1
|
Wiśniewski P, Jakubczyk A, Trucco EM, Kobyliński P, Suszek H, Zaorska J, Rydzewska M, Kopera M. Interoception, alexithymia, and anxiety among individuals with alcohol use disorder. Front Psychiatry 2023; 14:1229985. [PMID: 37810600 PMCID: PMC10556496 DOI: 10.3389/fpsyt.2023.1229985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 09/11/2023] [Indexed: 10/10/2023] Open
Abstract
Background Interoception (i.e., the ability to recognize bodily signals), alexithymia (i.e., the inability to recognize emotional states) and negative affect (i.e., unpleasant feelings such as anxiety) have been associated with alcohol use disorder (AUD). Previous research suggests that interoception may underlie alexithymia, which in turn may be associated with negative affectivity. However, this remains to be empirically tested. This study investigates whether alexithymia mediates the association between interoception and anxiety and whether this association differs across individuals with AUD and a healthy control (HC) comparison group. Methods The AUD group consisted of 99 participants enrolled in an 8-week abstinence-based inpatient treatment program. The HC group included 103 healthy individuals. The heartbeat counting task (HCT) was used to assess interoception (cardiac interoceptive accuracy). The Toronto Alexithymia Scale (TAS-20) was used to assess alexithymia. The Brief Symptom Inventory (BSI) was used to assess anxiety. Results The moderated mediation model with interoception as the predictor, alexithymia as the mediator, and negative affect (i.e., state anxiety) as the dependent variable was tested. The analysis showed that the conditional indirect effect of interoception on anxiety via alexithymia was significant for individuals with AUD [ab = -0.300, bootstrap 95% CI = (-0.618, -0.088)], as well as for HCs [ab = -0.088, bootstrap 95% CI = (-0.195, -0.014)]; however, the conditional indirect effect significantly differed across HCs and individuals with AUD. Namely, the mediated effect was greater among individuals with AUD compared to the HC group. Conclusion The results suggests that interoceptive impairment contributes to greater negative affect (i.e., state anxiety) via alexithymia especially for individuals with AUD. Improving emotion recognition via therapeutic methods focused on strengthening interoceptive abilities could improve outcomes for individuals receiving treatment for AUD.
Collapse
Affiliation(s)
- Paweł Wiśniewski
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Andrzej Jakubczyk
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Elisa M. Trucco
- Department of Psychology, Center for Children and Families, Florida International University, Miami, FL, United States
- Department of Psychiatry, Addiction Center, University of Michigan, Ann Arbor, MI, United States
| | - Paweł Kobyliński
- Laboratory of Interactive Technologies, National Information Processing Institute, Warsaw, Poland
| | - Hubert Suszek
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - Justyna Zaorska
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | | | - Maciej Kopera
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| |
Collapse
|
2
|
Kulkarni KR, O'Brien M, Gu X. Longing to act: Bayesian inference as a framework for craving in behavioral addiction. Addict Behav 2023; 144:107752. [PMID: 37201396 DOI: 10.1016/j.addbeh.2023.107752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 05/08/2023] [Accepted: 05/10/2023] [Indexed: 05/20/2023]
Abstract
Traditionally, craving is considered a defining feature of drug addiction. Accumulating evidence suggests that craving can also exist in behavioral addictions (e.g., gambling disorder) without drug-induced effects. However, the degree to which mechanisms of craving overlap between classic substance use disorders and behavioral addictions remains unclear. There is, therefore, an urgent need to develop an overarching theory of craving that conceptually integrates findings across behavioral and drug addictions. In this review, we will first synthesize existing theories and empirical findings related to craving in both drug-dependent and -independent addictive disorders. Building on the Bayesian brain hypothesis and previous work on interoceptive inference, we will then propose a computational theory for craving in behavioral addiction, where the target of craving is execution of an action (e.g., gambling) rather than a drug. Specifically, we conceptualize craving in behavioral addiction as a subjective belief about physiological states of the body associated with action completion and is updated based on both a prior belief ("I need to act to feel good") and sensory evidence ("I cannot act"). We conclude by briefly discussing the therapeutic implications of this framework. In summary, this unified Bayesian computational framework for craving generalizes across addictive disorders, provides explanatory power for ostensibly conflicting empirical findings, and generates strong hypotheses for future empirical studies. The disambiguation of the computational components underlying domain-general craving using this framework will lead to a deeper understanding of, and effective treatment targets for, behavioral and drug addictions.
