Beyond inhibition: a dual-process perspective to renew the exploration of binge drinking

Neural mechanisms linked to treatment outcomes and recovery in substance-related and addictive disorders

The present review focuses on potential neural mechanisms underlying recovery from psychiatric conditions characterised by impaired impulse control, specifically substance use disorders, gambling disorder, and internet gaming disorder. Existing treatments (both pharmacological and psychological) for these addictions may impact brain processes, and these have been evaluated in neuroimaging studies. Medication challenge and short-term intervention administration will be considered with respect to treatment utility. Main models of addiction (e.g., dual process, reward deficiency syndrome) will be considered in the context of extant data. Additionally, advanced analytic approaches (e.g., machine-learning approaches) will be considered with respect to guiding treatment development efforts. Thus, this narrative review aims to provide directions for treatment development for addictive disorders.

Risk Factors for Binge Drinking in Young Adulthood: The Roles of Aggregate Genetic Liability and Impulsivity-Related Processes

OBJECTIVE

Binge drinking is characterized by excessive alcohol use and is widespread in youth. We explore the relationship between binge drinking's risk factors by considering (a) aggregate genetic liability (polygenic risk score [PGS]) for alcohol use and problems and (b) impulsivity-related processes. We examined whether the associations between PGS and binge drinking were mediated by impulsivity, with a possible shared genetic liability between alcohol phenotypes and impulsivity.

METHOD

Participants were from the Avon Longitudinal Study of Parents and Children (N = 2,545). We evaluated PGS for alcohol use and problems and impulsivity-related processes (sensation seeking at age 18 and inhibition at age 24) and measured binge drinking frequency (24 years old) as the outcome. Correlations and structural equation models were used to test a hypothesized model of the relationships among these variables.

RESULTS

Higher binge drinking frequency was related to higher aggregate genetic liability for alcohol use and problems in both models (standardized betas = .055-.064, all ps < .009). We found an association between binge drinking and sensation seeking (standardized beta = .224, p < .0001) but not inhibition (standardized beta = -.015, p = .437). Although the association between binge drinking and PGS for alcohol use and problems was mainly direct, a proportion of the association with alcohol problems was mediated by sensation seeking (14.61%).

CONCLUSIONS

Targeting sensation seeking at the end of adolescence may be means to prevent binge drinking in adulthood, whereas considering the role of genetic factors may improve our understanding of at-risk youth.

Alcohol-related stimuli modulate functional connectivity during response inhibition in young binge drinkers

Binge drinking is a pattern of intermittent excessive alcohol consumption that is highly prevalent in young people. Neurocognitive dual-process models have described substance abuse and adolescence risk behaviours as the result of an imbalance between an overactivated affective-automatic system (related to motivational processing) and damaged and/or immature reflective system (related to cognitive control abilities). Previous studies have evaluated the reflective system of binge drinkers (BDs) through neutral response inhibition tasks and have reported anomalies in theta (4-8 Hz) and beta (12-30 Hz) bands. The present study aimed to investigate the influence of the motivational value of alcohol-related stimuli on brain functional networks devoted to response inhibition in young BDs. Sixty eight BDs and 78 control participants performed a beverage Go/NoGo task while undergoing electrophysiological recording. Whole cortical brain functional connectivity (FC) was evaluated during successful response inhibition trials (NoGo). BDs exhibited fast-beta and theta hyperconnectivity in regions related to cognitive control. These responses were modulated differently depending on the motivational content of the stimuli. The increased salience of alcohol-related stimuli may lead to overactivation of the affective-automatic system in BDs, and compensatory neural resources of the reflective system will thus be required during response inhibition. In BDs, inhibition of the response to alcohol stimuli may require higher theta FC to facilitate integration of information related to the task goal (withholding a response), while during inhibition of the response to no-alcoholic stimuli, higher fast-beta FC would allow to apply top-down inhibitory control of the information related to the prepotent response.

Towards an Ideology-Free, Truly Mechanistic Health Psychology

Efficient transfer of concepts and mechanistic insights from the cognitive to the health sciences and back requires a clear, objective description of the problem that this transfer ought to solve. Unfortunately, however, the actual descriptions are commonly penetrated with, and sometimes even motivated by, cultural norms and preferences, a problem that has colored scientific theorizing about behavioral control—the key concept for many psychological health interventions. We argue that ideologies have clouded our scientific thinking about mental health in two ways: by considering the societal utility of individuals and their behavior a key criterion for distinguishing between healthy and unhealthy people, and by dividing what actually seem to be continuous functions relating psychological and neurocognitive underpinnings to human behavior into binary, discrete categories that are then taken to define clinical phenomena. We suggest letting both traditions go and establish a health psychology that restrains from imposing societal values onto individuals, and then taking the fit between behavior and values to conceptualize unhealthiness. Instead, we promote a health psychology that reconstructs behavior that is considered to be problematic from well-understood mechanistic underpinnings of human behavior.

