Motivation and Self-Regulation in Addiction: A Call for Convergence

A comprehensive evaluation of the neurocognitive predictors of problematic alcohol use, eating, pornography, and internet use: A 6-month longitudinal study

Background and aims

Cognitive control and reward-related abnormalities are centrally implicated in addiction. However, findings from longitudinal studies addressing neurocognitive predictors of addictive behaviors are mixed. Further, little work has been conducted predicting non-substance-related addictive behaviors. Our study aimed to assess predictors of substance and non-substance addictive behaviors in a community sample, systematically evaluating each neurocognitive function's independent influence on addictive behavior.

Methods

Australians (N = 294; 51.7% female; M[SD] age = 24.8[4.7] years) completed online neurocognitive tasks and surveys at baseline and 3-month follow-up. Self-report scales assessed problematic alcohol use, addictive eating (AE), problematic pornography use (PPU), and problematic internet use (PUI) at 3- and 6-month follow-ups. Linear regressions with bootstrapping assessed neurocognitive predictors for each addictive behavior across a 6-month period.

Results

Neurocognition at baseline did not predict AE or PUI severity at 6-month follow-up. Less delay discounting at baseline predicted higher PPU at 6-month follow-up (β = -0.16, p = 0.005). Poorer performance monitoring at baseline predicted higher AE at 3-month follow-up (β = -0.16, p = 0.004), and more reward-related attentional capture at 3-months predicted higher AE at 6-month follow-up (β = 0.14, p = 0.033). Less reward-related attentional capture (β = -0.14, p = 0.003) and less risk-taking under ambiguity (β = -0.11, p = 0.029) at baseline predicted higher PUI at 3-month follow-up. All findings were of small effect size. None of the neurocognitive variables predicted problematic alcohol use.

Discussion and conclusions

We were unable to identify a core set of specific neurocognitive functions that reliably predict multiple addictive behavior types. However, our findings indicate both cognitive control and reward-related functions predict non-substance addictive behaviors in different ways. Findings suggest that there may be partially distinct neurocognitive mechanisms contributing to addiction depending on the specific addictive behavior.

Happy Hour: The association between trait hedonic capacity and motivation to drink alcohol

The (over)consumption of alcohol and other addictive substances is often conceptualized as a problem of low self-control (i.e., people's inability to inhibit unwanted impulses). According to that view, people drink because they cannot resist. In the present studies, we approached this from a different perspective and tested whether alcohol consumption might also be a problem of low hedonic capacity (i.e., people's inability to experience pleasure and relaxation, often due to intrusive thoughts). According to that view, people drink because it helps them enjoy or cope with negative thoughts or emotions. In two studies among individuals at low risk of harmful alcohol use (e.g., AUDIT < 7) we consistently found that trait hedonic capacity was unrelated to alcohol consumption but negatively related to coping motivation (drinking alcohol to cope with negative thoughts and feelings; Study 1: N = 348; Study 2: N = 302, preregistered). Exploratory analyses in study 2 (conducted during the COVID-19 pandemic) also showed that people with low, but not high, trait hedonic capacity drank more alcohol in response to stress. Our findings are in line with the notion that people's drinking motivation and behavior might not only be a problem of poor self-control but also of low trait hedonic capacity. They align with a new direction in addiction prevention and treatment research, which explores ways to help people to seek out and savor hedonic experiences from non-drug related reinforcers (e.g., engaging in leisure activities).

Gambling Motives and Offshore Gambling: A Finnish Population Study

The rise of online gambling has drawn attention towards offshore gambling. Currently there is lack of evidence on reasons and motivations to gamble on offshore gambling sites. This study investigated the general gambling motives of onshore and offshore gamblers, and the reasons to gamble on offshore gambling sites. The study used binary logistic regression model to analyze the data from Finnish Gambling 2019 population survey including adult past-year online gamblers (n = 1,422). The validated measure for problem gambling severity (PGSI, Problem Gambling Severity Index) was used. Furthermore, data-driven qualitative analysis was used to form categories for the reasons to gamble on offshore gambling sites. Offshore gambling was more common among men and younger age groups than among women or older age groups. Offshore gamblers gambled less often for money or worthy causes than onshore gamblers. Furthermore, offshore gamblers had more different types of motives to gamble, they gambled more frequently and had higher problem gambling severity scores (PGSI) than onshore gamblers. Finally, the most common reasons to gamble offshore were: (1) larger game supply and game features, (2) benefits, bonuses, and the usability of the website, and (3) inner motivation. Offshore gambling is characterized with intensity and diversity of gambling behavior and motives, and it poses a risk especially for young men.

Attentional Biases and Their Association with Substance-Use-Related Problems and Addictive Behaviors: The Utility of a Gamified Value-Modulated Attentional Capture Task

Background

Attentional biases towards reward stimuli have been implicated in substance use-related problems. The value-modulated attentional capture (VMAC) task assesses such reward-related biases. The VMAC task widely used in lab studies tends to be monotonous and susceptible to low effort. We therefore tested a gamified online version of the VMAC that aimed to increase participant engagement. Our goal was to examine how VMAC is associated with substance use-related problems and addictive behaviors, and whether this association is moderated by cognitive control.

Methods

We recruited 285 participants from an online community, including heavy alcohol users. All participants completed a novel gamified version of the VMAC task, measures of substance use and addictive behaviors (addictive-like eating behavior, problematic smartphone use), the WebExec measure of problems with executive functions, and the Stroop Adaptive Deadline Task (SDL) as a measure of cognitive control.

Results

The gamified VMAC task successfully identified value-modulated attentional capture effects towards high-reward stimuli. We found no significant associations between VMAC scores, problematic alcohol or cannabis use, addictive behaviors, or any moderation by a behavioral measure of cognitive control. Exploratory analyses revealed that self-reported cognitive problems were associated with more alcohol-, and cannabis-related problems, and addictive behaviors. Greater attentional capture (VMAC) was associated with more cannabis use-related problems among individuals with higher levels of self-reported cognitive problems.

Conclusions

Our study is one of the first to demonstrate the utility of the gamified version of the VMAC task in capturing attentional reward biases. Self-reported problems with cognitive functions represent a key dimension associated with substance use-related problems and addictive behaviors.