Collapse
Affiliation(s)
- Kaustubh R Kulkarni
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Center for Computational Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Madeline O'Brien
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Center for Computational Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Xiaosi Gu
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Center for Computational Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
| |
Collapse
|
3
|
Lyvers M, Thorberg FA. Alexithymia and Alcohol Use: Evaluating the Role of Interoceptive Sensibility with the Revised Multidimensional Assessment of Interoceptive Awareness. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2023:1-13. [PMID: 37361346 PMCID: PMC10072022 DOI: 10.1007/s10862-023-10034-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2023] [Indexed: 06/28/2023]
Abstract
Alexithymia has been linked to risky or problematic alcohol use, with a common interpretation invoking deficient emotion regulation and use of alcohol to cope with distress. An alternative explanation positing a general deficit of interoception in alexithymia suggested that poor awareness of internal cues of overconsumption may promote excessive drinking. The present study assessed predictions based on these hypotheses in 337 young adult alcohol users recruited online. Participants completed validated questionnaire indices of alcohol use, alexithymia, emotion regulation, interoceptive sensibility, and sensitivity to reward and punishment. Alcohol use was positively correlated with alexithymia and reward sensitivity, and negatively correlated with emotion regulation as expected, but was uncorrelated with interoceptive sensibility. Alexithymia was not significantly correlated with most dimensions of interoceptive sensibility but was highly negatively correlated with emotion regulation. Hierarchical regression controlling for demographic variables indicated that alexithymia, emotion regulation, sex, and sensitivity to reward and punishment were significant predictors of alcohol use levels. Bootstrapped mediation test controlling for all other variables indicated mediation of the association between alexithymia and alcohol use by deficient emotion regulation but not interoceptive sensibility. Results supported the emotion regulation deficit interpretation of the association of alexithymia with alcohol use. Limitations concerning interoception measurement, online samples, self-report measures, cross-sectional designs, and collection of data during the COVID-19 pandemic are discussed. Future research could follow up on these findings by testing interoceptive accuracy in addition to interoceptive sensibility in relation to alexithymia and alcohol use.
Collapse
|
4
|
Strigo IA, Murphy E, Mitchell JM, Spadoni AD. Learning from addiction: Craving of prescription opioids in chronic pain sufferers. Neurosci Biobehav Rev 2022; 142:104904. [PMID: 36202255 PMCID: PMC10917419 DOI: 10.1016/j.neubiorev.2022.104904] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 09/30/2022] [Accepted: 10/01/2022] [Indexed: 01/19/2023]
Abstract
Prescription opioids are a primary driver of opioid-related deaths. Although craving is a substantial component of OUD, the degree to which craving leads to misuse among chronic pain patients on long-term prescription opioids is unknown. A clear understanding of the factors that lead to misuse in this vulnerable population is needed for the development of safe and effective practices for opioid taper. This narrative review summarizes the relevant literature on the role of craving in addiction and chronic pain through epidemiological and behavioral studies. The first part of this review examines the role of craving in predicting opioid use/misuse in individuals with chronic pain with and without OUD. The second part covers methods on how craving is evaluated experimentally using both subjective and objective measures and provides related findings. The overall goal of this review is to facilitate the development of a population-specific description of craving in those who use opioids to control chronic pain and to describe how it may be mechanistically linked to patterns of opioid (mis)use.