A biological framework for emotional dysregulation in alcohol misuse: from gut to brain

Alcohol use disorder (AUD) has been associated with impairments in social and emotional cognition that play a crucial role in the development and maintenance of addiction. Repeated alcohol intoxications trigger inflammatory processes and sensitise the immune system. In addition, emerging data point to perturbations in the gut microbiome as a key regulator of the inflammatory cascade in AUD. Inflammation and social cognition are potent modulators of one another. At the same time, accumulating evidence implicates the gut microbiome in shaping emotional and social cognition, suggesting the possibility of a common underlying loop of crucial importance for addiction. Here we propose an integrative microbiome neuro-immuno-affective framework of how emotional dysregulation and alcohol-related microbiome dysbiosis could accelerate the cycle of addiction. We outline the overlapping effects of chronic alcohol use, inflammation and microbiome alterations on the fronto-limbic circuitry as a convergence hub for emotional dysregulation. We discuss the interdependent relationship of social cognition, immunity and the microbiome in relation to alcohol misuse- from binge drinking to addiction. In addition, we emphasise adolescence as a sensitive period for the confluence of alcohol harmful effects and emotional dysregulation in the developing gut-brain axis.

Incentive sensitization in binge behaviors: A mini review on electrophysiological evidence

Introduction

Binge behavior not only refers to the consumption of substances such as alcohol or food, but is also used in relation to gaming, watching and gambling. Dependent on context it makes for a widespread, benign recreational activity or can pose a serious mental health problem with deleterious consequences. Incentive sensitization theory describes the attribution of salience towards stimuli strongly associated with dopamine-mediated reward as a result of repeated consumption. The sensitized neural networks cause cue-triggered craving and excessive desire, but thus, this mechanism may also be applicable to stimulus-induced behaviors not associated with classical withdrawal symptoms. Event-related potentials (ERP) are a useful method of examining motivated attention towards incentive stimuli. This mini review aims to synthesize ERP findings from different types of binge behaviors in order to compare cue-reactivity to incentive stimuli.

Methods

Studies investigating binge drinking, binge eating as well as binge watching, gaming and gambling were screened. To limit the influence of concurrent task demands, ERP studies applying picture viewing paradigms with incentive stimuli were selected.

Results

Across binge behaviors, evidence on altered mid-latency ERPs has been mixed. However, studies investigating later stages of attentional processes more consistently find enlarged P300 and late positive potentials (LPP) amplitudes to relevant cues.

Conclusion

An altered attentional processing of incentive stimuli reflecting motivated attention is in line with incentive sensitization theory. Considering the limited number of studies, especially regarding binge behaviors not involving substances, more research is needed to attain a more thorough understanding of incentive sensitization across binge behaviors.

Emotional processes in binge drinking: A systematic review and perspective

Binge drinking is a widespread alcohol consumption pattern commonly engaged by youth. Here, we present the first systematic review of emotional processes in relation to binge drinking. Capitalizing on a theoretical model describing three emotional processing steps (emotional appraisal/identification, emotional response, emotional regulation) and following PRISMA guidelines, we considered all identified human studies exploring emotional abilities among binge drinkers. A literature search was conducted in PubMed, Scopus, and PsychINFO, and a standardized methodological quality assessment was performed for each study. The main findings offered by the 43 studies included are: 1) regarding emotional appraisal/identification, binge drinking is related to heightened negative emotional states, including greater severity of depressive and anxiety symptoms, and have difficulties in recognizing emotional cues expressed by others; 2) regarding emotional response, binge drinkers exhibit diminished emotional response compared with non-binge drinkers; 3) regarding emotional regulation, no experimental data currently support impaired emotion regulation in binge drinking. Variability in the identification and measurement of binge drinking habits across studies limits conclusions. Nevertheless, current findings establish the relevance of emotional processes in binge drinking and set the stage for new research perspectives to identify the nature and extent of emotional impairments in the onset and maintenance of excessive alcohol use.

