learn to choose novel or non-novel stimuli to gain monetary reward. Level of AUD symptomatology was negatively associated with both optimal decision-making and BOLD response modulation by RPE within striatum and regions of prefrontal cortex. The neural alterations in RPE representation were particularly pronounced when participants were exploring novel stimuli. Level of CUD symptomatology moderated the relationship between novelty propensity and RPE representation within inferior parietal lobule and dorsomedial prefrontal cortex. These data expand on an emerging literature investigating individual associations of AUD symptomatology levels versus CUD symptomatology levels and RPE representation during reinforcement processing and provide insight on the role of neuro-computational processes underlying reinforcement learning/decision-making in adolescents.

Impulsivity as a Risk Factor for Suicide in Bipolar Disorder

The accurate assessment of suicide risk in psychiatric, especially affective disorder diagnosed patients, remains a crucial clinical need. In this study, we applied temperament and character inventory (TCI), Barratt impulsiveness scale 11 (BIS-11), PEBL simple reaction time (SRT) test, continuous performance task (CPT), and Iowa gambling task (IGT) to seek for variables linked with attempted suicide in bipolar affective disorder group (n = 60; attempters n = 17). The main findings were: strong correlations between self-report tool scores and objective parameters in CPT; the difference between attempters and non-attempters was found in the number of correctly responded trials in IGT; only one parameter differed between attempters and non-attempters in BPI diagnosis; and no significant differences between suicide attempters and non-attempters in TCI, BIS-11, and SRT were found. These justify the conclusion that impulsivity itself is not a strong predictor, and used as a single variable might not be sufficient to indicate the high suicide risk group among bipolar patients.

Variation on the CRH Gene Determines the Different Performance of Opioid Addicts and Healthy Controls in the IOWA Gambling Task

BACKGROUND

The hypothalamus-pituitary-adrenal (HPA) axis, the biological substrate of stress reactivity, and related genetic variations play a crucial role in the initiation and maintenance of drug addiction. On the behavioral level, substance abusers are characterized by impulsivity and the inability to pursue long-term goals. The neural substrate of these behaviors is assumed to be related to the ventromedial prefrontal cortex (VMPFC). One of the most established paradigms to assess VMPFC deficiency is the IOWA gambling task (IGT).

AIMS

The aim of this study was to investigate the interplay between the HPA axis-related genetic variation on corticotropin-releasing hormone (CRH; secreted from the hypothalamus and constituting the starting point of the HPA axis) gene and opioid addiction, with respect to IGT performance. There is some evidence that stress and pathological HPA axis hyperactivity, in the same way as drug addiction, is related to a poorer IGT performance.

METHODS

In total, 138 long-term opioid addicts (mean age 38.63 years [SD 9.15]) and 160 healthy controls (mean age 22.57 years [SD 5.86]) performed the IGT and were genotyped for 6 SNPs covering the CRH gene and adjacent regions (rs3176921, rs6999780, rs7816410, rs1870393, rs1814583, and rs11996294). The first 5 of these 6 SNPs build a haplotype block spanning 15 kb on the CRH gene.

RESULTS

We found a significant group difference in the total IGT score, with higher scores in controls than in opioids. Most interestingly, there was a 3-way interaction, group × haplotype × block. Carriers homozygous for the TGTAA-haplotype differed in IGT performance dependent on group. In the control group, carriers homozygous for the TGTAA-haplotype showed a linear learning curve across blocks of trials, which was not observed in participants without this homozygosity. There were diametric effects in opioid addicts. Controlling for age and gender did not change the findings.

CONCLUSION

This study provides genetic evidence for the interplay between stress, decision-making, and opioid addiction.

The personality profile of chronic alcohol dependent patients with comorbid gambling disorder symptoms

BACKGROUND AND AIMS

The importance of personality characteristics in the diagnosis and treatment of gambling disorder (GD) and alcohol use disorder (AUD) is often highlighted in scientific literature. This study aimed to test predictions about the associations of temperament and character in chronic AUD patients with comorbid GD symptoms and without them.

METHODS

Chronic AUD patients enrolled from an inpatient clinic were divided in two groups based on cluster analysis, AUD patients with (AUD + GD group: n = 30) and without (AUD group: n = 68) GD symptoms. Severity of GD symptoms and personality dimensions (Cloninger's Temperament and Character Inventory Revised, TCI-R) were assessed. Associations of tested variables were analysed with analysis of covariance, one-sample and independent sample t-tests.

RESULTS

GD symptoms proved to be a clustering factor in terms of personality, where AUD + GD group expressed a more maladaptive personality profile. Compared to Hungarian normative TCI-R scores, both patient groups showed elevated levels of Harm Avoidance and Novelty Seeking with lower scores of Self-directedness, while the AUD + GD group scored lower on Persistence and Cooperation as well. The AUD + GD group reported significantly higher levels of Harm Avoidance, with lower scores of Reward Dependence compared to the AUD group.

DISCUSSION

Comorbid GD symptom severity is an important factor in chronic AUD, where AUD patients with comorbid GD symptoms exhibited a more maladaptive personality constellation than singular AUD patients. These emphasize the need of special attention for comorbid GD symptoms in AUD, since treatment recommendations and prognosis for them may also differ.