Collapse
Affiliation(s)
- Irina A Strigo
- Emotion and Pain Laboratory, San Francisco Veterans Affairs Healthcare Center, 4150 Clement Street, San Francisco, CA 94121, USA; Department of Psychiatry, University of California San Francisco, 401 Parnassus Ave, San Francisco, CA 94143, USA.
| | - Emily Murphy
- Emotion and Pain Laboratory, San Francisco Veterans Affairs Healthcare Center, 4150 Clement Street, San Francisco, CA 94121, USA
| | - Jennifer M Mitchell
- Department of Psychiatry, University of California San Francisco, 401 Parnassus Ave, San Francisco, CA 94143, USA; Department of Neurology, University of California San Francisco, 401 Parnassus Ave, San Francisco, CA 94143, USA
| | - Andrea D Spadoni
- San Diego Veterans Affairs Healthcare Center, 3350 La Jolla Village Drive, San Diego, CA 92121, USA; Department of Psychiatry, University of California San Diego, San Diego, CA 92300, USA
| |
Collapse
|
5
|
Sönmez MB, Meriç IA, Sübay B, Görgülü Y. Relationship of Interoceptive Accuracy With Risky Decision-Making and Treatment Outcomes in Male Patients With Alcohol Use Disorder. J PSYCHOPHYSIOL 2022. [DOI: 10.1027/0269-8803/a000300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Lower levels of interoceptive awareness (IA) may be present in individuals with substance use disorder (SUD), and damage to related brain regions caused by substance use may disrupt IA. Disturbance in the bodily feedback system may fail to engage in effective decision-making. This study focused on the premise that interoceptive accuracy (IAc), as the primary construct of IA, is implicated in SUD and that poor IAc is linked to risky decision-making and adversely affects treatment outcomes. Eighty-five patients with alcohol use disorder (AUD) (current severity: moderate or severe) and 87 healthy control subjects were enrolled in the present study. All participants performed the heart rate tracking task and a computerized version of the Iowa gambling task (IGT). Characteristics of patients’ addiction profiles were assessed with the Addiction Profile Index (API) Clinical Form. IAc and IGT scores of patients with AUD were lower than healthy controls. IGT scores of patients with low IAc were lower than those of patients with high IAc and decreased IAc is predictive of decreased IGT scores. No significant differences were determined in treatment outcomes at 3, 6, and 12 months after hospitalization between the low-IAc and high-IAc patient groups. Our results suggest that IAc is implicated in AUD and that poor IAc is predictive of increased risky decision-making. Risky decision-making that results in substance use may be partly related to a deficit in the interoceptive ability to guide behavior. Focus on IAc without reference to complex clinical case presentations in AUD makes it difficult to draw any definitive conclusions about the role of IAc in clinical outcomes.
Collapse
Affiliation(s)
| | - Işıl Avcu Meriç
- Department of Psychiatry, School of Medicine, Trakya University, Edirne, Turkey
- Department of Psychiatry, Tekirdağ Dr. İsmail Fehmi Cumalioğlu City Hospital, Tekirdağ, Turkey
| | - Büşra Sübay
- Department of Psychiatry, School of Medicine, Trakya University, Edirne, Turkey
- Department of Psychiatry, Acıbadem Etiler Outpatient Clinic, Istanbul, Turkey
| | - Yasemin Görgülü
- Department of Psychiatry, School of Medicine, Trakya University, Edirne, Turkey
| |
Collapse
|
6
|
May AC, Davis C, Kirlic N, Stewart JL. Mindfulness-Based Interventions for the Treatment of Aberrant Interoceptive Processing in Substance Use Disorders. Brain Sci 2022; 12:brainsci12020279. [PMID: 35204042 PMCID: PMC8870441 DOI: 10.3390/brainsci12020279] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/04/2022] [Accepted: 02/09/2022] [Indexed: 12/24/2022] Open
Abstract
Altered interoception, or the processing of bodily signals, has been argued to play a role in the development and maintenance of substance use disorders (SUD). Therefore, interoceptive interventions focusing on bodily awareness, such as mindfulness meditation, may improve treatment outcomes for individuals with SUD. Here we review: (1) subjective, behavioral and brain evidence for altered interoceptive processing in SUD, focusing on insular and anterior cingulate cortices (INS, ACC), key regions for interoceptive processing; (2) research highlighting links between mindfulness and brain function; and (3) extant brain research investigating mindfulness-based interventions in SUD. SUD tend to be characterized by heightened INS and ACC responses to drug cues but blunted interoceptive awareness and attenuated INS and ACC responses during tasks involving bodily attention and/or perturbations. In contrast, mindfulness interventions in healthy individuals are linked to enhanced INS and ACC responses and heightened interoceptive awareness. It is crucial for future research to identify: (1) whether mindfulness-based treatments are efficacious across substance classes; (2) what particular approaches and dosages show the largest effect sizes in enhancing INS and ACC function to non-drug stimuli and reducing responsivity to substance cues, thereby improving SUD treatment outcomes (reducing drug craving and relapse).