Physical activity: A promising adjunctive treatment for severe alcohol use disorder

Substance use disorder develops from complex interactions between socio-environmental and neurobiological factors. A neurocognitive model of addiction, the triadic model, proposes that Alcohol Use Disorder (AUD) is the result of an imbalance between the reflective and the impulsive subcomponents along with a disruption of the regulatory subcomponent. Physical activity is considered as an emerging treatment for severe AUD (sAUD). This short review examines the efficacy and mechanisms of action of physical intervention as an adjunctive treatment in severe AUD (sAUD) within the theoretical framework of the triadic model. Physical activity is a feasible, safe, and less stigmatizing approach than classical treatments. It improves sAUD patients' mental and physical comorbidities. The key finding of this short review is that physical activity could contribute to a rebalancing of the triadic model in sAUD patients by 1) improving neuroplasticity and cognitive functioning, 2) reducing impulsivity and urgency, and improving emotional regulation, and 3) reducing craving. This rebalancing could eventually reduce the risk of relapse. However, due to methodological issues, it remains difficult to observe an effect of physical activity on drinking outcomes. At best, a trend towards a reduction in alcohol consumption was noted. The mechanisms that could explain the benefits of physical activity in sAUD patients involve multiple physiological processes such as dopaminergic or glutamatergic transmission and signaling or neuroplasticity. Future randomized controlled trials should include neuropsychological and impulsivity assessments, in more controlled environments. Physical activity could contribute to a personalization of sAUD treatment using each subcomponent of the triadic model as a therapeutic target. Physical exercise could be an adjunctive treatment for sAUD patients, favoring the benefit of more usual treatments such as cognitive behavioral therapies. It could also be a stand-alone intervention in less severe patients.

Electroencephalographic signatures of the binge drinking pattern during adolescence and young adulthood: A PRISMA-driven systematic review

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Controls and binge drinkers (BDs) do not differ in their behavioral performance.

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BDs show increased neural activity during attention, working memory and inhibition.

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Augmented P3 amplitude in BDs was the most solid electrophysiological finding.

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Evidence does not support specific gender vulnerabilities to the effects of BD.

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Memory, emotional processing and decision-making processes need further exploration.

Research on neurophysiological impairments associated with binge drinking (BD), an excessive but episodic alcohol use pattern, has significantly increased over the last decade. This work is the first to systematically review –following PRISMA guidelines- the empirical evidence regarding the effects of BD on neural activity –assessed by electroencephalography- of adolescents and young adults. A systematic review was conducted in 34 studies (N = 1723). Results indicated that binge drinkers (BDs) showed similar behavioral performance as non/low drinkers. The most solid electrophysiological finding was an augmented P3 amplitude during attention, working memory and inhibition tasks. This increased neural activity suggests the recruitment of additional resources to perform the task at adequate/successful levels, which supports the neurocompensation hypothesis. Similar to alcoholics, BDs also displayed increased reactivity to alcohol-related cues, augmented resting-state electrophysiological signal and reduced activity during error detection –which gives support to the continuum hypothesis. Evidence does not seem to support greater vulnerability to BD in females. Replication and longitudinal studies are required to account for mixed results and to elucidate the extent/direction of the neural impairments associated with BD.

Response Inhibition and Binge Drinking During Transition to University: An fMRI Study

BACKGROUND

Binge Drinking (BD), a highly prevalent drinking pattern among youth, has been linked with anomalies in inhibitory control. However, it is still not well characterized whether the neural mechanisms involved in this process are compromised in binge drinkers (BDs). Furthermore, recent findings suggest that exerting inhibitory control to alcohol-related stimuli requires an increased effort in BDs, relative to controls, but the brain regions subserving these effects have also been scarcely investigated. Here we explored the impact of BD on the pattern of neural activity mediating response inhibition and its modulation by the motivational salience of stimuli (alcohol-related content).

METHODS

Sixty-seven (36 females) first-year university students, classified as BDs (n = 32) or controls (n = 35), underwent fMRI as they performed an alcohol-cued Go/NoGo task in which pictures of alcoholic or non-alcoholic beverages were presented as Go or NoGo stimuli.

RESULTS

During successful inhibition trials, BDs relative to controls showed greater activity in the bilateral inferior frontal gyrus (IFG), extending to the anterior insula, a brain region usually involved in response inhibition tasks, despite the lack of behavioral differences between groups. Moreover, BDs displayed increased activity in this region restricted to the right hemisphere when inhibiting a prepotent response to alcohol-related stimuli.

CONCLUSIONS

The increased neural activity in the IFG/insula during response inhibition in BDs, in the absence of behavioral impairments, could reflect a compensatory mechanism. The findings suggest that response inhibition-related activity in the right IFG/insula is modulated by the motivational salience of stimuli and highlight the role of this brain region in suppressing responses to substance-associated cues.

