Neurogenetic adaptive mechanisms in alcoholism

Association patterns of antisocial personality disorder across substance use disorders

There is a high prevalence of antisocial personality disorder (ASPD) in individuals affected by substance use disorders (SUD). However, there is limited information on the specific patterns of association of ASPD with SUD severity and specific SUD diagnostic criteria. We investigated the association of alcohol, cannabis, cocaine, opioid, and tobacco use disorders (AUD, CanUD, CocUD, OUD, and TUD, respectively) in 1660 individuals with ASPD and 6640 controls matched by sex (24% female), age, and racial/ethnic background in a sample ascertained for addiction-related traits. Generalized linear regressions were used to test ASPD with respect to the five DSM-5 SUD diagnoses, their severity (i.e., mild, moderate, severe), and their diagnostic criteria. We found that ASPD is associated with the diagnosis and severity of AUD (Odds Ratio, ORs = 1.89 and 1.25), CanUD (ORs = 2.13 and 1.32), and TUD (ORs = 1.50 and 1.21) (ps < 0.003). Of the specific diagnostic criteria, the "hazardous use" criterion showed the strongest association with ASPD across the five SUDs investigated (from ORTUD = 1.88 to ORCanUD = 1.37). However, when criteria of different SUDs were included in the same model, ASPD was independently associated only with TUD "hazardous use" and CocUD "attempts to quit". Attempting to quit cocaine was inversely related to the presence of ASPD and remained significant (OR = 0.57, 95% confidence interval = 0.36-0.89) after controlling for interactive effects with sex. The current work provides novel insights into ASPD-SUD comorbidity, supporting the existence of different SUD patterns among individuals affected by ASPD.

Incubation of methamphetamine craving in punishment-resistant individuals is associated with activation of specific gene networks in the rat dorsal striatum

Methamphetamine use disorder (MUD) is characterized by loss of control over compulsive drug use. Here, we used a self-administration (SA) model to investigate transcriptional changes associated with the development of early and late compulsivity during contingent footshocks. Punishment initially separated methamphetamine taking rats into always shock-resistant (ASR) rats that continued active lever pressing and shock-sensitive (SS) rats that reduced their lever pressing. At the end of the punishment phase, rats underwent 15 days of forced abstinence at the end of which they were re-introduced to the SA paradigm followed by SA plus contingent shocks. Interestingly, 36 percent of the initial SS rats developed delayed shock-resistance (DSR). Of translational relevance, ASR rats showed more incubation of methamphetamine craving than DSR and always sensitive (AS) rats. RNA sequencing revealed increased striatal Rab37 and Dipk2b mRNA levels that correlated with incubation of methamphetamine craving. Interestingly, Bdnf mRNA levels showed HDAC2-dependent decreased expression in the AS rats. The present SA paradigm should help to elucidate the molecular substrates of early and late addiction-like behaviors.

Drinking While Stressed and Drinking to Cope Differentially Relate to Mental Health

Excessive alcohol use, as well as drinking to manage distress, are known to undermine mental health. The current study examined the unique associations of simply consuming alcohol while stressed, versus using alcohol to cope with distress, with mental health during the early stages of COVID-19. Participants (N = 264) reported their alcohol use and use of alcohol/substances to cope with stress daily for 22 days and completed measures of mental health at baseline and every 7 days thereafter. Hierarchical regression models were tested to predict drinking while stressed, drinking to cope, and mental health. At baseline, drinking while stressed was not significantly associated with mental health when coping motives were accounted for. However, drinking to cope was significantly associated with greater stress, anxiety, depression, and loneliness. Drinking while stressed was significantly predicted by baseline stress and loneliness, while drinking to cope was significantly predicted by baseline anxiety. Drinking while stressed was not a significant predictor of change in mental health when coping motives were accounted for. Drinking to cope was a significant predictor of increases in depression but not of change in stress, anxiety, or loneliness. The motivation to manage distress appears to be driving the negative effects of alcohol use on mental health.

Targeting Symptom-Specific Networks With Transcranial Magnetic Stimulation

Increasing evidence suggests that the clinical effects of transcranial magnetic stimulation are target dependent. Within any given symptom, precise targeting of specific brain circuits may improve clinical outcomes. This principle can also be extended across symptoms-stimulation of different circuits may lead to different symptom-level outcomes. This may include targeting different symptoms within the same disorder (such as dysphoria vs. anxiety in patients with major depression) or targeting the same symptom across different disorders (such as primary major depression and depression secondary to stroke, traumatic brain injury, epilepsy, multiple sclerosis, or Parkinson's disease). Some of these symptom-specific changes may be desirable, while others may be undesirable. This review focuses on the conceptual framework through which symptom-specific target circuits may be identified, tested, and implemented.

OPRM1 Gene Polymorphism in Women with Alcohol Use Disorder

The main aims of the present study were to explore the relationship of the OPRM1 gene rs1074287 polymorphism in alcohol-dependent women with their personality traits and to try to find out whether any specific features may influence alcohol cravings and be a prognostic for alcohol dependency and treatment in AUD women. Our study found a notable correlation between openness and the interaction of the ORIM1 gene and AUD. The alcohol use disorder subjects with genotype AG showed a higher level of openness compared to the control group with genotypes AG (p = 0.0001) and AA (p = 0.0125). The alcohol use disorder subjects with the AA genotype displayed higher levels of openness than the control group with genotype AG (p = 0.0271). However, the alcohol use disorder subjects with the AA genotype displayed lower levels of openness than the control group with genotype GG (p = 0.0212). Our study indicates that openness as a personality trait is correlated with the OPRM1 gene rs1074287 polymorphism in alcohol-dependent women. These are the first data and results exploring such a relationship between opioid and alcohol pathways and the mental construction of AUD women. Personality traits such as openness to experience and neuroticism might play major roles in the addiction mechanism, especially in genetically predisposed females, independent of the reward system involved in the emotional disturbances that coexist with anxiety and depression.

Two subtypes of compulsive sexual behavior disorder

Models explaining addictive behaviors such as the Interaction of Person-Affect-Cognition-Execution (I-PACE) model emphasize the importance of reinforcement mechanisms for developing and maintaining these behaviors, including compulsive sexual behavior disorder (CSBD) as well as personal characteristics as vulnerability factors. This study aimed to determine whether there are CSBD subtypes distinguished by reinforcement sensitivity. We hypothesize that one subtype is sensitive to positive reinforcement (C+subtype) and one is sensitive to negative reinforcement (Ȼ-subtype). We calculated a cluster analysis with data from 62 patients with CSBD and tested differences between the identified clusters by t-test. The sample consisted only of men. Cluster variables were: the sensitivity to the Behavioral Inhibition and Approach System (BIS/BAS), the severity of depressive symptoms (BDI-II), the severity of Trait Anxiety (STAI-T), Sexual Sensation Seeking (SSSS), Thrill- and Adventure-Seeking (SSS-V subscale), Disinhibition (SSS-V subscale), Experience Seeking (SSS-V subscale), and Boredom Susceptibility (SSS-V subscale). Between-cluster differences were analyzed for Trait Sexual Motivation (TSMQ) and Sexual Compulsivity (SCS). The results showed a two-cluster solution with cluster 1 representing patients sensitive to negative reinforcement (Ȼ-subtype) and cluster 2 representing patients sensitive to positive reinforcement (C+subtype). No significant difference in symptom severity of Sexual Compulsivity between clusters was found. Cluster 2 showed higher Importance of Sex and a higher motivation to seek sexual encounters than cluster 2. We found a two-cluster solution regarding reinforcement sensitivity in patients with CSBD. This may have clinical implications regarding individual therapy by focusing on the underlying maintenance mechanisms.

