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ADHD and addictive behavior in crack-cocaine users. Encephale 2022; 49:284-288. [DOI: 10.1016/j.encep.2022.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 12/21/2021] [Accepted: 01/05/2022] [Indexed: 11/20/2022]
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Abstract
PURPOSE OF REVIEW The goal was to review recent (1/2015-2/2020) evidence of impulsivity as a feature of substance use disorders or use of substances (alcohol, cannabis, nicotine, opioids, stimulants) in males compared to females in terms of: a) impulsivity in substance-using groups (or substance-using compared to control groups), and b) relationship between impulsivity and substance use behavior, clinical severity, or treatment outcomes. RECENT FINDINGS Of 361 papers identified by the searches, 69 met inclusion criteria, and 39 were highlighted for considering sex/gender in relation to impulsivity in substance-using populations. Taken together, findings supported higher impulsivity in males and females who use substances, relative to controls; and higher impulsivity was linked with more substance use/severity in both sex/genders. There were mixed findings regarding male versus female differences in impulsivity among individuals who use substances, or in the magnitude of the relationship between impulsivity and substance use severity. SUMMARY The current body of evidence does not point to a consistent sex/gender difference in the role of impulsivity within and across substance use disorders. Impulsivity is a clinically-relevant construct for male and female individuals who use substances, across a range of substances.
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Sensitivity to gains during risky decision-making differentiates chronic cocaine users from stimulant-naïve controls. Behav Brain Res 2020; 379:112386. [PMID: 31778734 DOI: 10.1016/j.bbr.2019.112386] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 11/04/2019] [Accepted: 11/24/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND Chronic cocaine use has been consistently associated with decision-making impairments that contribute to the development and maintenance of drug-taking. However, the underlying cognitive processes of risk-seeking behaviours observed in chronic cocaine users (CU) have so far remained unclear. Here we therefore tested whether CU differ from stimulant-naïve controls in their sensitivity to gain, loss, and probability of loss information when making decisions under risk. METHOD A sample of 96 participants (56 CU and 40 controls) performed the no-feedback version of the Columbia Card Task, designed to assess risk-taking in relation to gain, loss, and probability of loss information. Additionally, cognitive performance and impulsivity were determined. Current and recent substance use was objectively assessed by toxicological urine and hair analysis. RESULTS Compared to controls, CU showed increased risk-seeking in unfavourable decision scenarios in which the loss probability was high and the returns were low, and a tendency for increased risk aversion in more favourable decision scenarios. In comparison to controls, CU were less sensitive to gain, but similarly sensitive to loss and probability of loss information. Further analysis revealed that individual differences in sensitivity to loss and probability of loss information were related to cognitive performance and impulsivity. CONCLUSION Reduced sensitivity to gains in people with CU may contribute to their propensity for making risky decisions. While these alterations in gain sensitivity might directly relate to cocaine use per se, the individual psychopathological profile of CU might moderate sensitivity to loss information.
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Bhatti JA, Thiruchelvam D, Redelmeier DA. Traumatic brain injury as an independent risk factor for problem gambling: a matched case-control study. Soc Psychiatry Psychiatr Epidemiol 2019; 54:517-523. [PMID: 30232507 DOI: 10.1007/s00127-018-1583-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 08/20/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE To assess whether traumatic brain injury (TBI) increases the risks of subsequent problem gambling. METHODS We conducted a matched case-control analysis of adults in Ontario, Canada. The study included those who self-reported their gambling activities in the Canadian Community Health Survey 2007-2008. Using Problem Gambling Severity Index, we defined cases as those who were problem gamblers and controls who were recreational gamblers. Cases were matched to controls 1:2 using propensity scores based on demographics, prior mental health, and self-reported behaviours. The main predictor was prior TBI defined as requiring emergency care and identified using ICD-10 codes from administrative health databases. We estimated the likelihood of prior TBI in problem gamblers compared to controls using conditional logistic regression. RESULTS Of 30,652 survey participants, 16,002 (53%) reported gambling activity of whom 14,910 (49%) were recreational gamblers and 4% (n = 1092) were problem gamblers. A total of 1469 respondents (5%) had a prior TBI. Propensity score matching yielded 2038 matched pairs with 1019 cases matched to 2037 controls. Case-control analysis showed a significant association between prior TBI and subsequent problem gambling (odds ratio 1.27, 95% confidence interval 1.07-1.51, P = 0.007). The increased risk was mostly apparent in men aged 35 to 64 years who reported alcohol use or smoking. The relative risk of problem gambling in those with two or more TBIs equated to an odds ratio of 2.04 (95% confidence interval 1.05-3.99). CONCLUSIONS We found that a prior TBI was associated with an increased subsequent risk of problem gambling. Our findings support more awareness, screening, and treating problem gambling risks among TBI patients.