Attentional and approach biases to alcohol cues among young adult drinkers: An ecological momentary assessment study

Alcohol-specific attentional biases (AttB) and approach biases (AppB) are postulated to play a role in alcohol use disorders but their association with drinking in young adults remains unknown. A subsample of young adults with risky alcohol use (N = 296) enrolled in a randomized trial, testing different text message interventions completed weekly tasks via a mobile app for up to 14 weeks: Alcohol Stroop was used to measure AttB and Approach-Avoidance Task was used to measure AppB. Participants also provided reports of their alcohol consumption up to twice per week. We analyzed feasibility of measuring alcohol biases on mobile phones, whether repeated testing and conditions of testing affected mean reaction times (RTs), and whether mean AttB and AppB scores were associated with baseline alcohol use severity and same-day binge drinking (4+/5+ drinks per occasion for women/men). Task completion decreased from 93% on Week 1% to 39% by Week 14 with a mean of 8.2 weeks completed. Mean RTs for Alcohol Stroop decreased over weeks assessed. RTs to Stroop and Approach-Avoid tasks were longer when participants reported distractions or after alcohol and/or drug use. Mean AttB and AppB scores were not associated with baseline drinking, and within-day fluctuations of AttB and AppB scores did not predict same day binge drinking. Barriers to measuring alcohol biases in the natural environment include learning effects, contextual influences of distractions and prior alcohol/drug use, and absence of robust associations of RTs to alcohol cues with either baseline or same-day alcohol consumption. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Electrophysiological Correlates of an Alcohol-Cued Go/NoGo Task: A Dual-Process Approach to Binge Drinking in University Students

Binge drinking is a common pattern of alcohol consumption in adolescence and youth. Neurocognitive dual-process models attribute substance use disorders and risk behaviours during adolescence to an imbalance between an overactivated affective-automatic system (involved in motivational and affective processing) and a reflective system (involved in cognitive inhibitory control). The aim of the present study was to investigate at the electrophysiological level the degree to which the motivational value of alcohol-related stimuli modulates the inhibition of a prepotent response in binge drinkers. First-year university students (n = 151, 54 % females) classified as binge drinkers (n = 71, ≥6 binge drinking episodes, defined as 5/7 standard drinks per occasion in the last 180 days) and controls (n = 80, <6 binge drinking episodes in the last 180 days) performed a beverage Go/NoGo task (pictures of alcoholic and nonalcoholic drinks were presented according to the condition as Go or NoGo stimuli; Go probability = 0.75) during event-related potential recording. In binge drinkers but not controls, the amplitude of the anterior N2-NoGo was larger in response to nonalcohol than in response to alcohol pictures. No behavioural difference in task performance was observed. In terms of dual-process models, binge drinkers may require increased activation to monitor conflict in order to compensate for overactivation of the affective-automatic system caused by alcohol-related bias.

Light and heavy drinking in jurisdictions with different alcohol policy environments

BACKGROUND

A basic, yet untested tenet underlying alcohol control policies is that they should affect both light and heavy drinking, thereby shifting the entire population in a favourable direction. The aim of this study was to test this assumption in young Swiss men.

METHODS

Cross-sectional self-reported data - from 5755 young Swiss men participating in the Cohort Study on Substance Use Risk Factors (C-SURF), a large cohort study on young men living within 21 jurisdictions across Switzerland - were analysed via nested logistic regression. With this approach, a set of increasingly-heavy drinking patterns was broken down into a set of nested regression models, each one estimating the probability of heavier drinking, conditional on the lighter drinking pattern. Drinking patterns relating to heavy episodic drinking (HED), heavy volume drinking (HVD) on weekends, and workweek drinking, as well as alcohol use disorder (AUD) were examined. The explanatory variable was a previously-used alcohol policy environment index (APEI) reflecting the number of alcohol control policies implemented in each jurisdiction. Conventional and multilevel logistic regression models were tested, adjusted for age, education, linguistic region, urban/rural status, attention-deficit/hyperactivity disorder, depression, sensation seeking, antisocial personality disorder, and unobserved heterogeneity between jurisdictions.

RESULTS

For HED, weekend HVD, and AUD, negative relationships with the APEI were found, such that with a higher APEI the probability of lighter drinking patterns was increased while the probability of heavier patterns was reduced, including a reduced probability of the heaviest patterns. These relationships were non-linear, however, and tapered off towards the heavy end of the drinking spectrum. No relationship was identified between the APEI and workweek drinking patterns.

CONCLUSION

Among young Swiss men, stricter alcohol policy environments were associated with a global shift towards lighter drinking, consistent with the basic tenet behind the universal prevention approach.

Identifying Inhibitory Subcomponents Associated with Changes in Binge Drinking Behavior: A 6-Month Longitudinal Design

BACKGROUND

Links between response inhibition and young adult problematic drinking (e.g., binge drinking) have been established, but only to an extent. Considering the presence of some inconsistent findings associated with these 2 variables, this study proposes the need to investigate the extent in which different inhibitory subcomponents are associated with binge drinking behaviors of the same sample.