Association Patterns of Antisocial Personality Disorder across Substance Use Disorders

There is a high prevalence of antisocial personality disorder (ASPD) in individuals affected by substance use disorders (SUD). However, there is limited information on the specific patterns of association of ASPD with SUD severity and specific SUD diagnostic criteria. We investigated the association of alcohol, cannabis, cocaine, opioid, and tobacco use disorders (AUD, CanUD, CocUD, OUD, and TUD, respectively) in 1,660 individuals with ASPD and 6,640 controls matched by sex (24% female), age, and racial/ethnic background in a sample ascertained for addiction-related traits. Generalized linear regressions were used to test the association of ASPD with the five DSM-5 SUD diagnoses, their severity (i.e., mild, moderate, severe), and their individual diagnostic criteria. We found that ASPD is associated with the diagnosis and severity of AUD (Odds Ratio, ORs=1.89 and 1.25), CanUD (ORs=2.13 and 1.32), and TUD (ORs=1.50 and 1.21) ( ps <.003). Of the specific diagnostic criteria, the "hazardous use" criterion showed the strongest association with ASPD across the five SUDs investigated (from OR TUD =1.88 to OR CanUD =1.37). However, when criteria of different SUDs were included in the same model, ASPD was independently associated only with TUD "hazardous use" and CocUD "attempts to quit". Attempting to quit cocaine was inversely related to the presence of ASPD and remained significant (OR=0.57, 95% confidence interval = 0.36-0.89) after controlling for interactive effects with sex. The current work provides novel insights into how different SUDs, their severity, and their diagnostic criteria associate with ASPD, potentially furthering our understanding of the impact of polysubstance addiction on mental health.

Old and New Biomarkers of Alcohol Abuse: Narrative Review

The harmful use of alcohol is responsible for 5.1% of the global burden of disease, and the early detection of alcohol problems may prevent its development and progression. Therefore, the aim of the study is to review traditional and new biomarkers associated with alcohol use. The nature and practical application and limitations of alcohol biomarkers in the diagnosis and monitoring of drinking are reviewed. Despite the limited specificity and sensitivity in alcohol drinking detection, traditional biomarkers are useful in clinical practice, and new generations of biomarkers, e.g., proteomic markers, are in need of further investigation. Traditional biomarkers are broadly available and cost-efficient, providing valuable data on the complications of drinking and prognosis, as well as on concurrent conditions affected by drinking. The most important challenge in the future will be to translate methodically advanced methods of detecting alcohol markers into simpler and cheaper methods. Larger population studies are also needed to test the usefulness of these potential markers of alcohol use.

Alcohol Use Disorder and Associated Factors Among Elderly in Ethiopia

Background

The aim of this study was to investigate the magnitude and associated factors of alcohol use disorder among the elderly living in 3 towns in South West Ethiopia.

Method

Cross-sectional community-based study was done among 382 elderly people aged 60 or more from February to March 2022 in South West Ethiopia. The participants were selected by a systematic random sampling method. Alcohol use disorder, quality of sleep, cognitive impairment, and depression were assessed by using AUDIT, Pittsburgh Sleep Quality Index, Standardized Mini Mental State Examination, and geriatric depression scale, respectively. Also, suicidal behavior, elder abuse, and other clinical and environmental factors were assessed. The data was entered into Epi Data Manager Version 4.0.2 before being exported to SPSS Version 25 for analysis. A logistic regression model was used, and variables with a P-value less than .05 in the final fitting model were stated as independent predictors of alcohol use disorder (AUD).

Result

The magnitude of alcohol use disorder, current alcohol use, and life-time alcohol use among the elderly was 27.5%, 52.4%, and 89.3%, respectively. Also, 7%, 23%, 8.9%, and none of the elderly had nicotine, khat, inhalants, and cannabis use disorder, respectively. Furthermore, AUD was associated with cognitive impairment (AOR, 95% CI; 2.79 (1.47-5.30)), poor sleep quality (AOR, 95% CI; 3.27 (1.23-8.69)), chronic medical illness (AOR, 95% CI; 2.12 (1.20-3.74)), and suicidal ideation (AOR, 95% CI; 5.27 (2.21-12.60)).

Conclusion

Problematic alcohol use was higher among the elderly, and cognitive impairment, poor sleep quality, having chronic medical illness, and suicidal ideation were risk factors for AUD. Therefore, community level screening for AUD and comorbid risk factors among this particular age group and managing them is crucial to prevent further complications due to AUD.

Novelty, uncertainty, and the looming horizon

Novelty and uncertainty are powerful drivers of exploration that are often conflated. In this issue of Neuron, Cockburn and colleagues dissociate the two and report a key interaction: close to task termination, novel options appear much more attractive relative to uncertain options.

Novelty preference does not predict trait cocaine behaviors in male rats

Heightened novelty seeking is a risk factor for the initiation of drug use and development of substance use disorders. In rats, novelty seeking can be examined by assessing preference for a novel environment. Some evidence indicates that high novelty preferring (HNP) rats have higher drug intake compared to low novelty preferring (LNP) rats, although these data are mixed. Moreover, the extent to which the HNP phenotype can predict other initial drug behaviors, including economic demand for cocaine, has not been tested. Here, we screened a cohort (n=60) of male rats for novelty preference and several subsequent cocaine behaviors, including locomotor reactivity to a cocaine priming injection, acquisition of cocaine self-administration, as well as cocaine demand using a within-session behavioral economics procedure. Novelty preference did not correlate with cocaine behaviors, nor were there any differences between HNP and LNP rats identified using a median split strategy. Moreover, regression analyses indicated that novelty preference did not have predictive utility for any of the cocaine behaviors tested. Thus, the extent to which the novelty preference trait can predict initial cocaine-related behaviors in male rats may be limited. This is in contrast to the novel locomotor reactivity phenotype, which is strongly linked with initial cocaine intake, indicating that these traits are distinct and differentially predict cocaine behaviors in rats.

Central nervous system monoamine metabolite response to alcohol exposure is associated with future alcohol intake in a nonhuman primate model (Macaca mulatta)

It is widely held that the central monoamine neurotransmitters modulate alcohol intake. Few studies, however, directly assess the relationship between baseline and alcohol-induced monoamine turnover, as well as the change from baseline, as predictors of alcohol intake. Using a nonhuman primate model, this study investigates baseline, alcohol-induced and alcohol-induced change in monoamine activity and their relationship with alcohol intake. Alcohol-naïve, adolescent rhesus macaques (Macaca mulatta, N = 114) were administered a standardized intravenous bolus of alcohol solution (16.8%, v/v) on two occasions, approximately 1 month apart. One month prior to and 1 h following each alcohol infusion, cisternal cerebrospinal fluid (CSF) was obtained and assayed for monoamine metabolite concentrations. Approximately 6-7 months later, subjects were allowed unfettered access to an aspartame-sweetened alcohol solution (8.4%, v/v) for 1 h/day, 5 days/week, over 5-7 weeks. Results showed strong positive correlations between baseline and post-infusion CSF monoamine metabolite concentrations, indicating a trait-like response. Low baseline and post-infusion serotonin and dopamine metabolite concentrations and a smaller change in serotonin and dopamine metabolites from one infusion to the next were associated with higher alcohol intake. Low baseline and post-infusion norepinephrine metabolite concentrations predicted high alcohol intake, but unlike the other monoamines, a greater change in norepinephrine metabolite concentrations from one infusion to the next was associated with higher alcohol intake. These findings suggest that individual differences in naturally occurring and alcohol-induced monoamine activity, as well as the change between exposures, are important modulators of initial alcohol consumption and may play a role in the risk for excessive alcohol intake.

