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Li X, Wang Z. Associations between intraindividual reaction time variability, baseline respiratory sinus arrhythmia, and trait impulsivity in males with substance use disorders. Int J Psychophysiol 2024; 205:112445. [PMID: 39369760 DOI: 10.1016/j.ijpsycho.2024.112445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Revised: 09/17/2024] [Accepted: 10/02/2024] [Indexed: 10/08/2024]
Abstract
Trait impulsivity, characterized by the tendency to act without adequate consideration of potential consequences in pursuit of immediate rewards, is a recognized vulnerability marker for substance use disorders (SUDs). Cognitive control deficits are implicated in the manifestation of high trait impulsivity, and intraindividual reaction time variability (IIRTV), an indicator of cognitive control, may influence trait impulsivity. Baseline respiratory sinus arrhythmia (RSA) reflects vagal tone, serves as an index of physiological self-regulation, which has been demonstrated to be related to trait impulsivity. However, it is unclear whether IIRTV is associated with trait impulsivity and whether it interacts with baseline RSA to influence trait impulsivity. A total of 113 males with SUDs participated (Mage = 46.04 years, SD = 11.53) in this study. Trait impulsivity was assessed using a self-report questionnaire, IIRTV was measured through a two-choice oddball task, and baseline RSA was obtained through the collection of electrocardiogram (ECG) data. The results indicated that IIRTV interacted with baseline RSA to influence trait impulsivity. These findings suggested that cognitive control indexed by IIRTV, might represent a central nervous correlate of trait impulsivity, and that it interacted with vagal tone indexed by baseline RSA, to influence trait impulsivity.
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Affiliation(s)
- Xin Li
- School of Psychology, Shaanxi Normal University, Shaanxi Provincial Key Research Center of Child Mental and Behavioral Health, Xi'an, China
| | - Zhenhong Wang
- School of Psychology, Shaanxi Normal University, Shaanxi Provincial Key Research Center of Child Mental and Behavioral Health, Xi'an, China.
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Murphy E, Poudel G, Ganesan S, Suo C, Manning V, Beyer E, Clemente A, Moffat BA, Zalesky A, Lorenzetti V. Real-time fMRI-based neurofeedback to restore brain function in substance use disorders: A systematic review of the literature. Neurosci Biobehav Rev 2024; 165:105865. [PMID: 39197715 DOI: 10.1016/j.neubiorev.2024.105865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 08/16/2024] [Accepted: 08/25/2024] [Indexed: 09/01/2024]
Abstract
INTRODUCTION Real-time functional magnetic resonance based-neurofeedback (fMRI-neurofeedback) is a neuromodulation tool where individuals self-modulate brain function based on real-time feedback of their brain activity. fMRI-neurofeedback has been used to target brain dysfunction in substance use disorders (SUDs) and to reduce craving, but a systematic synthesis of up-to-date literature is lacking. METHOD Following PRISMA guidelines, we conducted a systematic review of all the literature that examined the effects of fMRI-neurofeedback on individuals with regular psychoactive substance use (PROSPERO pre-registration = CRD42023401137). RESULTS The literature included 16 studies comprising 446 participants with SUDs involving alcohol, tobacco, and cocaine. There is consistent between-condition (e.g., fMRI-neurofeedback versus control), less consistent pre-to-post fMRI-neurofeedback, and little intervention-by-time effects on brain function in prefrontal-striatal regions and craving. CONCLUSION The evidence for changes in brain function/craving was early and inconsistent. More rigorous experiments including repeated measure designs with placebo control conditions, are required to confirm the efficacy of fMRI-neurofeedback in reducing brain alterations and craving in SUDs.
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Affiliation(s)
- Ethan Murphy
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioral and Health Sciences, Faculty of Health, Australian Catholic University, Australia
| | - Govinda Poudel
- Mary MacKillop Institute for Health Research, Australian Catholic University, Australia
| | - Saampras Ganesan
- Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Australia; Department of Biomedical Engineering, The University of Melbourne, Australia; Contemplative Studies Centre, Melbourne School of Psychological Sciences, The University of Melbourne, Australia
| | - Chao Suo
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioral and Health Sciences, Faculty of Health, Australian Catholic University, Australia; BrainPark, Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
| | - Victoria Manning
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Clayton, Australia; Turning Point, Eastern Health, Melbourne, Victoria, Australia
| | - Emillie Beyer
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioral and Health Sciences, Faculty of Health, Australian Catholic University, Australia
| | - Adam Clemente
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioral and Health Sciences, Faculty of Health, Australian Catholic University, Australia
| | - Bradford A Moffat
- Melbourne Brain Centre Imaging Unit, Department of Radiology, The University of Melbourne, Australia
| | - Andrew Zalesky
- Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Australia; Department of Biomedical Engineering, The University of Melbourne, Australia
| | - Valentina Lorenzetti
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioral and Health Sciences, Faculty of Health, Australian Catholic University, Australia.
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Vincent SR, Graupman EE, McGarrigle WJ, Kosson DS. Psychopathy traits explain variance shared between features of substance use disorders and violence. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2024; 34:431-445. [PMID: 39267284 DOI: 10.1002/cbm.2353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 08/25/2024] [Indexed: 09/17/2024]
Abstract
BACKGROUND There is a substantial research literature on identifying risk and protective factors for violence perpetration. Substance use disorders have long been identified as constituting a significant predictor of violent behaviour. Psychopathy traits have also been similarly recognised, but inter-relationships between psychopathy traits, features of substance use disorders and violence have been little explored. AIMS To determine the degree to which shared variance between substance dependence symptoms and violence, as indicated by criminal charges for violent offences, among jailed men can be explained by psychopathy traits. METHODS Features of dependence on substances in three drug classes (alcohol, cannabis and cocaine) were assessed in a sample of 682 men in a county jail awaiting trial on criminal charges, many for violent offences. Statistical comparisons of zero-order and partial correlations tested whether accounting for psychopathy total and facet scores, assessed by the Psychopathy Checklist-Revised (PCL-R), affected associations between substance dependence symptoms and violent charges. RESULTS Total PCL-R scores accounted for a significant proportion of the shared variance between the history of criminal charges for violence offences and lifetime substance dependence symptoms in all three drug classes. At the facet level, controlling for ratings on the interpersonal and modified antisocial facets reduced the association between criminal charges for violent offences and symptoms of cocaine dependence; controlling for ratings on a modified antisocial facet also attenuated links between alcohol and cannabis dependence symptoms and history of charges for violent offences. CONCLUSION These findings build on the sparse literature to date on the role of psychopathy traits on relationships between features of substance use disorders and violence. Given that the observed connection between substance dependence symptoms and charges for violent offences is partly accounted for by individual differences in psychopathy traits, it follows that effective treatment for those traits may be useful, perhaps essential to reducing links between features of some substance use disorders and violent offending.
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Affiliation(s)
- Samuel R Vincent
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA
| | - Emily E Graupman
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA
| | | | - David S Kosson
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA
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Martín-Ríos R, Perales JC, López-Torrecillas F, Muñoz López L. Associations of Reversal Learning Performance With Personality Disorder Profile and Drug Abuse History in a Sample of Prison Inmates. Assessment 2024:10731911241278307. [PMID: 39291930 DOI: 10.1177/10731911241278307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2024]
Abstract
Prison inmate samples present a high prevalence of impulsivity- and compulsivity-related behavioral problems. The Probabilistic Reversal Learning Task (PRLT) is a useful tool to assess decision-making, and we explore its associations with inmates' personality disorder (antisocial personality disorder, APD; obsessive-compulsive personality disorder, OCPD; or both) and history of drug abuse. Mixed-effects methods were used to model acquisition and reacquisition curves across PRLT, in a sample of 275 prison inmates diagnosed with OCPD, APD, or both. Two aspects were assessed: general discrimination learning and decision-making inflexibility. Participants with a mixed personality disorder profile showed a clear pattern of decisional inflexibility. A history of drug abuse was associated with a general poorer performance but not with decision-making inflexibility. Inability to adapt to changing contingencies, and thus to adverse consequences of previously rewarded choices, was not linked to compulsivity, as hypothesized to be present in OCPD and substance use disorders, but to the mixed APD/OCPD profile.
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Affiliation(s)
- Raquel Martín-Ríos
- Department of Personality, Assessment and Clinical Psychology, Faculty of Psychology, University of Granada, Spain
| | - José C Perales
- Department of Experimental Psychology; Mind, Brain and Behavior Research Center (CIMCYC), Universidad de Granada, Spain
| | - Francisca López-Torrecillas
- Department of Personality, Assessment and Clinical Psychology, Faculty of Psychology, University of Granada, Spain
| | - Lucas Muñoz López
- Department of Personality, Assessment and Clinical Psychology, Faculty of Psychology, University of Granada, Spain
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Amanollahi M, Jameie M, Looha MA, A Basti F, Cattarinussi G, Moghaddam HS, Di Camillo F, Akhondzadeh S, Pigoni A, Sambataro F, Brambilla P, Delvecchio G. Machine learning applied to the prediction of relapse, hospitalization, and suicide in bipolar disorder using neuroimaging and clinical data: A systematic review. J Affect Disord 2024; 361:778-797. [PMID: 38908556 DOI: 10.1016/j.jad.2024.06.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 05/22/2024] [Accepted: 06/17/2024] [Indexed: 06/24/2024]
Abstract
BACKGROUND Bipolar disorder (BD) is associated with increased morbidity/mortality. Adverse outcome prediction might help with the management of patients with BD. METHODS We systematically reviewed the performance of machine learning (ML) studies in predicting adverse outcomes (relapse or recurrence, hospital admission, and suicide-related events) in patients with BD. Demographic, clinical, and neuroimaging-related poor outcome predictors were also reviewed. Three databases (PubMed, Scopus, and Web of Science) were explored from inception to July 2023. RESULTS Eighteen studies, accounting for >30,000 patients, were included. Support vector machine, decision trees, random forest, and logistic regression were the most frequently used ML algorithms. ML models' area under the receiver operating characteristic (ROC) curve (AUC), sensitivity, and specificity ranged from 0.71 to 0.98, 72.7-92.8 %, and 59.0-95.2 % for relapse/recurrence prediction (4 studies (3 on relapses and 1 on recurrences). The corresponding values were 0.78-0.88, 21.4-100 %, and 77.0-99.7 % for hospital admissions (3 studies, 21,266 patients), and 0.71-0.99, 44.4-97.9 %, and 38.9-95.0 % for suicide-related events (10 studies, 5558 patients). Also, one study addressed a combination of the interest outcomes. Adverse outcome predictors included early onset BD, BD type I, comorbid psychiatric or substance use disorder, circadian rhythm disruption, hospitalization characteristics, and neuroimaging parameters, including increased dynamic amplitude of low-frequency fluctuation, decreased frontolimbic functional connectivity and aberrant dynamic functional connectivity in corticostriatal circuitry. CONCLUSIONS ML models can predict adverse outcomes of BD with relatively acceptable performance measures. Future studies with larger samples and nested cross-validation validation should be conducted to reach more reliable results.
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Affiliation(s)
- Mobina Amanollahi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Melika Jameie
- Neuroscience Research Center, Iran University of Medical Sciences, Tehran, Iran; Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Azizmohammad Looha
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh A Basti
- Islamic Azad University, Tehran Medical Branch, Tehran, Iran
| | - Giulia Cattarinussi
- Department of Neuroscience (DNS), University of Padova, Padua, Italy; Padova Neuroscience Center, University of Padova, Italy
| | - Hossein Sanjari Moghaddam
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fabio Di Camillo
- Department of Neuroscience (DNS), University of Padova, Padua, Italy
| | - Shahin Akhondzadeh
- Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Alessandro Pigoni
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Fabio Sambataro
- Department of Neuroscience (DNS), University of Padova, Padua, Italy; Padova Neuroscience Center, University of Padova, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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Nolan LJ, Embling R, Wilkinson LL. Breadth of substance use is associated with the selection of a larger food portion size via elevated impulsivity. Physiol Behav 2024; 283:114594. [PMID: 38789067 DOI: 10.1016/j.physbeh.2024.114594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 05/07/2024] [Accepted: 05/21/2024] [Indexed: 05/26/2024]
Abstract
Substance use is associated with altered or elevated food consumption and disordered eating. In the present study we examined whether breadth (variety) of drug use was associated with elevated portion size in a general population sample as it was in persons in recovery from substance use disorder. Furthermore, measures of emotional eating, impulsivity, food misuse, food craving were taken as possible mediators and reward responsiveness was examined as a potential moderator of this association. 444 adults (48.6 % women, mean age of 47.8 years) completed an online study in which they were asked to make judgements of ideal portion size for 6 different foods using a validated online tool that allowed participants to adjust the portion size of images of foods. Ideal portion size has been identified as a strong predictor of actual consumption. Participants were also asked to report the number of substances used in the past and provide anthropometric information. The results confirmed that breadth of drug use was associated with selection of higher portion size. Reward responsiveness was not a moderator of this relationship. Of the tested mediators, only impulsivity mediated the association between breadth of drug use and portion size. The results show that impulsivity may underlie the association between eating and substance use.
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Affiliation(s)
- Laurence J Nolan
- Department of Psychology, Wagner College, Staten Island, 1 Campus Rd, Staten Island, NY 10301 USA.
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Baroni M, Bastiani L, Scalese M, Biagioni S, Denoth F, Fizzarotti C, Potente R, Miniati M, Menicucci D, Molinaro S. Executive functions and addictions: a Structural Equation Modeling Approach and the Italian validation of the Adult Executive Functioning Inventory (ADEXI). APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-8. [PMID: 39154224 DOI: 10.1080/23279095.2024.2388230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/19/2024]
Abstract
INTRODUCTION the work aims to observe the associations between psychoactive substance use and gambling and executive functioning as well as to validate the Italian version of the "Adult Executive Functioning Inventory" (ADEXI) scale. METHODS data were collected through a representative cross-sectional study among 5,160 people (18-84 years old) called IPSAD® (Italian Population Survey on Alcohol and Other Drugs). Structural Equation Modeling (SEM) was performed to explore the associations between ADEXI and other behaviors measured with standardized questionnaires. Cronbach α has been performed to investigate the psychometric properties of the Italian version of the ADEXI scale. RESULTS SEM showed that both WM and INH were correlated with problematic cannabis use (WM r = 0.112; INH r = 0.251) and gambling (WM r = 0.101; INH r = 0.168), while problematic alcohol use was correlated only with INH (r = 0.233). Cronbach α for the WM subscale was 0.833 (CI 0.826-0.840), while for INH was 0.694 (CI 0.680-0.708). CONCLUSION results pointed out a strong correlation between addictions (substance-related and non-substance-related) and WM and INH impairments among the adult general population. Moreover, the ADEXI scale could be considered a valuable tool for general population surveys to detect working memory and inhibition characteristics.
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Affiliation(s)
- Marina Baroni
- Institute of Clinical Physiology, National Research Council of Italy, Pisa, Italy
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Luca Bastiani
- Institute of Clinical Physiology, National Research Council of Italy, Pisa, Italy
| | - Marco Scalese
- Institute of Clinical Physiology, National Research Council of Italy, Pisa, Italy
| | - Silvia Biagioni
- Institute of Clinical Physiology, National Research Council of Italy, Pisa, Italy
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Francesca Denoth
- Institute of Clinical Physiology, National Research Council of Italy, Pisa, Italy
| | - Corrado Fizzarotti
- Institute of Clinical Physiology, National Research Council of Italy, Pisa, Italy
| | - Roberta Potente
- Institute of Clinical Physiology, National Research Council of Italy, Pisa, Italy
| | - Mario Miniati
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Danilo Menicucci
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Sabrina Molinaro
- Institute of Clinical Physiology, National Research Council of Italy, Pisa, Italy
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Gómez-Martínez C, Babio N, Camacho-Barcia L, Júlvez J, Nishi SK, Vázquez Z, Forcano L, Álvarez-Sala A, Cuenca-Royo A, de la Torre R, Fanlo-Maresma M, Tello S, Corella D, Vásquez AA, Dalsgaard S, Franke B, Fernández-Aranda F, Salas-Salvadó J. Glycated hemoglobin, type 2 diabetes, and poor diabetes control are positively associated with impulsivity changes in aged individuals with overweight or obesity and metabolic syndrome. Ann N Y Acad Sci 2024. [PMID: 39150983 DOI: 10.1111/nyas.15205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2024]
Abstract
Impulsivity has been proposed to have an impact on glycemic dysregulation. However, it remains uncertain whether an unfavorable glycemic status could also contribute to an increase in impulsivity levels. This study aims to analyze associations of baseline and time-varying glycemic status with 3-year time-varying impulsivity in older adults at high risk of cardiovascular disease. A 3-year prospective cohort design was conducted within the PREDIMED-Plus-Cognition substudy. The total population includes 487 participants (mean age = 65.2 years; female = 50.5%) with overweight or obesity and metabolic syndrome. Insulin resistance (HOMA-IR), glycated hemoglobin (HbA1c), presence of type 2 diabetes mellitus, and type 2 diabetes control were evaluated. Impulsivity was measured using the Impulsive Behavior Scale questionnaire and various cognitive measurements. Impulsivity z-scores were generated to obtain Global, Trait, and Behavioral Impulsivity domains. Linear mixed models were used to study the longitudinal associations across baseline, 1-year, and 3-year follow-up visits. HOMA-IR was not significantly related to impulsivity. Participants with higher HbA1c levels, type 2 diabetes, and poor control of diabetes showed positive associations with the Global Impulsivity domain over time, and those with higher HbA1c levels were further related to increases in the Trait and Behavioral Impulsivity domains over the follow-up visits. These results suggest a potential positive feedback loop between impulsivity and glycemic-related dysregulation.