Collapse
Affiliation(s)
- April C. May
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA 92037, USA
- Correspondence:
| | - Chrysantha Davis
- Laureate Institute for Brain Research, Tulsa, OK 74136, USA; (C.D.); (N.K.); (J.L.S.)
| | - Namik Kirlic
- Laureate Institute for Brain Research, Tulsa, OK 74136, USA; (C.D.); (N.K.); (J.L.S.)
| | - Jennifer L. Stewart
- Laureate Institute for Brain Research, Tulsa, OK 74136, USA; (C.D.); (N.K.); (J.L.S.)
- Department of Community Medicine, University of Tulsa, Tulsa, OK 74104, USA
| |
Collapse
|
7
|
Avcu Meriç I, Sönmez MB. Decision-making, interoceptive awareness and mindful attention awareness in male patients with alcohol use disorder. Cogn Neuropsychiatry 2022; 27:35-48. [PMID: 34874230 DOI: 10.1080/13546805.2021.2011183] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Decision-making deficits in individuals with alcohol use disorder (AUD) may be partly related to their decreased interoceptive awareness (IA), which is associated with some aspects of mindfulness. METHODS 52 abstinent male inpatients with AUD (current severity: moderate or severe) and 52 healthy male volunteers performed the heart rate tracking task and a computerised version of the Iowa gambling task (IGT). Trait mindfulness was evaluated with the mindful attention awareness scale (MAAS). RESULTS Heartbeat perception (HBP), MAAS, and IGT scores of patients with AUD were significantly lower than those of healthy controls. The difference between groups with respect to IGT scores did not remain significant after controlling for the covariates, and HBP scores were linked significantly to the subjects' IGT performance. HBP scores significantly predicted IGT scores of both the overall sample and patients. MAAS scores did not correlate significantly with HBP and IGT scores in either the patient or control group. CONCLUSION It is possible that IA plays a role in decision-making and decreased interoceptive accuracy is a predictor of impaired decision-making in individuals with AUD. More empirical data are needed to develop a better insight into the relationship between IA and multi-dimensional nature of mindfulness.
Collapse
Affiliation(s)
- Işıl Avcu Meriç
- Department of Psychiatry, School of Medicine, Trakya University, Edirne, Turkey
| | | |
Collapse
|
8
|
Wiśniewski P, Maurage P, Jakubczyk A, Trucco EM, Suszek H, Kopera M. Alcohol use and interoception - A narrative review. Prog Neuropsychopharmacol Biol Psychiatry 2021; 111:110397. [PMID: 34224795 PMCID: PMC8380667 DOI: 10.1016/j.pnpbp.2021.110397] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 05/31/2021] [Accepted: 06/29/2021] [Indexed: 01/29/2023]
Abstract
Interoception, defined as the ability to perceive and interpret body signals, may play an important role in alcohol use disorder (AUD). Earlier studies suggested an association between interoception impairment and known risk factors for AUD (e.g., alexithymia, emotion dysregulation, impulsivity, pain). Neurobiological studies show that the neurotoxicity of alcohol affects various elements of the interoceptive system (especially the insula) at structural and functional levels, with differential short/long term impacts. Conversely, primary interoceptive impairments may promote alcohol consumption and foster the evolution towards addiction. Despite convincing evidence demonstrating that interoception impairment may be an important contributor to the development and course of AUD, only a few studies directly evaluated interoceptive abilities in AUD. The research shows that interoceptive accuracy, the objective component of interoception, is lower in AUD individuals, and is correlated with craving and emotion dysregulation. Interoceptive sensibility is in turn higher in AUD individuals compared to healthy controls. Moreover, there is evidence that therapy focused on improving the ability to sense signals from the body in addiction treatment is effective. However, important methodological limitations in interoceptive measures persist, and it is therefore necessary to further investigate the associations between interoception and AUD.