The effects of mobile phone dependence on athletic performance and its mechanisms

Mobile phone dependence (also known as internet dependence, MPD), defined as a problematic behavior characterized by excessive use or intermittent craving to use a mobile phone, results in various social, behavioral, and affective problems in daily life. In sports, MPD is directly related to the physical and mental health and sports performance of athletes. The individual and environmental factors, neurobiological mechanisms and theoretical models of MPD affecting athletic performance were analyzed by reviewing previous studies, aiming to construct effective training and development protocols to prevent and control the occurrence of MPD in athletes. At present, athletic performance can be affected by MPD through individual factors and environmental factors. The neurobiological mechanisms between the two are based on the brain reward system and microwave radiation from mobile phones, with athletic performance being restricted by alterations in the corresponding brain regions. Relevant theoretical models mainly include the social cognitive model of self-regulation and the integrative model of self-control, which explain the interrelationship between MPD and athletic performance from the perspectives of athletes' self-regulation and self-control, respectively. As an emerging phenomenon, the influence pathways and mechanisms by which MPD affects athletic performance need to be further investigated. A longitudinal perspective should be adopted to trace the dynamic impact relationship between the two, and developing relevant theoretical frameworks from an interdisciplinary research perspective should be valuable for providing theoretical support for coaches and sports administrators to formulate scientific training protocols and thus improve the mental health of athletes.

Effects of physical exercise on adolescent short video addiction: A moderated mediation model

Objective

To discuss the effects of physical exercise (PE) on adolescent short video addiction (SVA) and analyze the mediating effects of self-control (SC) and the moderating effects of the cumulative ecological risk (CER), aiming to provide theoretical support for PE relative to adolescent SVA, investigate the underlying mechanisms of the effects of PE.

Methods

The Physical Activity Rating Scale-3, Problematic TikTok Use Scale, Self-Control Scale, and Cumulative Ecological Risk Scale were used to survey 756 adolescents in Chongqing and Chengdu, China. SPSS was used to construct a research model by conducting reliability, confirmatory factor, common method bias, and AMOS analyses.

Results

PE was significantly and negatively related to adolescent SVA (β = -0.30, p < 0.01). SC served as a partial mediator between PE and adolescent SVA, the direct and indirect effect values are -0.304 and -0.167 respectively, showing that SC negatively predicted the relationship between the two variables. The CER moderated the effect of PE (t = -11.679, p < 0.001) and SC (t = -15.069, p < 0.001) on adolescent SVA.

Conclusion

PE mitigates and moderates adolescent SVA through the mediating effect of SC and the moderating effect of CER.

Feasibility, Engagement, and Usability of a Remote, Smartphone-Based Contingency Management Program as a Treatment Add-On for Patients Who Use Methamphetamine: Single-Arm Pilot Study

BACKGROUND

In the United States, methamphetamine-related overdoses have tripled from 2015 to 2020 and continue to rise. However, efficacious treatments such as contingency management (CM) are often unavailable in health systems.

OBJECTIVE

We conducted a single-arm pilot study to evaluate the feasibility, engagement, and usability of a fully remotely delivered mobile health CM program offered to adult outpatients who used methamphetamine and were receiving health care within a large university health system.

METHODS

Participants were referred by primary care or behavioral health clinicians between September 2021 and July 2022. Eligibility criteria screening was conducted by telephone and included self-reported methamphetamine use on ≥5 out of the past 30 days and a goal of reducing or abstaining from methamphetamine use. Eligible participants who agreed to take part then completed an initial welcome phase that included 2 videoconference calls to register for and learn about the CM program and 2 "practice" saliva-based substance tests prompted by a smartphone app. Participants who completed these welcome phase activities could then receive the remotely delivered CM intervention for 12 consecutive weeks. The intervention included approximately 24 randomly scheduled smartphone alerts requesting a video recording of themselves taking a saliva-based substance test to verify recent methamphetamine abstinence, 12 weekly calls with a CM guide, 35 self-paced cognitive behavioral therapy modules, and multiple surveys. Financial incentives were disbursed via reloadable debit cards. An intervention usability questionnaire was completed at the midpoint.

RESULTS

Overall, 37 patients completed telephone screenings, with 28 (76%) meeting the eligibility criteria and consenting to participate. Most participants who completed a baseline questionnaire (21/24, 88%) self-reported symptoms consistent with severe methamphetamine use disorder, and most had other co-occurring non-methamphetamine substance use disorders (22/28, 79%) and co-occurring mental health disorders (25/28, 89%) according to existing electronic health records. Overall, 54% (15/28) of participants successfully completed the welcome phase and were able to receive the CM intervention. Among these participants, engagement with substance testing, calls with CM guides, and cognitive behavioral therapy modules varied. Rates of verified methamphetamine abstinence in substance testing were generally low but varied considerably across participants. Participants reported positive opinions about the intervention's ease of use and satisfaction with the intervention.

CONCLUSIONS

Fully remote CM can be feasibly delivered within health care settings lacking existing CM programs. Although remote delivery may help reduce barriers to treatment access, many patients who use methamphetamine may struggle to engage with initial onboarding. High rates of co-occurring psychiatric conditions in the patient population may also contribute to uptake and engagement challenges. Future efforts could leverage greater human-to-human connection, more streamlined onboarding procedures, larger incentives, longer durations, and the incentivization of non-abstinence-based recovery goals to increase uptake and engagement with fully remote mobile health-based CM.

Losing sight of Luck: Automatic approach tendencies toward gambling cues in Canadian moderate- to high-risk gamblers - A replication study

Evidence for approach bias tendencies to underly automatic behavioural impulses towards seeking out gambling activities in the presence of appetitive salient cues was first shown by Boffo et al. (2018) in a Dutch sample. Relative to non-problem gamblers, moderate-to-high-risk gamblers demonstrated stronger approach tendencies towards gambling-related stimuli compared with neutral ones. Moreover, gambling approach bias was associated with past-month gambling behaviour and predictive of gambling activity persistence over time. The current study aimed to replicate these findings within a Canadian sample evaluating the concurrent and longitudinal correlates of gambling approach bias. The study was conducted online, available throughout Canada. Twenty-seven non-treatment-seeking moderate-to-high-risk gamblers and 26 non-problem gamblers community-recruited via multiple channels (i.e., internet and newspaper advertisements, land-based flyers, and university recruitment portals). Participants completed two online assessment sessions 6-months apart. Each session included (1) self-report measures of gambling behaviour (frequency, duration, and expenditure), (2) self-report assessment of problem gambling severity (PGSI), and (3) a gambling approach-avoidance task, utilising culturally relevant stimuli tailored to individual gambling habits. However, our study failed to replicate Boffo et al. (2018) findings in a Canadian sample. Relative to non-problem gamblers, moderate-to-high-risk gamblers did not exhibit greater approach bias tendencies towards gambling-related stimuli compared to neutral stimuli. Moreover, gambling approach bias was not predictive of prospective gambling behaviour (frequency, duration, or expenditure) or severity of gambling problems. Reported results do not provide evidence for approach tendencies contributing to problematic gambling behaviour in a Canadian sample of moderate-to-high-risk gamblers compared to non-problematic gambler controls. Further replications on the topic are needed. Future research should evaluate approach tendencies within the gambling context, considering the potential impact of task reliability to assess approach bias in light of individual gambling modality preferences.