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Affiliation(s)
- Carlos Gómez-Martínez
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia. Grup d'Alimentació, Nutrició, Desenvolupament i Salut Mental (ANUT-DSM), Unitat de Nutrició Humana, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari Sant Joan de Reus, Reus, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Nancy Babio
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia. Grup d'Alimentació, Nutrició, Desenvolupament i Salut Mental (ANUT-DSM), Unitat de Nutrició Humana, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari Sant Joan de Reus, Reus, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Lucía Camacho-Barcia
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Clinical Psychology, Bellvitge University Hospital, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Jordi Júlvez
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Clinical and Epidemiological Neuroscience Group (NeuroÈpia), Reus, Spain
| | - Stephanie K Nishi
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia. Grup d'Alimentació, Nutrició, Desenvolupament i Salut Mental (ANUT-DSM), Unitat de Nutrició Humana, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari Sant Joan de Reus, Reus, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Toronto 3D (Diet, Digestive Tract and Disease) Knowledge Synthesis and Clinical Trials Unit, Toronto, Ontario, Canada
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Zenaida Vázquez
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, Instituto de Investigación Sanitaria de Navarra (IdISNA), University of Navarra, Pamplona, Spain
| | - Laura Forcano
- Integrative Pharmacology and Systems Neurosciences Research Group, Neurosciences Research Program, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Andrea Álvarez-Sala
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Aida Cuenca-Royo
- Integrative Pharmacology and Systems Neurosciences Research Group, Neurosciences Research Program, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Rafael de la Torre
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Integrative Pharmacology and Systems Neurosciences Research Group, Neurosciences Research Program, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Faculty of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Marta Fanlo-Maresma
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge-IBIDELL, Hospitalet de Llobregat, Barcelona, Spain
| | - Susanna Tello
- Integrative Pharmacology and Systems Neurosciences Research Group, Neurosciences Research Program, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Dolores Corella
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Alejandro Arias Vásquez
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Søren Dalsgaard
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Barbara Franke
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Fernando Fernández-Aranda
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Clinical Psychology, Bellvitge University Hospital, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Jordi Salas-Salvadó
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia. Grup d'Alimentació, Nutrició, Desenvolupament i Salut Mental (ANUT-DSM), Unitat de Nutrició Humana, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari Sant Joan de Reus, Reus, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
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Gómez-Martínez C, Paolassini-Guesnier P, Fezeu L, Srour B, Hercberg S, Touvier M, Babio N, Salas-Salvadó J, Péneau S. Trait impulsivity is associated with an increased risk of type 2 diabetes incidence in adults over 8 years of follow-up: results from the NutriNet-Santé cohort. BMC Med 2024; 22:332. [PMID: 39148083 PMCID: PMC11328429 DOI: 10.1186/s12916-024-03540-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 07/24/2024] [Indexed: 08/17/2024] Open
Abstract
BACKGROUND Type 2 diabetes is one of the most prevalent and preventable diseases worldwide and impulsivity, a psychological trait characterized by making quick decisions without forethought, has been suggested as a key feature for health-related conditions. However, there have been no studies examining the relationships between impulsivity and the incidence of type 2 diabetes and our aim was to assess the prospective association between trait impulsivity and the risk of developing type 2 diabetes. METHODS A prospective observational study design was conducted between May 2014 and February 2023 within the NutriNet-Santé cohort. A web-based platform was used to collect data from the French adult population, with voluntary enrollment and participation. Of the 157,591 adults (≥ 18 years old) participating in the NutriNet-Santé study when impulsivity was assessed, 109,214 participants were excluded due to prevalent type 1 or 2 diabetes or missing data for impulsivity or follow-up data for type 2 diabetes. Trait impulsivity, and the attention, motor, and non-planning subfactors, were assessed at baseline using the Barratt Impulsiveness Scale 11. Incident type 2 diabetes was ascertained through follow-up. Medical information was reviewed by NutriNet-Santé physician experts to ascertain incident diabetes cases based on the ICD-10. Cox regression models, using hazard ratios and 95% confidence intervals (HR [95% CI]), were performed to evaluate associations between impulsivity per 1 standard deviation increment and type 2 diabetes risk, adjusting by recognized confounders. RESULTS Of the 48,377 individuals studied (women 77.6%; age at baseline = 50.6 year ± 14.5 years), 556 individuals developed type 2 diabetes over a median follow-up of 7.78 (IQR: 3.97-8.49) years. Baseline impulsivity was associated with an increased risk of type 2 diabetes incidence (HR = 1.10 [1.02, 1.20]). The motor impulsivity subfactor was positively associated with type 2 diabetes risk (HR = 1.14 [1.04, 1.24]), whereas no associations were found for attention and non-planning impulsivity subfactors. CONCLUSIONS Trait impulsivity was associated with an increased type 2 diabetes risk, mainly driven by the motor impulsivity subfactor. If these results are replicated in other populations and settings, trait impulsivity may become an important psychological risk factor to be considered in the prevention of type 2 diabetes. COHORT REGISTRATION Name of registry: The NutriNet-Santé Study. A Web-based Prospective Cohort Study of the Relationship Between Nutrition and Health and of Dietary Patterns and Nutritional Status Predictors. Cohort registration number: NCT03335644. Date of registration: October 11, 2017. URL: https://clinicaltrials.gov/ct2/show/NCT03335644.
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Affiliation(s)
- Carlos Gómez-Martínez
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Alimentació, Nutrició, Desenvolupament i Salut Mental (ANUT-DSM), Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Pauline Paolassini-Guesnier
- Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, 93017, Bobigny, France
| | - Léopold Fezeu
- Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, 93017, Bobigny, France
| | - Bernard Srour
- Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, 93017, Bobigny, France
| | - Serge Hercberg
- Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, 93017, Bobigny, France
| | - Mathilde Touvier
- Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, 93017, Bobigny, France
| | - Nancy Babio
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Alimentació, Nutrició, Desenvolupament i Salut Mental (ANUT-DSM), Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Jordi Salas-Salvadó
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Alimentació, Nutrició, Desenvolupament i Salut Mental (ANUT-DSM), Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Sandrine Péneau
- Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, 93017, Bobigny, France.
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10
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Arteaga-Henríquez G, Ramos-Sayalero C, Ibañez-Jimenez P, Karina Rosales-Ortiz S, Kilencz T, Schiweck C, Schnorr I, Siegl A, Arias-Vasquez A, Bitter I, Fadeuilhe C, Ferrer M, Lavebratt C, Matura S, Reif A, Réthelyi JM, Richarte V, Rommelse N, Antoni Ramos-Quiroga J. Efficacy of a synbiotic in the management of adults with Attention-Deficit and Hyperactivity Disorder and/or Borderline Personality Disorder and high levels of irritability: Results from a multicenter, randomized, placebo-controlled, "basket" trial. Brain Behav Immun 2024; 120:360-371. [PMID: 38885746 DOI: 10.1016/j.bbi.2024.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 06/07/2024] [Accepted: 06/12/2024] [Indexed: 06/20/2024] Open
Abstract
Irritability worsens prognosis and increases mortality in individuals with Attention-Deficit and Hyperactivity Disorder (ADHD) and/or Borderline Personality Disorder (BPD). However, treatment options are still insufficient. The aim of this randomized, double blind, placebo-controlled study was to investigate the superiority of a synbiotic over placebo in the management of adults with ADHD and/or BPD and high levels of irritability. The study was conducted between February 2019 and October 2020 at three European clinical centers located in Hungary, Spain and Germany. Included were patients aged 18-65 years old diagnosed with ADHD and/or BPD and high levels of irritability (i.e., an Affectivity Reactivity Index (ARI-S) ≥ 5, plus a Clinical Global Impression-Severity Scale (CGI-S) score ≥ 4). Subjects were randomized 1(synbiotic):1(placebo); the agent was administered each day, for 10 consecutive weeks. The primary outcome measure was end-of-treatment response (i.e., a reduction ≥ 30 % in the ARI-S total score compared to baseline, plus a Clinical Global Impression-Improvement (CGI-I) total score of < 3 (very much, or much improved) at week 10). Between-treatment differences in secondary outcomes, as well as safety were also investigated. Of the 231 included participants, 180 (90:90) were randomized and included in the intention-to-treat-analyses. Of these, 117 (65 %) were females, the mean age was 38 years, ADHD was diagnosed in 113 (63 %), BPD in 44 (24 %), both in 23 (13 %). The synbiotic was well tolerated. At week 10, patients allocated to the synbiotic experienced a significantly higher response rate compared to those allocated to placebo (OR: 0.2, 95 % CI:0.1 to 0.7; P = 0.01). These findings suggest that that (add-on) treatment with a synbiotic may be associated with a clinically meaningful improvement in irritability in, at least, a subgroup of adults with ADHD and/or BPD. A superiority of the synbiotic over placebo in the management of emotional dysregulation (-3.6, 95 % CI:-6.8 to -0.3; P = 0.03), emotional symptoms (-0.6, 95 % CI:-1.2 to -0.05; P = 0.03), inattention (-1.8, 95 % CI: -3.2 to -0.4; P = 0.01), functioning (-2.7, 95 % CI: -5.2 to -0.2; P = 0.03) and perceived stress levels (-0.6, 95 % CI: -1.2 to -0.05; P = 0.03) was also suggested. Higher baseline RANK-L protein levels were associated with a significantly lower response rate, but only in the synbiotic group (OR: 0.1, 95 % CI: -4.3 to - 0.3, P = 0.02). In the placebo group, higher IL-17A levels at baseline were significantly associated with a higher improvement in in particular, emotional dysregulation (P = 0.04), opening a door for new (targeted) drug intervention. However, larger prospective studies are warranted to confirm the findings. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03495375.
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Affiliation(s)
- Gara Arteaga-Henríquez
- Department of Mental Health, Hospital Universitari Vall d́Hebron, Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health, and Addictions, Vall d́Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Biomedical Network Research Center on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain; NCRR-The National Center for Register-Based Research, Aahrus University. Aahrus, Denmark.
| | - Carolina Ramos-Sayalero
- Group of Psychiatry, Mental Health, and Addictions, Vall d́Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain
| | - Pol Ibañez-Jimenez
- Group of Psychiatry, Mental Health, and Addictions, Vall d́Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain
| | - Silvia Karina Rosales-Ortiz
- Group of Psychiatry, Mental Health, and Addictions, Vall d́Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain
| | - Tünde Kilencz
- Semmelweis University, Department of Psychiatry and Psychotherapy, Budapest, Hungary
| | - Carmen Schiweck
- Goethe University Frankfurt, University Hospital, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Frankfurt, Germany
| | - Isabel Schnorr
- Goethe University Frankfurt, University Hospital, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Frankfurt, Germany
| | - Anne Siegl
- Goethe University Frankfurt, University Hospital, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Frankfurt, Germany
| | - Alejandro Arias-Vasquez
- Department of Human Genetics, Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behavior, Nijmegen, the Netherlands; Department of Psychiatry, Radboudd University Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, the Netherlands
| | - István Bitter
- Semmelweis University, Department of Psychiatry and Psychotherapy, Budapest, Hungary
| | - Christian Fadeuilhe
- Department of Mental Health, Hospital Universitari Vall d́Hebron, Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health, and Addictions, Vall d́Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Biomedical Network Research Center on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain
| | - Marc Ferrer
- Department of Mental Health, Hospital Universitari Vall d́Hebron, Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health, and Addictions, Vall d́Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Biomedical Network Research Center on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autónoma de Barcelona, Barcelona, Catalonia, Spain
| | - Catharina Lavebratt
- Department of Molecular Medicine and Surgery, Karolinska Instituet, Stockholm, Sweden; Center for Molecular Medicine, Karolinska University Hospital Solna, Stockholm, Sweden
| | - Silke Matura
- Goethe University Frankfurt, University Hospital, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Frankfurt, Germany
| | - Andreas Reif
- Goethe University Frankfurt, University Hospital, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Frankfurt, Germany
| | - János M Réthelyi
- Semmelweis University, Department of Psychiatry and Psychotherapy, Budapest, Hungary
| | - Vanesa Richarte
- Department of Mental Health, Hospital Universitari Vall d́Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Center on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autónoma de Barcelona, Barcelona, Catalonia, Spain
| | - Nanda Rommelse
- Karakter Child and Adolescent Psychiatry University Center, Stockholm, the Netherlands
| | - Josep Antoni Ramos-Quiroga
- Department of Mental Health, Hospital Universitari Vall d́Hebron, Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health, and Addictions, Vall d́Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Biomedical Network Research Center on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autónoma de Barcelona, Barcelona, Catalonia, Spain
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11
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Gendy MNS, Remers S, Samokhvalov AV, Sousa S, Rush B, Costello J, MacKillop J. Using Latent Profile Analysis to Characterize Clinical Heterogeneity and Impulsivity in a Large Residential Addiction Treatment Program. Subst Use Misuse 2024; 59:1673-1682. [PMID: 39086209 DOI: 10.1080/10826084.2024.2352604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/02/2024]
Abstract
Objectives: Clinical heterogeneity among patients in addiction treatment settings represents a challenge as most of the treatment programs are designed to treat substance use disorders (SUD) generally rather than offering more tailored approaches addressing individual patient needs. Systematic characterization of clinical heterogeneity may permit more individualized care paths toward improving outcomes. Methods: Data were collected from a large inpatient SUD treatment program between April 2018 and March 2020 (n = 1519). Latent profile analysis (LPA) was applied to identify latent clusters based on differences in substance use and co-occurring depression, anxiety, and post-traumatic stress disorder. Results: Five distinct profiles emerged: Profile 1 (38%) exhibited the lowest substance use and lowest psychiatric severity (Overall Low); Profile 2 (39%) exhibited high alcohol and psychiatric severity; Profile 3 (13%) exhibited high opioid severity and low psychiatric severity. Profile 4 (8%) exhibited high cannabis use and high psychiatric severity, and profile 5 (3%) exhibited high polysubstance use other than alcohol and cannabis use. The latter two profiles were younger and exhibited higher self-regulatory deficits. The (High Alc/high psych) and the (High Cann/Psych) profiles exhibited differentially higher psychiatric severity. Profiles showing high polysubstance use, as well as high cannabis use and high psychiatric severity, showed significantly higher impulsive behavior than the others. Conclusions: LPA revealed five clusters of patients varying substantially in terms of SUD and psychiatric severity. Addressing common features of clinical heterogeneity for tailored care paths in a personalized treatment approach may improve treatment outcomes.