Collapse
Affiliation(s)
- Paweł Wiśniewski
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland.
| | - Pierre Maurage
- Louvain Experimental Psychopathology research group (LEP), Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
| | - Andrzej Jakubczyk
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Elisa M Trucco
- Department of Psychology, Center for Children and Families, Florida International University, Miami, FL, USA; Department of Psychiatry, Addiction Center, University of Michigan, Ann Arbor, MI, USA
| | - Hubert Suszek
- Department of Psychology, University of Warsaw, Warsaw, Poland
| | - Maciej Kopera
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| |
Collapse
|
9
|
Interoception and alcohol: Mechanisms, networks, and implications. Neuropharmacology 2021; 200:108807. [PMID: 34562442 DOI: 10.1016/j.neuropharm.2021.108807] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 09/20/2021] [Accepted: 09/21/2021] [Indexed: 01/25/2023]
Abstract
Interoception refers to the perception of the internal state of the body and is increasingly being recognized as an important factor in mental health disorders. Drugs of abuse produce powerful interoceptive states that are upstream of behaviors that drive and influence drug intake, and addiction pathology is impacted by interoceptive processes. The goal of the present review is to discuss interoceptive processes related to alcohol. We will cover physiological responses to alcohol, how interoceptive states can impact drinking, and the recruitment of brain networks as informed by clinical research. We also review the molecular and brain circuitry mechanisms of alcohol interoceptive effects as informed by preclinical studies. Finally, we will discuss emerging treatments with consideration of interoception processes. As our understanding of the role of interoception in drug and alcohol use grows, we suggest that the convergence of information provided by clinical and preclinical studies will be increasingly important. Given the complexity of interoceptive processing and the multitude of brain regions involved, an overarching network-based framework can provide context for how focused manipulations modulate interoceptive processing as a whole. In turn, preclinical studies can systematically determine the roles of individual nodes and their molecular underpinnings in a given network, potentially suggesting new therapeutic targets and directions. As interoceptive processing drives and influences motivation, emotion, and subsequent behavior, consideration of interoception is important for our understanding of processes that drive ongoing drinking and relapse.
Collapse
|
10
|
Strohacker K, Keegan R, Beaumont CT, Zakrajsek RA. Applying P-Technique Factor Analysis to Explore Person-Specific Models of Readiness-to-Exercise. Front Sports Act Living 2021; 3:685813. [PMID: 34250469 PMCID: PMC8267010 DOI: 10.3389/fspor.2021.685813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 05/24/2021] [Indexed: 11/13/2022] Open
Abstract
Recent research in exercise prescription and periodization has emphasized the importance of subjective experience, both in medium- and long-term monitoring, but also in the acute experience. Emerging evidence also highlights an important role of subjective readiness (pre-exercise mental and physical states) in determining how exercise is experienced, and in acutely modifying the prescribed exercise intensity. The concept of "readiness-to-exercise" shows promise in enabling and informing this acute decision-making to optimize the experiences and outcomes of exercise. While subjective experiences can be effectively assessed using psychometric scales and instruments, these are often developed and deployed using cross-sectional samples, with resulting structures that reflect a normative pattern (nomothetic). These patterns may fail to reflect individual differences in sensitivity, experience and saliency (idiographic). We conducted this research with the primary aim of comparing the nomothetical and idiographic approaches to modeling the relatively novel concept of readiness-to-exercise. Study 1 (nomothetic) therefore analyzed data collected from 572 participants who completed a one-time survey using R-technique factor analysis. Results indicated a four-factor structure that explained 60% of the variance: "health and fitness;" "fatigue;" "vitality" and "physical discomfort." Study 2 (idiographic) included a sample of 29 participants who completed the scale multiple times, between 42 and 56 times: permitting intra-individual analysis using separate P-technique factor analyses. Our analyses suggested that many individuals displayed personal signature, or "profiles" of readiness-to-exercise that differed in structure from the nomothetic form: only two participants' personal signatures contained four structures as modeled in Study 1, whereas the majority demonstrated either two or three factors. These findings raise important questions about how experiential data should be collected and modeled, for use in research (conceptual development and measurement) and applied practice (prescribing, monitoring)-as well as in more applied research (implementation, effectiveness).