METHODS

Through the use of a 6-month longitudinal design, changes in Alcohol Use Questionnaire (AUQ) binge score of 163 college students (50.3% female) with a mean age of 21.06 years (SD = 1.83) were correlated with performance on 3 different inhibitory control tasks. Each task was selected to assess separate inhibitory subcomponents: Stop Signal Task (e.g., cancellation of a response), Go/No-Go Task (e.g., withholding of a response), and Simon Task (e.g., inhibiting response interference). Response inhibition was also compared between 2 groups, those who had a substantial increase in AUQ binge score during participation (inAUQ) and those who had a substantial decrease in AUQ binge score (deAUQ).

RESULTS

A significant correlation was found with a change in AUQ binge score and stop signal reaction time among females only, where an increase in binge drinking score positively correlated with a reduced ability to cancel an already-initiated inhibitory response. Differences in inhibitory performance, where inAUQ performed worse than deAUQ, approached significance.

CONCLUSIONS

The results suggest that the cancellation of a prepotent response, as opposed to the withholding of response or interference inhibition, is a more sensitive inhibitory measure associated with increases in binge drinking behavior among female young adult college students. Further exploration of inhibitory subcomponents relative to substance use is greatly needed (e.g., more extensive longitudinal designs and neuroimaging techniques).

Alcohol consumption, drinker identity, and quality of life among students: why there cannot be one prevention strategy for all

INTRODUCTION

The objective for this study was to combine drinking characteristics and two subjective measures, drinker identity and alcohol-related quality of life, i.e., negative impact of alcohol on quality of life, to determine relevant profiles for indicated prevention programs. In particular, we hypothesized that different profiles of students with high level of alcohol consumption exist when exploring subjectivity.

METHODS

We performed an online survey among 16,930 students. We collected sociodemographics and environmental data, including alcohol-related quality of life, drinker identity, and drinking characteristics. We performed a hierarchical clustering on principal components. We described all variables in each cluster and explored between clusters differences by Kruskal-Wallis tests.

RESULTS

We identified five clusters as regarding drinker identity, drinking characteristics, and alcohol-related quality of life. Among these five clusters, three clusters presented high drinking characteristics. A very vulnerable cluster showed high level of alcohol consumption, impact on quality of life and on academic results, and strong drinker identity. An egodystonic cluster showed high level of consumption, mild impact on quality of life and on academic results, but low drinker identity. A cluster seemed short-term super-adapted in heavy drinking environment, showing high level of alcohol consumption and drinker identity, but low impact on quality of life and on academic results (all between clusters p values < 0.001 with Kruskal-Wallis tests).

CONCLUSION

The subjective experience of students from these clusters was significantly different (p value < 0.001), and could explain some inadequacy of certain prevention strategies, considering binge drinker student as a homogeneous group. Prospective studies are needed to explore changes over time of these clusters.

Tick-tock goes the croc: a high-density EEG study of risk-reactivity and binge-drinking

Links between individual differences in risk processing and high-risk behaviors such as binge-drinking have long been the focus of active research. However, investigations in this area almost exclusively utilize decision-making focused paradigms. This emphasis makes it difficult to assess links between risk behaviors and raw risk reactivity independent of decision and feedback processes. A deeper understanding of this association has the potential to shed light on the role of risk reactivity in high-risk behavior susceptibility. To contribute toward this aim, this study utilizes a popular risk-taking game, the crocodile dentist, to assess links between individual differences in decision-free risk-reactivity and reported binge-drinking frequency levels. In this task, participants engage in a series of decision-free escalating risk responses. Risk-reactivity was assessed by measuring late positive potential responses toward risk-taking action initiation cues using high-density 256-Channel EEG. The results indicate that, after controlling for overall alcohol consumption frequency, higher rates of reported binge-drinking are associated with both increased general risk-taking responsivity and increased risk-reactivity escalation as a function of risk level. These findings highlight intriguing links between risk reactivity and binge-drinking frequency, making key contributions in the areas of risk-taking and affective science.

The dual-process model in young adults with a consistent binge drinking trajectory into adulthood

BACKGROUND

Binge Drinking (BD) generally declines once students have left university. However, many individuals continue to partake in BD into adulthood, constituting a scarcely investigated high-risk group towards whom interventions should be prioritized. Following the dual-process model, we examined the relationship between BD and both the reflective system (executive functions) and the affective system (alcohol bias) in young adults with a consistent BD trajectory. We considered impulsivity as a moderator in the relationship between BD and alcohol bias.

METHODS

A cohort of 63 (31♀) young adults were followed for eleven years (18-29 years old). In the last assessment, participants, with high and low drinking trajectories underwent neuropsychological assessment of executive functions (working memory [SOPT], cognitive flexibility [TMT -Verbal Fluency], inhibition [Stroop]) and alcohol bias (Addiction Stroop). The Barratt Impulsivity Scale measured impulsivity. Generalized linear mixed models and regression-based moderation models were applied.