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Affiliation(s)
- Marie N S Gendy
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare, McMaster University, Hamilton, Canada
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Canada
- Homewood Research Institute, Guelph, Canada
| | - Shannon Remers
- Homewood Research Institute, Guelph, Canada
- Homewood Health Inc., Guelph, Canada
| | - Andriy V Samokhvalov
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Canada
- Homewood Research Institute, Guelph, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | | | - Brian Rush
- Homewood Research Institute, Guelph, Canada
- Center for Addiction and Mental Health, Toronto, Canada
| | - Jean Costello
- Homewood Research Institute, Guelph, Canada
- Homewood Health Inc., Guelph, Canada
- Homewood Health Centre, Guelph, Canada
| | - James MacKillop
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare, McMaster University, Hamilton, Canada
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Canada
- Homewood Research Institute, Guelph, Canada
- Michael G. DeGroote Centre for Medicinal Cannabis Research, St. Joseph's Healthcare, McMaster University, Hamilton, Canada
- Department of Psychology, Neuroscience, and Behavior, McMaster University, Hamilton, Canada
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12
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Reck A, Sweet LH, Geier C, Kogan SM, Cui Z, Oshri A. Food insecurity and adolescent impulsivity: The mediating role of functional connectivity in the context of family flexibility. Dev Sci 2024:e13554. [PMID: 39054810 DOI: 10.1111/desc.13554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 07/08/2024] [Accepted: 07/09/2024] [Indexed: 07/27/2024]
Abstract
Adolescent food insecurity is a salient adversity hypothesized to affect neural systems associated with increased impulsive behavior. Family environments shape how adverse experiences influence development. In this study, hypotheses were tested regarding the conjoint effects of food insecurity and family flexibility on impulsivity via alterations in connectivity between regions within the salience and central executive networks. Such alterations are reflected in resting-state functional connectivity (rsFC) metrics between the anterior insula (AI) and the middle frontal gyrus (MFG). Hypotheses were tested in a longitudinal moderated mediation model with two waves of data from 142 adolescents (Time 1 [T1] Mage = 12.89, SD = 0.85; Time 2 [T2] Mage = 15.01, SD = 1.07). Data on past-year household food insecurity, family flexibility, and rsFC were obtained at T1. Impulsivity was self-reported by the adolescent at T1 and T2. Findings revealed that high T1 left-to-left rsFC between the AI and MFG was associated with increased impulsivity at T2. The interaction of family flexibility and food insecurity was associated with AI and MFG rsFC. In the context of low family flexibility, food insecurity was linked to high levels of AI and MFG rsFC. Conversely, in the context of optimal family flexibility, food insecurity was associated with low levels of AI and MFG rsFC. Conditional indirect analysis suggests that the links among food insecurity, rsFC, and impulsive behavior depend on family flexibility. RESEARCH HIGHLIGHTS: Adolescent food insecurity was associated with anterior insula and middle frontal gyrus connectivity only at certain levels of family flexibility. High family flexibility attenuated the link between food insecurity and neural connectivity, while low levels of family flexibility increased this risk. High left anterior insula and left middle frontal gyrus connectivity was associated with increased impulsivity 1 year later.
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Affiliation(s)
- Ava Reck
- Department of Human Development and Family Science, University of Georgia, Athens, Georgia, USA
| | - Lawrence H Sweet
- Department of Psychology, University of Georgia, Athens, Georgia, USA
| | - Charles Geier
- Department of Human Development and Family Science, University of Georgia, Athens, Georgia, USA
| | - Steven M Kogan
- Department of Human Development and Family Science, University of Georgia, Athens, Georgia, USA
| | - Zehua Cui
- Department of Psychology, University of Maryland, College Park, Maryland, USA
| | - Assaf Oshri
- Department of Human Development and Family Science, University of Georgia, Athens, Georgia, USA
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13
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McAnulty C, Bastien G, Ledjiar O, Eugenia Socias M, Le Foll B, Lim R, Jutras-Aswad D. Mediating effect of craving on the impact of buprenorphine/naloxone and methadone treatment on opioid use: Results from a randomized controlled trial. Addict Behav 2024; 154:108023. [PMID: 38579594 DOI: 10.1016/j.addbeh.2024.108023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 03/22/2024] [Accepted: 03/25/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND The relationship between opioid craving and opioid use is unclear. We sought to determine to what extent craving mediated the relationship between opioid agonist therapy and changes in opioid use. METHODS Data came from a pragmatic, 24-week, pan-Canadian, multi-centric, open-label, randomized controlled trial comparing flexible buprenorphine/naloxone take-home doses to standard supervised methadone models of care for the treatment of prescription-type opioid use disorder. Participants were randomly allocated to buprenorphine/naloxone or methadone models of care. 270 people with prescription-type opioid use disorder were included in analyses. There were 93 women (34.4%) and 2 transgender (0.7%) participants. Most participants were white (67.4%), 45.9% reported unstable living conditions, and 44.8% had psychiatric comorbidities. Generalized linear mixed models followed by mediation analysis estimated the direct effect of treatment group on Timeline Followback-reported next-week opioid use and the indirect effect through past 24-hour opioid craving measured using the Brief Substance Craving Scale at week 2, 6, 10, 14, 18 and 22. RESULTS Upon mediation analysis, the average direct effect of treatment on opioid use was 0.465 (95 % CI = 0.183 to 0.751, p < 0.001). The average causal mediated effect was 0.144 (95 % CI = 0.021 to 0.110; p < 0.001). Craving accounted for 23.6 % of the effect of treatment on opioid use (p < 0.001). CONCLUSIONS Past 24-hour craving was associated with increased next-week opioid use; however, craving only partially mediated the effect of buprenorphine/naloxone and methadone on next-week opioid use. Research is needed to develop a comprehensive understanding of factors mediating opioid use during opioid agonist therapy.
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Affiliation(s)
- Christina McAnulty
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, 2900 boul. Edouard-Montpetit, Montréal, Québec H3T 1J4, Canada; Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), 900 Saint-Denis Street, Montréal, Québec H2X 0A9, Canada
| | - Gabriel Bastien
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, 2900 boul. Edouard-Montpetit, Montréal, Québec H3T 1J4, Canada; Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), 900 Saint-Denis Street, Montréal, Québec H2X 0A9, Canada
| | - Omar Ledjiar
- Unité de recherche Clinique appliquée (URCA), Research Centre, Centre Hospitalier Ste-Justine, 3175 chemin de la Côte Ste-Catherine, Montréal, Québec H3T 1C5, Canada
| | - M Eugenia Socias
- British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, British Columbia V6Z 2A9, Canada; Department of Medicine, Faculty of Medicine, University of British Columbia, 1045 Howe Street, Vancouver, British Columbia V6Z 2A9, Canada
| | - Bernard Le Foll
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, 500 University Avenue, 5th Floor, Toronto, Ontario M5G 1V7, Canada; Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, Ontario M5T 1R8, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 3M7, Canada; Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada; Department of Pharmacology and Toxicology, Faculty of Medicine, Medical Sciences Building, University of Toronto, 1 King's College Circle, Toronto, Ontario M5S 1A8, Canada; Waypoint Research Institute, Waypoint Centre for Mental Health Care, 500 Church Street, Penetanguishene, Ontario L9M 1G3, Canada
| | - Ron Lim
- Department of Psychiatry and Family Medicine, Cumming School of Medicine, University of Calgary, 2500 University Drive NW, Calgary, Alberta T2N 1N4, Canada
| | - Didier Jutras-Aswad
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, 2900 boul. Edouard-Montpetit, Montréal, Québec H3T 1J4, Canada; Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), 900 Saint-Denis Street, Montréal, Québec H2X 0A9, Canada.
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14
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Chauhan S, Pandey R, Vakani K, Norbury R, Ettinger U, Kumari V. Sleep quality mediates the association between chronotype and mental health in young Indian adults. NPJ MENTAL HEALTH RESEARCH 2024; 3:31. [PMID: 38914742 PMCID: PMC11196584 DOI: 10.1038/s44184-024-00076-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 06/05/2024] [Indexed: 06/26/2024]
Abstract
There is increasing recognition of 'higher preference for eveningness' as a potential independent risk factor for poor mental health. To examine the chronotype-mental health relationship while also quantifying the potential roles of poor sleep quality, relevant personality traits, and childhood trauma, we assessed 282 young adults (18-40 years; 195 females) residing in North India, between January and March 2023 (to control for seasonal variation), using self-report measures of diurnal preference, sleep patterns, mental health (depression, anxiety, and stress), personality traits (extraversion, neuroticism, schizotypy, and impulsivity), and childhood trauma. The results showed a significant association between eveningness and poor mental health but this association was fully mediated by poor sleep quality. Neuroticism, emotional abuse and cognitive disorganisation were correlated with eveningness as well as with poor mental health and sleep quality. Neuroticism and emotional abuse, but not cognitive disorganisation, also had indirect effects on mental health via sleep quality. Our findings highlight the crucial role played by sleep quality in the chronotype-mental health relationship.
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Affiliation(s)
- Satyam Chauhan
- Division of Psychology, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK.
- Centre for Cognitive and Clinical Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK.
| | - Rakesh Pandey
- Department of Psychology, Faculty of Social Sciences, Banaras Hindu University, Varanasi, India
| | - Krupa Vakani
- Division of Psychology, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
- Centre for Cognitive and Clinical Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
| | - Ray Norbury
- Division of Psychology, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
- Centre for Cognitive and Clinical Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
| | | | - Veena Kumari
- Division of Psychology, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK.
- Centre for Cognitive and Clinical Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK.
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15
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Ward JH, Becker K, Smith J, Price A, Newlove-Delgado T. Patient, supporter and primary healthcare professional perspectives on health risks in over 16s with attention deficit hyperactivity disorder (ADHD) in England: a national survey study. BMC Health Serv Res 2024; 24:751. [PMID: 38898441 PMCID: PMC11188530 DOI: 10.1186/s12913-024-11188-5] [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: 08/07/2023] [Accepted: 06/10/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Current research suggests that people with attention deficit hyperactivity disorder (ADHD) are at higher risk of physical and mental health disorders. This study aimed to explore these health risks in ADHD from the perspectives of multiple stakeholders. METHODS This study forms part of the 'Managing young people with ADHD in Primary care (MAP) study'. A survey developed by the study team was distributed to over 16 year olds with ADHD, their supporters, primary healthcare professionals and health commissioners across England, via social media and through patient/clinical networks (September-October 2022). This survey contained two questions on health risks. Question one asked about views on health risks in ADHD (free text). Question two asked about advice given (options list and free text). Descriptive statistics summarised responses to questions one and two, and qualitative analysis (reflexive thematic analysis) was used to explore free text responses from question one. RESULTS 782 participants responded to the MAP survey. Of these, 206 healthcare professionals, 157 people with ADHD and 88 supporters answered question one. The most mentioned perceived risks were substance misuse, sleep disorders, weight management and smoking. More people with ADHD reported disordered eating as a health risk (n = 32) than healthcare professionals (n = 5). Generated themes included perceived health risks, impact of living with ADHD, lack of adequate healthcare, and need for ADHD awareness. In respect to advice given (question two), based on responses from 258 professionals, 162 people with ADHD and 100 supporters, the most common advice discussed in consultation was mental health (n = 149, n = 50 and n = 17 respectively). High numbers of respondents reported not giving/receiving advice on wider health (n = 38, n = 88 and n = 61 respectively). CONCLUSIONS Findings demonstrate that respondents perceived a range of physical and mental health risks posed by ADHD. These related to difficulties with activities of daily living, as well as healthcare interactions and the impact of core features of ADHD (e.g. impulsivity, emotional dysregulation). These risks are not currently explicitly addressed in United Kingdom national guidance on ADHD. More work is needed to examine and address the broader health outcomes of people with ADHD.
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Affiliation(s)
- John H Ward
- University of Exeter Medical School, 2.05 South Cloisters, St Luke's Campus, Heavitree Road, Exeter, UK.
- Department of Psychiatry, University of Oxford, Oxford, UK.
- Royal Devon University Hospital NHS Foundation Trust, Devon, UK.
- Oxford Health NHS Foundation Trust, Oxford, UK.
| | - Kieran Becker
- University of Exeter Medical School, 2.05 South Cloisters, St Luke's Campus, Heavitree Road, Exeter, UK
| | - Jane Smith
- University of Exeter Medical School, 2.05 South Cloisters, St Luke's Campus, Heavitree Road, Exeter, UK
| | - Anna Price
- University of Exeter Medical School, 2.05 South Cloisters, St Luke's Campus, Heavitree Road, Exeter, UK
| | - Tamsin Newlove-Delgado
- University of Exeter Medical School, 2.05 South Cloisters, St Luke's Campus, Heavitree Road, Exeter, UK
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16
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Muñoz-López L, Fernández-García-Valdecasas B, López-Rodríguez S, Sánchez-Barrera MB. Analysis of writing in personality disorders in prison population. Front Psychiatry 2024; 15:1391463. [PMID: 38855649 PMCID: PMC11157106 DOI: 10.3389/fpsyt.2024.1391463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 04/26/2024] [Indexed: 06/11/2024] Open
Abstract
Abstract Writing involves the activation of different processing modes than reading comprehension, and therefore the level of activation varies depending on the moment and the task. Objectives to analyze the profiles in terms of the proposed coding from the PROESC in terms of personality disorders [Antisocial Personality Disorder (ASPD) with drugs possession and consumption crimes (DPCC) and Obsessive-Compulsive Personality Disorder (OCPD)] with gender violence crimes (GVC) in the prisoners. Design The sample was composed of 194 men. The participants were divided into two groups. Group 1 (ASPD; DPCC) consisted of 81 men, and Group 2 (OCPD; GVC) consisted of 113 men. Main outcome measures They completed the Demographic, Offense, and Behavioral Interview in Institutions, the International Personality Disorders Examination (IPDE), and Writing Processes Evaluation Battery (PROESC). Results Group 2 made more mistake than Group 1 in narratives tasks. Conclusion Participants know phoneme-grapheme correspondence rules, language disturbances of a reiterative and persistent nature may appear in those who show compulsive behavior.
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Affiliation(s)
- Lucas Muñoz-López
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Education and Sports Sciences, University of Granada, Melilla, Spain
| | | | - Slava López-Rodríguez
- Department of Didactics of Language and Literature, University of Granada, Granada, Spain
| | - María Blanca Sánchez-Barrera
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Granada, Granada, Spain
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17
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Langabeer JR, Vega FR, Cardenas-Turanzas M, Cohen AS, Lalani K, Champagne-Langabeer T. How Financial Beliefs and Behaviors Influence the Financial Health of Individuals Struggling with Opioid Use Disorder. Behav Sci (Basel) 2024; 14:394. [PMID: 38785885 PMCID: PMC11117791 DOI: 10.3390/bs14050394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 05/02/2024] [Accepted: 05/08/2024] [Indexed: 05/25/2024] Open
Abstract
The surge in opioid use disorder (OUD) over the past decade escalated opioid overdoses to a leading cause of death in the United States. With adverse effects on cognition, risk-taking, and decision-making, OUD may negatively influence financial well-being. This study examined the financial health of individuals diagnosed with OUD by reviewing financial beliefs and financial behaviors. We evaluated quality of life, perceptions of financial condition during active use and recovery, and total debt. We distributed a 20-item survey to 150 individuals in an outpatient treatment program for OUD in a large metropolitan area, yielding a 56% response rate. The results revealed low overall financial health, with a median debt of USD 12,961 and a quality-of-life score of 72.80, 9.4% lower than the U.S. average (82.10). Most participants (65.75%) reported improved financial health during recovery, while a higher majority (79.45%) worsened during active use. Unemployment affected 42% of respondents, and 9.52% were employed only part-time. Regression analysis highlighted a strong association between lack of full-time employment and a lack of financial advising with total debt. High financial anxiety and active use were associated with lower quality of life. Individuals with OUD may benefit from financial interventions, resources, and counseling to improve their financial health.
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Affiliation(s)
- James R. Langabeer
- Center for Behavioral Emergency and Addiction Research, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (J.R.L.); (F.R.V.); (M.C.-T.); (A.S.C.)
| | - Francine R. Vega
- Center for Behavioral Emergency and Addiction Research, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (J.R.L.); (F.R.V.); (M.C.-T.); (A.S.C.)
| | - Marylou Cardenas-Turanzas
- Center for Behavioral Emergency and Addiction Research, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (J.R.L.); (F.R.V.); (M.C.-T.); (A.S.C.)
| | - A. Sarah Cohen
- Center for Behavioral Emergency and Addiction Research, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (J.R.L.); (F.R.V.); (M.C.-T.); (A.S.C.)
| | - Karima Lalani
- School of Public Health, University of Washington, Seattle, WA 98195, USA;
| | - Tiffany Champagne-Langabeer
- Center for Behavioral Emergency and Addiction Research, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (J.R.L.); (F.R.V.); (M.C.-T.); (A.S.C.)