Addicted to compulsion: assessing three core dimensions of addiction across obsessive-compulsive disorder and gambling disorder

OBJECTIVE

Several studies suggested that obsessive-compulsive disorder (OCD) patients display increased impulsivity, impaired decision-making, and reward system dysfunction. In a Research Domain Criteria (RDoC) perspective, these findings are prototypical for addiction and have led some authors to view OCD as a behavioral addiction. Thus, the aim of this study was to investigate similarities and differences on impulsivity, decision-making, and reward system, as core dimensions of addiction, across OCD and gambling disorder (GD) patients.

METHODS

Forty-four OCD patients, 26 GD patients, and 40 healthy controls (HCs) were included in the study. Impulsivity was assessed through the Barratt Impulsiveness Scale, decision-making through the Iowa Gambling Task, and reward system through a self-report clinical instrument (the Shaps-Hamilton Anhedonia Scale) assessing hedonic tone and through an olfactory test assessing hedonic appraisal to odors.

RESULTS

Both OCD and GD patients showed increased impulsivity when compared to HCs. More specifically, the OCD patients showed cognitive impulsivity, and the GD patients showed both increased cognitive and motor impulsivity. Furthermore, both OCD and GD patients showed impaired decision-making performances when compared to HCs. Finally, GD patients showed increased anhedonia and blunted hedonic response to pleasant odors unrelated to gambling or depression/anxiety symptoms, while OCD patients showed only increased anhedonia levels related to OC and depression/anxiety symptoms.

CONCLUSION

OCD patients showed several similarities and some differences with GD patients when compared to HCs on impulsivity, decision-making, and reward system, three core dimensions of addiction. These results could have relevant implications for the research of new treatment targets for OCD.

Personality Traits and Impulsivity Tasks Among Substance Use Disorder Patients: Their Relations and Links With Retention in Treatment

BACKGROUND

Various authors have described the elements of impulsive approach and inhibitory control in drug users. These two components have been studied in terms of personality traits, performance on tasks that measure impulsive behavior, and neurophysiology. However, few studies have analyzed the association between these constructs. Thus, the aim of the present study is to analyze the associations between personality traits and performance on impulsivity tasks.

METHODS

A follow-up study was conducted with a baseline assessment at the beginning and end of treatment. The sample was composed of 121 patients undergoing treatment in therapeutic communities. Personality domains were evaluated through the PID-5. The impulsivity tasks employed were the Iowa Gambling Task (IGT), Delay Discounting Test (DDT), Go/No-Go and Stroop test.

RESULTS

A correlation was found between DDT scores and the domains of detachment (r = -.315; p<.01), antagonism (r = -.294; p<.01), and disinhibition (r = .215; p<.05). Performance on the Stroop task was significantly associated with psychoticism (r = .232; p<.05) and negative affect (r = .212; p<.05). Multivariate analysis revealed that IGT scores and negative affect predict retention in treatment.

CONCLUSIONS

These findings partially support the hypothesized association between sensation-seeking personality traits and detachment with impulsive choice tasks; and the relationships between negative affect and psychoticism traits with performance on inhibitory control tasks. Further, impulsive choice task scores and negative affect are both shown to predict retention in treatment.

Monoaminergic modulation of decision-making under risk of punishment in a rat model

The ability to decide advantageously among options that vary in both their risks and rewards is critical for survival and well-being. Previous work shows that some forms of risky decision-making are robustly modulated by monoamine signaling, but it is less clear how monoamine signaling modulates decision-making under risk of explicit punishment. The goal of these experiments was to determine how this form of decision-making is modulated by dopamine, serotonin, and norepinephrine signaling, using a task in which rats choose between a small, 'safe' food reward and a large food reward associated with variable risks of punishment. Preference for the large, risky reward (risk-taking) was reduced by administration of a D2/3 dopamine receptor agonist (bromocriptine) and a selective D2 agonist (sumanirole). The selective D3 agonist PD128907 appeared to attenuate reward discrimination abilities but did not affect risk-taking per se. In contrast, drugs targeting serotonergic and noradrenergic signaling had few if any effects on choice behavior. These data suggest that in contrast to other forms of risky decision-making, decision-making under risk of punishment is selectively modulated by dopamine signaling, predominantly through D2 receptors.

My own personal hell: approaching and exceeding thresholds of too much alcohol

Objectives: Government guidelines aim to promote sensible alcohol consumption but such advice is disconnected from people's lived experiences. This research investigated how people construct personal thresholds of 'too much' alcohol. Design and measures: One hundred fifty drinkers completed an online survey (M_age = 23.29(5.51); 64.7% female). Participants were asked whether they had an intuitive sense of what constitutes too much alcohol. They wrote open-ended descriptions of how that threshold had been established and how it felt to approach/exceed it. These qualitative accounts were coded using thematic analysis and interpreted with an experiential theoretical framework. Results: Personal thresholds were based on previously experienced embodied states rather than guidelines, or health concerns. Describing the approach to their threshold, 75% of participants fell into two distinct groups. Group 1's approach was an entirely negative embodied experience (nausea/anxiety) and Group 2's approach was an entirely positive, embodied experience (relaxed/pleasurable). These groups differed significantly in awareness of alcohol's effects, agency and self-perceptions, but not on alcohol consumption. Exceeding their threshold was an entirely negative embodied experience for all. Conclusion: These findings illustrate that people are guided by experientially grounded conceptions of consumption. Interventions could target different groups of drinker according to their embodied experience during the approach to 'too much' alcohol.