Genetic association of nucleus accumbens 5-hydroxyindoleacetic acid level and alcohol preference drinking in a quasi-congenic male mice: Potential modulation by Grm7 gene polymorphism

OBJECTIVE

To test the hypothesis that predisposition to high alcohol drinking behavior is genetically associated with hypoactive serotonergic function in the Nucleus Accumbens (NAc).

METHOD

Alcohol avoiding C5A3 and alcohol preferring I5B25A mice of the Quasi-congenic Recombinant QTL Introgression (RQI) mouse strains were subjected to in vivo microdialysis in the NAc. Neurotransmitter and metabolite contents were analyzed by HPLC and samples were collected in three phases: Baseline, Control, and Alcohol. Samples were collected with 20 min intervals.

RESULTS

Between-strain differences restricted to small chromosome segments significantly affected both alcohol preference drinking and NAc 5-HIAA levels [F_{1, 13} = 5.569 p=.035 (General Linear Model Repeated Measures ANOVA and Tests of Between-Subjects Effects)]. Whole genome biallelic DNA marker genotyping allowed the identification of 16 differential microsatellite markers associated with low 5-HIAA levels and excessive alcohol drinking. Chromosome 6 markers were linked to Grm7 (51.19 centimorgan), a reported candidate gene for modulation of addiction. The results are consistent with earlier reports of association of low 5-HIAA and high alcohol consumption in rats and primates, including Homo sapiens.

CONCLUSION

Low NAc 5-HIAA and high alcohol consumption are genetically associated in a quasi-congenic mouse model carrying variants of the Grm7 gene. We propose that constitutional polymorphism in Grm7 may modulate CRF neuron activity via altered mGluR7 expression thus targeting CRF pathways to substance use circuits. This raises the possibility of modulation of DRN 5-HT neurons leading to hypo- or hyper-serotonergic condition in NAc and higher or lower alcohol preference drinking.

No evidence for trait- and state-level urgency moderating the daily association between negative affect and subsequent alcohol use in two college samples

It remains unclear whether the negative reinforcement pathway to problematic drinking exists, and if so, for whom. One idea that has received some support recently is that people who tend to act impulsively in response to negative emotions (i.e. people high in negative urgency) may specifically respond to negative affect with increased alcohol consumption. We tested this idea in a preregistered secondary data analysis of two ecological momentary assessment studies using college samples. Participants (N = 226) reported on their current affective state multiple times per day and also the following morning reported alcohol use of the previous night. We assessed urgency both at baseline and during the momentary affect assessments. Results from our Bayesian model comparison procedure, which penalises increasing model complexity, indicate that no combination of the variables of interest (negative affect, urgency, and the respective interactions) outperformed a baseline model that included two known demographic predictors of alcohol use. A non-preregistered exploratory analysis provided some evidence for the effect of daily positive affect, positive urgency, as well as their interaction on subsequent alcohol use. Taken together, our results suggest that college students' drinking may be better described by a positive rather than negative reinforcement cycle.

Alcohol-related phenotypes and platelet serotonin concentration

Alcohol dependence is a chronic relapsing mental disorder with heterogeneous and complex underlying biology. It is frequently associated with nicotine dependence, severity of alcohol dependence symptoms, and diverse alcohol-related phenotypes, including the presence of delirium tremens and withdrawal symptoms, early or late onset of alcohol abuse, aggression, suicidal behavior, and anxiety. While searching for peripheral biomarkers of altered serotonergic (5-HT) function in alcohol dependence and alcohol-related behaviors, we determined a peripheral biomarker, i.e., platelet 5-HT concentration in a large group of Caucasian subjects with alcohol dependence subdivided according to the presence of specific alcohol-related phenotypes and smoking status. Individuals with alcohol dependence (n = 661) of both sexes were evaluated using Structural Clinical Interview based on DSM-IV criteria, while platelet 5-HT concentration was determined using the spectrophotofluorimetric method. Smoking is significantly associated, while sex and age are not, with platelet 5-HT concentration. Severe alcohol dependence and lack of withdrawal symptoms were associated with significantly decreased platelet 5-HT concentration in alcohol-dependent non-smokers. In smokers, significantly lower platelet 5-HT concentration was found in patients with the late onset of alcohol abuse. These results suggested that platelet 5-HT concentration might be used as a peripheral marker of different alcohol-related phenotypes, after controlling for the effects of smoking and sex.

Adolescents' Online Pornography Exposure and Its Relationship to Sociodemographic and Psychopathological Correlates: A Cross-Sectional Study in Six European Countries

The aim of the study was to assess the prevalence of online exposure to pornography in European adolescents and its relationship to sociodemographic and psychopathological correlates. A cross-sectional school-based survey of 10,930 adolescents (5211 males/5719 females), aged 14-17 years old (mean age 15.8 ± 0.7) was carried out in six European countries (Greece, Spain, Poland, Romania, the Netherlands, and Iceland). Anonymous self-completed questionnaires covered exposure to pornography, internet use and dysfunctional internet behavior, and psychopathological syndromes (measured by Achenbach's Youth Self-Report). The prevalence of any online exposure to pornography was 59% overall and 24% for exposure at least once a week. The likelihood of online exposure to pornography was greater in male adolescents, heavier internet users, and those who displayed dysfunctional internet behavior. Country-specific analyses confirmed that the gender effect existed in every country, although its strength varied, from an odds ratio of 1.88 in Poland to 14.9 in Greece. Online exposure to pornography was shown to be associated with externalizing problem scale scores, especially rule-breaking and aggressive behavior, but also associated with higher scores in competences, namely activities and social competence. Exposure to pornography is ubiquitous, more relevant to boys, and is associated with both positive qualities/competences and externalizing behavioral problems.

Incipient alcohol use in childhood: Early alcohol sipping and its relations with psychopathology and personality

Prior research has shown that sipping of alcohol begins to emerge during childhood and is potentially etiologically significant for later substance use problems. Using a large, community sample of 9- and 10-year-olds (N = 11,872; 53% female), we examined individual differences in precocious alcohol use in the form of alcohol sipping. We focused explicitly on features that are robust and well-demonstrated correlates of, and antecedents to, alcohol excess and related problems later in the lifespan, including youth- and parent-reported externalizing traits (i.e., impulsivity, behavioral inhibition and activation) and psychopathology. Seventeen percent of the sample reported sipping alcohol outside of a religiously sanctioned activity by age 9 or 10. Several aspects of psychopathology and personality emerged as small but reliable correlates of sipping. Nonreligious sipping was related to youth-reported impulsigenic traits, aspects of behavioral activation, prodromal psychotic-like symptoms, and mood disorder diagnoses, as well as parent-reported externalizing disorder diagnoses. Religious sipping was unexpectedly associated with certain aspects of impulsivity. Together, our findings point to the potential importance of impulsivity and other transdiagnostic indicators of psychopathology (e.g., emotion dysregulation, novelty seeking) in the earliest forms of drinking behavior.