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18
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Fox KR, Rausch JR, Grant VR, Ferketich AK, Groner JA, Garg V, Cua CL, Jackson JL. Associations of Impulsivity and Risky Decision-Making with E-Cigarette-Related Outcomes Among Adolescents with Congenital Heart Disease: Variable- and Person-Oriented Approaches. Behav Med 2024:1-12. [PMID: 38706412 DOI: 10.1080/08964289.2024.2347226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 04/01/2024] [Indexed: 05/07/2024]
Abstract
Adolescents with congenital heart disease (CHD) have elevated risk for acquired cardiovascular complications, increasing their vulnerability to e-cigarette-related health harms. Impulsivity and risky decision-making have been associated with adolescent substance use, but the relationships between these factors and e-cigarette-related outcomes among cardiovascular at-risk adolescents with CHD are unknown. This cross-sectional study aimed to (a) determine the associations of impulsivity and risky decision-making with e-cigarette-related outcomes (i.e. susceptibility, ever use, perceptions of harm and addictiveness) via variable-oriented analysis (logistic regression), (b) identify groups of adolescents with similar profiles of impulsivity and risky decision-making via exploratory person-oriented analysis (latent profile analysis; LPA), and (c) examine differences on e-cigarette-related outcomes between profile groups. Adolescents aged 12 to 18 years with CHD (N = 98) completed a survey assessing impulsivity facets (Short UPPS-P) and e-cigarette-related outcomes and were administered a risky decision-making task (Iowa Gambling Task, Version 2; IGT2). In variable-oriented analyses, impulsivity facets (negative urgency, positive urgency, lack of premeditation) but not risky decision-making were associated with e-cigarette susceptibility and ever use. The exploratory LPA identified two groups with similar patterns of responding on the Short UPPS-P and IGT2 labeled "Low Impulsivity" and "High Impulsivity," which were primarily characterized by significant differences in negative and positive urgency. Adolescents in the High Impulsivity group had increased odds of e-cigarette susceptibility but not ever use compared to the Low Impulsivity group. This work indicates that strategies to prevent e-cigarette use among adolescents with CHD may be enhanced by addressing impulsivity, particularly negative and positive urgency.
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Affiliation(s)
- Kristen R Fox
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Joseph R Rausch
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Victoria R Grant
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Amy K Ferketich
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Judith A Groner
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
| | - Vidu Garg
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
- The Heart Center, Nationwide Children's Hospital, Columbus, OH, USA
- Center for Cardiovascular Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Clifford L Cua
- The Heart Center, Nationwide Children's Hospital, Columbus, OH, USA
| | - Jamie L Jackson
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
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19
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Litenski MN, O'Reardon AB, Pabon N, Hernandez M, Niyazov Y, Cruz J. Navigating Treatment Challenges: A Case Study on Refractory Psychosis in a Chronic MDMA (3,4-Methylenedioxymethamphetamine) User. Cureus 2024; 16:e59641. [PMID: 38832158 PMCID: PMC11146661 DOI: 10.7759/cureus.59641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Accepted: 05/04/2024] [Indexed: 06/05/2024] Open
Abstract
MDMA (3,4-methylenedioxymethamphetamine), also known as Ecstasy, is a synthetic amphetamine with hallucinogenic and stimulant properties, which has become increasingly favored as a substance for recreational use. Despite its deceptive reputation as "safe," chronic MDMA use is associated with neuropsychiatric complications, including psychosis. We describe a case of a 23-year-old woman with chronic MDMA use disorder and childhood trauma, who presented with severe psychosis and catatonic features. While initial diagnostic possibilities included drug-induced psychosis and mood disorders, the patient's history and presentation supported a diagnosis of bipolar I disorder with psychotic features, which was exacerbated by MDMA use. Conventional antipsychotics failed to improve psychotic symptoms and led to worsening of catatonia, requiring electroconvulsive therapy (ECT) for improvement. Socioeconomic barriers hindered follow-up care, leading to an Emergency Department (ED) admission shortly after discharge. This case highlights the intricate interplay between substance use, psychiatric illness, and trauma, and showcases ECT's efficacy in severe psychosis. It emphasizes the necessity for comprehensive mental health services, especially for vulnerable populations, and calls for further research into MDMA's psychiatric effects and optimal treatment approaches for individuals with co-occurring substance use and psychiatric disorders.
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Affiliation(s)
- Melissa N Litenski
- Department of Psychiatry and Behavioral Health, Florida International University, Herbert Wertheim College of Medicine, Miami, USA
| | - Aoife B O'Reardon
- Department of Psychiatry and Behavioral Health, Florida International University, Herbert Wertheim College of Medicine, Miami, USA
| | - Nicole Pabon
- Department of Psychiatry, Mount Sinai Medical Center, Miami, USA
| | | | - Yakov Niyazov
- Department of Psychiatry, Mount Sinai Medical Center, Miami, USA
| | - Jose Cruz
- Department of Psychiatry, Mount Sinai Medical Center, Miami, USA
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20
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Kräplin A, Joshanloo M, Wolff M, Fröhner JH, Baeuchl C, Krönke KM, Bühringer G, Smolka MN, Goschke T. No evidence for a reciprocal relationship between daily self-control failures and addictive behavior in a longitudinal study. Front Psychol 2024; 15:1382483. [PMID: 38751764 PMCID: PMC11095395 DOI: 10.3389/fpsyg.2024.1382483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 04/09/2024] [Indexed: 05/18/2024] Open
Abstract
Introduction We all experience occasional self-control failures (SCFs) in our daily lives, where we enact behaviors that stand in conflict with our superordinate or long-term goals. Based on the assumption that SCFs share common underlying mechanisms with addictive disorders, we tested the hypothesis that a generally higher susceptibility to daily SCFs predicts more addictive behavior, or vice versa. Methods At baseline, 338 individuals (19-27 years, 59% female) from a community sample participated in multi-component assessments. These included among others (1) a clinical interview on addictive behaviors (quantity of use, frequency of use, DSM-5 criteria; n = 338) and (2) ecological momentary assessment of SCFs (n = 329, 97%). At the 3-year and 6 year follow-up, participation rates for both assessment parts were 71% (n = 240) and 50% (n = 170), respectively. Results Controlling for age, gender, IQ, and baseline addiction level, random-intercept cross-lagged panel models revealed that participants who reported more SCFs also showed pronounced addictive behavior at the between-person level, but we found no evidence of a predictive relationship at the within-person level over time. Discussion A higher rate of SCFs is associated with more addictive behavior, while there is no evidence of an intraindividual predictive relationship. Novel hypotheses suggested by additional exploratory results are that (1) only addiction-related SCFs in daily life are early markers of an escalation of use and thus for addictive disorders and that (2) an explicit monitoring of SCFs increases self-reflection and thereby promotes the mobilization of cognitive control in response to goal-desire conflicts.
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Affiliation(s)
- Anja Kräplin
- Department of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Mohsen Joshanloo
- Department of Psychology, Keimyung University, Daegu, Republic of Korea
| | - Max Wolff
- Department of Psychology, Technische Universität Dresden, Dresden, Germany
- Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Mind Foundation, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - Juliane Hilde Fröhner
- Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Christian Baeuchl
- Department of Psychology, Technische Universität Dresden, Dresden, Germany
- Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | | | - Gerhard Bühringer
- Department of Psychology, Technische Universität Dresden, Dresden, Germany
- Institut für Therapieforschung, Munich, Germany
| | - Michael N. Smolka
- Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Thomas Goschke
- Department of Psychology, Technische Universität Dresden, Dresden, Germany
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21
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Avramescu RG, Hernandez G, Flores C. Rewiring the future: drugs abused in adolescence may predispose to mental illness in adult life by altering dopamine axon growth. J Neural Transm (Vienna) 2024; 131:461-467. [PMID: 38036858 PMCID: PMC11055695 DOI: 10.1007/s00702-023-02722-6] [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: 08/31/2023] [Accepted: 11/10/2023] [Indexed: 12/02/2023]
Abstract
Adolescence is a period of increased exploration and novelty-seeking, which includes new social behaviors, as well as drug experimentation, often spurred on by peer pressure. This is unfortunate, as the immature state of the adolescent brain makes it particularly susceptible to the negative developmental impact of drug use. During adolescence, dopamine terminals, which have migrated from the ventral tegmental area, pause in the nucleus accumbens, before segregating by either forming local connections or growing towards the prefrontal cortex (PFC). This developmentally late and lengthy process renders adolescent dopamine axon pathfinding vulnerable to disruption by substance use. Indeed, exposure to stimulant drugs in adolescent male mice, but not females, triggers dopamine axons to mistarget the nucleus accumbens and to grow ectopically to the PFC. Some evidence suggests that at this novel site, the functional organization of the ectopic dopamine axons mirrors that of the intended target. The structural rewiring dysregulates local synaptic connectivity, leading to poor impulse control ability, deficits of which are a core symptom of substance-use disorders. In the present commentary, we argue that different substances of abuse induce dopamine mistargeting events with the off-target trajectory prescribed by the type of drug, leading to psychiatric outcomes later in life.
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Affiliation(s)
| | - Giovanni Hernandez
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Cecilia Flores
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada.
- Department of Psychiatry, McGill University, Montreal, QC, Canada.
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, QC, Canada.
- Ludmer Centre for Neuroinformatics & Mental Health, McGill University, Montreal, QC, Canada.
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22
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Donlon J, Kumari P, Varghese SP, Bai M, Florentin OD, Frost ED, Banks J, Vadlapatla N, Kam O, Shad MU, Rahman S, Abulseoud OA, Stone TW, Koola MM. Integrative Pharmacology in the Treatment of Substance Use Disorders. J Dual Diagn 2024; 20:132-177. [PMID: 38117676 DOI: 10.1080/15504263.2023.2293854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
The detrimental physical, mental, and socioeconomic effects of substance use disorders (SUDs) have been apparent to the medical community for decades. However, it has become increasingly urgent in recent years to develop novel pharmacotherapies to treat SUDs. Currently, practitioners typically rely on monotherapy. Monotherapy has been shown to be superior to no treatment at all for most substance classes. However, many randomized controlled trials (RCTs) have revealed that monotherapy leads to poorer outcomes when compared with combination treatment in all specialties of medicine. The results of RCTs suggest that monotherapy frequently fails since multiple dysregulated pathways, enzymes, neurotransmitters, and receptors are involved in the pathophysiology of SUDs. As such, research is urgently needed to determine how various neurobiological mechanisms can be targeted by novel combination treatments to create increasingly specific yet exceedingly comprehensive approaches to SUD treatment. This article aims to review the neurobiology that integrates many pathophysiologic mechanisms and discuss integrative pharmacology developments that may ultimately improve clinical outcomes for patients with SUDs. Many neurobiological mechanisms are known to be involved in SUDs including dopaminergic, nicotinic, N-methyl-D-aspartate (NMDA), and kynurenic acid (KYNA) mechanisms. Emerging evidence indicates that KYNA, a tryptophan metabolite, modulates all these major pathophysiologic mechanisms. Therefore, achieving KYNA homeostasis by harmonizing integrative pathophysiology and pharmacology could prove to be a better therapeutic approach for SUDs. We propose KYNA-NMDA-α7nAChRcentric pathophysiology, the "conductor of the orchestra," as a novel approach to treat many SUDs concurrently. KYNA-NMDA-α7nAChR pathophysiology may be the "command center" of neuropsychiatry. To date, extant RCTs have shown equivocal findings across comparison conditions, possibly because investigators targeted single pathophysiologic mechanisms, hit wrong targets in underlying pathophysiologic mechanisms, and tested inadequate monotherapy treatment. We provide examples of potential combination treatments that simultaneously target multiple pathophysiologic mechanisms in addition to KYNA. Kynurenine pathway metabolism demonstrates the greatest potential as a target for neuropsychiatric diseases. The investigational medications with the most evidence include memantine, galantamine, and N-acetylcysteine. Future RCTs are warranted with novel combination treatments for SUDs. Multicenter RCTs with integrative pharmacology offer a promising, potentially fruitful avenue to develop novel therapeutics for the treatment of SUDs.
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Affiliation(s)
- Jack Donlon
- Cooper Medical School of Rowan University, Camden, New Jersey, USA
| | - Pooja Kumari
- Community Living Trent Highlands, Peterborough, Canada
| | - Sajoy P Varghese
- Addiction Recovery Treatment Services, Veterans Affairs Northern California Health Care System, University of California, Davis, Sacramento, California, USA
| | - Michael Bai
- Columbia University, New York, New York, USA
| | - Ori David Florentin
- Department of Psychiatry, Westchester Medical Center, Valhalla, New York, USA
| | - Emma D Frost
- Department of Neurology, Cooper University Health Care, Camden, New Jersey, USA
| | - John Banks
- Talkiatry Mental Health Clinic, New York, New York, USA
| | - Niyathi Vadlapatla
- Thomas Jefferson High School for Science and Technology, Alexandria, Virginia, USA
| | - Olivia Kam
- Stony Brook University Renaissance School of Medicine, Stony Brook, New York, USA
| | - Mujeeb U Shad
- Department of Psychiatry, University of Nevada Las Vegas, Las Vegas, Nevada, USA
| | - Shafiqur Rahman
- Department of Pharmaceutical Sciences, College of Pharmacy, South Dakota State University, Brookings, South Dakota, USA
| | - Osama A Abulseoud
- Department of Psychiatry and Psychology, Alix School of Medicine at Mayo Clinic, Phoenix, Arizona, USA
| | - Trevor W Stone
- Nuffield Department of Orthopedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK
| | - Maju Mathew Koola
- Department of Psychiatry and Behavioral Health, Cooper University Health Care, Cooper Medical School of Rowan University, Camden, New Jersey, USA
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23
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Kwon M, Choi H, Park H, Ahn WY, Jung YC. Neural correlates of model-based behavior in internet gaming disorder and alcohol use disorder. J Behav Addict 2024; 13:236-249. [PMID: 38460004 PMCID: PMC10988400 DOI: 10.1556/2006.2024.00006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 12/26/2023] [Accepted: 02/08/2024] [Indexed: 03/11/2024] Open
Abstract
Background An imbalance between model-based and model-free decision-making systems is a common feature in addictive disorders. However, little is known about whether similar decision-making deficits appear in internet gaming disorder (IGD). This study compared neurocognitive features associated with model-based and model-free systems in IGD and alcohol use disorder (AUD). Method Participants diagnosed with IGD (n = 22) and AUD (n = 22), and healthy controls (n = 30) performed the two-stage task inside the functional magnetic resonance imaging (fMRI) scanner. We used computational modeling and hierarchical Bayesian analysis to provide a mechanistic account of their choice behavior. Then, we performed a model-based fMRI analysis and functional connectivity analysis to identify neural correlates of the decision-making processes in each group. Results The computational modeling results showed similar levels of model-based behavior in the IGD and AUD groups. However, we observed distinct neural correlates of the model-based reward prediction error (RPE) between the two groups. The IGD group exhibited insula-specific activation associated with model-based RPE, while the AUD group showed prefrontal activation, particularly in the orbitofrontal cortex and superior frontal gyrus. Furthermore, individuals with IGD demonstrated hyper-connectivity between the insula and brain regions in the salience network in the context of model-based RPE. Discussion and Conclusions The findings suggest potential differences in the neurobiological mechanisms underlying model-based behavior in IGD and AUD, albeit shared cognitive features observed in computational modeling analysis. As the first neuroimaging study to compare IGD and AUD in terms of the model-based system, this study provides novel insights into distinct decision-making processes in IGD.
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Affiliation(s)
- Mina Kwon
- Department of Psychology, Seoul National University, Seoul, South Korea
| | - Hangnyoung Choi
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, South Korea
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Harhim Park
- Department of Psychology, Seoul National University, Seoul, South Korea
| | - Woo-Young Ahn
- Department of Psychology, Seoul National University, Seoul, South Korea
- Department of Brain and Cognitive Sciences, Seoul National University, Seoul, South Korea
- AI Institute, Seoul National University, Seoul, South Korea
| | - Young-Chul Jung
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, South Korea
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, South Korea
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24
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Nolan LJ. Food selection in a buffet scenario by persons in recovery from substance use disorder: Testing a parallel mediation model including impulsivity, food craving, and breadth of drug use. Physiol Behav 2024; 275:114458. [PMID: 38184288 DOI: 10.1016/j.physbeh.2024.114458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/02/2024] [Accepted: 01/04/2024] [Indexed: 01/08/2024]
Abstract
Elevated food cravings and higher food consumption and body weight have been reported in studies of people in recovery from substance use disorder (SUD). In a previous study, SUD recovery status predicted the energy from selected food images in a virtual buffet meal, most strongly in those with high reward responsiveness. The present study was conducted to determine which psychological variables might mediate the relationship between SUD recovery status and food selection and to replicate the finding that reward responsiveness moderated this relationship. In an online study, 216 women and men (109 in recovery from SUD) were asked to choose from among 16 food images in an all-you-can-eat buffet scenario. Food craving, impulsivity, "food addiction", irrational food beliefs, anhedonia, and breadth of drug use were examined as potential mediators while reward responsiveness was examined as a potential moderator. The amount of energy in the selected foods was the outcome variable. Results indicated that breadth of drug use was a mediator; being in SUD recovery predicted higher variety of drug use which predicted higher food selection. However, reward responsiveness did not moderate the relationship between SUD recovery status and energy from the selected foods. Exploratory analysis indicated that lack of premeditation, a measure of impulsivity, with food craving partially mediated the relationship between breadth of drug use and energy from selected foods and that lack of premeditation fully mediated it for sweet foods. The results confirm an association between substance use and food selection and suggest a mechanism via impulsivity.