Collapse
Affiliation(s)
- Kelley Strohacker
- Kinesiology, Recreation, and Sport Studies, The University of Tennessee, Knoxville, Knoxville, TN, United States
| | - Richard Keegan
- Research Institute for Sport and Exercise Science, Faculty of Health, University of Canberra, Bruce, ACT, Australia
| | - Cory T Beaumont
- Kinesiology, Recreation, and Sport Studies, The University of Tennessee, Knoxville, Knoxville, TN, United States
| | - Rebecca A Zakrajsek
- Kinesiology, Recreation, and Sport Studies, The University of Tennessee, Knoxville, Knoxville, TN, United States
| |
Collapse
|
11
|
Sübay B, Sönmez MB. Interoceptive Awareness, Decision-Making and Impulsiveness in Male Patients with Alcohol or Opioid Use Disorder. Subst Use Misuse 2021; 56:1275-1283. [PMID: 33985408 DOI: 10.1080/10826084.2021.1914108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The present study was prepared on the assumption that interoceptive awareness (IA) and decision-making processes are implicated in addiction, and that somatic feedback plays an important role in decision-making. METHODS The study participants included 80 abstinent male inpatients with alcohol use disorder (n = 40) or opioid use disorder (n = 40) according to DSM-5 criteria (current severity: moderate or severe), along with 40 healthy male volunteers. All participants performed the heart rate tracking task as an objective physiological performance measure of IA and a computerized version of the Iowa gambling task (IGT) as a validated measure of decision-making. Impulsiveness was assessed using the Barratt Impulsiveness Scale 11 (BIS-11). Craving was evaluated with the Penn Alcohol Craving Scale (PACS) or Substance Craving Scale (SCS). RESULTS (1) Heartbeat perception (HBP) and IGT scores were similar between the patients with alcohol or opioid addiction, being significantly lower than those in the control group, and the difference remained significant even when controlling for the factors that were significant in bivariate analyses; (2) HBP scores of patients correlated significantly with IGT scores, even when controlling the effect of the related variables; (3) BIS-11 scores of patients negatively correlated significantly with HBP scores and did not correlate significantly with IGT scores; and (4) PACS/SCS scores did not correlate significantly with HBP and IGT scores. CONCLUSIONS Our findings support the hypothesis that IA and decision-making processes are implicated in addiction and that decreased IA is associated with impaired decision-making.