Nomophobia and smartphone addiction amidst COVID-19 home confinement: the parallel mediating role of digital gaming and social media tools usage across secondary school students

Introduction

With the inevitable technological boom enforced by the COVID-19 lockdowns and online emergency remote teaching practices, the prevalence of nomophobia (NMP) and smartphone addiction (SA) among adolescents has become a pressing issue, which has come under scrutiny. However, the impact of social media tools usage (SMTU) and digital gaming behavior (DGB) on these phenomena remains unclear since there is little research focusing on the complex interplay among these variables. Regarding this context, the present study aimed to explore the parallel mediating role of secondary school students' SMTU and DGB in the relation between NMP and SA.

Methods

In line with this aim, we employed a cross-sectional design with a critical case sampling strategy and collected data through an online survey from a total of 427 secondary school students in Istanbul in the 2021-2022 academic year. In order to test the parallel mediation model, we employed multiple linear regression models by utilizing PROCESS models with 5000 BC bootstrap samples and 95% CI.

Results and discussion

Results illustrated that there was an increase in the prevalence of NMP and SA during the COVID-19 home confinement as consistent with the previous research. The results also indicated that among the multiple mediators, the mediating role of SMTU was significant in the relation between NMP and SA. This means NMP has direct and indirect significant impact on SA through SMTU. However, the mediating role of DGB was found nonsignificant in this relationship. Our results are robust and hold key contributions to both theoria and praxis in educational psychology research realm by disentangling the complex underlying mechanism between NMP, SMTU, DGB, and SA. On the practical side, our results provide insightful implications for school boards and researchers in the development of effective interventions.

A comprehensive overview of substance abuse amongst Syrian individuals in an addiction rehabilitation center

Objectives

This study aims to provide a comprehensive overview of substance abuse amongst Syrian individuals in an addiction rehabilitation center.

Methods

This is a descriptive cross-sectional survey-based study, from patients receiving treatment in an addiction rehabilitation center in Damascus. Syria. The study was conducted over a period of nine months.

Results

A total of 82 participants were recruited, the majority of them were males (n = 78.95.1%). More than half of those investigated reported multi-level failure (n = 46, 56.1%) during their education. Most of the participants (n = 44, 53.7%) started to use drugs at a friend's home. The family was shown to play a positive role in stopping the initial drug taking trials at early stages (33/56, 58.9%). Again, friends' effect was the main reason for the return of abusing drugs (20/56, 35.7%). Sources of drugs were mainly from drug promoters for most of the participants (n = 58, 70.7%) followed by friends (n = 28, 34.1%). Participants revealed that taking drugs were mostly accompanied by additional habits such as cigarette smoking before using their drugs (n = 65, 79.3%), or drinking alcohol (57.3%). Surprisingly, participants believed that drug abuse does not lead to addiction (n = 52, 63.4%). The most common experienced feeling was depressed, desperate, or sad (n = 47, 57.3%), followed by anxiety and the desire to escape reality and resort to imaginations (n = 44, 53.7%).

Conclusions

The findings of this study indicate the need of policymakers to give more attention, in developing preventive strategies, to friends, as a main cause of addiction, in addition to the family influences on individual's drug abuse, addiction behaviors, and mindsets. Understanding the influencing factors could spot the light on the key to solve the addiction problem. A realist rehabilitation programs must be well designed and implemented as the level of individuals, institutions and communities to face this problematic addiction disaster.

Self-Control, Parental Monitoring, and Adolescent Problematic Mobile Phone Use: Testing the Interactive Effect and Its Gender Differences

Previous studies have revealed that self-control was one of the critical factors of adolescent problematic mobile phone use. Few studies, however, have explored the interaction of internal control force (i.e., self-control) and external control force such as parental monitoring. The present study tested the interactive effect of self-control and parental monitoring on adolescent problematic mobile phone use and its gender differences. A sample of 926 adolescents completed our anonymous self-report survey. Results showed that self-control and parental monitoring negatively predicted problematic mobile phone use, while gender positively predicted problematic mobile phone use. Self-control and parental monitoring had an interactive effect on problematic mobile phone use, with the effect of self-control on problematic mobile phone use being stronger for adolescents with low levels of parental monitoring than for those with high levels of parental monitoring. Self-control and gender had an interactive effect on problematic mobile phone use, with the effect of self-control on adolescent problematic mobile phone use being stronger in girls than in boys. Moreover, there were significant gender differences in the interaction of self-control and parental monitoring, in that the interactive effect of self-control and parental monitoring on problematic mobile phone use was more potent in girls than in boys. The findings reveal how the internal control force (i.e., self-control) and external control force (i.e., parental monitoring) work together in explaining adolescent problematic mobile phone use and uncover the potential gender differences in exploring adolescent problematic mobile phone use from the individual-environment perspective. Limitations and implications are discussed.

Can psychedelic-assisted psychotherapy play a role in enhancing motivation to change in addiction treatment settings?

Despite growing availability of several evidence-based approaches in the treatment of substance use disorders, existing pharmacotherapy and psychosocial interventions continue to have significant limitations, such as low treatment retention rates and high rates of relapse. There is a need to develop new strategies and models to address these limitations and target underlying psychosocial drivers of addiction, such as motivation to change – a crucial factor in achieving positive addiction treatment outcomes. Re-emerging clinical evidence and literature signal the promise of psychedelic-assisted psychotherapies as being novel, adjunctive treatments for a range of mental health and substance use disorders, encouraging further research. However, there remains a lack of formally validated metrics to evaluate recovery capital and motivation, limiting interpretation of the growing psychedelic literature. This commentary describes the current state of this line of investigation and potential impact of psychedelic-assisted psychotherapy on enhancing motivation to change in addiction treatment, and the need for validated metrics to evaluate recovery motivation and capital to assess the potential for psychedelic-assisted psychotherapies to elicit positive, lasting changes in substance use behaviors among those seeking treatment.

Perceived stress and mobile phone addiction among college students: The roles of self-control and security

OBJECTIVE

According to the General Strain Theory, stress can lead to a range of problem behaviors. In the current study, we focused on the association between perceived stress and mobile phone addiction. We hypothesized that this association is mediated by low self-control and that the first path of the mediation is moderated by security.