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Affiliation(s)
- Laurence J Nolan
- Department of Psychology, Wagner College, 1 Campus Rd., Staten Island, NY, 10301, USA.
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Luken A, Rabinowitz JA, Wells JL, Sosnowski DW, Strickland JC, Thrul J, Kirk GD, Maher BS. Designing and Validating a Novel Method for Assessing Delay Discounting Associated With Health Behaviors: Ecological Momentary Assessment Study. JMIR Form Res 2024; 8:e48954. [PMID: 38412027 PMCID: PMC10933719 DOI: 10.2196/48954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 12/15/2023] [Accepted: 01/02/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Delay discounting quantifies an individual's preference for smaller, short-term rewards over larger, long-term rewards and represents a transdiagnostic factor associated with numerous adverse health outcomes. Rather than a fixed trait, delay discounting may vary over time and place, influenced by individual and contextual factors. Continuous, real-time measurement could inform adaptive interventions for various health conditions. OBJECTIVE The goals of this paper are 2-fold. First, we present and validate a novel, short, ecological momentary assessment (EMA)-based delay discounting scale we developed. Second, we assess this tool's ability to reproduce known associations between delay discounting and health behaviors (ie, substance use and craving) using a convenience-based sample. METHODS Participants (N=97) were adults (age range 18-71 years), recruited on social media. In phase 1, data were collected on participant sociodemographic characteristics, and delay discounting was evaluated via the traditional Monetary Choice Questionnaire (MCQ) and our novel method (ie, 7-item time-selection and 7-item monetary-selection scales). During phase 2 (approximately 6 months later), participants completed the MCQ, our novel delay discounting measures, and health outcomes questions. The correlations between our method and the traditional MCQ within and across phases were examined. For scale reduction, a random number of items were iteratively selected, and the correlation between the full and random scales was assessed. We then examined the association between our time- and monetary-selection scales assessed during phase 2 and the percentage of assessments that participants endorsed using or craving alcohol, tobacco, or cannabis. RESULTS In total, 6 of the 7 individual time-selection items were highly correlated with the full scale (r>0.89). Both time-selection (r=0.71; P<.001) and monetary-selection (r=0.66; P<.001) delay discounting rates had high test-retest reliability across phases 1 and 2. Phase 1 MCQ delay discounting function highly correlated with phase 1 (r=0.76; P<.001) and phase 2 (r=0.45; P<.001) time-selection delay discounting scales. One or more randomly chosen time-selection items were highly correlated with the full scale (r>0.94). Greater delay discounting measured via the time-selection measure (adjusted mean difference=5.89, 95% CI 1.99-9.79), but not the monetary-selection scale (adjusted mean difference=-0.62, 95% CI -3.57 to 2.32), was associated with more past-hour tobacco use endorsement in follow-up surveys. CONCLUSIONS This study evaluated a novel EMA-based scale's ability to validly and reliably assess delay discounting. By measuring delay discounting with fewer items and in situ via EMA in natural environments, researchers may be better able to identify individuals at risk for poor health outcomes.
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Affiliation(s)
- Amanda Luken
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Jill A Rabinowitz
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Jonathan L Wells
- Department of Epidemiology, School of Population Health, Virginia Commonwealth University, Richmond, VA, United States
| | - David W Sosnowski
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Justin C Strickland
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Johannes Thrul
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD, United States
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Gregory D Kirk
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
- School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Brion S Maher
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
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Clare K, Park K, Pan Y, Lejuez CW, Volkow ND, Du C. Neurovascular effects of cocaine: relevance to addiction. Front Pharmacol 2024; 15:1357422. [PMID: 38455961 PMCID: PMC10917943 DOI: 10.3389/fphar.2024.1357422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 01/22/2024] [Indexed: 03/09/2024] Open
Abstract
Cocaine is a highly addictive drug, and its use is associated with adverse medical consequences such as cerebrovascular accidents that result in debilitating neurological complications. Indeed, brain imaging studies have reported severe reductions in cerebral blood flow (CBF) in cocaine misusers when compared to the brains of healthy non-drug using controls. Such CBF deficits are likely to disrupt neuro-vascular interaction and contribute to changes in brain function. This review aims to provide an overview of cocaine-induced CBF changes and its implication to brain function and to cocaine addiction, including its effects on tissue metabolism and neuronal activity. Finally, we discuss implications for future research, including targeted pharmacological interventions and neuromodulation to limit cocaine use and mitigate the negative impacts.
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Affiliation(s)
- Kevin Clare
- New York Medical College, Valhalla, NY, United States
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, United States
| | - Kicheon Park
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, United States
| | - Yingtian Pan
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, United States
| | - Carl W. Lejuez
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
| | - Nora D. Volkow
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States
| | - Congwu Du
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, United States
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McLoughlin A. Why do people use drugs? A neglected question. Ir J Med Sci 2024; 193:329-333. [PMID: 37314679 DOI: 10.1007/s11845-023-03416-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 05/26/2023] [Indexed: 06/15/2023]
Abstract
The aim of this article is to revisit the multivariate causes of drug use. From the initial drive to experiment, to a progression towards dependence, this review endeavours to extrapolate the aetiology of causation. In doing so, prevalence of, and attitudes towards drug use are firstly examined. Influences on why people use illicit drugs are subsequently explored through the lens of established risk factors. Drug use and dependence are embedded within a complex interplay of invidual, genetic, cultural, and socio-economic components. By exploring the aetiology of drug use in a holistic sense, this will not only aid the therapeutic quality of intervention from clinicians, but enable the development of more comprehensive and tailored intervention plans in supporting recovery.
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Chang HM, Chen C, Lu ML, Jou S, Santos VHJ, Goh KK. The interplay of childhood trauma, oxytocin, and impulsivity in predicting the onset of methamphetamine use. CHILD ABUSE & NEGLECT 2024; 147:106579. [PMID: 38048654 DOI: 10.1016/j.chiabu.2023.106579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 11/19/2023] [Accepted: 11/23/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Childhood trauma is associated with substance use disorders, including methamphetamine use disorder (MUD). Oxytocin, involved in social bonding, stress regulation, and reward processing, may influence addiction vulnerability and impulsivity in individuals with a history of childhood trauma. OBJECTIVE To investigate the relationships among childhood trauma, oxytocin levels, impulsivity, and the age of first methamphetamine use in individuals with MUD. PARTICIPANTS AND SETTING The study included 298 male participants (148 individuals with MUD and 150 healthy controls) from both probation offices and psychiatric clinics. METHODS Childhood trauma was assessed using the Childhood Trauma Questionnaire-Short Form (CTQ-SF), impulsivity with the Barratt Impulsiveness Scale-11 (BIS-11), and plasma oxytocin levels were obtained. RESULTS Individuals with MUD exhibited higher levels of childhood trauma, impulsivity, and lower plasma oxytocin levels compared to healthy controls. Childhood trauma was associated with a younger age of first methamphetamine use, higher impulsivity, and lower oxytocin levels among individuals with MUD. Plasma oxytocin levels partially mediated the relationship between childhood trauma and both the age of first methamphetamine use and impulsivity. Serial mediation analysis demonstrated that oxytocin levels and impulsivity sequentially mediated the relationship between childhood trauma and the age of first methamphetamine use. CONCLUSIONS The findings reveal the complex interplay among childhood trauma, oxytocin, impulsivity, and methamphetamine use, emphasizing the importance of considering these factors in prevention and intervention strategies for MUD. Future research should explore oxytocin and impulsivity-focused interventions to mitigate the effects of childhood trauma and reduce MUD development risk.
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Affiliation(s)
- Hu-Ming Chang
- Department of Addiction Sciences, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan; Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chenyi Chen
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Mind, Brain and Consciousness, College of Humanities and Social Sciences, Taipei Medical University, Taipei, Taiwan; Neuroscience Research Center, Taipei Medical University Hospital, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; The Innovative and Translational Research Center for Brain Consciousness, Taipei Medical University, Taipei, Taiwan
| | - Mong-Liang Lu
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Susyan Jou
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Graduate School of Criminology, National Taipei University, Taipei, Taiwan
| | - Vitor Hugo Jesus Santos
- Department of Psychiatry and Mental Health, Faculty of Health Sciences (FCS-UBI), Cova da Beira University Hospital Center, Covilhã, Portugal
| | - Kah Kheng Goh
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan; The Innovative and Translational Research Center for Brain Consciousness, Taipei Medical University, Taipei, Taiwan; Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
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Hinojosa CA, Sitar SI, Zhao JC, Barbosa JD, Hien DA, Welsh JW, Fani N, van Rooij SJ. Functional Domains of Substance Use and their Implications to Trauma: A Systematic Review of Neuroimaging Studies. CHRONIC STRESS (THOUSAND OAKS, CALIF.) 2024; 8:24705470241258752. [PMID: 38846598 PMCID: PMC11155333 DOI: 10.1177/24705470241258752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 05/16/2024] [Indexed: 06/09/2024]
Abstract
Substance use disorder (SUD) is a significant health problem, and trauma exposure is a known risk factor for the escalation of substance use. However, the shared neural mechanisms through which trauma is associated with substance use are still unknown. Therefore, we systematically review neuroimaging studies focusing on three domains that may contribute to the overlapping mechanisms of SUD and trauma-reward salience, negative emotionality, and inhibition. Using PRISMA guidelines, we identified 45 studies utilizing tasks measuring these domains in alcohol, tobacco, and cannabis use groups. Greater reward, lesser regulation of inhibitory processes, and mixed findings of negative emotionality processes in individuals who use substances versus controls were found. Specifically, greater orbitofrontal cortex, ventral tegmental area, striatum, amygdala, and hippocampal activation was found in response to reward-related tasks, and reduced activation was found in the inferior frontal gyrus and hippocampus in response to inhibition-related tasks. Importantly, no studies in trauma-exposed individuals met our review criteria. Future studies examining the role of trauma-related factors are needed, and more studies should explore inhibition- and negative-emotionality domains in individuals who use substances to uncover clinically significant alterations in these domains that place an individual at greater risk for developing a SUD.
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Affiliation(s)
- Cecilia A. Hinojosa
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Siara I. Sitar
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Joshua C. Zhao
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Joshua D. Barbosa
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Denise A. Hien
- Center of Alcohol and Substance Use Studies, Graduate School of Applied and Professional Psychology, Rutgers University-New Brunswick, Piscataway, NJ, USA
| | - Justine W. Welsh
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Negar Fani
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Sanne J.H. van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
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Lv Q, Zhang M, Jiang H, Liu Y, Zhao S, Xu X, Zhang W, Chen T, Su H, Zhang J, Wang H, Zhang J, Feng Y, Li Y, Li B, Zhao M, Wang Z. Metabolic and functional substrates of impulsive decision-making in individuals with heroin addiction after prolonged methadone maintenance treatment. Neuroimage 2023; 283:120421. [PMID: 37879424 DOI: 10.1016/j.neuroimage.2023.120421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 10/08/2023] [Accepted: 10/23/2023] [Indexed: 10/27/2023] Open
Abstract
Elevated impulsivity has been frequently reported in individuals with opioid addiction receiving methadone maintenance therapy (MMT), but the underlying neural mechanisms and cognitive subprocesses are not fully understood. We acquired functional magnetic resonance imaging (fMRI) data from 37 subjects with heroin addiction receiving long-term MMT and 33 healthy controls who performed a probabilistic reversal learning task, and measured their resting-state brain glucose using fluorine-18-fluorodeoxyglucose positron emission tomography (18F-FDG PET). Subjects receiving MMT exhibited significantly elevated self-reported impulsivity, and computational modeling revealed a marked impulsive decision bias manifested as switching more frequently without available evidence. Moreover, this impulsive decision bias was associated with the dose and duration of methadone use, irrelevant to the duration of heroin use. During the task, the switch-related hypoactivation in the left rostral middle frontal gyrus was correlated with the impulsive decision bias while the function of reward sensitivity was intact in subjects receiving MMT. Using prior brain-wide receptor density data, we found that the highest variance of regional metabolic abnormalities was explained by the spatial distribution of μ-opioid receptors among 10 types of neurotransmitter receptors. Heightened impulsivity in individuals receiving prolonged MMT is manifested as atypical choice bias and noise in decision-making processes, which is further driven by deficits in top-down cognitive control, other than reward sensitivity. Our findings uncover multifaceted mechanisms underlying elevated impulsivity in subjects receiving MMT, which might provide insights for developing complementary therapies to improve retention during MMT.
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Affiliation(s)
- Qian Lv
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; School of Psychological and Cognitive Sciences, Beijing Key Laboratory of Behavior and Mental Health, IDG/McGovern Institute for Brain Research, Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, China
| | - Miao Zhang
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haifeng Jiang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yilin Liu
- Institute of Neuroscience, State Key Laboratory of Neuroscience, CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China; University of Chinese Academy of Sciences, China
| | - Shaoling Zhao
- Institute of Neuroscience, State Key Laboratory of Neuroscience, CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China; University of Chinese Academy of Sciences, China
| | - Xiaomin Xu
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wenlei Zhang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Tianzhen Chen
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hang Su
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jiangtao Zhang
- Tongde Hospital of Zhejiang Province (Zhejiang Mental Health Center), Zhejiang Office of Mental Health, Hangzhou, China
| | - Heqiu Wang
- Tongde Hospital of Zhejiang Province (Zhejiang Mental Health Center), Zhejiang Office of Mental Health, Hangzhou, China
| | - Jianmin Zhang
- Tongde Hospital of Zhejiang Province (Zhejiang Mental Health Center), Zhejiang Office of Mental Health, Hangzhou, China
| | - Yuanjing Feng
- College of Information Engineering, Zhejiang University of Technology, Hangzhou, China
| | - Yongqiang Li
- College of Information Engineering, Zhejiang University of Technology, Hangzhou, China
| | - Biao Li
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Min Zhao
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
| | - Zheng Wang
- School of Psychological and Cognitive Sciences, Beijing Key Laboratory of Behavior and Mental Health, IDG/McGovern Institute for Brain Research, Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, China.
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Wang Y, Zuo J, Hao W, Wu L, Liu F, Wang Q, He L, Peng P, Zhou Y, Li M, Yang Q, Wang X, Liu T, Potenza MN. Relationships Between Impulsivity, Methamphetamine use Disorder and Gambling Disorder. J Gambl Stud 2023; 39:1635-1650. [PMID: 36973505 DOI: 10.1007/s10899-023-10201-6] [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] [Accepted: 03/12/2023] [Indexed: 03/29/2023]
Abstract
Methamphetamine use disorder (MAUD) and gambling disorder (GD) frequently co-occur. Individuals with both conditions are typically more difficult to treat than those with either disorder alone. This study aimed to investigate the co-occurrence and clinical characteristics of people with MAUD and GD. Between March 2018 and August 2020, 350 men with methamphetamine use entering a compulsory drug rehabilitation center in Changsha, Hunan Province received semi-structured interviews. Participants completed the Barratt Impulsiveness Scale-11 and provided information on childhood upbringings and drug use characteristics. Independent sample t-tests compared differences between individuals with MAUD and with and without co-occurring GD. Dichotomous logistic regression was used to statistically predict co-occurring GD. The prevalence of GD was 45.1%. Most individuals (39.1% overall) had post-onset methamphetamine use (PoMAU-GD). The number of MAUD symptoms, history of gambling by family members, age of first sexual activity, and non-planning impulsivity statistically predicted PoMAU-GD, jointly explaining 24.0% of the total variance. The regression model fit well (HLχ2 = 5.503, p = 0.70), in which the specificity was 0.80, the sensitivity was 0.64, and the area under the curve was 0.79 (95%CI: 0.75-0.84). This study clarifies the prevalence of and potential risk factors for GD among individuals engaging in compulsory MAUD treatment in China. The high prevalence and associated clinical features of GD in the MAUD group highlight the importance of screening for GD in this population and intervening accordingly.