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Affiliation(s)
- Junaid A Bhatti
- Sunnybrook Research Institute, Evaluative Clinical Sciences, Toronto, Canada.
- Departments of Surgery and Medicine, University of Toronto, Toronto, Canada.
- Institute for Clinical Evaluative Sciences, Toronto, Canada.
- Department of Surgery, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, G106, Toronto, ON, M4N 3M5, Canada.
| | | | - Donald A Redelmeier
- Sunnybrook Research Institute, Evaluative Clinical Sciences, Toronto, Canada
- Departments of Surgery and Medicine, University of Toronto, Toronto, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Canada
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Saleme DM, Kluwe-Schiavon B, Soliman A, Misiak B, Frydecka D, Moustafa AA. Factors underlying risk taking in heroin-dependent individuals: Feedback processing and environmental contingencies. Behav Brain Res 2018; 350:23-30. [PMID: 29778626 DOI: 10.1016/j.bbr.2018.04.052] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 03/23/2018] [Accepted: 04/28/2018] [Indexed: 10/16/2022]
Abstract
Evidence suggests that factors influencing risk-taking include whether decisions are made based on emotions (affective systems) or cognitions (deliberative systems), the processing of feedback (e.g., deciding to attend a rehabilitation facility for opioid addiction treatment after an intervention held by a family member), and attention to environmental contingencies (e.g., considering the probability of an outcome such as the likelihood of contracting tetanus from a shared needle; or the gains and losses associated with a decision, such as the benefits and costs of taking drugs). Although drug-dependent individuals tend to take more risks than non-drug users, the factors underlying risk-taking are unknown. The current study tested, for the first time, the influences of performance feedback (i.e., whether feedback about performance is integrated into decision-making in heroin-dependent individuals) and attention to environmental contingencies (i.e., the influence of the probability of a loss, the gain amount, and the loss amount associated with a scenario) on risk-taking in heroin-dependent individuals. Heroin-dependent patients undergoing maintenance therapy for opioid addiction (n = 25) and healthy controls (n = 27) completed the feedback and no-feedback conditions of the Columbia Card Task (CCT). Analyses of covariance, controlling for education and task design (the order in which the CCT conditions were completed) as covariates revealed a significant interaction between (a) probability, gain and loss amount, and group, and (b) group and probability. Our findings suggest that heroin-dependent patients pay less attention to environmental contingencies during risk-taking than controls. Addressing these factors may facilitate greater adherence to treatment programs and lower rates of relapse.
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Affiliation(s)
- Daniella M Saleme
- School of Social Sciences and Psychology, Western Sydney University, Sydney, NSW, Australia
| | - Bruno Kluwe-Schiavon
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| | - Abdrabo Soliman
- Department of Social Sciences, College of Arts and Sciences, Qatar University, Qatar
| | - Błażej Misiak
- Department of Genetics, Wroclaw Medical University, Wroclaw, Poland
| | - Dorota Frydecka
- Departement of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Ahmed A Moustafa
- School of Social Sciences and Psychology, Western Sydney University, Sydney, NSW, Australia; Marcs Institute for Brain and Behaviour, Western Sydney University, Sydney, NSW, Australia.