Operant over-responding is more sensitive than reversal learning for revealing behavioral changes after withdrawal from alcohol consumption

In humans, prior alcohol use is linked with impulsivity and impaired decision-making, but the nature of this relationship is unclear. In a previous study in rats, we found that prior alcohol access led to over-responding in go/no-go discrimination training, but had no effect on discrimination learning. It was unclear whether this over-responding effect would occur in a reversal learning task, or whether prior alcohol would impair reversal learning in our task. In the present experiments, we determined whether six weeks of chronic intermittent alcohol access would induce over-responding or impair reversal learning in our task. Our task allowed for multiple responses/trial with limited reinforcement, so over-responding could be assessed. In Exp. 1, we gave three days of discrimination training prior to access to 20% alcohol or water, then reversed task contingencies starting 4 days after the end of alcohol access. In Exp. 2, we gave either three or six days of discrimination training prior to the same alcohol access and reversal learning procedures to determine if the original training length would affect alcohol's behavioral effects. We found no reversal learning deficits in either experiment. Across both experiments, we found that the Alcohol group exhibited over-responding to the active lever, but this effect was smaller than in our previous discrimination experiments. Our data suggest that there are behavioral changes after voluntary alcohol access that can be missed by some discrimination/reversal learning assessments, and our over-responding task can detect these transient changes. However, over-responding is more pronounced in discrimination than reversal learning.

Clinical Usefulness of the Iowa Gambling Task in Severe Alcohol Use Disorders: Link with Relapse and Cognitive-Physiological Deficits

BACKGROUND

Decision-making impairments have been repeatedly evaluated in severe alcohol use disorders (SAUD) using the Iowa Gambling Task (IGT). The IGT, capitalizing on strong theoretical background and ecological significance, allowed identifying large-scale deficits in this population and is now a standard decision-making assessment in therapeutic settings. However, the clinical usefulness of the IGT, particularly regarding its ability to predict relapse and its link with key cognitive-physiological deficits, remains to be clarified.

METHODS

Thirty-eight recently detoxified patients with SAUD and 38 matched healthy controls performed the IGT, a neuropsychological task using monetary rewards to assess decision making under uncertainty and under risk. Disease characteristics (e.g., duration and intensity), cognitive abilities, psychopathological comorbidities, and physiological damage were also measured, as well as relapse rates 6 months later.

RESULTS

Compared to controls, patients with SAUD presented a dissociation between preserved decision making under uncertainty and impaired decision making under risk. In the SAUD group, while relapsers (55% of the sample) presented lower global cognitive functioning and stronger liver damage than nonrelapsers at detoxification time, no difference was found between these subgroups for the IGT. IGT results were not related to alcohol-consumption characteristics or cognitive-physiological deficits.

CONCLUSIONS

SAUD is not related to a global IGT deficit, as suggested earlier, but rather to a specific impairment for decision making under risk. This deficit is not associated with other disease-related variables and has no relapse prediction power. These results question the clinical usefulness of the IGT as a tool identifying key treatment levers and guiding (neuro)psychological rehabilitation.

Cognitive and behavioural dispositions in offspring at high risk for alcoholism

OBJECTIVES

Offspring with family history of alcoholism are considered to be at high risk for alcoholism. The present study sought to expand our understanding of cognitive and behavioural dispositions associated with executive control and self-regulation in alcohol naïve offspring with and without family history of alcoholism.

METHODS

Sample comprised of alcohol naive offspring in two groups: (i) at high risk (n = 34) and (ii) at low risk for alcoholism (n = 34). Both groups were matched on age (+/-1 year), education (+/-1 year) and gender. Measures used were: Mini-International Neuropsychiatric Interview, Family Interview for Genetic Studies, Socio-demographic Data Sheet, Annett's Handedness Questionnaire, Barratt's Impulsiveness Scale-version 11, Digit Span Test, Spatial Span Test, Tower of London, Wisconsin Card Sorting Test, Iowa Gambling Task (IGT) and Game of Dice Task (GDT).

RESULTS

Results showed that alcohol naive offspring at high risk for alcoholism reported significantly high impulsivity and demonstrated significant differences on executive functions and decision making tasks. Correlation analysis revealed that high impulsivity was significantly associated with poor performance on explicit decision making task (GDT) and executive function task (WCST). There was no significant correlation between two decision making tasks (IGT and GDT) in both groups and performance on IGT was not significantly associated with impulsivity and executive functions.

CONCLUSIONS

The present study indicates cognitive and behavioural dispositions in alcohol naive offspring at high risk for alcoholism and support the sub-optimal balance between reflective and impulsive system responsible for addiction. Furthermore, present study supports separability between two different types of decision making tasks.

Influence of Personality Traits on the Severity of Alcohol Use Disorders

INTRODUCTION

Alcohol Use Disorders (AUD) are the most prevalent psychiatric diagnosis in the general population. The study of personality characteristics, using Cloninger Personality Inventory (TCI-R), allows us to know the evolution of these patients at the beginning of treatment.

MATERIAL AND METHOD

We conducted a cross-sectional, observational and descriptive study for 3 years with a total of 304 patients. We studied the severity of their alcohol disorder by the Alcohol Dependency Intensity Scale (EIDA), Scale of Obsessive Consumption Compulsive (OCDS) and European version of the Addiction Severity Index (EUROPASI); we studied the relationship with the personality traits of TCI-R.