Autistic Personality Traits and Treatment Outcome for Alcohol Use Disorders

ABSTRACT

The importance of personality traits for the outcome of psychiatric treatment, including treatment for alcohol use disorder (AUD), has been widely acknowledged. Also, research on autism spectrum disorders has evolved in recent years, emphasizing that the behavioral traits within these neuropsychiatric disorders exist on a dimension both within and outside the boundaries of psychopathology. In the present study, the relationship between personality traits associated with autistic functioning and level of alcohol use among patients before and after concluded AUD treatment was investigated. The participants (n = 165, diagnosed with AUD) were part of a longitudinal project on AUD treatment. Data from personality questionnaires (Structured Clinical Interview of Personality Disorders II and Temperament and Character Inventory) were used to assess autistic personality traits (APTs) based on behavior within Wing's triad, which were related to background and treatment outcome. The chosen APT items illustrated a personality functioning with an emphasis on social interaction and rigidity. Only certain included questions were indicative of still having a problematic drinking pattern 2.5 years after treatment entry, which adhered to phobic, obsessive-compulsive, and schizoid personality traits, as well as rigidity/stubbornness. Albeit with modest influence, the degree of APTs was associated with heavier drinking at treatment entry, and symptoms relating to social interaction and rigidity were associated with still having a problematic drinking pattern 2.5 years after treatment entry. A higher degree of such traits may result in having problems taking advice from others and establishing treatment alliance, important parts of treatment efficacy, making assessment of such traits relevant to clinicians.

Acetaldehyde Enhances Alcohol Sensitivity and Protects against Alcoholism: Evidence from Alcohol Metabolism in Subjects with Variant ALDH2*2 Gene Allele

Alcoholism is a complex behavior trait influenced by multiple genes as well as by sociocultural factors. Alcohol metabolism is one of the biological determinants that can significantly influence drinking behaviors. Alcohol sensitivity is thought to be a behavioral trait marker for susceptibility to develop alcoholism. The subjective perceptions would be an indicator for the alcohol preference. To investigate alcohol sensitivity for the variants ADH1B*2 and ALDH2*2, sixty healthy young males with different combinatory ADH1B and ALDH2 genotypes, ADH1B*2/*2–ALDH2*1/*1 (n = 23), ADH1B*2/*2–ALDH2*1/*2 (n = 27), and ADH1B*1/*1–ALDH2*1/*1 (n = 10), participated in the study. The subjective perceptions were assessed by a structured scale, and blood ethanol and acetaldehyde were determined by GC and HPLC after an alcohol challenge in two dose sessions (0.3 g/kg or 0.5 g/kg ethanol). The principal findings are (1) dose-dependent increase of blood ethanol concentration, unaffected by ADH1B or ALDH2; (2) significant build-up of blood acetaldehyde, strikingly influenced by the ALDH2*2 gene allele and correlated with the dose of ingested alcohol; (3) the increased heart rate and subjective sensations caused by acetaldehyde accumulation in the ALDH2*2 heterozygotes; (4) no significant effect of ADH1B polymorphism in alcohol metabolism or producing the psychological responses. The study findings provide the evidence of acetaldehyde potentiating the alcohol sensitivity and feedback to self-control the drinking amount. The results indicate that ALDH2*2 plays a major role for acetaldehyde-related physiological negative responses and prove the genetic protection against development of alcoholism in East Asians.

Exploration of the Impact of Combining Risk Phenotypes on the Likelihood of Alcohol Problems in Young Adults

AIMS

We tested the hypothesis that high novelty seeking (NS-an externalizing trait), sweet-liking (SL-a phenotype that may reflect processing of hedonic stimuli) and initial insensitivity to the impairing effects of alcohol (SRE-A) act independently and synergistically to increase the likelihood of having alcohol-related problems in young adults.

METHODS

A sample of 145 young adults, ages 18-26, balanced for gender and alcohol use disorders identification test (AUDIT) scores <8 or ≥8 were selected from a prior sample. NS, SL and SRE-A were assessed along with AUDIT score and family history of alcoholism (FH). The effect of phenotypes and their interaction on the likelihood of alcohol problems was assessed.

RESULTS

All three phenotypes contribute to the total AUDIT score. The best-fitting model explaining 35.8% of AUDIT variance includes all three phenotypes and an interaction between NS and SL/sweet-disliking (SDL) status. The addition of FH to the model explains an additional 4% of variance in both models. Classification and regression tree analysis showed that the main phenotype influencing AUDIT score is NS. The SL/SDL phenotype is a strong modifying factor for high NS. SRE-A was shown to be a weak modifier for individuals with low NS.

CONCLUSION

The evidence supports the hypothesis that the presence of multiple alcohol use disorders (AUD) risk phenotypes with different underlying neurobiological mechanisms within an individual (SL, NS and SRE-A) represents a higher likelihood for developing alcohol-related problems and may allow for a graded assessment of risk for AUD and offer the possibility for early intervention strategies.

Promising vulnerability markers of substance use and misuse: A review of human neurobehavioral studies

Substance use often begins, and noticeably escalates, during adolescence. Identifying predictive neurobehavioral vulnerability markers of substance use and related problems may improve targeted prevention and early intervention initiatives. This review synthesizes 44 longitudinal studies and explores the utility of developmental imbalance models and neurobehavioral addiction frameworks in predicting neural and cognitive patterns that are associated with prospective substance use initiation and escalation among young people. A total of 234 effect sizes were calculated and compared. Findings suggest that aberrant neural structure and function of regions implicated in reward processing, cognitive control, and impulsivity can predate substance use initiation, escalation, and disorder. Functional vulnerability markers of substance use include hyperactivation during reward feedback and risk evaluation in prefrontal and ventral striatal regions, fronto-parietal hypoactivation during working memory, distinctive neural patterns during successful (fronto-parietal hyperactivation) and failed response inhibition (frontal hypoactivation), and related cognitive deficits. Structurally, smaller fronto-parietal and amygdala volume and larger ventral striatal volume predicts prospective substance misuse. Taken together, the findings of this review suggest that neurobehavioral data can be useful in predicting future substance use behaviors. Notably, little to no research has empirically tested the underlying assumptions of widely used theoretical frameworks. To improve the reliability and utility of neurobehavioral data in predicting future substance use behaviors, recommendations for future research are provided. This article is part of the special issue on 'Vulnerabilities to Substance Abuse.'

Genetically selected alcohol-preferring msP rats to study alcohol use disorder: Anything lost in translation?

For several decades, genetically selected alcohol-preferring rats have been successfully used to mimic and study alcohol use disorders (AUD). These rat lines have been instrumental in advancing our understanding of the neurobiology of alcoholism and enabling pharmacological studies to evaluate drug efficacy on alcohol drinking and relapse. Moreover, the results of these studies have identified genetic variables that are linked to AUD vulnerability. This is an up-to-date review that focuses on genetically selected Marchigian Sardinian alcohol-preferring (msP) rats. To support the translational relevance of the findings that are obtained from msP rats and highlight important similarities to AUD patients, we also discuss the results of recent brain imaging studies. Finally, to demonstrate the importance of studying sex differences in animal models of AUD, we present original data that highlight behavioral differences in the response to alcohol in male and female rats. Female msP rats exhibited higher alcohol consumption compared with males. Furthermore, msP rats of both sexes exhibit higher anxiety- and depressive-like behaviors in the elevated plus maze and forced swim test, respectively, compared with unselected Wistar controls. Notably, voluntary alcohol drinking decreases foot-shock stress and depressive-like behavior in both sexes, whereas anxiety-like behavior in the elevated plus maze is attenuated only in males. These findings suggest that male and female msP rats both drink high amounts of alcohol to self-medicate negative affective symptoms. For females, this behavior may be driven by an attempt to treat stress and depressive-like conditions. For males, generalized anxiety appears to be an important additional factor in the motivation to drink alcohol. This article is part of the special issue on 'Vulnerabilities to Substance Abuse.'