RESULTS

BD was associated with weak inhibitory control, poor working memory and greater alcohol bias moderated by non-planning impulsivity. At moderate levels of non-planning impulsivity, BD was associated with greater alcohol bias. This association was not found at high levels of impulsivity. These deficits were related to loss of control over drinking and severity of alcohol use.

CONCLUSIONS

The imbalance between poor cognitive control and greater alcohol bias may contribute to the persistence of BD into adulthood. The findings highlight the complexities of the dual-process model, with intervention implications.

Dysfunctional Early Processing of Facial Expressions in Hazardous Drinkers: Evidence from an ERP Study

Chronic alcohol intoxication impairs multiple cognitive functions. According to the dual system model (DSM), the development of alcohol dependence (AD) involves the imbalance between the automatic-affective system and the reflective system. However, the cognitive functions of non-AD hazardous drinkers (HDs) remain unclear. The present study aimed to explore how the HDs process facial expressions differently from the healthy subjects. Sixteen HDs and seventeen control subjects (CSs) completed an emotional working memory (WM) task while the electroencephalogram (EEG) was recorded. We found that there was no significant group difference in behavioral performance between the two groups. In the ERP data, relative to the CSs, the HDs showed delayed latencies of P1 and N170. Moreover, the CSs showed significant differences between the amplitudes of neural/fear and disgust expressions while these differences were insignificant in the HDs. The current results suggest that the main deficits in the processing of facial expression in HDs existed in the early automatic-affective system instead of in the reflective system.

Do Executive Functions Predict Binge-Drinking Patterns? Evidence from a Longitudinal Study in Young Adulthood

Background: Impairments in executive functions (EFs) are related to binge drinking in young adulthood, but research on how EFs influence future binge drinking is lacking. The aim of the current report is therefore to investigate the association between various EFs and later severity of, and change in, binge drinking over a prolonged period during young adulthood.

Methods: At baseline, 121 students reported on their alcohol habits (Alcohol use disorder identification test; Alcohol use questionnaire). Concurrently, EFs [working memory, reversal, set-shifting, response inhibition, response monitoring and decision-making (with ambiguity and implicit risk)] were assessed. Eighteen months later, information on alcohol habits for 103 of the participants were gathered. Data were analyzed by means of multilevel regression modeling.

Results: Future severity of binge drinking was uniquely predicted by performance on the Information sampling task, assessing risky decision-making (β = -1.86, 95% CI: -3.69, -0.04). None of the study variables predicted severity or change in binge drinking.

Conclusion: Future severity of binge drinking was associated with making risky decisions in the prospect for gain, suggesting reward hypersensitivity. Future studies should aim at clarifying whether there is a causal association between decision-making style and binge drinking. Performance on all executive tasks was unrelated to change in binge drinking patterns; however, the finding was limited by overall small changes, and needs to be confirmed with longer follow-up periods.

Students worry about the impact of alcohol on quality of life: Roles of frequency of binge drinking and drinker self-concept

INTRODUCTION

The aim of this study was to clarify the impact of binge drinking, its intensity and frequency, and drinker self-concept on health-related quality-of-life (HRQOL) in students.

METHODS

This cross-sectional online survey included 16,930 students. We collected sociodemographics, environmental data, and drinking behaviors. We assessed HRQOL using the Alcohol Quality-of-Life scale, which explicitly explores the subjective negative impact on quality of life one attributes to his relationship with alcohol and the degree to which drinking is a part of an individual's self-concept. Data analyses were performed in 2015 and 2016. We described and compared binge drinkers and non-binge drinkers. Using a regression model we identified the independent factors associated with HRQOL.

RESULTS

The impact on HRQOL attributed to alcohol was significantly greater among binge drinkers. Factors of impact on HRQOL subjectively attributed to alcohol by students were: AUDIT-C score, interaction between gender and AUDIT-C score, strong individual identity as a drinker, binge-drinking frequency, financial difficulties, being a foreigner, fewer years since diploma, chronic condition, recent use of cannabis, psychostimulant, poppers or gambling. Sleep quality, ability to work, expenditure on alcohol, shame, and health-related concerns were the most strongly impacted quality of life areas.

CONCLUSIONS

Binge-drinking frequency should be considered as an important target in prevention programs. In addition, integrating findings on students' subjective perceptions of impairment of HRQOL by alcohol could enable the development of more acceptable and more relevant prevention messages.

Prevalence of at-risk drinking among Brazilian truck drivers and its interference on the performance of executive cognitive tasks

BACKGROUND

Binge drinking (BD) has been associated with an increase in the risk of alcohol-related injuries. Alcohol continues to be the main substance consumed by truck drivers, a population of special concern, since they are often involved in traffic accidents. The aim of this study was to estimate the prevalence of BD and its interference in the executive functioning among truck drivers in Sao Paulo, Brazil.