RESULTS AND CONCLUSIONS

The personality lines influence the evolution of alcohol use disorder (AUD). People with higher scores on Reward Dependency (RD), Persistence (P), Cooperation (CO) and Autotranscendence (ST) have a better prognosis while people with higher scores on Search for Novelty (SN) and Avoidance of Damage (AD) have a worst prognosis. Women present differences in consumption in relation to men, as a consequence of their personality. Women have lower scores in Persistence (P) y Self-Transcendence (ST) which are associated with the greater severity of their addiction.

Relationship of low doses of alcohol voluntarily consumed during adolescence and early adulthood with subsequent behavioral flexibility

Previous alcohol use is associated with impaired decision-making and impulsivity in humans, but the relationship between alcohol use and decision-making/impulsivity is unclear. In two experiments, we determined whether chronic intermittent access to alcohol during adolescence and early adulthood would alter or be correlated with performance in a go/no-go reversal task, a devaluation task, or operant extinction. Rats received 6 weeks of chronic intermittent access to 20% alcohol or water from postnatal day 26 to 66 and then behavioral testing was initiated 1.5-2.5 weeks later. We found no evidence that voluntary alcohol consumption altered behavior in either task. However, we found that rats that consumed more alcohol made fewer commission errors in reversal learning compared with rats that drank less. There was no relationship between alcohol consumption and reversal learning omission errors. Alcohol consumption was not correlated with the magnitude of the devaluation effect, but rats that consumed more alcohol showed faster extinction during the devaluation test. Our results suggest that the relationships between behavioral flexibility and alcohol consumption may represent individual differences. Future work will determine the neurobiological and genetic bases of these behavioral differences.

Decision making measured by the Iowa Gambling Task in alcohol use disorder and gambling disorder: a systematic review and meta-analysis

BACKGROUND AND AIMS

Gambling disorder (GD) and alcohol use disorder (AD) have similar features, such as elevated impulsivity and decision-making deficits, which are directly linked to relapse and poor therapeutic outcomes. Our aim was to assess decision-making characteristics in GD and AD patients compared to healthy controls (HC) based on one of the most frequently used measures of decision-making: the Iowa Gambling Task (IGT).

METHODS

In our systematic literature search of three databases, we identified 1198 empirical articles that mentioned decision-making deficits with the use of the IGT in patients diagnosed with either AD or GD. Possible effects were calculated using meta-analysis. In the end, 17 studies (including 1360 participants) were suitable for inclusion in the meta-analysis reporting data for 23 group contrasts.

RESULTS

The random effects estimate indicated impaired IGT performance in both AD patients (N=500; d=-0.581, CI:-89.5<δ<-26.6%) and an even greater deficit in GD patients (N=292; d=-1.034, CI:-156.1<δ<50.7%) compared to HCs. Sampling variances were calculated for both AD (v₁=0.0056) and GD groups (v₂=0.0061), from which the z-score was calculated (z=-21.0785; p<0.05), which indicates a statistically significant difference between AD and GD groups. No significant moderating effects of age, gender or education were found.

CONCLUSIONS

There is enough evidence to support that decision-making deficit associated with addictive disorders, and that the deficit is more expressed in gambling disorder than in alcohol use disorder. Impaired decision-making plays an important part in poor therapeutic outcomes, thus provides a promising opportunity for cognitive intervention.

Affective decision-making moderates the effects of automatic associations on alcohol use among drug offenders

BACKGROUND

This study used a dual-process model of cognition in order to investigate the possible influence of automatic and deliberative processes on lifetime alcohol use in a sample of drug offenders.

OBJECTIVE

The objective was to determine if automatic/implicit associations in memory can exert an influence over an individual's alcohol use and if decision-making ability could potentially modify the influence of these associations.

METHODS

168 participants completed a battery of cognitive tests measuring implicit alcohol associations in memory (verb generation) as well as their affective decision-making ability (Iowa Gambling Task). Structural equation modeling procedures were used to test the relationship between implicit associations, decision-making, and lifetime alcohol use.

RESULTS

Results revealed that among participants with lower levels of decision-making, implicit alcohol associations more strongly predicted higher lifetime alcohol use.

CONCLUSION

These findings provide further support for the interaction between a specific decision function and its influence over automatic processes in regulating alcohol use behavior in a risky population. Understanding the interaction between automatic associations and decision processes may aid in developing more effective intervention components.

Stages of dysfunctional decision-making in addiction

Drug use is a choice with immediate positive outcomes, but long-term negative consequences. Thus, the repeated use of drugs in the face of negative consequences suggests dysfunction in the cognitive mechanisms underpinning decision-making. This cognitive dysfunction can be mapped into three stages: the formation of preferences involving valuation of decision options; choice implementation including motivation, self-regulation and inhibitory processes; and feedback processing implicating reinforcement learning. This article reviews behavioral studies that have examined alterations in these three stages of decision-making in people with substance use disorders. Relative to healthy individuals, those with alcohol, cannabis, stimulant and opioid use disorders value risky options more highly during the formation of preferences; have a greater appetite for superficially attractive rewards during choice implementation; and are both more efficient in learning from rewards and less efficient in learning from losses during feedback processing. These observed decision-making deficits are most likely due to both premorbid factors and drug-induced effects. Because decision-making deficits have been prospectively associated with a greater risk of drug relapse, we advocate for greater research on modulating the component stages that give rise to dysfunctional decision-making in disorders of addiction.