Disinhibitory trait profile and its relation to Cluster B personality disorder features and substance use problems

Certain personality and motivational traits may present vulnerability towards disinhibitory psychopathology (e.g. antisocial personality disorder, substance abuse). Cluster analysis was used to separately group 306 women and 274 men on impulsivity, Constraint, Negative Emotionality, behavioural activation system (BAS), and behavioural inhibition system (BIS) scores. As expected, a ‘disinhibited’ group with low Constraint, high impulsivity, weak BIS, and strong BAS emerged that showed elevated drug use problems, and histrionic and antisocial personality disorder features across gender. A ‘high affectivity’ group with high Negative Emotionality and strong BIS also showed elevated drug use problems and personality disorder features. Results suggested that two different trait profiles are associated with disinhibitory psychopathology and both may present vulnerability toward the development of such disorders. Copyright © 2006 John Wiley & Sons, Ltd.

Predictive factors of long-term follow-up in treatment of Korean alcoholics with naltrexone or acamprosate

Medication is integral in treating alcohol use disorder. However, because of the small to medium effect size, much effort is being exerted to identify predicting factors for effective pharmacological treatment in alcohol abuse disorder. Rather than focusing on abstinence days, alcohol craving, or frequency of drinking, which has been the focus of previous studies. Recently, there have been several studies which focused on follow-up length as an indicator of pharmacological treatment effe ctiveness. The purpose of this study was to investigate the predicting factors of long-term follow-up in treating Korean alcoholics with naltrexone or acamprosate. A retrospective study was conducted. Medical records of all patients diagnosed from November 2008 to May 2017 with alcohol abuse or alcohol dependence at psychiatric clinics at PNUYH were reviewed. We examined total days of which naltrexone or acamprosate were prescribed, and investigated if there were predicting factors maintaining follow-up at least 180 days or more. With these data, logistic regression analysis was conducted. In naltrexone long group compared to naltrexone short group, factors of having medical comorbidities [odds ratio (OR) = 5.477, P = 0.012] showed higher OR. In acamprosate long group, factors of age (OR = 1.083, P = 0.030), and use of more than four psychotropic medications (OR = 7.107, P = 0.030), showed higher OR. In both medications, predicting factors were different from the other. Further study to investigate the reasons would provide us with a new insight.

Neonatal temperament and neuromotor differences are predictive of adolescent alcohol intake in rhesus monkeys (Macaca mulatta)

Identifying predictors of teenage alcohol use disorder (AUDs) is a major health initiative, with studies suggesting that there are distinct personality-related traits that underlie patterns of alcohol intake. As temperament is biologically based, identifiable early in life, and stable across time, it is considered the foundation of personality. As such, we hypothesized that neonatal temperament traits would predict anxiety-mediated adolescent alcohol consumption. To test this, N = 145 rhesus macaque (Macaca mulatta) infants (14 days of age), reared in a neonatal nursery (n = 82) or in a control condition with their mothers (n = 63) were assessed with a widely used standardized nonhuman primate testing battery, the Infant Behavioral Assessment Scale (IBAS), modeled after the Brazelton Neonatal Assessment Scale, evaluating visual orienting, temperament, motor maturity and, more recently, sensory sensitivity. As adolescents (3-4 years of age), these same subjects were allowed unfettered access to a sweetened-alcohol solution for 1 hr/day, 4 days/week, over 5-7 weeks. Subjects were allowed to self-administer alcohol while housed alone (n = 70) or socially in their home cage (n = 55). Linear regressions showed that alcohol intake was predicted by neonatal orienting ability (β = -.35; p = .01), state control (β = -.19; p = .04), and motor maturity (β = -.24; p = .01). Poor neonatal orienting, state control (ease of consolability), and motor maturity were associated with higher adolescent alcohol intake in rhesus monkeys. These findings suggest that neonatal temperament is predictive of patterns of adolescent alcohol intake. To the extent that these results generalize to humans, they provide evidence that early-life temperament and neurodevelopment may be important risk factors for adolescent AUDs and that the IBAS may be used as an assessment tool for identifying such risk.

A trait-like propensity to experience internalizing symptoms is associated with problem alcohol involvement across adulthood, but not adolescence

There are stable between-person differences in an internalizing "trait," or the propensity to experience symptoms of internalizing disorders, such as social anxiety, generalized anxiety disorder, and depression. Trait internalizing may serve as a marker of heightened risk for problem alcohol outcomes (such as heavier drinking, binge drinking, or alcohol dependence). However, prior research on the association between internalizing symptoms and alcohol outcomes has been largely mixed in adolescence, with more consistent support for an association during adulthood. It may be that trait internalizing is only associated with problem alcohol outcomes in adulthood, after individuals have gained experience with alcohol. Some evidence suggested that these effects may be stronger for women than men. We used data from a community sample (n = 790) interviewed during adolescence (ages 14-16) and again at ages 21, 24, 27, 30, 33, and 39. Using generalized estimating equations, we tested the association between trait internalizing and alcohol outcomes during both adolescence and adulthood, and tested whether adult trait internalizing mediated the association between adolescent trait internalizing and adult alcohol outcomes. Trait internalizing in adulthood (but not adolescence) was associated with more frequent alcohol use, binge drinking and symptoms of alcohol use disorders, and mediated the effects of adolescent trait internalizing on alcohol outcomes. We observed no moderation by gender or change in these associations over time. Understanding the developmental pathways of trait internalizing may provide further insights into preventing the emergence of problem alcohol use behavior during adulthood. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

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

BACKGROUND AND AIMS

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

METHODS

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

RESULTS

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

DISCUSSION

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

Alcohol Use Disorder and Risk of Suicide in a Swedish Population-Based Cohort

OBJECTIVE

The authors examined the association between alcohol use disorder (AUD) and risk of suicide, before and after accounting for psychiatric comorbidity, and assessed the extent to which the observed association is due to a potentially causal mechanism or genetic and familial environmental confounding factors that increase risk for both.

METHODS

Longitudinal population-wide Swedish medical, criminal, and pharmacy registries were used to evaluate the risk of death by suicide as a function of AUD history. Analyses employed prospective cohort and co-relative designs, including data on 2,229,880 native Swedes born between 1950 and 1970 and observed from age 15 until 2012.

RESULTS

The lifetime rate of suicide during the observation period was 3.54% for women and 3.94% for men with AUD, compared with 0.29% and 0.76% of women and men, respectively, without AUD. In adjusted analyses, AUD remained robustly associated with suicide: hazard ratios across observation periods ranged from 2.61 to 128.0 among women and from 2.44 to 28.0 among men. Co-relative analyses indicated that familial confounding accounted for some, but not all, of the observed association. A substantial and potentially causal relationship remained after accounting for a history of other psychiatric diagnoses.

CONCLUSIONS

AUD is a potent risk factor for suicide, with a substantial association persisting after accounting for confounding factors. These findings underscore the impact of AUD on suicide risk, even in the context of other mental illness, and implicate the time frame shortly after a medical or criminal AUD registration as critical for efforts to reduce alcohol-related suicide.

Are genes coding for dopamine receptors implicated in alcoholism?

Part of the familial factor of alcoholism is associated with the existence of genetic vulnerability. Genetic factors which interact with the pathogenesis of alcoholism are nevertheless complex, partial and for the moment partly unknown at the biological level. Recently, many association studies have been published concerning alcohol-dependence and genes coding for the second dopamine receptor. These associations, which have had positive replications, raise many questions. First of all, should the inheritance of alcoholism be regarded as a definitive fact? Secondly what is inherited? It could be alcoholism in general, a component of this disease (for instance, dependence on, sensitivity to or the seeking-process for alcohol), a specific pattern of drinking, presence of complications linked to alcohol abuse, or more general features, common to many addiction diseases. Thirdly, how could dopamine be linked to alcoholism? Furthermore, how should these positive associations be considered, given that two of these studies were negative, and that all linkage studies were negative. Lastly, are there other clues and ways of finding genetic vulnerability factors for alcohol abuse?