METHODS

College students (N = 397; ages 16-21; 51.89% females) from a university in Hunan Province, China, were surveyed by cluster sampling method. The students completed the Smartphone Addiction Scale-Short Version (SAS-SV), the Depression Anxiety Stress Scale (DASS-21), the Self-Control Scale (SCS), and the Security Questionnaire (SQ) during regular class time. SPSS26.0 statistical software was used for descriptive statistics and Pearson correlation analyses, the SPSS macro PROCESS was used to test the mediating effects of self-control and the moderating role of security.

RESULTS

Mediation analysis showed that as expected, perceived stress was associated with lower self-control, which in turn was associated with a higher risk for mobile phone addiction. Also as expected, moderated mediation analysis indicated that the association between perceived stress and self-control was moderated by security. Specifically, the relationship between perceived stress and self-control was stronger for low security.

CONCLUSION

This study provides useful insight into the understanding of how perceived stress increases the risk of mobile phone addiction. The results are consistent with the General Strain Theory and further indicate that concrete approaches are required for the prevention and intervention to reduce mobile phone addiction among college students.

Acute impact of self-guided mental imagery on craving in cocaine use disorder: a mixed-methods analysis of a randomized controlled trial

Mental imagery manipulations are used to treat several psychological disorders, but their utility in treating cocaine use disorder (CUD) is unknown. Using prompted re-experiences and simulations with contrasting valence, we assessed the acute impact of a deliberate mental imagery task on cocaine craving.

DESIGN

A quantitative-qualitative 'mixed-methods' analysis of data collected for a randomized controlled trial that was stopped prematurely.

SETTING

UK National Health Service addictions treatment clinic and outpatient clinical research facility (laboratory).

PARTICIPANTS

Adults with CUD. The original target sample was 120. All participants enrolled at the point the original trial was stopped were included (38 enrolled, 31 completed study).

INTERVENTIONS

Personalized (3-minute) cue-exposure (handling cocaine paraphernalia and watching video of drug preparation), immediately followed by a single 5-minute, audio-recorded, self-guided and verbally described imagery task with random assignment to one of four conditions: two mental imagery memory re-experiences (positive image before initiation to cocaine use or a negative image of a 'worst time' adverse cocaine use episode) or two future simulations (positive theme of recovery from CUD or negative theme of worsened CUD).

MEASUREMENTS

Task transcripts were rated for imagery detail using five dimensions using a six-point scale of imagery detail (ID) (total score = 0-25) and thematically coded. The outcome measure was cocaine craving using the Craving Experiences Questionnaire-strengths version (CEQ-S11; score = 0-110) reported at baseline, arrival at the laboratory, and immediately after the cue-exposure and mental imagery tasks.

FINDINGS

A mixed-effects, longitudinal, restricted linear regression, with the past-positive imagery condition as referent, showed main effects of reduced craving after the imagery task (b = -29.2, 95% confidence interval (CI) = -45.3 to -13.1, P-value < 0.001) and increased craving for the future-negative task (b = 14.2, 95% CI = 0.1-28.4, P-value 0.049). There was a future-negative task by post-imagery craving interaction (b = 28.1, 95% CI = 0.1-56.1, P-value 0.049). A theory-driven, deductive/inductive qualitative analysis of the transcripts revealed six major themes: sensory characteristics, CUD vicious cycle, self-care, emotions and appraisals, social role and CUD recovery. Positively themed simulations included interpersonal connections and rewarding activity; negative images included personal adversity, with appraisals of self-criticism and hopelessness. Transcripts with more imagery detail were not associated with significantly greater reductions in craving in the positive or negative imagery task (r = -0.32, 95% CI = -0.69 to 0.13 and r = 0.06, 95% CI = -0.58 to 0.53, respectively).

CONCLUSION

In people with cocaine use disorder, after cue-exposure, a self-guided imagery task with positive themes reduced craving, whereas mental imagery simulating worsened cocaine use disorder did not appear to.

Sex and dependence related neuroanatomical differences in regular cannabis users: findings from the ENIGMA Addiction Working Group

Males and females show different patterns of cannabis use and related psychosocial outcomes. However, the neuroanatomical substrates underlying such differences are poorly understood. The aim of this study was to map sex differences in the neurobiology (as indexed by brain volumes) of dependent and recreational cannabis use. We compared the volume of a priori regions of interest (i.e., amygdala, hippocampus, nucleus accumbens, insula, orbitofrontal cortex (OFC), anterior cingulate cortex and cerebellum) between 129 regular cannabis users (of whom 70 were recreational users and 59 cannabis dependent) and 114 controls recruited from the ENIGMA Addiction Working Group, accounting for intracranial volume, age, IQ, and alcohol and tobacco use. Dependent cannabis users, particularly females, had (marginally significant) smaller volumes of the lateral OFC and cerebellar white matter than recreational users and controls. In dependent (but not recreational) cannabis users, there was a significant association between female sex and smaller volumes of the cerebellar white matter and OFC. Volume of the OFC was also predicted by monthly standard drinks. No significant effects emerged the other brain regions of interest. Our findings warrant future multimodal studies that examine if sex and cannabis dependence are specific key drivers of neurobiological alterations in cannabis users. This, in turn, could help to identify neural pathways specifically involved in vulnerable cannabis users (e.g., females with cannabis dependence) and inform individually tailored neurobiological targets for treatment.

Mindfulness for Sustainable Internet Use in Chinese Junior Secondary School Students: A Dual-Path Mediation Model

Mindfulness training can reduce Internet addiction and promote sustainable development, but the possible mediators of this impact have not been thoroughly explored. This study explored the mediating roles of self-control and maladaptive cognitions in the association between mindfulness and Internet addiction to fill this gap. Altogether, 771 Chinese adolescents (M = 13.87 years, SD = 0.78 years) were surveyed about their mindfulness, self-control, maladaptive cognitions, and Internet addiction. The confirmed model presented a good model fit and revealed that (i) mindfulness, self-control, maladaptive cognitions, and Internet addiction were significantly correlated; (ii) mindfulness had indirect negative effects on Internet addiction, mediated by self-control; (iii) mindfulness had an indirect negative impact on Internet addiction, mediated by the path of self-control to maladaptive cognitions; and (iv) this dual-path mediation model might apply to male and female adolescents. The results of the present study suggest that both self-control and maladaptive cognitions are key factors in the association between mindfulness and Internet addiction.

Reward-Related Responses and Tonic Craving in Cocaine Addiction: An Imaging Study of the Monetary Incentive Delay Task

BACKGROUND

Cocaine addiction is associated with altered sensitivity to natural reinforcers and intense drug craving. However, previous findings on reward-related responses were mixed, and few studies have examined whether reward responses relate to tonic cocaine craving.