Individual differences in voluntary alcohol intake in rats: relationship with impulsivity, decision making and Pavlovian conditioned approach

RATIONALE

Alcohol use disorder (AUD) has been associated with suboptimal decision making, exaggerated impulsivity, and aberrant responses to reward-paired cues, but the relationship between AUD and these behaviors is incompletely understood.

OBJECTIVES

This study aims to assess decision making, impulsivity, and Pavlovian-conditioned approach in rats that voluntarily consume low (LD) or high (HD) amounts of alcohol.

METHODS

LD and HD were tested in the rat gambling task (rGT) or the delayed reward task (DRT). Next, the effect of alcohol (0-1.0 g/kg) was tested in these tasks. Pavlovian-conditioned approach (PCA) was assessed both prior to and after intermittent alcohol access (IAA). Principal component analyses were performed to identify relationships between the most important behavioral parameters.

RESULTS

HD showed more optimal decision making in the rGT. In the DRT, HD transiently showed reduced impulsive choice. In both LD and HD, alcohol treatment increased optimal decision making in the rGT and increased impulsive choice in the DRT. PCA prior to and after IAA was comparable for LD and HD. When PCA was tested after IAA only, HD showed a more sign-tracking behavior. The principal component analyses indicated dimensional relationships between alcohol intake, impulsivity, and sign-tracking behavior in the PCA task after IAA.

CONCLUSIONS

HD showed a more efficient performance in the rGT and DRT. Moreover, alcohol consumption enhanced approach behavior to reward-predictive cues, but sign-tracking did not predict the level of alcohol consumption. Taken together, these findings suggest that high levels of voluntary alcohol intake are associated with enhanced cue- and reward-driven behavior.

Impaired Decision-Making, Higher Impulsivity, and Drug Severity in Substance Dependence and Pathological Gambling

OBJECTIVES

Substance use disorder is characterized by impaired decision making, impulsivity, and risk taking. Pathological gambling shares many of these characteristics, and having both diagnoses may be associated with greater problems than either diagnosis alone. We investigated whether among substance-dependent individuals, comorbid pathological gambling would be associated with worse decision making, greater impulsivity, risk taking, and drug severity.

METHODS

Ninety-six substance-dependent individuals were recruited from a residential treatment program and divided into 1 of the 2 groups depending on whether they met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for pathological gambling (SDPG, n = 26) or not (SD, n = 70). Ninety-two controls were recruited from the community. Participants completed a decision-making task (modified Iowa Gambling Task), measures of impulsivity (Barratt Impulsivity Scale and Delay Discounting), and risk taking (Balloon Analog Risk Task). Decision making was analyzed using a computational model. We tested for group differences using analysis of covariance or Kruskal-Wallis and appropriate post-hoc tests.

RESULTS

The groups differed in decision-making parameters (P < 0.001) and self-reported impulsivity (P < 0.001). All post-hoc comparisons were significant on these measures, and indicated stepwise changes in controls, followed by SD, followed by SDPG, with SDPG performing worse on decision making and being more impulsive. Compared with SD, SDPG had greater drug severity (P < 0.001). No group differences were observed in delay discounting or risk taking.

CONCLUSIONS

Compared with individuals with substance dependence without pathological gambling, those with both disorders demonstrated worse decision making and significantly more drug-related symptoms. When evaluating patients with substance dependence, clinicians should consider diagnostic assessments for gambling, as the co-occurrence of both disorders may impact clinical characteristics.

Compulsivity and Impulsivity in Pathological Gambling: Does a Dimensional-Transdiagnostic Approach Add Clinical Utility to DSM-5 Classification?

Although the phenomenology of Pathological Gambling (PG) is clearly characterized by impulsive features, some of the Diagnostic and Statistical Manual of Mental Disorder (DSM-5) criteria for PG are similar to those of Obsessive Compulsive Disorder (OCD). Therefore, the compulsive-impulsive spectrum model may be a better (or complementary) fit with PG phenomenology. The present exploratory research was designed to further investigate the compulsive and impulsive features characterizing PG, by comparing PG individuals, alcohol dependents (ADs), OCD patients, and healthy controls (HCs) on both self-report and cognitive measures of compulsivity and impulsivity. A better understanding of the shared psychological and cognitive mechanisms underlying differently categorized compulsive and impulsive disorders may significantly impact on both clinical assessment and treatment strategies for PG patients. With respect to self-report measures, PG individuals reported more compulsive and impulsive features than did HCs. As regards motor inhibition ability indices, PG individuals and HCs performed similarly on the Go/No-go task and better than AD individuals and OCD patients. Results from the Iowa Gambling Task highlighted that PG, AD, and OCD participants performed worse than did HCs. An in-depth analysis of each group's learning profile revealed similar patterns of impairment between PG and AD individuals in decision-making processes. Current findings support the utility of adopting a dimensional-transdiagnostic approach to complement the DSM-5 classification when working with PG individuals in clinical practice. Indeed, clinicians are encouraged to assess both compulsivity and impulsivity to provide individualized case conceptualizations and treatment plans focusing on the specific phenomenological features characterizing each PG patient.