A French family study of two groups of alcoholic men

Alcoholic and psychiatric family history were investigated in two groups of alcoholics, recruited differently, and controls. Alcoholics with or without a family history of alcoholism (AFH + and AFH − ) were compared with regard to professional qualifications, personal psychiatric history, age at onset and reasons given for becoming alcoholic. The results can be summarized as follows: the family ‘aggregate’ of alcoholism found was independent of the recruitment. This was not the case for personal psychiatric history for which a gradient was found in the two alcoholic groups. Rates of alcoholism were higher in both the first and second degree relatives. Alcoholics with AFH+ and AFH− differed significantly with regard to inducement by profession, and tended to differ as to age of onset.

Two types classification of male alcoholism confirmed

In recent years a two types classification of male alcoholism has been proposed by several authors. The study aimed at a testing of type I/type II classification of alcoholism in an independent sample. A total of 351 Research Diagnostic Criteria (RDC) male alcoholics consecutively admitted for an inpatient psychiatric treatment were studied. Type II characteristics were extracted from the pertinent literature; 19 available variables best representing these characteristics were selected. The data was collected using the method of a retrospective evaluation of clinical records. Cluster analysis yielded two clusters which were well separated from each other. Heterogeneity of the male inpatient population of alcoholics was demonstrated and the existence of broadly defined type I and type II alcoholism was confirmed.

Reexamining the Psychometric Properties of the Substance Use Risk Profile Scale

The Substance Use Risk Profile Scale (SURPS), a widely used self-report questionnaire, assesses four personality traits which predict risk for substance use (i.e., anxiety sensitivity, hopelessness, impulsivity, and sensation seeking). Given its use in research and clinical settings, as well as potential utility, this study aimed to provide a comprehensive psychometric evaluation of the SURPS. Undergraduate participants (N = 718; 69% White; 26% Hispanic, aged 18-25 years, M = 19.00, SD = 1.33) completed a battery of measures, including the SURPS. Tests of measurement invariance, convergent and criterion validity, and internal consistency were conducted, as well as item response theory analyses and a treatment assignment simulation. Several items were removed before partial measurement invariance across gender was established with little information lost. Despite removing several SURPS items, the proposed factor structure was not empirically supported. More work is necessary to determine the predictive utility of assessing these personality traits to predict substance-related outcomes.

Single nucleotide polymorphism heritability and differential patterns of genetic overlap between inattention and four neurocognitive factors in youth

Theoretical models of attention-deficit/hyperactivity disorder implicate neurocognitive dysfunction, yet neurocognitive functioning covers a range of abilities that may not all be linked with inattention. This study (a) investigated the single nucleotide polymorphism (SNP) heritability (h2SNP) of inattention and aspects of neurocognitive efficiency (memory, social cognition, executive function, and complex cognition) based on additive genome-wide effects; (b) examined if there were shared genetic effects among inattention and each aspect of neurocognitive efficiency; and (c) conducted an exploratory genome-wide association study to identify genetic regions associated with inattention. The sample included 3,563 participants of the Philadelphia Neurodevelopmental Cohort, a general population sample aged 8-21 years who completed the Penn Neurocognitive Battery. Data on inattention was obtained with the Kiddie Schedule of Affective Disorders (adapted). Genomic relatedness matrix restricted maximum likelihood was implemented in genome-wide complex trait analysis. Analyses revealed significant h2SNP for inattention (20%, SE = 0.08), social cognition (13%, SE = 0.08), memory (17%, SE = 0.08), executive function (25%, SE = 0.08), and complex cognition (24%, SE = 0.08). There was a positive genetic correlation (0.67, SE = 0.37) and a negative residual covariance (-0.23, SE = 0.06) between inattention and social cognition. No SNPs reached genome-wide significance for inattention. Results suggest specificity in genetic overlap among inattention and different aspects of neurocognitive efficiency.

Neuropsychophysiological Measures of Alcohol Dependence: Can We Use EEG in the Clinical Assessment?

Addiction management is complex, and it requires a bio-psycho-social perspective, that ought to consider the multiple etiological and developmental factors. Because of this, a large amount of resources has been allocated to assess the vulnerability to dependence, i.e., to identify the processes underlying the transition from substance use to dependence, as well as its course, in order to determine the key points in its prevention, treatment, and recovery. Consequently, knowledge \from neuroscience must be taken into account, which is why different initiatives have emerged with this objective, such as the "Research Domain Criteria" (RDoC), and the "Addiction Neuroclinical Assessment" (ANA). Particularly, neuropsychophysiological measures could be used as markers of cognitive and behavioral attributes or traits in alcohol dependence, and even trace clinical change. In this way, the aim of this narrative review is to provide an overview following ANA clinical framework, to the most robust findings in neuropsychophysiological changes in alcohol dependence, that underlie the main cognitive domains implicated in addiction: incentive salience, negative emotionality, and executive functioning. The most consistent results have been found in event-related potential (ERP) analysis, especially in the P3 component, that could show a wide clinical utility, mainly for the executive functions. The review also shows the usefulness of other components, implicated in affective and substance-related processing (P1, N1, or the late positive potential LPP), as well as event-related oscillations, such as theta power, with a possible use as vulnerability or clinical marker in alcohol dependence. Finally, new tools emerging from psychophysiology research, based on functional connectivity or brain graph analysis could help toward a better understanding of altered circuits in alcohol dependence, as well as communication efficiency and effort during mental operations. This review concludes with an examination of these tools as possible markers in the clinical field and discusses methodological differences, the need for more replicability studies and incipient lines of work. It also uses consistent findings in psychophysiology to draw possible treatment targets and cognitive profiles in alcohol dependence.

Alcohol Use Disorder Interventions Targeting Brain Sites for Both Conditioned Reward and Delayed Gratification

Alcohol use disorder is a destructive compulsion characterized by chronic relapse and poor recovery outcomes. Heightened reactivity to alcohol-associated stimuli and compromised executive function are hallmarks of alcohol use disorder. Interventions targeting these two interacting domains are thought to ameliorate these altered states, but the mutual brain sites of action are yet unknown. Although interventions on alcohol cue reactivity affect reward area responses, how treatments alter brain responses when subjects exert executive effort to delay gratification is not as well-characterized. Focusing on interventions that could be developed into effective clinical treatments, we review and identify brain sites of action for these two categories of potential therapies. Using activation likelihood estimation (ALE) meta-analysis, we find that interventions on alcohol cue reactivity localize to ventral prefrontal cortex, dorsal anterior cingulate, and temporal, striatal, and thalamic regions. Interventions for increasing delayed reward preference elicit changes mostly in midline default mode network regions, including posterior cingulate, precuneus, and ventromedial prefrontal cortex-in addition to temporal and parietal regions. Anatomical co-localization of effects appears in the ventromedial prefrontal cortex, whereas effects specific to delay-of-gratification appear in the posterior cingulate and precuneus. Thus, the current available literature suggests that interventions in the domains of cue reactivity and delay discounting alter brain activity along midline default mode regions, specifically in the ventromedial prefrontal cortex for both domains, and the posterior cingulate/precuneus for delay-of-gratification. We believe that these findings could facilitate targeting and development of new interventions, and ultimately treatments of this challenging disorder.