METHODS

We combined functional magnetic resonance imaging and a monetary incentive delay task to investigate these issues. Imaging data were processed with published routines, and the results were evaluated with a corrected threshold. We compared reward responses of 50 cocaine-dependent individuals (CDs) and 45 healthy controls (HCs) for the ventral striatum (VS) and the whole brain. We also examined the regional responses in association with tonic cocaine craving, as assessed by the Cocaine Craving Questionnaire (CCQ) in CDs. We performed mediation analyses to evaluate the relationship between regional responses, CCQ score, and recent cocaine use.

RESULTS

The VS showed higher activation to large as compared with small or no wins, but this reward-related activity did not differ between CDs and HCs. The precentral gyrus (PCG), anterior insula, and supplementary motor area showed higher activation during large vs no wins in positive correlation with the CCQ score in CDs. Mediation analyses suggested that days of cocaine use in the prior month contributed to higher CCQ scores and, in turn, PCG reward responses.

CONCLUSIONS

The results highlight a unique relationship between reward responses of the primary motor cortex, tonic cocaine craving, and recent cocaine use. The motor cortex may partake in the cognitive motor processes critical to drug-seeking behavior in addicted individuals.

Reward-related attentional capture predicts non-abstinence during a one-month abstinence challenge

BACKGROUND

While it is generally recognised that cognitive attributes can predict behaviour change outcomes in the field of addiction this question is typically studied in treatment seeking samples (to predict treatment outcomes and relapse). However the concept of behaviour change applies to the entire spectrum of addiction-like behaviours and initiatives such as temporary abstinence challenges offer insight into an understudied but equally relevant point of the spectrum. Thus the current study examined whether reward-related attentional capture predicted non-abstinence during IkPas (the Dutch national dry January campaign translated: NoThanks!).

METHOD

Participants included 1130 adults who had complete baseline data and performed above chance level on the cognitive task. Of these 683 participants completed the post-IkPas assessment and were included in the primary analysis. A binary logistic regression examined whether reward-related attentional capture predicted drinking during IkPas controlling for alcohol use at baseline (among other potential confounders).

RESULTS

Participants who showed greater reward-related attentional capture before IkPas were more likely to not remain abstinent from drinking during IkPas (p = .014). Findings were replicated using multiple imputation to replace missing data (p = .013).

CONCLUSION

These findings provide important insights into the cognitive mechanisms that support successful behaviour change such as the ability to ignore task-irrelevant reward cues and may inform the development of tools that individuals could use to maximise their likelihood of achieving successful behaviour change.

Community reinforcement and family training and rates of treatment entry: a systematic review

BACKGROUND AND AIMS

Adaptations with different modes of delivery and target addictions have found highly divergent rates of success for Community Reinforcement Approach and Family Training (CRAFT). This study aims to clarify which (1) treatment components and (2) participant characteristics contribute to rates of identified patient (IP) treatment entry.

METHOD

Systematic review of CRAFT evaluation studies of all designs (controlled and uncontrolled) with data synthesis and narrative analysis of addiction treatment services and university research departments in North America and Europe.

RESULTS

A total of 691 concerned significant others (CSOs), predominately female spouses/parents, participating in 20 distinct treatment conditions from 14 studies. The main outcome of IP treatment entry rate reported by CSOs up to 12 months after starting CRAFT with key predictors/correlates including IP addiction, IP-CSO relationship, CRAFT modality and integration of treatment for IP. Meta-analysis found CRAFT to be twice as effective as controls/comparison groups. Multi-modality treatment, including both individual and group sessions, yielded the highest IP treatment entry rates (77 and 86%), with progressively lower rates for individual (12.5-71%), group (60%) and self-directed workbook (13.3-40%) modalities. While all five studies targeting gambling addiction had consistently low rates (12.5-23%), other treatment components, including therapist training, treatment fidelity and integrating treatment for the IP, were implicated.

CONCLUSIONS

Adaptations of Community Reinforcement Approach and Family Training for different delivery modalities and addictions have yielded widely varying rates of treatment engagement for the identified patient, with those offering the most comprehensive support to the concerned significant other, including individual and group sessions, having highest levels of engagement success.

Sedentary Behavior and Problematic Smartphone Use in Chinese Adolescents: The Moderating Role of Self-Control

This study investigated smartphone use characteristics including the purpose of smartphone use (i.e., leisure, learning, or work) and situational smartphone use (i.e., sitting, standing, or moving about) in Chinese adolescents. Moreover, it tested the moderating role of self-control in the link between sedentary behavior and problematic smartphone use. A total of 947 adolescents completed measures of the purpose of their smartphone use, situational smartphone use, sedentary behavior, self-control, time on smartphone, and smartphone addiction. Results showed that the majority of smartphone use was for leisure and learning, and 90.9% of adolescents reported typically sitting as they used the smartphone. Problematic smartphone use was positively correlated with sedentary behavior and negatively correlated with self-control. Moreover, the relationship between sedentary behavior and problematic smartphone use was moderated by self-control, in that the negative correlation was stronger for adolescents with low self-control and weaker for those with high self-control. These results contribute to the understanding of when sedentary behavior is associated with problematic smartphone use. Several limitations and implications are discussed in this study.

Integrating Empathy and Interpersonal Emotion Regulation

When individuals experience empathy , they often seek to bolster others’ well-being. But what do empathizers want others to feel? Though psychologists have studied empathy and prosociality for decades, this question has yet to be clearly addressed. This is because virtually all existing research focuses on cases in which improving others’ well-being also comprises heightening their positive affect or decreasing their negative affect and helping them reach their own emotional goals. In this review, I argue that real-life empathic goals encompass a broader range—including sometimes worsening targets’ affect or contravening their wishes in order to improve their well-being—that can be productively integrated into the framework of interpersonal emotion regulation (IER). I review the empathic IER spectrum in a number of contexts, including close relationships, professional caregiving, and group-based emotions. Integrating empathy and IER provides a synthetic and generative way to ask new questions about how social emotions produce prosocial actions.

