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Su H, Ye T, Cao S, Hu C. Understanding the shift to compulsion in addiction: insights from personality traits, social factors, and neurobiology. Front Psychol 2024; 15:1416222. [PMID: 39315036 PMCID: PMC11416939 DOI: 10.3389/fpsyg.2024.1416222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 08/26/2024] [Indexed: 09/25/2024] Open
Abstract
Compulsion stands as a central symptom of drug addiction; however, only a small fraction of individuals who use drugs exhibit compulsive characteristics. Differences observed in Sign-trackers (ST) and Goal-trackers (GT) during Pavlovian conditioning may shed light on individual variances in drug addiction. Here, we focus on the behavioral attributes, formation processes, and neural mechanisms underlying ST and how they drive addiction toward compulsivity in humans. We will explore addiction from three interconnected levels: individual personality traits, social factors, and neurobiology. Furthermore, we distinguish between the processes of sensitization and habituation within ST. These nuanced distinctions across various aspects of addiction will contribute to our understanding of the addiction development process and the formulation of targeted preventive strategies.
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Affiliation(s)
- Haodong Su
- College of Humanities, Anhui Science and Technology University, Chuzhou, China
- Psychological Education Research Department, Anhui Science and Technology University, Chuzhou, China
| | - Tongtong Ye
- College of Humanities, Anhui Science and Technology University, Chuzhou, China
- Psychological Education Research Department, Anhui Science and Technology University, Chuzhou, China
| | - Songyan Cao
- College of Humanities, Anhui Science and Technology University, Chuzhou, China
| | - Chunyan Hu
- College of Humanities, Anhui Science and Technology University, Chuzhou, China
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Grubbs JB, Tahk R, Chapman H, Milner LA, Kraus SW. Substance use disorders among armed forces veterans with gambling disorder: Insights from an inpatient treatment sample. J Psychiatr Res 2024; 177:82-89. [PMID: 38991268 DOI: 10.1016/j.jpsychires.2024.06.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 05/28/2024] [Accepted: 06/24/2024] [Indexed: 07/13/2024]
Abstract
Armed forces veterans are especially prone to experiencing a variety of addictive disorders, including gambling disorder. Even so, gambling disorder in veterans remains understudied generally, and there remain significant gaps in the research literature with regards to how gambling disorder relates to the experience and expression of comorbid substance use disorders. The present work examines the prevalence, presentation, and clinical associations of substance use disorders in U.S. Armed Forces veterans receiving inpatient treatment for gambling disorder. Participants (N = 664) were veterans from all branches of the U.S. Armed Forces receiving inpatient treatment for gambling disorder through the Department of Veteran Affairs Healthcare System. Clinical data from the time of intake was analyzed. A substantial portion of veterans (36.1%) met current criteria for an SUD, with another 16.5% reporting a history of SUD. Alcohol use disorder was the most commonly reported SUD (76.1% of those with a current SUD), with polysubstance use disorders and stimulant use disorders each occurring in at least 25% of those with SUDs. SUD status was related to greater levels of impulsivity, but there was no evidence that SUD status was related to gambling symptom severity, gambling preferences, or further psychiatric comorbidities.
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Affiliation(s)
- Joshua B Grubbs
- Department of Psychology, Center on Alcohol, Substance use, And Addictions, University of New Mexico, United States.