METHODS

A non-probabilistic sample of 684 truck drivers was requested to answer a structured research instrument on their demographic data and alcohol use. They performed cognitive tests to assess their executive functioning and inventories about confounding variables. The participants were then divided according to their involvement in BD.

RESULTS

17.5% of the interviewees have reported being engaged in BD. Binge drinkers showed a better performance on one test, despite having done so at the expense of more mistakes and lower accuracy. More interestingly, binge drinkers took three seconds longer than non-binge drinkers to inhibit an inadequate response, which is worrisome in the context of traffic. Overall, the deleterious effect of BD on performance remained after controlling for the effects of confounding variables in regression logistic models.

CONCLUSIONS

As the use of alcohol among truck drivers may be as a way to get by with their work conditions, we believe that a negotiation between their work organization and public authorities would reduce such use, preventing negative interferences on truck drivers' cognitive functioning, which by its turn may also prevent traffic accidents.

Binge Drinking of Ethanol during Adolescence Induces Oxidative Damage and Morphological Changes in Salivary Glands of Female Rats

This study investigates morphological and biochemistry effects of binge ethanol consumption in parotid (PG) and submandibular (SG) salivary glands of rats from adolescence to adulthood. Female Wistar rats (n = 26) received ethanol at 3 g/kg/day (20% w/v) for 3 consecutive days/week from the 35th until the 62nd day of life. Animals were treated in two periods: 1 week (G1) and 4 weeks (G2), with a control (treated with distilled water) and an ethanol group to each period. In morphological analysis, morphometric and immunohistochemistry evaluation for smooth muscle actin (αSMA), cytokeratin-18 (CK-18), and vimentin (VIM) were made. Biochemical changes were analyzed by concentration of nitrites and levels of malondialdehyde (MDA). The difference between groups in each analysis was evaluated by Mann-Whitney U test or Student's t-test (p ≤ 0.05). PG showed, at one week of ethanol exposure, lower CK-18 and α-SMA expression, as well as MDA levels. After four weeks, lower CK-18 and higher MDA levels were observed in PG exposed to ethanol, in comparison to control group. SG showed lower α-SMA expression after 1 and 4 weeks of ethanol exposure as well as higher MDA levels after 1 week. Ethanol binge consumption during adolescence promotes tissue and biochemical changes with only one-week binge in acinar and myoepithelial PG cells.

Binge Drinkers Are Fast, Able to Stop - but They Fail to Adjust

Binge drinking leads to brain damage. However, at present few studies have taken into account the continuity in the binge drinking phenomenon, and treated binge drinking as a clearly separable category from other types of drinking patterns. The aim of the present study was to investigate whether severity of binge drinking can predict specific neurocognitive changes in healthy young adults. A total of 121 students aged 18 to 25 were assessed by means of the three last questions of the Alcohol Use Questionnaire combined into binge score. The binge score was entered as a predictor of cognitive performance of the CANTAB Stop Signal Task including reaction time, inhibition processing time, and response adjustment. Anxiety and depression symptoms were also measured. Binge score significantly predicted less adjustment following failures, and faster reaction times. Binge score did not predict inhibition performance. Symptoms of depression and anxiety were not significantly related to binge score. Binge drinking in healthy young adults predicts impairment in response adjustment and fast reaction time, but is unrelated to inhibition. The study supports the view that binge drinking is a continuous phenomenon, rather than discrete category, and the findings are possibly shedding light on why binge drinkers continue their drinking pattern despite negative consequences. (JINS, 2016, 22, 38-46).

Binge drinking chez les jeunes : lectures clinique, neuropsychologique et neurobiologique

Plus de la moitié des jeunes de 17 ans en France déclaraient avoir bu au moins 5 verres en une occasion au cours du mois écoulé en 2011. Les étudiants s’engagent plus facilement dans des modes de consommation d’alcool à risque comme le binge drinking, que les jeunes du même âge non étudiants. Ce mode de consommation s’installe dans les habitudes des nouvelles générations d’étudiants (Spilka, 2012). Si de nombreuses données sont disponibles sur les conséquences aiguës de ces alcoolisations (hépatites aiguës, grossesses non désirées, violences, accidents de la route…), un intérêt croissant se porte sur les conséquences à moyen et long terme sur la qualité de vie, comme sur le fonctionnement neural et neurocognitif de ces pratiques. Ainsi, l’exploration de la qualité de vie liée à l’alcool permet de mieux comprendre le basculement d’une pratique sociétalement valorisée à un état pathologique. En complément, alors qu’il a été montré que le cerveau adolescent paraît particulièrement vulnérable à la toxicité de l’alcool , la pratique du binge drinking a été impliquée dans des altérations cognitives, notamment au niveau du contrôle inhibiteur préfrontal. La mise en évidence de ces altérations pourraient ouvrir une nouvelle voie thérapeutique. Des perspectives récentes proposent de confronter les altérations neurobiologiques aux difficultés émotionnelles retrouvées elles aussi dans le trouble d’usage d’alcool . Ces lectures complémentaires du phénomène de binge drinking permettent ainsi d’appréhender de façon innovante la transition d’un comportement socialement intégré vers le trouble d’usage d’alcool, en identifiant des mécanismes physiopathologiques communs et des sous-groupes plus à risque.