Hypothalamic response to cocaine cues and cocaine addiction severity

The dopaminergic motive system is compromised in cocaine addiction. Abundant research has examined the roles of the dopaminergic midbrain and ventral striatum (VS) in cue-induced craving and habitual drug consumption. Interconnected with the dopaminergic circuits, the hypothalamus is widely implicated in motivated behavior, including food and drug seeking. However, very few studies have investigated how the hypothalamus responds to drug cues and whether hypothalamic responses are related to clinical features such as craving and addiction severity. Here, in 23 cocaine-dependent individuals (CD) exposed to cocaine vs neutral cues during functional magnetic resonance imaging (fMRI), we examined regional responses using established routines. At a corrected threshold, CD demonstrated increased activation to cocaine vs neutral cues in bilateral visual cortex, inferior parietal and middle frontal gyri, and the hypothalamus. The extent of hypothalamus but not other regional response was correlated with craving and cocaine addiction severity, each as assessed by the Cocaine Craving Questionnaire (CCQ) and Cocaine Selective Severity Assessment (CSSA). In contrast, subjective "acute" craving as elicited by cocaine cues during fMRI involved deactivation of bilateral orbitofrontal cortex (OFC) and angular gyri (AG), and the OFC and AG responses were not related to CCQ or CSSA score. These findings distinguished tonic craving as a critical factor in capturing cocaine addiction severity and substantiated a role of the hypothalamus in motivational dysfunction in cocaine addiction.

Mothering, Substance Use Disorders and Intergenerational Trauma Transmission: An Attachment-Based Perspective

Background: A growing body of research underlines that interpersonal trauma in childhood leads to heightened susceptibility for substance use disorders (SUDs) in later life. Little research has been conducted on parenting experiences of mothers in recovery from substance use, taking into account their own upbringing as a child and the potential aftermath of interpersonal childhood trauma. Methods: Through in-depth qualitative interviews, 23 mothers with SUDs reflected on parenting experiences and parent-child bonding, related to both their children and parents. Interviews were transcribed verbatim and data were analyzed adopting thematic analysis. Results: Throughout the narratives, consequences of trauma on mothers' sense of self and its subsequent impact on parenting arose as salient themes. Five latent mechanisms of intergenerational trauma transmission were identified: 1) early interpersonal childhood trauma experiences in mothers; 2) trauma as a precursor of substance use; 3) substance use as a (self-fooling) enabler of parental functioning; 4) continued substance use impacting parental functioning; and 5) dysfunctional parental functioning and its relational impact upon offspring. Discussion: Findings suggest disruptive attachment can increase the vulnerability for SUDs on the one hand, but can be an expression of underlying trauma on the other, hence serving as a covert mechanism by which trauma can be transmitted across generations. Results indicate the need for preventive, attachment-based and trauma-sensitive interventions targeted at disruptive intergenerational patterns.

A Neurobehavioral Approach to Addiction: Implications for the Opioid Epidemic and the Psychology of Addiction

Two major questions about addictive behaviors need to be explained by any worthwhile neurobiological theory. First, why do people seek drugs in the first place? Second, why do some people who use drugs seem to eventually become unable to resist drug temptation and so become "addicted"? We will review the theories of addiction that address negative-reinforcement views of drug use (i.e., taking opioids to alleviate distress or withdrawal), positive-reinforcement views (i.e., taking drugs for euphoria), habit views (i.e., growth of automatic drug-use routines), incentive-sensitization views (i.e., growth of excessive "wanting" to take drugs as a result of dopamine-related sensitization), and cognitive-dysfunction views (i.e., impaired prefrontal top-down control), including those involving competing neurobehavioral decision systems (CNDS), and the role of the insula in modulating addictive drug craving. In the special case of opioids, particular attention is paid to whether their analgesic effects overlap with their reinforcing effects and whether the perceived low risk of taking legal medicinal opioids, which are often prescribed by a health professional, could play a role in the decision to use. Specifically, we will address the issue of predisposition or vulnerability to becoming addicted to drugs (i.e., the question of why some people who experiment with drugs develop an addiction, while others do not). Finally, we review attempts to develop novel therapeutic strategies and policy ideas that could help prevent opioid and other substance abuse.

Workaholism, Motivation, and Addiction in the Workplace: A Critical Review and Implications for HRD

Despite the wide use of the term workaholism, universally defined as an addiction to work, there is little consensus on this concept and how people become workaholics. This article critically reviews the workaholism literature to reframe the concept of workaholism and to provide implications for human resource development (HRD). Through a literature review, four perspectives were found based on assumptions about behavioral motivation. The motivation and addiction processes in workaholism are discussed, focusing on the theories and characteristics of the workplace. The gaps and omissions are identified in the reviewed research, and a workaholism framework is suggested that emphasizes contextual and behavioral inclusiveness. This review contributes to literature on workaholism by illuminating current divergent opinions on workaholism and guiding future research. The recommendations can also enhance the practical development of individuals and organizations that currently or potentially face excessive work issues.

Does regular cannabis use affect neuroanatomy? An updated systematic review and meta-analysis of structural neuroimaging studies

Regular cannabis use is associated with adverse cognitive and mental health outcomes that have been ascribed to aberrant neuroanatomy in brain regions densely innervated with cannabinoid receptors. Neuroanatomical differences between cannabis users and controls have been assessed in multiple structural magnetic resonance imaging (sMRI) studies. However, there is heterogeneity in the results leading to cautious interpretation of the data so far. We examined the sMRI evidence to date in human cannabis users, to establish more definitely whether neuroanatomical alterations are associated with regular cannabis use. The regional specificity and association with cannabis use indices (i.e. cumulative dosage, duration) were also explored. We systematically reviewed and meta-analysed published sMRI studies investigating regional brain volumes (cortical, subcortical and global) in cannabis users and non-user controls. Three electronic databases were searched (PubMed, Scopus, and PsycINFO). A total of 17 meta-analyses were conducted (one for each cortical, subcortical and global volume) using the generic inverse variance method, whereby standardised mean difference in volume was calculated between users and non-users. Exploratory meta-regressions were conducted to investigate the association between cannabis use indices and regional brain volumes. A total of 30 articles were eligible for inclusion, contributing 106 effect sizes across 17 meta-analyses. Regular cannabis users had significantly smaller volumes of the hippocampus (SMD = 0.14, 95% CIs [0.02, 0.27]; Z = 2.29, p = 0.02, I² = 74%) and orbitofrontal cortex {medial (SMD = 0.30, 95% CIs [0.15, 0.45]; Z = 3.89, p = 0.0001, I² = 51%), lateral (SMD = 0.19, 95% CIs [0.07, 0.32]; Z = 3.10, p = 0.002, I² = 26%)} relative to controls. The volumes of the hippocampus and orbitofrontal cortex were not significantly associated with cannabis duration and dosage. Our findings are consistent with evidence of aberrance in brain regions involved in reward, learning and memory, and motivation circuits in the regular use of substances other than cannabis, pointing to commonality in neurobiological abnormalities between regular users of cannabis and of other substances.