| | - Regina Tahk
- Department of Psychology, University of New Mexico, United States
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Wüllhorst V, Lützkendorf J, Endrass T. Validation of the German long and short versions of the UPPS-P Impulsive Behavior Scale. J Clin Psychol 2024. [PMID: 38822708 DOI: 10.1002/jclp.23724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 05/13/2024] [Accepted: 05/22/2024] [Indexed: 06/03/2024]
Abstract
OBJECTIVE The UPPS-P Impulsive Behavior Scale is a widely used self-report measure of impulsivity, but there is currently no validated German version that includes the Positive Urgency scale. METHODS We combined existing German translations of UPPS scales and included the Positive Urgency dimension to validate the UPPS-P in a sample of 399 participants. In addition, we developed a revised short version of the UPPS-P (SUPPS-P) with 20 items and conducted a confirmatory factor analysis (CFA) to verify the structure in an independent validation sample with 349 participants. To determine evidence of convergent and discriminant validity, we used measures of impulsivity, depression, anxiety, stress, problematic alcohol and substance use. RESULTS CFA of the five factorial structure of the UPPS-P demonstrated acceptable fits and evidence of validity and reliability for the subscales. Psychometric characteristics of the SUPPS-P using the original item configuration were not satisfactory. As a result, we developed a revised German version of the SUPPS-P and confirmed the five-factor structure using a CFA in the validation sample. For the revised version, model fits and evidence of validity and internal consistencies were good. Associations with other constructs were as expected. For example, whereas Sensation Seeking was associated moderately with problematic alcohol use, lacking associations of Lack of Premeditation to internalizing symptoms showed evidence of discriminant validity. DISCUSSION The German translations of both UPPS-P and SUPPS-P are valid tools for measuring impulsive behaviors. They are well-suited for exploring the associations between different facets of impulsivity and psychopathological phenomena.
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Affiliation(s)
- Verena Wüllhorst
- Department of Addiction Research, Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Julia Lützkendorf
- Department of Addiction Research, Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Tanja Endrass
- Department of Addiction Research, Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
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Hildebrandt MK, Noack J, Wuellhorst R, Endrass T, Jauk E. Impulsivity mediates the association between narcissism and substance-related problems beyond the degree of substance use: a longitudinal observational study. BMC Psychiatry 2024; 24:280. [PMID: 38622531 PMCID: PMC11017556 DOI: 10.1186/s12888-024-05718-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 03/25/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Narcissism has been implied as a putative risk factor for substance use disorders (SUDs). However, previous research did not disentangle the degree of substance use from substance-related problems, the symptoms of SUDs. This preregistered study addressed the open question whether grandiose and vulnerable narcissism and their constituent traits convey specific SUD risk, that is, explain substance-related problems beyond the degree of use. Furthermore, we tested whether impulsivity or substance use motives linked to narcissistic self-regulation mediate this association. METHODS Narcissism, impulsivity, substance use motives, past-year substance use, and substance-related problems were assessed in 139 (poly-)substance users, 121 of whom completed a one-year follow-up. For significant longitudinal associations between narcissism factors and substance-related problems controlled for the degree of use, we tested impulsivity and substance use motives as mediators. RESULTS Grandiose narcissism (r =.24, p =.007) and its constituent factors antagonistic (r =.27, p =.003) and agentic narcissism (r =.18, p =.050), but not vulnerable narcissism, prospectively predicted substance-related problems beyond the degree of substance use. Associations of grandiose narcissism and antagonistic narcissism with substance-related problems were fully mediated by impulsivity, but not substance use motives. Impulsivity explained roughly one third of the association of both grandiose (P̂M = 0.30) and antagonistic narcissism (P̂M = 0.26) with substance-related problems. DISCUSSION We demonstrate that grandiose narcissism- particularly antagonistic but also agentic narcissism- is specifically linked to substance-related problems beyond the degree of substance use. The mediating effect of impulsivity but not substance use motives suggests that impulsivity may be a more important mechanism than narcissistic self-regulation in promoting SUD in narcissism. However, future studies may use more targeted measures than substance use motives to further probe the role of self-regulation. Similar result patterns for alcohol compared to all substances together indicate that mechanisms may be alike across substances. In conclusion, narcissistic individuals may not use substances more but have a higher SUD risk, informing prevention and treatment.