Impact émotionnel et cognitif du binge drinking

Le binge drinking (c’est-à-dire la consommation excessive mais épisodique d’alcool, typique du milieu étudiant) constitue désormais un problème majeur de santé publique, en particulier chez les adolescents et jeunes adultes. Les conséquences psychologiques, interpersonnelles et sociétales de ce mode de consommation sont largement établies, mais ses effets cognitifs et cérébraux n’ont été investigués que durant cette dernière décennie. Il a ainsi été clairement montré, sur base d’études en neuropsychologie et en neurosciences, que les binge drinkers présentent des modifications marquées du fonctionnement cérébral. Cependant, ces études se sont centrées sur des tâches cognitives (explorant par exemple la mémoire, l’attention ou les fonctions exécutives) et les déficits émotionnels associés au binge drinking restent totalement inconnus malgré le rôle majeur joué par ces altérations dans le maintien des troubles liés à la consommation excessive d’alcool. Après un passage en revue des données relatives aux troubles cognitifs, nous présenterons ici des études récentes ayant exploré pour la première fois les déficits émotionnels dans le binge drinking ainsi que leurs corrélats cérébraux, sur base d’une approche multidisciplinaire combinant électrophysiologie et neuroimagerie. Les résultats montrent clairement que le binge drinking conduit, au-delà des altérations cognitives, à des déficits marqués pour le traitement de stimulations émotionnelles, déficits qui pourraient être impliqués dans le développement et le maintien des troubles liés à la consommation d’alcool. Enfin, les limites des connaissances actuelles seront décrites, de même que les perspectives majeures pour les recherches futures. En particulier, sur base de résultats obtenus récemment via une analyse en clusters sur une large population de binge drinkers, nous insisterons sur la nécessité de sortir de la vision unitaire du binge drinking afin de considérer les sous-types de binge drinkers, qui présentent de grandes variations aux niveaux psychologique et cognitif.

Conflict anticipation in alcohol dependence - A model-based fMRI study of stop signal task

Background

Our previous work characterized altered cerebral activations during cognitive control in individuals with alcohol dependence (AD). A hallmark of cognitive control is the ability to anticipate changes and adjust behavior accordingly. Here, we employed a Bayesian model to describe trial-by-trial anticipation of the stop signal and modeled fMRI signals of conflict anticipation in a stop signal task. Our goal is to characterize the neural correlates of conflict anticipation and its relationship to response inhibition and alcohol consumption in AD.

Methods

Twenty-four AD and 70 age and gender matched healthy control individuals (HC) participated in the study. fMRI data were pre-processed and modeled with SPM8. We modeled fMRI signals at trial onset with individual events parametrically modulated by estimated probability of the stop signal, p(Stop), and compared regional responses to conflict anticipation between AD and HC. To address the link to response inhibition, we regressed whole-brain responses to conflict anticipation against the stop signal reaction time (SSRT).

Results

Compared to HC (54/70), fewer AD (11/24) showed a significant sequential effect — a correlation between p(Stop) and RT during go trials — and the magnitude of sequential effect is diminished, suggesting a deficit in proactive control. Parametric analyses showed decreased learning rate and over-estimated prior mean of the stop signal in AD. In fMRI, both HC and AD responded to p(Stop) in bilateral inferior parietal cortex and anterior pre-supplementary motor area, although the magnitude of response increased in AD. In contrast, HC but not AD showed deactivation of the perigenual anterior cingulate cortex (pgACC). Furthermore, deactivation of the pgACC to increasing p(Stop) is positively correlated with the SSRT in HC but not AD. Recent alcohol consumption is correlated with increased activation of the thalamus and cerebellum in AD during conflict anticipation.

Conclusions

The current results highlight altered proactive control that may serve as an additional behavioral and neural marker of alcohol dependence.

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We addressed the neural correlates of conflict anticipation in AD and HC in an SST.

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AD showed greater activation in preSMA and less deactivation in pgACC.

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Deactivation in pgACC inversely correlated with SSRT in HC but not AD.

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Alcohol use is correlated with greater thalamic and cerebellar activations in AD.