Think twice: Impulsivity and decision making in obsessive-compulsive disorder

BACKGROUND AND AIMS

Recent studies have challenged the anxiety-avoidance model of obsessive-compulsive disorder (OCD), linking OCD to impulsivity, risky-decision-making and reward-system dysfunction, which can also be found in addiction and might support the conceptualization of OCD as a behavioral addiction. Here, we conducted an exploratory investigation of the behavioral addiction model of OCD by assessing whether OCD patients are more impulsive, have impaired decision-making, and biased probabilistic reasoning, three core dimensions of addiction, in a sample of OCD patients and healthy controls.

METHODS

We assessed these dimensions on 38 OCD patients and 39 healthy controls with the Barratt Impulsiveness Scale (BIS-11), the Iowa Gambling Task (IGT) and the Beads Task.

RESULTS

OCD patients had significantly higher BIS-11 scores than controls, in particular on the cognitive subscales. They performed significantly worse than controls on the IGT preferring immediate reward despite negative future consequences, and did not learn from losses. Finally, OCD patients demonstrated biased probabilistic reasoning as reflected by significantly fewer draws to decision than controls on the Beads Task.

CONCLUSIONS

OCD patients are more impulsive than controls and demonstrate risky decision-making and biased probabilistic reasoning. These results might suggest that other conceptualizations of OCD, such as the behavioral addiction model, may be more suitable than the anxiety-avoidance one. However, further studies directly comparing OCD and behavioral addiction patients are needed in order to scrutinize this model.

Adherence to medication is associated with non-planning impulsivity in euthymic bipolar disorder patients

BACKGROUND

Adherence to medication is a major issue in bipolar disorder. Non-planning impulsivity, defined as a lack of future orientation, has been demonstrated to be the main impulsivity domain altered during euthymia in bipolar disorder patients. It was associated with comorbidities.

METHODS

To investigate relationship between adherence to medication and non-planning impulsivity, we included 260 euthymic bipolar patients. Adherence to medication was evaluated by Medication Adherence Rating Scale and non-planning impulsivity by Barrat Impulsiveness Scale. Univariate analyses and linear regression were used. We conducted also a path analysis to examine whether non-planning impulsivity had direct or indirect effect on adherence, mediated by comorbidities.

RESULTS

Adherence to medication was correlated with non-planning impulsivity, even after controlling for potential confounding factors in linear regression analysis (Beta standardized coefficient = 0.156; p = 0.015). Path analysis demonstrated only a direct effect of non-planning impulsivity on adherence to medication, and none indirect effect via substance use disorders and anxiety disorders.

LIMITATIONS

Our study is limited by its cross-sectional design and adherence to medication was assessed only by self-questionnaire.

CONCLUSIONS

Higher non-planning impulsivity is associated with low medication adherence, without an indirect effect via comorbidities.

Repeated ethanol exposure during early and late adolescence: double dissociation of effects on waiting and choice impulsivity

BACKGROUND

A strong association exists between impulsivity and binge drinking, and between adolescent alcohol exposure and alcohol abuse in humans. To understand the extent to which early-life alcohol exposure contributes to increased impulsivity, we developed an animal model of binge drinking using 2 strains of mice, C57BL/6J (B6) and DBA2/J (D2), that differ in both motor impulsivity and alcohol drinking.

METHODS

Mice were treated with 2 g/kg ethanol (EtOH) during their early (intermittent ethanol exposure [IEE]_Early; postnatal day [PND]30 to 45) or late (IEE_Late; PND45 to 60) adolescence or with saline (control group [CON]) throughout the adolescence period. To determine the consequences IEE on waiting impulsivity and attentional function, the number of premature responses and omissions, respectively, were evaluated in adulthood using the 5-choice serial reaction time task (5-CSRTT). To examine the effects of IEE on choice impulsivity, risky decision making was assessed in adulthood using a mouse version of the Iowa Gambling Task (mIGT). Additionally, the acute effects of EtOH in adulthood on waiting impulsivity and choice preference were investigated.

RESULTS

We provide experimental evidence that IEE during late, but not early, adolescence disrupts waiting impulsivity and attentional abilities in the 5-CSRTT. In contrast, IEE during early, but not late, adolescence altered risky decision making in the mIGT. D2 mice consistently showed lower premature responding than B6 mice in both the mIGT and the 5-CSRTT, but greater risky decision making on the mIGT. IEE and CON mice showed similar responsiveness to the acute EtOH effects on premature responding, but increased risky choices only in B6_IEE_Early mice.

CONCLUSIONS

Our observations suggest a direct effect of IEE during adolescence on waiting and choice impulsivity and attention later in life.

Decision making and impulsiveness in abstinent alcohol-dependent people and healthy individuals: a neuropsychological examination

Background

Alcohol dependence is associated with deficits in decision making and increased impulsiveness. Therefore, we compared decision making in abstinent alcohol-dependent people (“abstainers”) and matched healthy individuals (“comparison group”) to determine whether impulsiveness or personality traits play a role in decision making.

Methods

Abstainers (n = 40) were recruited from treatment facilities in and around Munich, Germany, and the comparison group (n = 40) through personal contacts and social media. We assessed decision making with the Iowa Gambling Task (IGT), impulsiveness with the Barratt Impulsiveness Scale (BIS-11) and personality traits with the NEO Five-Factor Inventory (NEO-FFI).