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Affiliation(s)
- Malin K Hildebrandt
- Institute of Clinical Psychology and Psychotherapy, Chair of Addiction Research, Faculty of Psychology, Technische Universität Dresden, Chemnitzer Str. 46a, 01187, Dresden, Germany.
| | - Josepha Noack
- Institute of Clinical Psychology and Psychotherapy, Chair of Addiction Research, Faculty of Psychology, Technische Universität Dresden, Chemnitzer Str. 46a, 01187, Dresden, Germany
| | - Raoul Wuellhorst
- Institute of Clinical Psychology and Psychotherapy, Chair of Addiction Research, Faculty of Psychology, Technische Universität Dresden, Chemnitzer Str. 46a, 01187, Dresden, Germany
| | - Tanja Endrass
- Institute of Clinical Psychology and Psychotherapy, Chair of Addiction Research, Faculty of Psychology, Technische Universität Dresden, Chemnitzer Str. 46a, 01187, Dresden, Germany
| | - Emanuel Jauk
- Department of Medical Psychology, Psychosomatics, and Psychotherapy, Medical University of Graz, Auenbruggerplatz 3, 8036, Graz, Austria
- Institute of Clinical Psychology and Psychotherapy, Chair of Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, Technische Universität Dresden, Chemnitzer Str. 46a, 01187, Dresden, Germany
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Vieira JL, Snaychuk LA, Milicevic J, Hodgins DC, Shead NW, Keough MT, Kim HS. Adverse Childhood Experiences and Problematic Cannabis Use: The Role of Emotion Dysregulation and Affective Impulsivity. CANNABIS (ALBUQUERQUE, N.M.) 2024; 6:111-126. [PMID: 38883277 PMCID: PMC11178067 DOI: 10.26828/cannabis/2023/000190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Problematic cannabis use is highly prevalent among postsecondary students. Consequently, there is a need to examine risk factors associated with problematic cannabis use in this population. The present study investigated whether emotion dysregulation mediates the relationship between adverse childhood experiences (ACEs) and problematic cannabis use, and whether affective impulsivity (negative and positive urgency) uniquely moderates this relationship. Participants consisted of current cannabis users (N = 586) recruited from five universities across Canada. Participants completed an online survey containing self-report measures of ACEs, emotion dysregulation, negative and positive urgency, and problematic cannabis use. Among the sample of postsecondary students, 36% (n = 213) met the threshold for problematic cannabis use. Moderated-mediation analyses revealed that ACEs were positively associated with emotion dysregulation and problematic cannabis use. There was also a significant indirect effect of emotion dysregulation on the association between ACEs and problematic cannabis use at moderate and high (but not low) levels of negative urgency, and at moderate and high (but not low) levels of positive urgency. The moderated-mediation models remained significant when controlling for other facets of impulsivity. Results suggest that elevated levels of emotion dysregulation and urgency are important proximal risk factors for problematic cannabis use among postsecondary students with a history of ACEs. While ACEs cannot be modified given their occurrence in the past, interventions that aim to build mindfulness and adaptive emotion regulation skills may be beneficial for reducing the likelihood that these students will engage in impulsive behaviors, such as cannabis use, when experiencing emotional distress.
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Affiliation(s)
- Jenna L Vieira
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Lindsey A Snaychuk
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Jana Milicevic
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - David C Hodgins
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - N Will Shead
- Department of Psychology, Mount Saint Vincent University, Halifax, NS, Canada
| | | | - Hyoun S Kim
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
- University of Ottawa Institute of Mental Health Research at the Royal, Ottawa, Ontario, Canada
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Petzold J, Hentschel A, Chen H, Kuitunen-Paul S, London ED, Heinz A, Smolka MN. Value-based decision-making predicts alcohol use and related problems in young men. J Psychopharmacol 2023; 37:1218-1226. [PMID: 37994802 PMCID: PMC10714696 DOI: 10.1177/02698811231212151] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
BACKGROUND Alcohol consumption is a leading cause of morbidity and mortality worldwide, disproportionately affecting young men. Heavy episodic drinking is particularly prevalent among men, with this behavior peaking between the ages of 20 and 24. AIMS We sought to identify dimensions of decision-making in men that would predict the development of hazardous alcohol use through emerging adulthood. METHODS This prospective observational study profiled value-based decision-making in 198 healthy men at age 18 and assessed their alcohol involvement annually until age 24. Latent growth curve modeling estimated individual variability in trajectories of alcohol involvement and regressed this variability on five choice dimensions. RESULTS Low loss aversion predicted sustained heavy episodic drinking from age 18 to 24. Both high delay discounting and risk-seeking for gains independently predicted a considerably higher cumulative alcohol use during these 6 years, with high delay discounting indicating escalating consumption from age 21. Risk-seeking for gains additionally predicted meeting more criteria for Alcohol Use Disorder in these 6 years. Risk-seeking for losses was not significantly related to alcohol outcomes. Choice preferences were largely independent of each other but were correlated with choice consistency, with low consistency predicting heavy episodic drinking from age 18 to 24 beyond these associations. CONCLUSIONS The predictive effects collectively suggest that overvaluing immediate and probabilistic incentives, rather than underestimating harm, drives hazardous drinking in young men. The differential relations of choice preferences and consistency to alcohol involvement through emerging adulthood provide distinct cognitive-behavioral patterns that warrant consideration in the development of harm reduction interventions.