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Affiliation(s)
- Yingying Wang
- School of Physical Education and Health, Hunan University of Technology and Business, Changsha, China
- Department of Psychiatry, The Second Xiangya, National Clinical Research Center for Mental Disorders, Hospital of Central South University, Changsha, China
| | - Jinsong Zuo
- Department of Psychiatry, The Second Xiangya, National Clinical Research Center for Mental Disorders, Hospital of Central South University, Changsha, China
- School of Life Science and Chemistry, Hunan University of Technology, Zhuzhou, China
| | - Wei Hao
- Department of Psychiatry, The Second Xiangya, National Clinical Research Center for Mental Disorders, Hospital of Central South University, Changsha, China
| | - Lingxiang Wu
- School of Science, Shaoyang University, Shaoyang, China
| | - Feng Liu
- Compulsory detoxification center of Changsha Public Security Bureau, Changsha, Hunan, China
| | - Qianjin Wang
- Department of Psychiatry, The Second Xiangya, National Clinical Research Center for Mental Disorders, Hospital of Central South University, Changsha, China
| | - Li He
- Department of Psychiatry, The Second Xiangya, National Clinical Research Center for Mental Disorders, Hospital of Central South University, Changsha, China
| | - Pu Peng
- Department of Psychiatry, The Second Xiangya, National Clinical Research Center for Mental Disorders, Hospital of Central South University, Changsha, China
| | - Yanan Zhou
- Department of Psychiatry, Brain Hospital of Hunan Province (The Second People's Hospital of Hunan Province), Changsha, China
| | - Manyun Li
- Department of Psychiatry, The Second Xiangya, National Clinical Research Center for Mental Disorders, Hospital of Central South University, Changsha, China
| | - Qian Yang
- Department of Psychiatry, The Second Xiangya, National Clinical Research Center for Mental Disorders, Hospital of Central South University, Changsha, China
| | - Xin Wang
- Department of Psychiatry, The Second Xiangya, National Clinical Research Center for Mental Disorders, Hospital of Central South University, Changsha, China
| | - Tieqiao Liu
- Department of Psychiatry, The Second Xiangya, National Clinical Research Center for Mental Disorders, Hospital of Central South University, Changsha, China.
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA.
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA.
- Connecticut Mental Health Center, New Haven, CT, USA.
- Department of Neuroscience, Yale School of Medicine, New Haven, CT, USA.
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Mellick WH, Tolliver BK, Brenner HM, Anton RF, Prisciandaro JJ. Alcohol Cue Processing in Co-Occurring Bipolar Disorder and Alcohol Use Disorder. JAMA Psychiatry 2023; 80:1150-1159. [PMID: 37556131 PMCID: PMC10413222 DOI: 10.1001/jamapsychiatry.2023.2726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 06/04/2023] [Indexed: 08/10/2023]
Abstract
Importance Reward circuitry dysfunction is a candidate mechanism of co-occurring bipolar disorder and alcohol use disorder (BD + AUD) that remains understudied. This functional magnetic resonance imaging (fMRI) research represents the first evaluation of alcohol cue reward processing in BD + AUD. Objective To determine how alcohol cue processing in individuals with BD + AUD may be distinct from that of individuals with AUD or BD alone. Design, Setting, and Participants This cross-sectional case-control study (April 2013-June 2018) followed a 2 × 2 factorial design and included individuals with BD + AUD, AUD alone, BD alone, and healthy controls. A well-validated visual alcohol cue reactivity fMRI paradigm was administered to eligible participants following their demonstration of 1 week or more of abstinence from alcohol and drugs assessed via serial biomarker testing. Study procedures were completed at the Medical University of South Carolina. Analysis took place between June and August 2022. Main Outcomes and Measures Past-week mood symptoms were rated by clinicians using the Montgomery-Åsberg Depression Rating Scale and Young Mania Rating Scale. The Alcohol Dependence Scale, Obsessive-Compulsive Drinking Scale, and Barratt Impulsiveness Scale were included questionnaires. Functional MRI whole-brain data were analyzed along with percent signal change within a priori regions of interest located in the ventral striatum, dorsal striatum, and ventromedial prefrontal cortex. Exploratory analyses of associations between cue reactivity and select behavioral correlates (alcohol craving, impulsivity, maximum number of alcohol drinks on a single occasion, and days since last alcohol drink) were also performed. Results Of 112 participants, 28 (25.0%) had BD + AUD, 26 (23.2%) had AUD alone, 31 (27.7%) had BD alone, and 27 (24.1%) were healthy controls. The mean (SD) age was 38.7 (11.6) years, 50 (45.5%) were female, 33 (30%) were smokers, and 37 (34.9%) reported recent alcohol consumption. Whole-brain analyses revealed a BD × AUD interaction (F = 10.64; P = .001; η2 = 0.09) within a cluster spanning portions of the right inferior frontal gyrus and insula. Region of interest analyses revealed a main association of BD (F = 8.02; P = .006; η2 = 0.07) within the dorsal striatum. In each instance, individuals with BD + AUD exhibited reduced activation compared with all other groups who did not significantly differ from one another. These hypoactivations were associated with increased impulsivity and obsessive-compulsive alcohol craving exclusively among individuals with BD + AUD. Conclusion and Relevance The findings of this study suggest conceptualizing reward dysfunction in BD + AUD by the potential interaction between blunted reward responsivity and deficient inhibitory control may help guide treatment development strategies. To this end, reduced right inferior frontal gyrus and insula alcohol cue reactivity represents a novel candidate biomarker of BD + AUD that may respond to pharmacological interventions targeting impulsivity-related neural mechanisms for improved executive control.
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Affiliation(s)
| | - Bryan K. Tolliver
- Addiction Sciences Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston
| | - Helena M. Brenner
- Addiction Sciences Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston
| | - Raymond F. Anton
- Addiction Sciences Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston
| | - James J. Prisciandaro
- Addiction Sciences Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston
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Kirwan M, Stewart R, Chen W, Hammett JF, Davis KC. Sexual Compulsivity Mediates the Association Between Childhood Sexual Abuse and Condom Use Resistance Among Men Who Have Sex with Men and Women. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:3457-3469. [PMID: 37697092 DOI: 10.1007/s10508-023-02681-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 07/27/2023] [Accepted: 07/31/2023] [Indexed: 09/13/2023]
Abstract
Despite the continued prevalence of HIV and condoms' proven effectiveness in HIV prevention, many young men continue to engage in condom use resistance (CUR). Research shows that sexual compulsivity and childhood sexual abuse (CSA) victimization are risk factors for CUR. Given that sexual activity between men is the most common method through which HIV is transmitted, and that men who have sex with men and women (MSMW) are up to five times as likely to contract or transmit HIV as men who have sex with women only (MSWO), understanding the CUR behaviors of MSMW is uniquely important. Young, single men who had had sex with a woman in the past year (N = 623) completed questionnaires assessing their previous sexual experiences with men and women, history of CSA, sexual compulsivity, and CUR to determine how MSMW classification may moderate the associations between these variables. Results revealed full, moderated mediation, such that CSA was significantly associated with sexual compulsivity among MSMW, but not MSWO. Furthermore, sexual compulsivity was subsequently associated with CUR, in a model accounting for 5.35% of CUR variance. Such findings suggest that exposure to CSA may render MSMW especially susceptible to maladaptive, sexually compulsive desires and behaviors. As a result, MSMW may be more likely to disregard the inherent risks associated with condomless sexual activity and engage in CUR. Thus, intervention programs seeking to reduce the transmission of HIV and other STIs should prioritize targeting MSMW who experienced CSA to reduce sexual compulsivity and increase condom use.
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Affiliation(s)
- Mitchell Kirwan
- Department of Psychology, University of Texas at El Paso, 500 W University Ave., El Paso, TX, 79968, USA.
| | - Robin Stewart
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Weiqi Chen
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Julia F Hammett
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Kelly Cue Davis
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
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Kim HS, McGrath DS, Hodgins DC. Addiction substitution and concurrent recovery in gambling disorder: Who substitutes and why? J Behav Addict 2023; 12:682-696. [PMID: 37578867 PMCID: PMC10562828 DOI: 10.1556/2006.2023.00046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/06/2023] [Accepted: 08/02/2023] [Indexed: 08/16/2023] Open
Abstract
Objectives When individuals recover from gambling disorder, their involvement in other potentially addictive substances and behaviors may also subsequently increase (substitution) or decrease (concurrent recovery). The objectives of this study were to identify and compare recovery processes associated with substitution and concurrent recovery in gambling disorder. Methods A mixed-method study was conducted with 185 people who were recovered from gambling disorder. Semi-structured interviews were used to: (i) establish onset and recovery of gambling disorder as well as other substance and behavioral addictions; and (ii) assess processes (e.g., reasons, emotional state, helpfulness) associated with addiction substitution and concurrent recovery. Participants also completed a survey assessing demographic characteristics, gambling behaviors, and psychological characteristics to compare demographic and clinical differences between participants who engaged in addiction substitution, concurrent recovery, or neither (controls). Results The most frequently reported reason for engaging in addiction substitution was as a substitute coping mechanism. The most reported reason for engaging in concurrent recovery was due to the addictions being mutually influenced. Negative emotional states were common when engaging in both addiction substitution and concurrent recovery. Although the three groups did not differ on gambling characteristics, addiction substitution was associated with greater underlying vulnerabilities including childhood adversity, impulsivity, emotion dysregulation, and, maladaptive coping skills. Conclusion Transdiagnostic treatments that target the underlying mechanisms of addictions may reduce the likelihood of engaging in addiction substitution.
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Affiliation(s)
- Hyoun S. Kim
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
- University of Ottawa, Institute of Mental Health Research at The Royal, Ottawa, ON, Canada
| | - Daniel S. McGrath
- University of Ottawa, Institute of Mental Health Research at The Royal, Ottawa, ON, Canada
| | - David C. Hodgins
- Department of Psychology, University of Calgary, Calgary, AB, Canada
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Liu M, Wu W, Zapolski T, Cyders MA. Measurement Invariance and Differential Relationship to Substance Use of the Short UPPS-P Impulsive Behavior Scale Across Racial Groups. Assessment 2023; 30:2212-2222. [PMID: 36604806 PMCID: PMC10634311 DOI: 10.1177/10731911221146339] [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] [Indexed: 01/07/2023]
Abstract
The Short UPPS-P Impulsive Behavior (SUPPS-P) scale assesses impulsive traits; however, its use among racial/ethnic minorities needs further testing. The aims of this study are to (a) test the measurement invariance of the SUPPS-P scale between White and racial/ethnic minority groups and (b) determine whether impulsive personality traits differentially relate to substance use outcomes across these groups. Participants were 1,301 young adults and recruited through a large public university or Amazon's Mechanical Turk. Multigroup confirmatory factor analysis concluded strong measurement invariance for Black, Asian American, and Hispanic/Latino groups, each compared with a White group. Most relationships between SUPPS-P traits and substance use did not differ across the groups compared, although two differences emerged with alcohol use. The SUPPS-P can validly and reliably measure impulsive traits in Black, Hispanic/Latino, and Asian American young to middle adults. Previous findings on risk patterns with the SUPPS-P likely generalize to these groups.
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Affiliation(s)
- Melissa Liu
- Department of Psychology, Indiana University Purdue University Indianapolis, Indianapolis, IN
| | - Wei Wu
- Department of Psychology, Indiana University Purdue University Indianapolis, Indianapolis, IN
| | - Tamika Zapolski
- Department of Psychology, Indiana University Purdue University Indianapolis, Indianapolis, IN
| | - Melissa A. Cyders
- Department of Psychology, Indiana University Purdue University Indianapolis, Indianapolis, IN
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Carli G, Cavicchioli M, Martini AL, Bruscoli M, Manfredi A, Presotto L, Mazzeo C, Sestini S, Perani D. Neurobiological Dysfunctional Substrates for the Self-Medication Hypothesis in Adult Individuals with Attention-Deficit Hyperactivity Disorder and Cocaine Use Disorder: A Fluorine-18-Fluorodeoxyglucose Positron Emission Tomography Study. Brain Connect 2023; 13:370-382. [PMID: 37097207 DOI: 10.1089/brain.2022.0076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023] Open
Abstract
Objectives: Attention-deficit hyperactivity disorder (ADHD) in adulthood shows high co-occurrence rates with cocaine use disorder (CoUD). The self-medication hypothesis (SMH) provides a theoretical explanation for this comorbidity. This study investigates the neurobiological mechanisms that could support SMH in adult patients with attention-deficit hyperactivity disorder with cocaine use disorder (ADHD-CoUD). Materials and Methods: We included 19 ADHD-CoUD patients (84.2% male; age: 32.11 years [7.18]) and 16 CoUD patients (68.7% male; age: 36.63 years [8.12]). All subjects underwent a fluorine-18-fluorodeoxyglucose positron emission tomography (18F-FDG PET) brain scan. We tested brain metabolism differences between ADHD-CoUD and CoUD patients using voxel-based and regions of interest (ROIs)-based analyses. The correlation between dependence/abstinence duration and regional brain metabolism was also assessed in the two groups. Lastly, we investigated the integrity of brain metabolic connectivity of mesocorticolimbic and nigrostriatal dopaminergic systems, and large-scale brain networks involved in ADHD and addictions. Results: The voxel-wise and ROIs-based approaches showed that ADHD-CoUD patients had a lower metabolism in the thalamus and increased metabolism in the amygdala and parahippocampus, bilaterally, than CoUD subjects and healthy controls (HCs). Metabolism in the thalamus negatively correlated with years of dependence in ADHD-CoUD patients. Moreover, connectivity analyses revealed that ADHD-CoUD patients had a more preserved metabolic connectivity than CoUD patients in the dopaminergic networks and large-scale networks involved in self-regulation mechanisms of attention and behaviors (i.e., anterior default mode network [ADMN], executive network [ECN], and anterior salience network [aSAN]). Conclusions: We demonstrated distinct neuropathological substrates underlying substance-use behaviors in ADHD-CoUD and CoUD patients. Furthermore, we provided neurobiological evidence in support of SMH, demonstrating that ADHD-CoUD patients might experience short-term advantages of cocaine assumption (i.e., compensation of dopaminergic deficiency and related cognitive-behavioral deficits).
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Affiliation(s)
- Giulia Carli
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Marco Cavicchioli
- Faculty of Psychology, Vita-Salute San Raffaele University, Milan, Italy
| | - Anna Lisa Martini
- Unit of Nuclear Medicine, Department of Diagnostic Imaging, N.O.P.-S. Stefano, U.S.L. Toscana Centro, Prato, Italy
| | - Matteo Bruscoli
- UFC Farmacotossicodipendenze, Department of Drug Addiction, N.O.P.-S. Stefano, U.S.L. Toscana Centro, Prato, Italy
| | - Antonella Manfredi
- UFC Farmacotossicodipendenze, Department of Drug Addiction, N.O.P.-S. Stefano, U.S.L. Toscana Centro, Prato, Italy
| | - Luca Presotto
- Department of Physics G. Occhialini, Università degli Studi di Milano Bicocca, Milan, Italy
| | - Christian Mazzeo
- Unit of Nuclear Medicine, Department of Diagnostic Imaging, N.O.P.-S. Stefano, U.S.L. Toscana Centro, Prato, Italy
| | - Stelvio Sestini
- Unit of Nuclear Medicine, Department of Diagnostic Imaging, N.O.P.-S. Stefano, U.S.L. Toscana Centro, Prato, Italy
| | - Daniela Perani
- Faculty of Psychology, Vita-Salute San Raffaele University, Milan, Italy
- In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Nuclear Medicine Unit, San Raffaele Hospital, Milan, Italy
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Kempeneers P, Mreyen K, Pallincourt R, Remacle F, Wildemeersch G, Simon J. Validation of the UPPS-P Impulsive Behavior Scale and Clinical Correlates of its Scores in French-Speaking Patients Starting a Residential Detoxification Program. Indian J Psychol Med 2023; 45:503-510. [PMID: 37772148 PMCID: PMC10523520 DOI: 10.1177/02537176231157411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/30/2023] Open
Abstract
Background Impulsivity is a multifaceted construct that plays a prominent role in substance use disorder (SUD). The UPPS-P model distinguishes five impulsivity components (positive urgency, negative urgency, lack of perseverance, lack of premeditation, and sensation seeking). This study aimed to explore the structure of the UPPS-P in patients hospitalized for SUDs and to investigate the relationship between the dimensions of impulsivity and clinical variables. Method Inpatients of a residential detoxification service (n = 125) were recruited. A confirmatory factor analysis was performed, and associations were assessed between the components of impulsivity and clinical indexes. Results The factor analysis supported a model of impulsivity with five interrelated latent variables. Good internal consistency was found. External validity was supported by relationships with psychological difficulties. Multiple correlations (Kendall) suggested that, except for its sensation-seeking component, impulsivity is a significant risk factor for both the severity of addictive problems and their comorbidities. Conclusion This study provides further evidence in favor of the 5-dimensional model of impulsivity. It highlights impulsivity as a transdiagnostic risk factor that should be considered in the management of SUD.