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Meade CS, Addicott M, Hobkirk AL, Towe SL, Chen NK, Sridharan S, Huettel SA. Cocaine and HIV are independently associated with neural activation in response to gain and loss valuation during economic risky choice. Addict Biol 2018; 23:796-809. [PMID: 28682013 PMCID: PMC6706251 DOI: 10.1111/adb.12529] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 05/10/2017] [Accepted: 05/16/2017] [Indexed: 01/26/2023]
Abstract
Stimulant abuse is disproportionately common in HIV-positive persons. Both HIV and stimulants are independently associated with deficits in reward-based decision making, but their interactive and/or additive effects are poorly understood despite their prevalent co-morbidity. Here, we examined the effects of cocaine dependence and HIV infection in 69 adults who underwent functional magnetic resonance imaging while completing an economic loss aversion task. We identified two neural networks that correlated with the evaluation of the favorable characteristics of the gamble (i.e. higher gains/lower losses: ventromedial prefrontal cortex, anterior cingulate, anterior and posterior precuneus and visual cortex) versus unfavorable characteristics of the gamble (i.e. lower gains/higher losses: dorsal prefrontal, lateral orbitofrontal, posterior parietal cortex, anterior insula and dorsal caudate). Behaviorally, cocaine and HIV had additive effects on loss aversion scores, with HIV-positive cocaine users being the least loss averse. Cocaine users had greater activation in brain regions that tracked the favorability of gamble characteristics (i.e. increased activation to gains, but decreased activation to losses). In contrast, HIV infection was independently associated with lesser activation in regions that tracked the unfavorability of gamble characteristics. These results suggest that cocaine is associated with an overactive reward-seeking system, while HIV is associated with an underactive cognitive control system. Together, these alterations may leave HIV-positive cocaine users particularly vulnerable to making unfavorable decisions when outcomes are uncertain.
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Affiliation(s)
- Christina S. Meade
- Duke University School of Medicine, Department of Psychiatry & Behavioral Sciences, Durham, NC, 27708, USA
- Duke Global Health Institute, Durham, NC, 27708, USA
- Duke University, Department of Psychology & Neuroscience, Durham, NC, 27708, USA
| | - Merideth Addicott
- Duke University School of Medicine, Department of Psychiatry & Behavioral Sciences, Durham, NC, 27708, USA
- Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC 27708, USA
| | - Andrea L. Hobkirk
- Duke University School of Medicine, Department of Psychiatry & Behavioral Sciences, Durham, NC, 27708, USA
- Duke Global Health Institute, Durham, NC, 27708, USA
| | - Sheri L. Towe
- Duke University School of Medicine, Department of Psychiatry & Behavioral Sciences, Durham, NC, 27708, USA
- Duke Global Health Institute, Durham, NC, 27708, USA
| | - Nan-kuei Chen
- Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC 27708, USA
- Duke University School of Medicine, Department of Radiology, Durham, NC, 27708, USA
| | | | - Scott A. Huettel
- Duke University, Department of Psychology & Neuroscience, Durham, NC, 27708, USA
- Duke University, Center for Cognitive Neuroscience, Durham, NC, 27708, USA
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Cho BR, Kwak MJ, Kim WY, Kim JH. Impulsive Action and Impulsive Choice Are Differentially Expressed in Rats Depending on the Age at Exposure to a Gambling Task. Front Psychiatry 2018; 9:503. [PMID: 30386266 PMCID: PMC6198148 DOI: 10.3389/fpsyt.2018.00503] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 09/25/2018] [Indexed: 01/23/2023] Open
Abstract
Impulsivity is considered an important feature associated with the development of numerous psychiatric disorders, including addictions. In the behavioral approach, impulsivity can be broadly divided into two distinct subtypes: impulsive action and choice. In the present study, we used a rodent version of the gambling task (rGT) to examine how impulsive action and impulsive choice are differentially influenced by difference in age at exposure (i.e., late adolescents/young adults vs. mature adults) to rGT. Rats were trained in a touch-screen chamber to learn the relationships between 4 light signals on the window of the screen and accompanying reward outcomes or punishments associated with different magnitudes and probabilities. Depending on their stabilized pattern of preference when allowed free choice, rats were categorized into risk-averse or risk-seeking group. While undergoing a series of experimental schemes, including extinction, re-acquisition, and acute cocaine injection, rats were re-tested for their premature response during inter-trial interval and choice preference toward the 4 different windows in rGT. Notably, rats exposed early, compared with those exposed late, to rGT showed increased impulsive action, particularly during re-acquisition period, in all sub-groups. In contrast, rats exposed late, compared with those exposed early, to rGT showed increased impulsive choice after acute cocaine injection, but these results were only obtained in a sub-group pre-categorized as high impulsive and risk-averse. These results suggest that different aspects of impulsivity can be differentially expressed during decision-making, and differentially influenced by the age at exposure to a gambling task.