Effects of Initiating Abstinence from Alcohol on Daily Craving and Negative Affect: Results from a Pharmacotherapy Clinical Trial

BACKGROUND

Craving and negative affect are distressing and commonly experienced during alcohol use disorder (AUD) treatment. Patients may assume that initiating abstinence will intensify their cravings and negative affect despite limited empirical data to support this assumption. This study extends and replicates, under improved methodological conditions, previous work that found reductions in daily craving associated with initiating abstinence.

METHODS

Seventy-eight adults (80.8% male, 57.1% Caucasian) in a clinical trial testing prazosin for AUD provided daily reports of drinking, craving, and negative affect for up to 12 weeks (mean = 64.77 daily reports). Participants were classified into 3 subgroups based on whether and when they initiated 14 days of continuous abstinence, including (i) "abstinence initiators" who quit drinking during treatment (n = 17), (ii) "already abstainers" who were abstinent at the start of treatment (n = 20), and (iii) "continued drinkers" who never initiated abstinence (n = 41). The timing and degree of change in craving and negative affect were compared across these groups using multivariate growth curve modeling.

RESULTS

All participant subgroups reported gradual reductions in craving over the course of treatment, with "abstinence initiators" reporting additional sudden reductions in craving upon initiating abstinence from alcohol. "Continued drinkers" reported higher levels of craving than "already abstainers" throughout the full course of treatment. Negative affect followed a different pattern of change, with "abstinence initiators" experiencing gradual reductions in negative affect after initiating abstinence but no changes prior to or immediately upon initiating abstinence, and with "already abstainers" and "continued drinkers" experiencing no changes in negative affect over time.

CONCLUSIONS

Initiating abstinence is associated with immediate reductions in craving, followed by gradual reductions in both craving and negative affect. Results provide insight into the timing and magnitude of changes in theoretically and clinically important variables and may help patients anticipate when to expect improvement in craving and negative effect.

Memory-Focused Cognitive Therapy for Cocaine Use Disorder: Theory, Procedures and Preliminary Evidence From an External Pilot Randomised Controlled Trial

BACKGROUND

Cocaine use disorder (CUD) is a debilitating condition with no NICE-recommended medication or specific psychosocial interventions. In the United Kingdom (UK), general counselling (treatment-as-usual; TAU) is widely delivered, but has limited effectiveness. We tested the feasibility, safety and preliminary efficacy of a novel, adjunctive psychosocial intervention for CUD, called 'memory-focused cognitive therapy' (MFCT).

METHODS

We did a two-arm, external pilot randomised controlled trial at a specialist community National Health Service addictions clinic in London, UK. 30 adults (≥18years), voluntarily seeking treatment for CUD (enrolled ≥14days; all with moderate-to-severe DSM5 CUD), were individually randomised (1:1) to a control group (ongoing TAU; 3×90min CUD cognitive conceptualisation assessments; 2×30min cocaine-related cue-induction procedures; and 3×30min research follow-ups); or to an intervention group (ongoing TAU; 3×90min cognitive conceptualisation assessments; 2×30min cocaine-related cue-induction procedures; 5×120min, one-to-one, MFCT sessions [in 1week]; and 3×60min research follow-ups and MFCT-relapse prevention). The primary outcome was the total percentage score on the frequency version of the Craving Experiences Questionnaire (CEQ-F) at 1-month follow-up after the intensive intervention week (clinical endpoint; recall period past 2weeks; higher score indicating greater craving). Secondary outcomes at the 1-month follow-up were percentage days abstinent (PDA) from cocaine, and longest period (days) of continuous abstinence (LPA) in the prior 28days. Outcomes were analysed as an unadjusted group mean difference (with Hedge's g effect size [ES]) and a 95% Confidence Interval [CI] for the primary outcome and a 90% CI for the secondary outcomes. Exploratory, multivariable linear (primary outcome) and Poisson regression models (secondary outcomes), with sex, age, months of regular cocaine use, baseline outcome score, and group estimated the effectiveness of the intervention. The trial is registered with the ISCRTN (ISRCTN16462783).

FINDINGS

Between July 15, 2015, and November 27, 2016, 58 patients were assessed for eligibility and 30 participants were randomised (14 to the control group and 16 to the intervention). With outcome data collected for all participants at the endpoint, the intervention group mean CEQ-F score (14·77; SD 21·47) was lower than the control group mean (51·75; SD 22·72); ES -1·62; 95% CI -2·45 to -0·80. MFCT was associated with more cocaine abstinence in the intervention group (PDA 85·94; SD 18·96) than the control group (PDA 54·59; SD 30·29); ES 1·19; 90% CI 0·54 to 1·84. There was also greater maximum abstinence in the intervention group (LPA 15·69; SD 10·10) than the control group (6·00; SD 7·36); ES 1·06; 90% CI 0·41 to 1·70. Exploratory, confounder-adjusted regression models for this preliminary effect supported the treatment association for reduced craving experiences (CEQ-F Coef. -28·25; 95% CI -45·15 to -11·35); more abstinence (PDA Incidence Rate Ratio [IRR] 1·56; 95% CI 1·31 to 1·88); and greater maximum abstinence (LPA IRR 2·56; 95% CI 1·96 to 3·35), although relative weak unmeasured confounding could overturn these model-adjusted exposure-outcome associations. There were four serious adverse events (among three participants). None were judged related to study procedures or interventions.

INTERPRETATION

In this first external pilot randomised controlled trial of MFCT for CUD, we have shown that the intervention and control procedures and acceptable feasible and safe, and report preliminary evidence that MFCT is associated with reduced craving and increased abstinence. These findings support progression to a substantive trial.

FUNDING SOURCE

UK National Institute for Health Research, Biomedical Research Centre.

Free will in addictive behaviors: A matter of definition

Certain people are at risk for using alcohol or other drugs excessively and for developing problems with their use. Their susceptibility might arise from a variety of factors, including their genetic make-up, brain chemistry, family background, personality and other psychological variables, and environmental and sociocultural variables. Moreover, after substance use has become established, there are additional cognitive-motivational variables (e.g., substance-related attentional bias) that contribute to enacting behaviors consistent with the person's motivation to acquire and use the substance. People who are at such risk are likely to choose to use addictive substances even though doing so entails negative consequences. In the sense of complete freedom from being determined by causal factors, we believe that there is no such thing as free will, but defined as ability to make choices from among multiple options, even though the choices are ultimately governed by natural processes, addicted individuals are free to choose. Although they might appear unable to exercise this kind of free will in decisions about their substance use, addictive behaviors are ultimately always goal-directed and voluntary. Such goal pursuits manifest considerable flexibility. Even some severely addicted individuals can cease their use when the value of continuing the use abruptly declines or when the subjective cost of continuing the use is too great with respect to the incentives in other areas of their lives. Formal treatment strategies (e.g., contingency management, Systematic Motivational Counseling, cognitive training) can also be used to facilitate this reversal.