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Affiliation(s)
- Johannes Petzold
- Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Angela Hentschel
- Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Hao Chen
- Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Sören Kuitunen-Paul
- Institute of Clinical Psychology and Psychotherapy, and Department of Child and Adolescent Psychiatry, Technische Universität Dresden, Dresden, Germany
- Chair of Clinical Psychology and Psychotherapy, Technische Universität Chemnitz, Chemnitz, Germany
| | - Edythe D London
- Department of Psychiatry and Biobehavioral Sciences, Department of Molecular and Medical Pharmacology, and the Brain Research Institute, University of California at Los Angeles, Los Angeles, CA, USA
| | - Andreas Heinz
- Department of Psychiatry and Neurosciences at Charité Campus Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Michael N Smolka
- Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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Infanti A, Valls-Serrano C, Perales JC, Vögele C, Billieux J. Gaming passion contributes to the definition and identification of problematic gaming. Addict Behav 2023; 147:107805. [PMID: 37523871 DOI: 10.1016/j.addbeh.2023.107805] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/30/2023] [Accepted: 07/13/2023] [Indexed: 08/02/2023]
Abstract
Even if for most people playing video games is a healthy leisure activity, a minority of vulnerable users present an excessive use associated to negative consequences (e.g., psychosocial maladjustment, sleep interference) and functional impairment. The current study first aims to identify psychological factors that contribute to discriminate highly involved (but healthy) gamers from problematic gamers. For that purpose, we used a cluster analysis approach to identify different groups of gamers based on their profiles of passion towards gaming (using the Dualistic Model of Passion). Another objective of the present study is to explore, using supervised machine-learning, how gaming disorder symptoms, assessed within the substance use disorder framework (e.g., tolerance, withdrawal), might be linked to harmonious and/or an obsessive passion for gaming. Three distinct clusters of gamers were identified based on their passion profiles, including risky gamers, engaged gamers, and casual gamers. Supervised machine-learning algorithms identified that specific gaming disorder symptoms (salience, mood modification, tolerance, low level of conflict) were predominantly related to harmonious passion, whereas others (withdrawal, high level of conflict, relapse) were more directly related to obsessive passion. Our results support the relevance of person-centered approaches to the treatment of problematic gaming.