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Affiliation(s)
- Bo Ram Cho
- Brain Korea 21 Plus Project for Medical Science, Brain Research Institute, Department of Physiology, Yonsei University College of Medicine, Seoul, South Korea
| | - Myung Ji Kwak
- Brain Korea 21 Plus Project for Medical Science, Brain Research Institute, Department of Physiology, Yonsei University College of Medicine, Seoul, South Korea
| | - Wha Young Kim
- Brain Korea 21 Plus Project for Medical Science, Brain Research Institute, Department of Physiology, Yonsei University College of Medicine, Seoul, South Korea
| | - Jeong-Hoon Kim
- Brain Korea 21 Plus Project for Medical Science, Brain Research Institute, Department of Physiology, Yonsei University College of Medicine, Seoul, South Korea
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Kim WY, Cho BR, Kwak MJ, Kim JH. Interaction between trait and housing condition produces differential decision-making toward risk choice in a rat gambling task. Sci Rep 2017; 7:5718. [PMID: 28720904 PMCID: PMC5515848 DOI: 10.1038/s41598-017-06408-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 06/21/2017] [Indexed: 11/28/2022] Open
Abstract
Poor decision-making is a core problem in psychiatric disorders such as pathological gambling and substance abuse. Both trait and environmental factors are considerably important to affect decision-making. However, it has not yet been systematically shown how they interact to affect risk preference in animal models evaluating decision-making. Here, we trained rats, housed in pairs or in isolation, in a touch screen chamber to detect the association between four different light signals on the screen and accompanied reward and punishment outcomes arranged with different schedules. Then, the rats were allowed to freely choose from 4 different light signals. Once animals showed a stabilized pattern of preference (risk-averse or risk-seeking), they were injected with saline or cocaine (a single injection per day for 7 days) followed by 2 weeks of withdrawal. Then, their preference of choice was re-tested in the touch screen chamber while they were cocaine challenged. All rats significantly changed their preference toward more risky choices when they were exposed to and challenged with cocaine, except those in the risk-averse/isolated housing group. These results indicate that the pre-existing trait toward risk and the housing condition interact to affect the quality of decision-making, and cocaine may help to aggravate this process.
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Affiliation(s)
- Wha Young Kim
- Department of Physiology, Brain Korea 21 Project for Medical Science, Brain Research Institute, Yonsei University College of Medicine, Seoul, 03722, South Korea
| | - Bo Ram Cho
- Department of Physiology, Brain Korea 21 Project for Medical Science, Brain Research Institute, Yonsei University College of Medicine, Seoul, 03722, South Korea
| | - Myung Ji Kwak
- Department of Physiology, Brain Korea 21 Project for Medical Science, Brain Research Institute, Yonsei University College of Medicine, Seoul, 03722, South Korea
| | - Jeong-Hoon Kim
- Department of Physiology, Brain Korea 21 Project for Medical Science, Brain Research Institute, Yonsei University College of Medicine, Seoul, 03722, South Korea.