Targeting self-regulation to promote health behaviors in children

Poor self-regulation (i.e., inability to harness cognitive, emotional, motivational resources to achieve goals) is hypothesized to contribute to unhealthy behaviors across the lifespan. Enhancing early self-regulation may increase positive health outcomes. Obesity is a major public health concern with early-emerging precursors related to self-regulation; it is therefore a good model for understanding self-regulation and health behavior. Preadolescence is a transition when children increase autonomy in health behaviors (e.g., eating, exercise habits), many of which involve self-regulation. This paper presents the scientific rationale for examining self-regulation mechanisms that are hypothesized to relate to health behaviors, specifically obesogenic eating, that have not been examined in children. We describe novel intervention protocols designed to enhance self-regulation skills, specifically executive functioning, emotion regulation, future-oriented thinking, and approach bias. Interventions are delivered via home visits. Assays of self-regulation and obesogenic eating behaviors using behavioral tasks and self-reports are implemented and evaluated to determine feasibility and psychometrics and to test intervention effects. Participants are low-income 9-12 year-old children who have been phenotyped for self-regulation, stress, eating behavior and adiposity through early childhood. Study goals are to examine intervention effects on self-regulation and whether change in self-regulation improves obesogenic eating.

Neural Correlates of Distorted Self-concept in Individuals With Internet Gaming Disorder: A Functional MRI Study

Background and aims: Discrepancy between ideal self-guide and actual self-concept evoke dejection-related feeling, and often individuals with internet gaming disorder (IGD) use games as the tool to escape those negative emotions. The aim of this study was to evaluate the pattern of self-discrepancy based on actual and ideal self-images and elucidate the neural correlates underlying the distorted self in individuals with IGD. Methods: Nineteen male individuals with IGD and 20 healthy controls (HCs) underwent functional magnetic resonance imaging where they decided on whether they agreed with the adjectives describing their actual or ideal self on a four-point Likert Scale. Two-sample t-test on the self-discrepancy contrast was conducted for neuroimaging analysis and correlation analysis was performed between the behavioral data and regional activities. Results: The IGD group evaluated both their ideal self and actual self more negatively than the HC group. Actual self-concept was associated with satisfaction with psychological needs as opposed to ideal self-guide. Brain activity in the inferior parietal lobule was significantly decreased in individuals with IGD relative to HCs in the self-discrepancy contrast. In addition, neural activity during evaluating actual self-concept showed a significant group difference. Conclusion: These results provide novel evidence for distorted self-concept of people with IGD. Individuals with IGD had a negative ideal and actual self-image. Neurobiologically, dysfunction in the inferior parietal lobule associated with emotional regulation and negative self-evaluation was found in IGD. Considering the characteristics of IGD that often develop in adolescence, this self-concept problem should be noted and applied with appropriate therapy.

Resting State Functional Connectivity of the Lateral and Medial Hypothalamus in Cocaine Dependence: An Exploratory Study

The role of dopamine in cocaine misuse has been extensively documented for the mesocorticolimbic circuit. Preclinical work from earlier lesion studies to recent multidisciplinary investigations has suggested that the hypothalamus is critically involved in motivated behavior, with the lateral and medial hypothalamus each involved in waking/feeding and resting/satiety. However, little is known of hypothalamus function and dysfunction in cocaine misuse. Here, we examined resting state functional connectivity of the lateral and medial hypothalamus in 70 individuals with cocaine dependence (CD) and 70 age as well as gender matched healthy controls (HC). Image pre-processing and analyses followed published work. Compared to HC, CD showed increased lateral hypothalamic connectivity with dorsolateral prefrontal cortex and decreased functional connectivity with the ventral precuneus. CD showed increased medial hypothalamic connectivity with the inferior parietal lobule and decreased connectivity with the ventromedial prefrontal cortex, temporal gyrus, fusiform gyrus, and ventral striatum. Further, at trend level significance, the connectivity strength between lateral hypothalamus and dorsolateral prefrontal cortex was positively correlated with total amount of cocaine use in the past month (p = 0.004, r = 0.35) and the connectivity strength between medial hypothalamus and ventral striatum was negatively correlated with cocaine craving as assessed by the Tiffany Cocaine Craving Questionnaire (p = 0.008, r = -0.33). Together, the findings demonstrated altered resting state functional connectivity of the hypothalamus and may provide new insight on circuit level deficits in cocaine dependence.

Try to Remember: Interplay between Memory and Substance Use Disorder

Memories associated with substance use disorders, or substance-associated cues increase the likelihood of craving and relapse during abstinence. There is a growing consensus that manipulation of synaptic plasticity may reduce the strength of substance abuse-related memories. On the biological front, there are new insights that suggest memories associated with substance use disorder may follow unique neurobiological pathways that render them more accessible to pharmacological intervention. In parallel to this, research in neurochemistry has identified several potential candidate molecules that could influence the formation and maintenance of long-term memory. Drugs that target these molecules (blebbistatin, isradipine and zeta inhibitory peptide) have shown promise at the preclinical stage. In this review, we shall provide an overview of the evolving understanding on the biochemical mechanisms involved in memory formation and expound on the premise that substance use disorder is a learning disorder.

Quit interest influences smoking cue-reactivity

Interest in quitting smoking is important to model in cue-reactivity studies, because the craving elicited by cue exposure likely requires different self-regulation efforts for smokers who are interested in quitting compared to those without any quit interest. The objective of the current study was to evaluate the role of quit interest in how cigarette cue exposure influences self-control efforts. Smokers interested in quitting (n=37) and smokers with no interest in quitting (n=53) were randomly assigned to a cigarette or neutral cue exposure task. Following the cue exposure, all participants completed two self-control tasks, a measure of risky gambling (the Iowa Gambling Task) and a cold pressor tolerance task. Results indicated that smokers interested in quitting had worse performance on the gambling task when exposed to a cigarette cue compared to neutral cue exposure. We also found that people interested in quitting tolerated the cold pressor task for a shorter amount of time than people not interested in quitting. Finally, we found that for people interested in quitting, exposure to a cigarette cue was associated with increased motivation to take steps toward decreasing use. Overall these results suggest that including quit interest in studies of cue reactivity is valuable, as quit interest influenced smoking cue-reactivity responses.