Results

The comparison group performed significantly better in the IGT (mean profit € 159.50, SD 977.92) than the abstainers (mean loss - € 1,400.13, SD 1,362.10; p < .001) and showed significantly less impulsiveness in the BIS-11 (comparison group: mean 56.03, SD 7.80; abstainers: mean 63.55, SD 11.47; p < .001). None of the five personality traits assessed with the NEO-FFI differed significantly between the groups.

Conclusion

The results confirm that abstinent alcohol-dependent people do not perform as well as healthy individuals in decision-making tasks and show greater impulsiveness, but in this study did not affect their decision-making ability.

Brain perfusion in polysubstance users: relationship to substance and tobacco use, cognition, and self-regulation

BACKGROUND

Brain perfusion is altered in both alcohol dependence and stimulant dependence. Although most substance users also abuse/depend on alcohol concurrently (polysubstance users; PSU), rigorous perfusion research in PSU is limited. Also, the relationships of perfusion abnormalities with cognition, impulsivity, or decision making are not well known.

METHODS

Arterial spin labeling MRI and neuropsychological measures assessed perfusion levels and neurocognition in 20 alcohol-dependent individuals with comorbid-stimulant dependence (PSU), 26 individuals dependent on alcohol only (ALC), and 31 light/non-drinking controls (LD). The patient groups included smokers and non-smokers.

RESULTS

ALC had lower perfusion than LD in subcortical and cortical brain regions including the brain reward/executive oversight system (BREOS). Contrary to our hypothesis, regional perfusion was generally not lower in PSU than ALC. However, smoking PSU had lower perfusion than smoking ALC in several regions, including BREOS. Lower BREOS perfusion related to greater drinking severity in smoking substance users and to greater smoking severity in smoking ALC. Lower regional perfusion in ALC and PSU correlated with worse performance in different cognitive domains; smoking status affected perfusion-cognition relationships in ALC only. Lower BREOS perfusion in both substance using groups related to higher impulsivity.

CONCLUSION

Although regional perfusion was not decreased in PSU as a group, the combination of cigarette smoking and polysubstance use is strongly related to hypoperfusion in important cortical and subcortical regions. As lower perfusion relates to greater smoking severity, worse cognition and higher impulsivity, smoking cessation is warranted for treatment-seeking PSU and ALC.

Impaired risk evaluation in people with Internet gaming disorder: fMRI evidence from a probability discounting task

This study examined how Internet gaming disorder (IGD) subjects modulating reward and risk at a neural level under a probability-discounting task with functional magnetic resonance imaging (fMRI). Behavioral and imaging data were collected from 19 IGD subjects (22.2 ± 3.08 years) and 21 healthy controls (HC, 22.8 ± 3.5 years). Behavior results showed that IGD subjects prefer the probabilistic options to fixed ones and were associated with shorter reaction time, when comparing to HC. The fMRI results revealed that IGD subjects show decreased activation in the inferior frontal gyrus and the precentral gyrus when choosing the probabilistic options than HC. Correlations were also calculated between behavioral performances and brain activities in relevant brain regions. Both of the behavioral performance and fMRI results indicate that people with IGD show impaired risk evaluation, which might be the reason why IGD subjects continue playing online games despite the risks of widely known negative consequence.

Altered performance in a rat gambling task after acute and repeated alcohol exposure

RATIONALE

A bidirectional relationship between alcohol use disorder (AUD) and deficits in impulse control and decision making has been suggested. However, the mechanisms by which neurocognitive impairments predispose to, or result from AUD remain incompletely understood.

OBJECTIVES

The aim of this study is to gain more insight in the effects of alcohol exposure on decision making and impulse control. We used two modified versions of the rat gambling task (rGT) that differ in the net gain and the punishment magnitude associated with the different response options.

METHODS

In experiment 1, we assessed the effects of acute alcohol treatment (0-0.8 g/kg) on rGT performance. In experiment 2, we determined the effects of alcohol on rGT acquisition (15 sessions, 0.6 g/kg). Next, these animals were challenged with alcohol (0-1.0 g/kg) prior to rGT sessions.

RESULTS

Acute alcohol treatment suppressed baseline performance in both rGT versions but only modestly altered decision making. Treatment with alcohol during acquisition increased risky choices in the rGT version that involved larger punishment and blunted the reduction in win-shift behavior during acquisition in both rGT versions. Moreover, rats treated with alcohol during acquisition showed an increase in premature and perseverative responding upon subsequent alcohol challenges (0-1.0 g/kg) and were less sensitive to the behavioral suppressant effects of alcohol.

CONCLUSIONS

Our results show that repeated alcohol exposure alters decision making during rGT acquisition and reduces the ability to adjust choice behavior on the basis of feedback. In addition, repeated alcohol exposure unmasks its behavioral disinhibitory effects in the rGT. Impaired responsiveness to choice feedback and behavioral disinhibition may contribute to the development of AUD.