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Lench DH, DeVries W, Hanlon CA. The effect of task difficulty on motor performance and frontal-striatal connectivity in cocaine users. Drug Alcohol Depend 2017; 173:178-184. [PMID: 28260681 PMCID: PMC5896281 DOI: 10.1016/j.drugalcdep.2016.12.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 12/04/2016] [Accepted: 12/08/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND There is growing recognition that chronic cocaine users have alterations in sensorimotor control that are positively related to low frontal-striatal connectivity within the motor system. These frontal-striatal motor circuits however, are modulated by circuits governing attention, which are also disrupted in cocaine users. This study's aim was to determine if sensorimotor control deficits are positively related to the difficulty of a motor task or exist independent of the increasing cognitive demand. METHODS Functional MRI data was collected from 40 individuals (20 non-treatment seeking chronic cocaine users, 20 age and gender matched non-drug using controls) as they mimicked an unpredictable finger-tapping sequence at various speeds. Dependent measures included task accuracy, percent BOLD signal change in sensorimotor regions of interest (ROIs), and functional connectivity (temporal correlations) between ROIs. RESULTS In both groups, as speed increased, the BOLD signal change increased in the primary motor cortex, supplementary motor area (SMA), cerebellum, and anterior cingulate cortex. Compared to controls, cocaine user SMA-Caudate and ACC-Putamen connectivity was lower at all speeds in the contralateral hemisphere. Furthermore, as speed increased there was a decrease in connectivity between additional ROI pairs among users. CONCLUSIONS These data support previous observations of sensorimotor performance deficits and dorsal frontal-striatal connectivity impairments among cocaine users. While previous studies demonstrate these deficits when performing a finger-tapping task at a single speed, we show that these same impairments exist at multiple levels of task difficulty. These data suggest that previously observed frontal-striatal connectivity in cocaine users during sensorimotor task performance are stable and not directly related to cognitive demands of the task.
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Affiliation(s)
- Daniel H Lench
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, 29425, USA
| | - William DeVries
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, 29425, USA
| | - Colleen A Hanlon
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, 29425, USA.
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Verdejo-Garcia A, Chong TTJ, Stout JC, Yücel M, London ED. Stages of dysfunctional decision-making in addiction. Pharmacol Biochem Behav 2017; 164:99-105. [PMID: 28216068 DOI: 10.1016/j.pbb.2017.02.003] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 01/27/2017] [Accepted: 02/03/2017] [Indexed: 01/26/2023]
Abstract
Drug use is a choice with immediate positive outcomes, but long-term negative consequences. Thus, the repeated use of drugs in the face of negative consequences suggests dysfunction in the cognitive mechanisms underpinning decision-making. This cognitive dysfunction can be mapped into three stages: the formation of preferences involving valuation of decision options; choice implementation including motivation, self-regulation and inhibitory processes; and feedback processing implicating reinforcement learning. This article reviews behavioral studies that have examined alterations in these three stages of decision-making in people with substance use disorders. Relative to healthy individuals, those with alcohol, cannabis, stimulant and opioid use disorders value risky options more highly during the formation of preferences; have a greater appetite for superficially attractive rewards during choice implementation; and are both more efficient in learning from rewards and less efficient in learning from losses during feedback processing. These observed decision-making deficits are most likely due to both premorbid factors and drug-induced effects. Because decision-making deficits have been prospectively associated with a greater risk of drug relapse, we advocate for greater research on modulating the component stages that give rise to dysfunctional decision-making in disorders of addiction.
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Affiliation(s)
- Antonio Verdejo-Garcia
- Monash Institute of Cognitive & Clinical Neuroscience (MICCN), Monash University, Australia; School of Psychological Sciences, Monash University, Australia.
| | - Trevor T-J Chong
- Monash Institute of Cognitive & Clinical Neuroscience (MICCN), Monash University, Australia; School of Psychological Sciences, Monash University, Australia
| | - Julie C Stout
- Monash Institute of Cognitive & Clinical Neuroscience (MICCN), Monash University, Australia; School of Psychological Sciences, Monash University, Australia
| | - Murat Yücel
- Monash Institute of Cognitive & Clinical Neuroscience (MICCN), Monash University, Australia; School of Psychological Sciences, Monash University, Australia
| | - Edythe D London
- Semel Institute of Neuroscience, University of California Los Angeles, United States
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