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Affiliation(s)
- Alexandre Infanti
- Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | | | - José C Perales
- Department of Experimental Psychology, Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
| | - Claus Vögele
- Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Joël Billieux
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland; Centre for Excessive Gambling, Addiction Medicine, Lausanne University Hospitals (CHUV), Lausanne, Switzerland
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Hildebrandt MK, Schwarz K, Dieterich R, Endrass T. Dissociating the Link of Neural Correlates of Inhibition to the Degree of Substance Use and Substance-Related Problems: A Preregistered, Multimodal, Combined Cross-sectional and Longitudinal Study. Biol Psychiatry 2023; 94:898-905. [PMID: 37356556 DOI: 10.1016/j.biopsych.2023.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/15/2023] [Accepted: 06/19/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND Frontal hypoactivation during inhibition is a promising phenotype for substance use disorders (SUDs), but studies comparing individuals with SUDs with unaffected individuals have reported inconsistent results. This may result from distinctive associations of neural correlates of inhibition with the degree of substance use and the severity of substance-related problems-two correlated but distinct facets of SUDs-reflecting a potentially disregarded confounding effect. This preregistered study tested whether frontal hypoactivation during inhibition is specifically linked to substance-related problems in SUDs beyond the degree of substance use. METHODS A stop signal task during functional magnetic resonance imaging, trait self-control, substance use, and substance-related problems in the past 12 months were assessed in 121 (poly)substance users. One hundred seven participants completed a 1-year follow-up. We examined the association between multimodal indicators of inhibition (neural activation in regions of interest, inhibitory performance, trait self-control) and substance-related problems while controlling for the degree of substance use. RESULTS Right inferior frontal gyrus hypoactivation explained variance in substance-related problems beyond the degree of substance use, while hyperactivation in the same region explained variance in the degree of substance use beyond the effects of substance-related problems, both cross-sectionally (problems: Bonferroni-Holm-corrected p = .048; use: p < .01) and prospectively (problems at trend level: p = .096; use: p = .01). Trait and behavioral inhibition were unrelated to problems beyond the effects of substance use (ps > .05). CONCLUSIONS We demonstrated that frontal hypoactivation during inhibition specifically relates to substance-related problems. Interestingly, increased activity may even represent a resilience factor in substance use without SUDs. Future studies should distinguish between processes linked to the degree of substance use and substance-related problems to advance understanding of why some substance users develop SUDs and others do not.
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Affiliation(s)
- Malin K Hildebrandt
- Department of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Dresden, Germany.
| | - Kristina Schwarz
- Department of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Dresden, Germany
| | - Raoul Dieterich
- Department of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Dresden, Germany
| | - Tanja Endrass
- Department of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Dresden, Germany
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Felton JW, Oddo LE, Cinader M, Maxwell T, Yi R, Chronis-Tuscano A. Parental future orientation and parenting outcomes: Development and validation of an adapted measure of parental decision making. PERSONALITY AND INDIVIDUAL DIFFERENCES 2023. [DOI: 10.1016/j.paid.2023.112181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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Hildebrandt MK, Dieterich R, Endrass T. Neural correlates of inhibitory control in relation to the degree of substance use and substance-related problems - A systematic review and perspective. Neurosci Biobehav Rev 2021; 128:1-11. [PMID: 34097979 DOI: 10.1016/j.neubiorev.2021.06.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 05/11/2021] [Accepted: 06/02/2021] [Indexed: 12/28/2022]
Abstract
Inhibitory control deficits are associated with substance use disorders (SUDs) and considered a risk factor. Most studies compare SUD groups with unaffected individuals, although the degree of substance use might relate to inhibitory control deficits and explain group differences. This raises the question to which extent these deficits are specifically linked to substance-related problems. We review studies reporting associations of inhibition-related neural activation (stop signal and go/nogo task) with continuous measures of the degree of substance use and substance-related problems, and with substance-related problems controlling for the degree of substance use. Results suggest negative associations between inhibition-related neural activation and the degree of substance use, but are inconclusive on the association with substance-related problems. Nonetheless, two studies reported significant associations of inhibition-related neural activation with substance-related problems controlling for the degree of substance use. Despite numerous studies showing alterations in inhibition-related neural activation in SUDs, the role of the degree of substance use needs further investigation and studies using dimensional approaches are necessary to uncover specific links to substance-related problems.
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Affiliation(s)
- Malin K Hildebrandt
- Technische Universität Dresden, Faculty of Psychology, Institute for Clinical Psychology and Psychotherapy, Addiction Research, Germany.
| | - Raoul Dieterich
- Technische Universität Dresden, Faculty of Psychology, Institute for Clinical Psychology and Psychotherapy, Addiction Research, Germany.
| | - Tanja Endrass
- Technische Universität Dresden, Faculty of Psychology, Institute for Clinical Psychology and Psychotherapy, Addiction Research, Germany.
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