Greater sensitivity to novelty in rats is associated with increased motor impulsivity following repeated exposure to a stimulating environment: implications for the etiology of impulse control deficits

Heightened motor impulsivity and increased novelty-seeking commonly co-occur in psychiatric disorders, including drug addiction. However, the relationship between these two phenomena remains unclear. One-time tests of novelty sensitivity commonly used in preclinical experiments, such as the open-field or novel-object test, fail to capture the fact that novelty-seekers repeatedly experience novel, stimulating situations. The present study therefore investigated whether repeated exposure to a novel, stimulating environment (SE) altered impulsive action. Male Long-Evans rats were trained to perform the five-choice serial reaction time task (5CSRTT) which measures motor impulsivity in the form of premature responding as well as attention and motivation. Animals were then exposed to a novel SE (1 h/day for 16 days) immediately prior to the 5CSRTT. Significant increases in premature responding were observed in a subgroup of reactive animals termed high responders (HR-SE). These rats were not more impulsive at baseline, and levels of impulsivity normalised once exposure to the SE was discontinued. No other aspect of 5CSRTT performance was affected by the SE challenge. We also determined that HR-SE rats were hyperactive in a novel environment. Biochemical analyses revealed changes in gene and protein expression within the dorsal hippocampus of HR-SE rats, including decreases in mRNA encoding the dopamine D1 receptor and brain-derived neurotrophic factor. These results indicate a novel mechanism by which impulsivity and novelty-reactivity interact that may enhance addiction vulnerability synergistically. Furthermore, studying such context-induced impulsivity may provide insight into the process by which environmental load precipitates psychiatric symptoms in impulse control disorders.

Relapse (number of detoxifications) in abstinent male alcohol-dependent patients as related to personality traits and types of tolerance to frustration

BACKGROUND

Personality traits like depression on the one hand and aggression and impulsivity on the other are assumed to be predisposing factors for different types of alcohol dependence. Both types are associated with sensitivity to frustration, but this may be different for the two types of personality according to whether they are confronted with frustrations caused by withdrawal from positive or infliction of negative events. It has not been shown so far if both types of personality factors and the two different sources of frustration are differently relevant for the propensity of relapse. This was investigated here in a study on 60 abstinent male alcohol-dependent patients.

METHODS

Correlations between the number of previous detoxifications reflecting liability to relapse and questionnaire scores on personality factors and on reactions to frustration were computed.

RESULTS

Bonferroni-corrected correlations yielded significant relationships between the number of detoxifications and the personality factor of aggression as well as pronounced depressive reactions to frustrating conditions of non-reward caused by humans. Controlling for impulsivity, aggression and depression revealed that depressive reactions to frustration are genuine predictors for probability of relapse independent of underlying personality factors. Persons particularly sensitive to frustrations from human denial of positive reinforcers are liable to relapse which fits the theory of sensitivity to reward in drug-addicted individuals.

CONCLUSION

Results demonstrate that relapse is clearly more related to aggression than to impulsivity, depression and anxiety and may be facilitated if persons are sensitive to frustrating conditions of non-reward caused by social partners.

Addictions and Personality Traits: Impulsivity and Related Constructs

Behavioral tendencies that might be captured through self-report measures may provide insight into personality features that are associated with substance addictions. Recently, impulsivity and related constructs, such as sensation-seeking, have been examined to help better understand their relationships with addictions. Here, we review recent findings that show links over developmental epochs between addictive behaviors and impulsivity, sensation-seeking, and other constructs that are theoretically linked. These findings have significant implications for generating improved treatments and interventions aimed at preventing the development of addictive disorders.

What makes Internet addicts continue playing online even when faced by severe negative consequences? Possible explanations from an fMRI study

In this study, we designed a continuous wins-and-losses task to monitor the mental activities during decision-making and their effects on subsequent decisions in Internet addiction disorder (IAD) subjects. In behavioral performance, IAD subjects show longer response time, lower repeat rate and greater Stroop effect than healthy controls. In neuroimaging results, IAD subjects show increased brain activities in the inferior frontal cortex, insula, anterior cingulate cortex and decreased activation in the caudate and posterior cingulate cortex after continuous wins than healthy controls. In addition, IAD subjects show increased brain activities in the inferior frontal gyrus and decreased brain activation in the posterior cingulate cortex after continuous losses. Thus, we concluded that IAD subjects engage more cognitive activities to finish the decision-making task. As a result, they cannot sufficiently focus on the executive function during this process. They also do not pay adequate attention to considering previous selections and relevant outcomes during decision-making.

Decision-making and impulsivity in eating disorder patients

Impairment in decision-making can be related to some pathological behaviors in eating disorders. This ability was assessed in 71 eating disorder patients (27 restricting type patients and 44 binge/purging type patients) and compared with 38 healthy controls using the Iowa Gambling Task. This task simulates real-life decision-making by assessing the ability to sacrifice immediate rewards in favor of long term gains. Furthermore, some studies have demonstrated a relationship between impulsivity and decision-making, so in our study the Barratt Impulsiveness Scale was also used. Eating disorder patients, both the restricting and the binge/purging groups, performed poorly in the Iowa Gambling Task compared to controls, confirming a deficit in decision-making in these patients. The restricting group showed poorer IGT performance than the binge/purging group. Interestingly, impulsivity was negatively correlated with decision-making, but only in the binge/purging group. In conclusion, our results confirm a specific deficit in eating disorder patients which may be related to their pathological eating behavior, and suggest that this impairment might be explained by different mechanisms in restricting and binge/purging disorders.