DSM-5 Maladaptive Personality Domains among Treatment-Seeking Individuals with Alcohol Use Disorder: The Role of Disinhibition and Negative Affectivity

Background: Dimensional models of personality and personality disorders (PDs) have been widely investigated among individuals with alcohol use disorders (AUD). Nevertheless, DSM-5 maladaptive personality domains showed mixed associations with AUD. Furthermore, no studies have explored the role of DSM-5 maladaptive personality domains on the comorbidity between AUD and different PDs. Objective(s): This study aims at investigating whether DSM-5 maladaptive personality dimensions could differentiate individuals with AUD from normative and healthy controls (HCs) subjects. The study also investigated relationships between these personality dimensions and AUD clinical features (i.e. onset, severity of concurrent substance use disorders), as well as their role in accounting for the comorbidity between AUD and PDs. Methods: This study administered the personality inventory for DSM-5 (PID-5) to 99 treatment-seeking individuals (male 68.8%; female 31.2%; age: 48.12 (14.32)) with AUD (41 AUD only; 58 AUD with PDs), comparing the participants' levels of PID-5 domains with normative data and the data from a HC sample (N = 40; male 50%; female 50%; age: 48.12 (14.32)). Results: Disinhibition and negative affectivity were relevant maladaptive personality dimensions of AUD, even when controlling for the impact of PD diagnoses. Disinhibition and negative affectivity were associated to the onset of AUD and the severity of concurrent substance use disorders. The co-occurrence of AUD and PDs is related to other two domains, namely antagonism and detachment. Conclusions: AUD is a complex psychopathological disorder in which both externalizing and internalizing aspects determine relevant clinical features.

Alcohol Use Disorder and Antisocial and Borderline Personality Disorders

Alcohol use disorder (AUD) frequently co-occurs with other psychiatric disorders, including personality disorders, which are pervasive, persistent, and impairing. Personality disorders are associated with myriad serious outcomes, have a high degree of co-occurrence with substance use disorders, including AUD, and incur significant health care costs. This literature review focuses on co-occurring AUD and personality disorders characterized by impulsivity and affective dysregulation, specifically antisocial personality disorders and borderline personality disorders. Prevalence rates, potential explanations and causal models of co-occurrence, prognoses, and the status of existing treatment research are summarized. Several important future research considerations are relevant to these complex, co-occurring conditions. Research assessing mechanisms responsible for co-occurring AUD and antisocial personality disorder or borderline personality disorder will further delineate the underlying developmental processes and improve understanding of onset and courses. In addition, increased focus on the efficacy and effectiveness of treatments targeting underlying traits or common factors in these disorders will inform future prevention and treatment efforts, as interventions targeting these co-occurring conditions have relatively little empirical support.

Development of Alcohol Use Disorder as a Function of Age, Severity, and Comorbidity with Externalizing and Internalizing Disorders in a Young Adult Cohort

Background

As part of the ongoing Collaborative Study of the Genetics of Alcoholism, we performed a longitudinal study of a high risk cohort of adolescents/young adults from families with a proband with an alcohol use disorder, along with a comparison group of age-matched controls. The intent was to compare the development of alcohol problems in subjects at risk with and without comorbid externalizing and internalizing psychiatric disorders.

Methods

Subjects (N = 3286) were assessed with a structured psychiatric interview at 2 year intervals over 10 years (2004-2017). The age range at baseline was 12-21.

Results

Subjects with externalizing disorders (with or without accompanying internalizing disorders) were at increased risk for the onset of an alcohol use disorder during the observation period. Subjects with internalizing disorders were at greater risk than those without comorbid disorders for onset of a moderate or severe alcohol use disorder. The statistical effect of comorbid disorders was greater in subjects with more severe alcohol use disorders. The developmental trajectory of drinking milestones and alcohol use disorders was also accelerated in those with more severe disorders.

Conclusions

These results may be useful for counseling of subjects at risk who present for clinical care, especially those subjects manifesting externalizing and internalizing disorders in the context of a positive family history of an alcohol use disorder. We confirm and extend findings that drinking problems in subjects at greatest risk will begin in early adolescence.

Personality traits and risky behavior among motorcyclists: An exploratory study

BACKGROUND

Personality traits have been associated with a series of dysfunctional behaviors, ranging from violence to drug abuse and other risky behaviors. However, few studies have investigated motorcycle riders' personality traits, and no research using the psychobiological model of personality was found. Thus, we investigated the association between temperament and character traits and the occurrence of Motorcycle Accidents (MAs).

METHODS

This cross-sectional study was conducted with a randomly selected of 153 Brazilian motorcycle riders (116 male and 37 female) with a mean age of 31.8randomly selected from the driver's license register, between 2015 and 2018. A sociodemographic questionnaire and the Temperament and Character Inventory (TCI) were used.

RESULTS

Of the 153 participants, 146 (95.4%) reported having been involved in previous accidents, with the main causes as follows: "other drivers' careless behavior" (34.9%); "personal disrespect of traffic rules" (18.5%) and "personal careless behavior" (20.6%). Motorcyclists exhibited higher scores for the temperament factors of novelty seeking and persistence and lower scores for harm avoidance and reward dependence in comparison to the Brazilian population). Considering the reason for motorcycle use, the group of riders that used their motorcycles for work exhibited more temperament factors associated with risk behaviors than those who did not. It was observed that 68.9% of them had low Harm Avoidance (HA) factor scores, whereas 72.1% had high Novelty Seeking (NS) factor scores.

DISCUSSION

The present study highlighted the influences of different personality traits on behaviors, decision-making and risk attitudes that can be potentially harmful to an individual and others. The results provided evidence that a lack of knowledge and experience in riding a motorcycle or any other vehicle, combined with personality traits, contribute to the adoption of risky behaviors that may act as triggers for most causes of Motorcycle Accidents.

Evidence for incentive salience sensitization as a pathway to alcohol use disorder

The incentive salience sensitization (ISS) theory of addiction holds that addictive behavior stems from the ability of drugs to progressively sensitize the brain circuitry that mediates attribution of incentive salience (IS) to reward-predictive cues and its behavioral manifestations. In this article, we establish the plausibility of ISS as an etiological pathway to alcohol use disorder (AUD). We provide a comprehensive and critical review of evidence for: (1) the ability of alcohol to sensitize the brain circuitry of IS attribution and expression; and (2) attribution of IS to alcohol-predictive cues and its sensitization in humans and non-human animals. We point out gaps in the literature and how these might be addressed. We also highlight how individuals with different alcohol subjective response phenotypes may differ in susceptibility to ISS as a pathway to AUD. Finally, we discuss important implications of this neuropsychological mechanism in AUD for psychological and pharmacological interventions attempting to attenuate alcohol craving and cue reactivity.

Personality and Alcohol-Related Risk: Neuroticism, Extraversion, and Alexithymia

Previous research has established associations of neuroticism and extraversion with risky or problematic alcohol use in both clinical and nonclinical samples. More recently, alexithymia—a personality trait defined by difficulties in identifying and describing feelings as well as concrete thinking—has been implicated as a risk factor for problematic drinking; however, whether it is an independent risk factor or overlaps with others has not been determined. The present study examined neuroticism, extraversion, and alexithymia in relation to risky drinking in a nonclinical sample of 285 alcohol consumers aged 18-60 years. Neuroticism and extraversion were measured with the International Personality Item Pool Big Five Factor Markers, whereas alexithymia was measured with the Toronto Alexithymia Scale 20. The Alcohol Use Disorders Identification Test provided an index of alcohol-related risk. Hierarchical regression indicated that neuroticism, extraversion, and alexithymia were all significant positive predictors of risky drinking after controlling for demographic and mood variables. Alexithymia was positively related to neuroticism, and both were negatively related to extraversion. The relationship between alexithymia and risky drinking was partially mediated by neuroticism, and the association of alexithymia with neuroticism was partially mediated by negative mood. Neuroticism, extraversion, and alexithymia appear to be independently related to alcohol-related risk, although the influence of alexithymia may partially overlap with that of neuroticism. Both alexithymia and neuroticism are associated with proneness to negative moods; a reliance on drinking to cope with such states may account for the links of both traits to risky or problematic drinking in line with Cloninger’s type I alcoholism. However, additional aspects of alexithymia may also contribute to its role in alcohol-related risk. The relationship of extraversion to risky drinking appears congruent with Cloninger’s type II alcoholism, where high reward sensitivity motivates drinking to enhance positive states.