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Affiliation(s)
- Philippe Kempeneers
- Alexians’ Psychiatric Hospital (CPFA),
68 rue du Château de Ruyff, 4841 Henri-Chapelle, Belgium
- Psychology and Neuroscience of
Cognition Research Unit (PsyNCog), University of Liège, Quartier Agora, 2 Place des
Orateurs, 4000 Liège, Belgium
| | - Kristina Mreyen
- Psychology and Neuroscience of
Cognition Research Unit (PsyNCog), University of Liège, Quartier Agora, 2 Place des
Orateurs, 4000 Liège, Belgium
| | - Romain Pallincourt
- Alexians’ Psychiatric Hospital (CPFA),
68 rue du Château de Ruyff, 4841 Henri-Chapelle, Belgium
| | - Florine Remacle
- Alexians’ Psychiatric Hospital (CPFA),
68 rue du Château de Ruyff, 4841 Henri-Chapelle, Belgium
- Psychology and Neuroscience of
Cognition Research Unit (PsyNCog), University of Liège, Quartier Agora, 2 Place des
Orateurs, 4000 Liège, Belgium
| | - Géraldine Wildemeersch
- Alexians’ Psychiatric Hospital (CPFA),
68 rue du Château de Ruyff, 4841 Henri-Chapelle, Belgium
| | - Jessica Simon
- Psychology and Neuroscience of
Cognition Research Unit (PsyNCog), University of Liège, Quartier Agora, 2 Place des
Orateurs, 4000 Liège, Belgium
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Loya JM, Benitez B, Kiluk BD. The Effect of Cognitive Behavioral Therapy on Impulsivity in Addictive Disorders: a Narrative Review. CURRENT ADDICTION REPORTS 2023; 10:485-493. [PMID: 38269068 PMCID: PMC10805411 DOI: 10.1007/s40429-023-00491-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2023] [Indexed: 01/26/2024]
Abstract
Purpose of Review Impulsivity is considered an important construct in the cycle of addiction, yet the effect of evidence-based treatments on impulsivity is unclear. The goal of this paper was to review the evidence regarding the effect of cognitive behavioral therapy (CBT), one of the most studied psychotherapies for addiction, on measures of impulsivity in addictive disorders. Recent Findings There is a robust literature implicating impulsivity as risk factor for development of a range of addictions and poorer treatment outcomes. However, this review identified only four randomized controlled trials evaluating CBT for an addictive behavior that included repeated assessment of impulsivity. All four were studies targeting substance use. Summary There is limited evidence that CBT has a direct effect on change in measures of impulsivity among individuals being treated for substance use. Future clinical trials should include repeated measurement of impulsivity to examine CBT's effect on the underlying characteristics of addiction.
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Affiliation(s)
- Jennifer M. Loya
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06510, USA
| | - Bryan Benitez
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06510, USA
| | - Brian D. Kiluk
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06510, USA
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Lee RSC, Albertella L, Christensen E, Suo C, Segrave RA, Brydevall M, Kirkham R, Liu C, Fontenelle LF, Chamberlain SR, Rotaru K, Yücel M. A Novel, Expert-Endorsed, Neurocognitive Digital Assessment Tool for Addictive Disorders: Development and Validation Study. J Med Internet Res 2023; 25:e44414. [PMID: 37624635 PMCID: PMC7615064 DOI: 10.2196/44414] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 02/16/2023] [Accepted: 07/22/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Many people with harmful addictive behaviors may not meet formal diagnostic thresholds for a disorder. A dimensional approach, by contrast, including clinical and community samples, is potentially key to early detection, prevention, and intervention. Importantly, while neurocognitive dysfunction underpins addictive behaviors, established assessment tools for neurocognitive assessment are lengthy and unengaging, difficult to administer at scale, and not suited to clinical or community needs. The BrainPark Assessment of Cognition (BrainPAC) Project sought to develop and validate an engaging and user-friendly digital assessment tool purpose-built to comprehensively assess the main consensus-driven constructs underpinning addictive behaviors. OBJECTIVE The purpose of this study was to psychometrically validate a gamified battery of consensus-based neurocognitive tasks against standard laboratory paradigms, ascertain test-retest reliability, and determine their sensitivity to addictive behaviors (eg, alcohol use) and other risk factors (eg, trait impulsivity). METHODS Gold standard laboratory paradigms were selected to measure key neurocognitive constructs (Balloon Analogue Risk Task [BART], Stop Signal Task [SST], Delay Discounting Task [DDT], Value-Modulated Attentional Capture [VMAC] Task, and Sequential Decision-Making Task [SDT]), as endorsed by an international panel of addiction experts; namely, response selection and inhibition, reward valuation, action selection, reward learning, expectancy and reward prediction error, habit, and compulsivity. Working with game developers, BrainPAC tasks were developed and validated in 3 successive cohorts (total N=600) and a separate test-retest cohort (N=50) via Mechanical Turk using a cross-sectional design. RESULTS BrainPAC tasks were significantly correlated with the original laboratory paradigms on most metrics (r=0.18-0.63, P<.05). With the exception of the DDT k function and VMAC total points, all other task metrics across the 5 tasks did not differ between the gamified and nongamified versions (P>.05). Out of 5 tasks, 4 demonstrated adequate to excellent test-retest reliability (intraclass correlation coefficient 0.72-0.91, P<.001; except SDT). Gamified metrics were significantly associated with addictive behaviors on behavioral inventories, though largely independent of trait-based scales known to predict addiction risk. CONCLUSIONS A purpose-built battery of digitally gamified tasks is sufficiently valid for the scalable assessment of key neurocognitive processes underpinning addictive behaviors. This validation provides evidence that a novel approach, purported to enhance task engagement, in the assessment of addiction-related neurocognition is feasible and empirically defensible. These findings have significant implications for risk detection and the successful deployment of next-generation assessment tools for substance use or misuse and other mental disorders characterized by neurocognitive anomalies related to motivation and self-regulation. Future development and validation of the BrainPAC tool should consider further enhancing convergence with established measures as well as collecting population-representative data to use clinically as normative comparisons.
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Affiliation(s)
- Rico S. C. Lee
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Lucy Albertella
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Erynn Christensen
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Chao Suo
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Rebecca A. Segrave
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Maja Brydevall
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Rebecca Kirkham
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Chang Liu
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Leonardo F. Fontenelle
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ)
- D’Or Institute for Research and Education, Rio de Janeiro, Brazil
| | - Samuel R. Chamberlain
- Department of Psychiatry, University of Southampton, Southampton, United Kingdom; and Southern Health NHS Foundation Trust, Southampton, UK
| | - Kristian Rotaru
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- Monash Business School, Monash University, Melbourne, Australia
| | - Murat Yücel
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
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Agurto C, Cecchi G, King S, Eyigoz EK, Parvaz MA, Alia-Klein N, Goldstein RZ. Speak and you shall predict: speech at initial cocaine abstinence as a biomarker of long-term drug use behavior. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.07.18.549548. [PMID: 37503140 PMCID: PMC10370100 DOI: 10.1101/2023.07.18.549548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Importance Valid biomarkers that can predict longitudinal clinical outcomes at low cost are a holy grail in psychiatric research, promising to ultimately be used to optimize and tailor intervention and prevention efforts. Objective To determine if baseline linguistic markers in natural speech, as compared to non-speech clinical and demographic measures, can predict drug use severity measures at future sessions in initially abstinent individuals with cocaine use disorder (iCUD). Design A longitudinal cohort study (August 2017 - March 2020), where baseline measures were used to predict outcomes collected at three-month intervals for up to one year of follow-up. Participants Eighty-eight initially abstinent iCUD were studied at baseline; 57 (46 male, age 50.7+/-7.9 years) came back for at least another session. Main Outcomes and Measures Outcomes were self-reported symptoms of withdrawal, craving, abstinence duration and frequency of cocaine use in the past 90 days at each study session. The predictors were derived from 5-min recordings of vocal descriptions of the positive consequences of abstinence and the negative consequences of using cocaine; the baseline cocaine and other common drug use measures, demographic and neuropsychological variables were used for comparison. Results Models using the non-speech variables showed the best predictive performance at three(r>0.45, P<2×10-3) and six months follow-up (r>0.37, P<3×10-2). At 12 months, the natural language processing-based model showed significant correlations with withdrawal (r=0.43, P=3×10-2), craving (r=0.72, P=5×10-5), days of abstinence (r=0.76, P=1×10-5), and cocaine use in the past 90 days (r=0.61, P=2×10-3), significantly outperforming the other models for abstinence prediction. Conclusions and Relevance At short time intervals, maximal predictive power was obtained with models that used baseline drug use (in addition to demographic and neuropsychological) measures, potentially reflecting a slow rate of change in these measures, which could be estimated by linear functions. In contrast, short speech samples predicted longer-term changes in drug use, implying deeper penetrance by potentially capturing non-linear dynamics over longer intervals. Results suggest that, compared to the common outcome measures used in clinical trials, speech-based measures could be leveraged as better predictors of longitudinal drug use outcomes in initially abstinent iCUD, as potentially generalizable to other substance use disorders and related comorbidity.
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Affiliation(s)
- Carla Agurto
- IBM Research, 1101 Kitchawan Rd, Yorktown Heights, NY, 10598
| | | | - Sarah King
- Psychiatry and Neuroscience Departments, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York City, NY, 10029
- Psychiatry and Neuroscience Departments, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York City, NY, 10029
| | - Elif K. Eyigoz
- IBM Research, 1101 Kitchawan Rd, Yorktown Heights, NY, 10598
| | - Muhammad A. Parvaz
- Psychiatry and Neuroscience Departments, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York City, NY, 10029
- Psychiatry and Neuroscience Departments, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York City, NY, 10029
- Artificial Intelligence and Human Health, Icahn School of Medicine at Mount Sinai, New York City, NY, 10029
| | - Nelly Alia-Klein
- Psychiatry and Neuroscience Departments, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York City, NY, 10029
- Psychiatry and Neuroscience Departments, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York City, NY, 10029
| | - Rita Z. Goldstein
- Psychiatry and Neuroscience Departments, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York City, NY, 10029
- Psychiatry and Neuroscience Departments, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York City, NY, 10029
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Zimmermann J, Zölch N, Coray R, Bavato F, Friedli N, Baumgartner MR, Steuer AE, Opitz A, Werner A, Oeltzschner G, Seifritz E, Stock AK, Beste C, Cole DM, Quednow BB. Chronic 3,4-Methylenedioxymethamphetamine (MDMA) Use Is Related to Glutamate and GABA Concentrations in the Striatum But Not the Anterior Cingulate Cortex. Int J Neuropsychopharmacol 2023; 26:438-450. [PMID: 37235749 PMCID: PMC10289146 DOI: 10.1093/ijnp/pyad023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 05/24/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND 3,4-Methylenedioxymethamphetamine (MDMA) is a widely used recreational substance inducing acute release of serotonin. Previous studies in chronic MDMA users demonstrated selective adaptations in the serotonin system, which were assumed to be associated with cognitive deficits. However, serotonin functions are strongly entangled with glutamate as well as γ-aminobutyric acid (GABA) neurotransmission, and studies in MDMA-exposed rats show long-term adaptations in glutamatergic and GABAergic signaling. METHODS We used proton magnetic resonance spectroscopy (MRS) to measure the glutamate-glutamine complex (GLX) and GABA concentrations in the left striatum and medial anterior cingulate cortex (ACC) of 44 chronic but recently abstinent MDMA users and 42 MDMA-naïve healthy controls. While the Mescher-Garwood point-resolved-spectroscopy sequence (MEGA-PRESS) is best suited to quantify GABA, recent studies reported poor agreement between conventional short-echo-time PRESS and MEGA-PRESS for GLX measures. Here, we applied both sequences to assess their agreement and potential confounders underlying the diverging results. RESULTS Chronic MDMA users showed elevated GLX levels in the striatum but not the ACC. Regarding GABA, we found no group difference in either region, although a negative association with MDMA use frequency was observed in the striatum. Overall, GLX measures from MEGA-PRESS, with its longer echo time, appeared to be less confounded by macromolecule signal than the short-echo-time PRESS and thus provided more robust results. CONCLUSION Our findings suggest that MDMA use affects not only serotonin but also striatal GLX and GABA concentrations. These insights may offer new mechanistic explanations for cognitive deficits (e.g., impaired impulse control) observed in MDMA users.
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Affiliation(s)
- Josua Zimmermann
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, ETH Zurich and University of Zurich, Zurich, Switzerland
| | - Niklaus Zölch
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - Rebecca Coray
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, ETH Zurich and University of Zurich, Zurich, Switzerland
| | - Francesco Bavato
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Nicole Friedli
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Markus R Baumgartner
- Center for Forensic Hair Analytics, Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - Andrea E Steuer
- Department of Forensic Pharmacology and Toxicology, Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - Antje Opitz
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, TU Dresden, Dresden, Germany
| | - Annett Werner
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, TU Dresden, Dresden, Germany
| | - Georg Oeltzschner
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Erich Seifritz
- Neuroscience Center Zurich, ETH Zurich and University of Zurich, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich (Drs Zölch and Seifritz), University of Zurich, Zurich, Switzerland
| | - Ann-Kathrin Stock
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, TU Dresden, Dresden, Germany
- Biopsychology, Faculty of Psychology, School of Science, TU Dresden, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, TU Dresden, Dresden, Germany
| | - David M Cole
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, ETH Zurich and University of Zurich, Zurich, Switzerland
| | - Boris B Quednow
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, ETH Zurich and University of Zurich, Zurich, Switzerland
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Trombello JM, Kulikova A, Mayes TL, Nandy K, Carmody T, Bart G, Nunes EV, Schmitz J, Kalmin M, Shoptaw S, Trivedi MH. Psychometrics of the Concise Health Risk Tracking Self-Report (CHRT-SR 16) Assessment of Suicidality in a Sample of Adults with Moderate to Severe Methamphetamine Use Disorder: Findings from the ADAPT-2 Randomized Trial. Neuropsychiatr Dis Treat 2023; 19:1443-1454. [PMID: 37377462 PMCID: PMC10292610 DOI: 10.2147/ndt.s406909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 04/28/2023] [Indexed: 06/29/2023] Open
Abstract
Background The co-occurrence of suicidality and substance use disorders has been well established, but rating scales to examine suicidal behavior and risk are sparse among participants with substance use disorders. We examined the psychometric properties of the 16-item Concise Health Risk Tracking Scale - Self Report (CHRT-SR16) to measure suicidality among adults with moderate-to-severe methamphetamine use disorder. Methods Participants (n = 403) with moderate-to-severe methamphetamine use disorder completed the CHRT-SR16 as part of a randomized, double-blind, placebo-controlled pharmacotherapy trial. The CHRT-SR16 factor structure was assessed using confirmatory factor analysis (CFA). Internal consistency was estimated with coefficients alpha (α) and omega (ω), test-retest reliability with intraclass correlation coefficient (ICC) and standard error of measurement, and convergent validity using Spearman's ρ rank order correlation coefficient test between CHRT-SR16 factors and the Patient Health Questionnaire (PHQ-9). The analyses utilized baseline and week 1 data (for test-retest reliability only). Results CFA revealed a seven-factor model of Pessimism, Helplessness, Social Support, Despair, Impulsivity, Irritability, and Suicidal Thoughts as the best-fitting model. The CHRT-SR16 also exhibited strong internal consistency (α = 0.89; ω = 0.89), test-retest reliability (ICC = 0.78) and convergent validity with the PHQ-9 total score (ρ = 0.62). Conclusion The CHRT-SR16 showed strong psychometric properties in a sample of participants with primary methamphetamine use disorder. Clinicaltrialsgov Identifier NCT03078075.