Ghrelin and aggressive behaviours-Evidence from preclinical and human genetic studies

Aggressive behaviour is of crucial importance in the defence for limited resources including food and mates and involves central serotonin as well as dopamine signalling. As ghrelin modulates food intake and sexual behaviour we initially investigated the hypothesis that central ghrelin signalling regulates aggressive behaviour in the resident intruder paradigm in male mice. Moreover, interaction between ghrelin signalling and serotonergic, noradrenergic as well as dopaminergic neurotransmission in aggression was investigated. The relevance of ghrelin for human aggression per se as well as for aggression induced by alcohol was evaluated in a human genetic association study comprising young men (n = 784) from the normal population assessed for anti-social behaviours. The present study demonstrates that central ghrelin infusion, but not ghrelin administered systemically, increases aggression. Moreover aggressive behaviour is decreased by pharmacological suppression of the growth hormone secretagogue receptor-1 A (GHSR-1A) by JMV2959. As indicated by the ex vivo biochemical data serotonin, rather than dopamine or noradrenaline, in amygdala may have central roles for the ability of JMV2959 to reduce aggression. This link between central serotonin, GHSR-1A and aggression is further substantiated by the behavioural data showing that JMV2959 cannot decrease aggression following depletion of central serotonin signalling. The genetic association study demonstrates that males carrying the Leu72Leu genotype of the pre-pro-ghrelin gene and displaying hazardous alcohol use are more aggressive when compared to the group carrying the Met-allele. Collectively, this contributes to the identification of central ghrelin pathway as an important modulator in the onset of aggressive behaviours in male mice.

Impact of Genetic Variation on Stress-Related Ethanol Consumption

BACKGROUND

The effect of stress on alcohol consumption in humans is highly variable, and the underlying processes are not yet understood. Attempts to model a positive relationship between stress and increased ethanol (EtOH) consumption in animals have been only modestly successful. Our hypothesis is that individual differences in stress effects on EtOH consumption are mediated by genetics.

METHODS

We measured alcohol consumption, using the drinking-in-the-dark (DID) paradigm in females from 2 inbred mouse strains, C57BL/6J (B6) and DBA/2J (D2), and 35 of their inbred progeny (the BXD family). A control group was maintained in normal housing and a stress group was exposed to chronic mild stress (CMS), consisting of unpredictable stressors over 7 weeks. These included predator, social, and environmental perturbations. Alcohol intake was measured over 16 weeks in both groups during baseline (preceding 5-week period), CMS (intervening 7-week period), and post-CMS (final 4-week period).

RESULTS

We detected a strong effect of CMS on alcohol intake. A few strains demonstrated CMS-related increased alcohol consumption; however, most showed decreased intake. We identified 1 nearly significant quantitative trait locus on chromosome 5 that contains the neuronal nitric oxide synthase gene (Nos1). The expression of Nos1 is frequently changed following alcohol exposure, and variants in this gene segregating among the BXD population may modulate alcohol intake in response to stress.

CONCLUSIONS

The results we present here represent the first study to combine chronic stress and alcohol consumption in a genetic reference population of mice. Differences in susceptibility to the effects of stressful environments vis-à-vis alcohol use disorders would suggest that the differences have at least some basis in genetic constitution. We have also nominated a likely candidate gene underlying the large individual differences in effects of stress on alcohol consumption.

Blunted stress reactivity reveals vulnerability to early life adversity in young adults with a family history of alcoholism

BACKGROUND AND AIMS

People with blunted stress reactivity have poor impulse control and also show increased risk for alcoholism. Exposure to early life adversity (ELA) contributes to blunted reactivity, but individual differences in susceptibility to ELA are not well understood. This study aimed to determine whether exposure to ELA has a greater impact on stress reactivity in young adults with a family history of alcoholism (FH+) compared with young adults with no family history of alcoholism (FH-).

DESIGN

Observational study using linear modeling.

SETTING

Oklahoma, USA.

PARTICIPANTS

Seven hundred and nine young adults (398 females) recruited through community advertisement.

MEASUREMENTS

We obtained heart rates and cortisol levels in subjects while undergoing public speaking and mental arithmetic stress compared with a resting control day (1418 test sessions). ELA was quantified as 0, 1 or > 1 adverse events experienced by age 15 years. FH+ people had one or two parents with an alcohol use disorder, and FH- controls had no such history for two generations.

FINDINGS

Increasing levels of ELA predicted progressive blunting of cortisol and heart rate reactivity for the whole sample (Fs = 4.57 and 4.70, Ps ≤ 0.011), but examination by FH status showed that the effect of ELA was significant only among FH+ (Fs ≥ 3.5, Ps < 0.05) and absent in FH- (Ps > 0.40). This difference in ELA impact was not explained by the cortisol diurnal cycle or subjective evaluation of the stressors.

CONCLUSIONS

People with a family history of alcoholism appear to be vulnerable, in terms of changes to physiological stress response, to the impact of exposure to early life adversity while people with no family history of alcoholism appear to be resilient. Blunted stress reactivity may reflect differential vulnerability to early life adversity in young adults with a family history of alcoholism.

Are Some Alcohol Use Disorder Criteria More (or Less) Externalizing than Others? Distinguishing Alcohol Use Symptomatology from General Externalizing Psychopathology

BACKGROUND

The externalizing spectrum contains a range of disinhibition-related conditions, such as conduct disorder, antisocial personality disorder, and substance use disorders. Comorbidity among externalizing disorders is commonly investigated at the syndromal and trait level precluding insight into the relationship of symptoms across externalizing disorders. It is unknown whether comorbidity across externalizing disorders holds constant across highly varied, individual alcohol use disorder (AUD) criteria. AUD criteria range from symptoms reflecting neuroadaptation (e.g., tolerance) to symptoms reflecting behavioral problems (e.g., social problems). The present study aimed to determine the degree to which individual AUD criteria are associated with symptomatology from other externalizing disorders. Characterization of the degree to which AUD criteria reflect neuroadaptation versus behavioral problems can be used to identify symptom profiles, which, in turn, can be used to inform diagnostic and treatment approaches.

METHODS

Data from 2 large nationally representative samples were used to examine associations between AUD criteria and externalizing behavior. Psychometric inquiries via multivariate and factor analytic approaches estimated relative associations of externalizing behavior and AUD criteria endorsement, as compared to alcohol consumption.

RESULTS

Our results indicate differential relations of externalizing behavior and AUD criteria endorsement. For example, social problems and role interference criteria were most strongly associated with externalizing behavior across analytic approaches, with general and unique associations with externalizing behavior. Additionally, tolerance was most weakly associated with externalizing behavior across approaches.

CONCLUSIONS

Results highlight potential etiological heterogeneity among AUD criteria that could guide future diagnostic refinements and aid in the identification of treatment targets.