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Affiliation(s)
- Joseph M Trombello
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Alexandra Kulikova
- Department of Educational Psychology, University of North Texas, Denton, TX, USA
| | - Taryn L Mayes
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Karabi Nandy
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Peter O’Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Thomas Carmody
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Peter O’Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Gavin Bart
- Department of Medicine, University of Minnesota, Hennepin County Medical Center, Minneapolis, MN, USA
| | - Edward V Nunes
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, NY, USA
| | - Joy Schmitz
- Faillace Department of Psychiatry and Behavioral Sciences, University of Texas (UT Health) at Houston, Houston, TX, USA
| | - Mariah Kalmin
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Steven Shoptaw
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Madhukar H Trivedi
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Akpoviroro O, Sauers NK, Akpoviroro OP, Uwandu Q, Castagne M, Rodrigues E, May P, Lewis M, Bolden B, Mirza W. Cancer treatment refusal decisions in advanced cancer: a retrospective case-control study. BMJ Support Palliat Care 2023:spcare-2022-003976. [PMID: 37295924 DOI: 10.1136/spcare-2022-003976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 05/25/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Cancer remains one of the leading causes of death worldwide. Despite advancements in anticancer therapy, some patients decide against treatment. Our study focused on characterising therapy refusal in advanced-stage malignancies and further determining if certain variables significantly correlated with refusal, compared with acceptance. METHODS Our inclusion criteria were patients aged 18-75 years, stage IV cancers between 1 January 2010 and 31 December 2015 and treatment refusal (cohort 1 (C1)). A randomly selected group of patients with stage IV cancers who accepted treatment within the same timeframe was used for comparison (cohort 2 (C2)). RESULTS There were 508 patients in C1 and 100 patients in C2. Female sex was associated with treatment acceptance (51/100, 51.0%) than refusal (201/508, 39.6%); p=0.03. There were no associations between treatment decisions and race, marital status, BMI, tobacco use, previous cancer history, or family cancer history. Government-funded insurance was associated with treatment refusal (337/508, 66.3%) than acceptance (35/100, 35.0%); p<0.001. Age was associated with refusal (p<0.001). Average age of C1 was 63.1 years (SD:8.1) and C2 was 59.2 years (SD:9.9). Only 19.1% (97/508) in C1 were referred to palliative medicine, with 18% (18/100) in C2; p=0.8. There was a trend for patients who accepted therapy to have more comorbidities per the Charlson Comorbidity Index(p=0.08). The treatment of psychiatric disorders after cancer diagnosis was inversely associated with treatment refusal (p<0.001). CONCLUSIONS The treatment of psychiatric disorders after cancer diagnosis was associated with cancer treatment acceptance. Male sex, older age and government-funded health insurance were associated with treatment refusal in patients with advanced cancer. Those who refused treatment were not increasingly referred to palliative medicine.
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Affiliation(s)
- Ogheneyoma Akpoviroro
- Department of Internal Medicine, Geisinger Wyoming Valley Medical Center, Wilkes-Barre, Pennsylvania, USA
| | - Nathan Kyle Sauers
- Department of Engineering, Pennsylvania State University, State College, Pennsylvania, USA
| | | | - Queeneth Uwandu
- Department of Internal Medicine, Geisinger Wyoming Valley Medical Center, Wilkes-Barre, Pennsylvania, USA
| | - Myriam Castagne
- General Clinical Research Center, Clinical and Translational Science Institute, Boston University, Boston, Massachusetts, USA
| | - Elga Rodrigues
- Department of Surgery, Boston University, Boston, Massachusetts, USA
| | - Patrick May
- Department of Biostatistics, Geisinger Wyoming Valley Medical Center, Wilkes-Barre, Pennsylvania, USA
| | - Meredith Lewis
- Phenomic Analytics & Clinical Data Core Department, Geisinger Wyoming Valley Medical Center, Wilkes-Barre, Pennsylvania, USA
| | - Brian Bolden
- Department of Palliative Medicine, Geisinger Wyoming Valley Medical Center, Wilkes-Barre, Pennsylvania, USA
| | - Wasique Mirza
- Department of Internal Medicine, Geisinger Wyoming Valley Medical Center, Wilkes-Barre, Pennsylvania, USA
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Floyd LJ, Brown K. Perceived neighborhood disorder as a moderator of the relationship between marijuana use and disinhibition in a sample of emerging adult African American females. J Ethn Subst Abuse 2023:1-15. [PMID: 37270673 PMCID: PMC10694336 DOI: 10.1080/15332640.2023.2195691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Disinhibition is associated with myriad risk-taking behaviors and adverse outcomes. Both marijuana use and poor neighborhood conditions have been associated with disinhibition. However, the extent to which neighborhood disorder interacts with marijuana use to influence disinhibition has not been studied, extensively. A better understanding of these relationships has implications for designing more effective tailored place-based interventions that aim to reduce risk taking behaviors and related adverse social and health outcomes associated with marijuana use. Thus, the purpose of this study was to examine the interactive effects of perceived neighborhood disorder and marijuana use on disinhibition. The sample included 120 African American female residents of disadvantaged neighborhoods (Mage = 23.6 ± 3.46). We employed hierarchical linear regression analysis to examine the interactive effects of marijuana use and perceived neighborhood disorder on disinhibition, while controlling for age and education. The interaction term was marginally significant (b = 5.66; t(109) = 1.72, p = .08). Next, the conditional effects were explored. Results indicated the association of marijuana use with disinhibition was stronger for females in the higher neighborhood disorder group, compared to those in the lower neighborhood disorder group (10.40 and 4.51, respectively). Our findings support the need for more research on the potential of neighborhood disorder to amplify the effects of marijuana use on disinhibition and related neurobehavioral traits. The identification of contextual moderators and high-risk sub-groups will aid in the design of more tailored place-based interventions that aim to reduce risk-taking behavior among those most vulnerable.
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Green R, Meredith LR, Mewton L, Squeglia LM. Adolescent Neurodevelopment Within the Context of Impulsivity and Substance Use. CURRENT ADDICTION REPORTS 2023; 10:166-177. [PMID: 38009082 PMCID: PMC10671920 DOI: 10.1007/s40429-023-00485-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2023] [Indexed: 11/28/2023]
Abstract
Purpose of Review The aim of the present review is to provide an update on recent studies examining adolescent neurodevelopment in the context of impulsivity and substance use. We provide a review of the neurodevelopmental changes in brain structure and function related to impulsivity, substance use, and their intersection. Recent Findings When examining brain structure, smaller gray matter volume coupled with lower white matter integrity is associated with greater impulsivity across three components: trait impulsivity, choice impulsivity, and response inhibition. Altered functional connectivity in networks including the inhibitory control network and reward processing network confers risk for greater impulsivity and substance use. Summary Across brain structure and function, there is evidence to suggest that overlapping areas involved in the rise in impulsivity during adolescence contribute to early substance use initiation and escalation. These overlapping neurodevelopmental correlates have promising implications for prevention and early intervention efforts for adolescent substance use.
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Affiliation(s)
- ReJoyce Green
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Lindsay R. Meredith
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Louise Mewton
- Matilda Centre for Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Lindsay M. Squeglia
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
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Ikegami M, Sorama M. Differential Neural Correlates in the Prefrontal Cortex during a Delay Discounting Task in Healthy Adults: An fNIRS Study. Brain Sci 2023; 13:brainsci13050758. [PMID: 37239230 DOI: 10.3390/brainsci13050758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 04/29/2023] [Accepted: 05/01/2023] [Indexed: 05/28/2023] Open
Abstract
The phenomenon of future rewards being devalued as a function of delay is referred to as delay discounting (DD). It is considered a measure of impulsivity, and steep DD characterizes psychiatric problems such as addictive disorders and attention deficit/hyperactivity disorder. This preliminarily study examined prefrontal hemodynamic activity using functional near-infrared spectroscopy (fNIRS) in healthy young adults performing a DD task. Prefrontal activity during a DD task with hypothetical monetary rewards was measured in 20 participants. A discounting rate (k-value) in the DD task was determined on the basis of a hyperbolic function. To validate the k-value, a DD questionnaire and the Barratt impulsiveness scale (BIS) were administered after fNIRS. The DD task induced a significant increase in oxygenated hemoglobin (oxy-Hb) concentration bilaterally in the frontal pole and dorsolateral prefrontal cortex (PFC) compared with a control task. Significant positive correlations were detected between left PFC activity and discounting parameters. Right frontal pole activity, however, showed significantly negative correlation with motor impulsivity as a BIS subscore. These results suggest that left and right PFCs have differential contributions when performing the DD task. The present findings suggest the idea that fNIRS measurement of prefrontal hemodynamic activity can be useful for understanding the neural mechanisms underlying DD and is applicable for assessing PFC function among psychiatric patients with impulsivity-related problems.
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Affiliation(s)
- Masanaga Ikegami
- Department of Psychology, Asahikawa Medical University, Asahikawa 078-8510, Japan
| | - Michiko Sorama
- Department of Psychology, Kyoto Notre Dame University, Kyoto 606-0847, Japan
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Niddam DM, Wu SW, Lai KL, Yang YY, Wang YF, Wang SJ. An altered reward system characterizes chronic migraine with medication overuse headache. Cephalalgia 2023; 43:3331024231158088. [PMID: 36855934 DOI: 10.1177/03331024231158088] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
BACKGROUND Medication overuse headache shares several characteristics with substance use disorders. However, key features of substance use disorders such as increased impulsivity and alterations in reward processing remain little explored in medication overuse headache. METHODS Temporal discounting and impulsive decision making behavior and the associated brain mechanisms were assessed in 26 chronic migraine patients with medication overuse headache and in 28 healthy controls. Regions-of-interest analyses were first performed for task-related regions, namely the ventral striatum and the ventromedial and dorsomedial prefrontal cortices. Resting-state functional connectivity between these regions were then explored. An additional 27 chronic migraine patients without medication overuse headache were included for comparison in the latter analysis. RESULTS Patients with medication overuse headache showed steeper temporal discounting behavior than healthy controls. They also showed weaker subjective value representations in the dorsomedial prefrontal cortex, when accepting larger delayed rewards, and in ventral striatum and ventromedial prefrontal cortex, when accepting the smaller immediate reward. Resting-state functional connectivity was reduced among the valuation regions when comparing patients with medication overuse headache to the other two control groups. CONCLUSIONS Patients with medication overuse headache were characterized by altered processing and dysconnectivity in the reward system during intertemporal choices and in the resting-state.
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Affiliation(s)
- David M Niddam
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Institute of Brain Science, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Institute of Neuroscience, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shih-Wei Wu
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Institute of Neuroscience, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Kuan-Lin Lai
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Neurology, The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yun-Yen Yang
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yen-Fang Wang
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Neurology, The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shuu-Jiun Wang
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Neurology, The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Valdes K, Lunsford D, Castelli J. Financial Acumen Improves After Financial Literacy Training in Individuals With Substance Use Disorder. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2023; 43:296-302. [PMID: 35754348 DOI: 10.1177/15394492221101846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Financial literacy is a skill that may be affected by decreased cognitive processes that arise from substance use disorder. The aim of this mixed-methods study was to determine change in financial acumen after participating in a financial literacy program. Study participants were recruited from a drug and alcohol treatment center in the Southeastern United States. A total of 31 males participated. A t-test was conducted to compare the scores on the financial tests. There was a significant difference between the financial literacy pretest (M = 74, SD = 13.58) and posttest (M = 84, SD = 10.50) scores; t(30) = -3.14, p = .003. Categories that emerged when participants were asked how the information would help manage their finances included: goal setting, saving, and understanding financial institutions. This study "provides preliminary evidence" that supports financial literacy program for this population and indicates that occupational therapy is a profession suited to do so.
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Johnson BN, Allen MI, Reboussin BA, LaValley C, Nader MA. Delay discounting as a behavioral phenotype associated with social rank in female and male cynomolgus monkeys: Correlation with kappa opioid receptor availability. Pharmacol Biochem Behav 2023; 225:173545. [PMID: 37004977 PMCID: PMC10732250 DOI: 10.1016/j.pbb.2023.173545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/22/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023]
Abstract
Cocaine use disorder (CUD) is a significant problem worldwide, with no FDA-approved treatments. Epidemiological data indicate that only about 17 % of people that use cocaine will meet DSM criteria for CUD. Thus, the identification of biomarkers predictive of eventual cocaine use may be of great value. Two potentially useful predictors of CUD are social hierarchies in nonhuman primates and delay discounting. Both social rank and preference for a smaller, immediate reinforcer relative to a larger, delayed reinforcer have been predictive of CUD. Therefore, we wanted to determine if there was also a relationship between these two predictors of CUD. In the present study, monkeys cocaine-naive responded under a concurrent schedule of 1- vs. 3-food pellets and delivery of the 3-pellet option was delayed. The primary dependent variable was the indifference point (IP), which is the delay that results in 50 % choice for both options. In the initial determination of IP, there were no differences based on sex or social rank of the monkeys. When the delays were redetermined after ~25 baseline sessions (range 5-128 sessions), dominant females and subordinate males showed the largest increases in IP scores from the first determination to the second. Because 13 of these monkeys had prior PET scans of the kappa opioid receptor (KOR), we examined the relationship between KOR availability and IP values and found that the change in IP scores from the first to the second determination significantly negatively predicted average KOR availability in most brain regions. Future studies will examine acquisition to cocaine self-administration in these same monkeys, to determine if IP values are predictive of vulnerability to cocaine reinforcement.
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Affiliation(s)
- Bernard N Johnson
- Department of Physiology & Pharmacology, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, NC 27157, United States of America
| | - Mia I Allen
- Department of Physiology & Pharmacology, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, NC 27157, United States of America
| | - Beth A Reboussin
- Department of Biostatistics, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, NC 27157, United States of America
| | - Christina LaValley
- Department of Physiology & Pharmacology, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, NC 27157, United States of America
| | - Michael A Nader
- Department of Physiology & Pharmacology, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, NC 27157, United States of America.
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Dacosta-Sánchez D, Fernández-Calderón F, Blanc-Molina A, Díaz-Batanero C, Lozano OM. Monitoring adherence and abstinence of cannabis use disorder patients: Profile identification and relationship with long-term treatment outcomes. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 148:209019. [PMID: 36933660 DOI: 10.1016/j.josat.2023.209019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 01/19/2023] [Accepted: 03/10/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Patients with cannabis use disorder (CUD) show heterogeneous sociodemographic and consumption patterns. Although previous studies, focused on identifying subgroups of CUD patients using input variables, have yielded useful results for planning individualized treatments, no published research has analyzed the profiles of CUD patients according to their therapeutic progress. This study therefore aims to identify subgroups of patients using adherence and abstinence indicators and to explore whether these profiles are associated with sociodemographic characteristics, consumption variables, and long-term therapeutic outcomes. METHODS This was a retrospective observational study with a multisite sample of 2055 CUD outpatients who were beginning treatment. The study monitored patient data at two-year follow-up. We conducted latent profiles analysis on the appointment attendance ratio and percentage of negative cannabis tests. RESULTS A three profile solution emerged: i) moderate abstinence/moderate adherence (n = 997); ii) high abstinence/moderate adherence (n = 613); and iii) high abstinence/high adherence (n = 445). The study found the most marked differences at the beginning of treatment for education level (chi2 (8) = 121.70, p < .001), source of referral (chi2 (12) = 203.55, p < .001), and frequency of cannabis use (chi2 (10) = 232.39, p < .001). Eighty percent of patients from the "high abstinence/high adherence" group were relapse-free at two year follow-up. This percentage decreased to 24.3 % in the "moderate abstinence/moderate adherence" group. CONCLUSIONS Research has shown adherence and abstinence indicators to be useful for identifying subgroups of patients with different prognoses regarding long-term success. Recognizing the sociodemographic and consumption variables associated with these profiles at the beginning of treatment could help to inform the design of more individualized interventions.
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Affiliation(s)
- Daniel Dacosta-Sánchez
- Department of Clinical and Experimental Psychology, University of Huelva. Avda. Fuerzas Armadas s/n. 21071, Huelva, Spain
| | - Fermín Fernández-Calderón
- Department of Clinical and Experimental Psychology, University of Huelva. Avda. Fuerzas Armadas s/n. 21071, Huelva, Spain; Research Center on Natural Resources, Health and the Environment, University of Huelva, Ed. Experimental Sciences, 21071 Huelva, Spain
| | - Andrea Blanc-Molina
- Department of Clinical and Experimental Psychology, University of Huelva. Avda. Fuerzas Armadas s/n. 21071, Huelva, Spain
| | - Carmen Díaz-Batanero
- Department of Clinical and Experimental Psychology, University of Huelva. Avda. Fuerzas Armadas s/n. 21071, Huelva, Spain; Research Center on Natural Resources, Health and the Environment, University of Huelva, Ed. Experimental Sciences, 21071 Huelva, Spain
| | - Oscar M Lozano
- Department of Clinical and Experimental Psychology, University of Huelva. Avda. Fuerzas Armadas s/n. 21071, Huelva, Spain; Research Center on Natural Resources, Health and the Environment, University of Huelva, Ed. Experimental Sciences, 21071 Huelva, Spain.
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