Collapse
Affiliation(s)
- Büşra Sübay
- School of Medicine, Department of Psychiatry, Trakya University, Edirne, Turkey
| | | |
Collapse
|
12
|
Bio-Behavioral Indices of Emotion Regulation: Potential Targets for Treatment in Addiction. CURRENT ADDICTION REPORTS 2020. [DOI: 10.1007/s40429-020-00330-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
13
|
Mollick JA, Kober H. Computational models of drug use and addiction: A review. JOURNAL OF ABNORMAL PSYCHOLOGY 2020; 129:544-555. [PMID: 32757599 PMCID: PMC7416739 DOI: 10.1037/abn0000503] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In this brief review, we describe current computational models of drug-use and addiction that fall into 2 broad categories: mathematically based models that rely on computational theories, and brain-based models that link computations to brain areas or circuits. Across categories, many are models of learning and decision-making, which may be compromised in addiction. Several mathematical models take predictive coding approaches, focusing on Bayesian prediction error. Other models focus on learning processes and (traditional) prediction error. Brain-based models have incorporated prefrontal cortex, basal ganglia, and the dopamine system, based on the effects of drugs on dopamine, motivation, and executive control circuits. Several models specifically describe how behavioral control may transition from habitual to goal-directed systems, consistent with computational accounts of compromised "model-based" control. Some brain-based models have linked this to the transition of behavioral control from ventral to dorsal striatum. Overall, we propose that while computational models capture some aspects of addiction and have advanced our thinking, most have focused on the effects of drug use rather than addiction per se, most have not been tested on and/or supported by human data, and few capture multiple stages and symptoms of addiction. We conclude by suggesting a path forward for computational models of addiction. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Collapse
Affiliation(s)
- Jessica A Mollick
- Clinical and Affective Neuroscience Lab, Department of Psychiatry, Yale University
| | - Hedy Kober
- Clinical and Affective Neuroscience Lab, Department of Psychiatry, Yale University
| |
Collapse
|
14
|
Reduction of auditory input improves performance on the heartbeat tracking task, but does not necessarily enhance interoception. Exp Brain Res 2020; 238:621-629. [PMID: 32016483 DOI: 10.1007/s00221-020-05740-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 01/23/2020] [Indexed: 10/25/2022]
Abstract
Previous research utilising a between-subjects design has indicated that the use of noise-dampening ear protectors might enhance interoceptive accuracy (IAcc). In the present study, we further examined this effect using a repeated-measures, within-participants design, and investigated potential mechanisms that might explain the effect. 50 participants completed the heartbeat tracking task (HTT) with and without the use of industrial ear protectors, in a counter-balanced order. Participants were asked to count the number of heartbeats occurring in five discrete time intervals of 25, 35, 45, 55 and 95 s, without feeling for a manual pulse. HTT scores were significantly higher when ear protectors were worn, and the improvement in performance was greatest for participants with lower baseline IAcc. The ear protectors were associated with significantly increased self-reported heartbeat audibility, task-related confidence and concentration, and decreased levels of distractibility. Heartbeat audibility was also correlated with HTT performance when the ear protectors were worn. Because the use of industrial ear defenders resulted in increased heartbeat audibility, this manipulation should not be used to assess causal hypotheses related to changes in IAcc. However, it may serve as a simple, non-invasive manipulation to assess the effects of 'externalised' interoceptive signals.
Collapse
|
15
|
Herman AM, Duka T. The Role of Impulsivity Facets on the Incidence and Development of Alcohol Use Disorders. Curr Top Behav Neurosci 2020; 47:197-221. [PMID: 32474898 DOI: 10.1007/7854_2020_137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Alcohol Use Disorder (AUD) is a chronic relapsing disorder defined according to the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5; American Psychiatric Association 2013), "by a cluster of behavioural and physical symptoms, which can include, withdrawal, tolerance and craving". Social, emotional, behavioural and cognitive factors are important contributors to AUD. Impulsivity, a multifaceted behavioural concept, defined as a predisposition for rapid and unplanned actions, without considering potential negative consequences of these actions, represents an important such factor. In this chapter, research on the role of distinct impulsivity dimensions in different severity stages of alcohol use is presented.Increased self-reported (trait) impulsivity and an inability to wait, as well as difficulty to adjust behaviour appropriately following a failure to withhold a response are observed across the spectrum of alcohol-use severities. Research on temporal impulsivity (inability to delay gratification) consistently shows deficits in more severe alcohol users. Data on temporal impulsivity in early stages of alcohol use are less consistent, with some studies showing no differences between high and moderate drinkers, while others indicating increased impulsivity in high alcohol users. Data on reflexion impulsivity are currently limited to draw conclusions. Recent research is also presented suggesting the importance of perception and interpretation of physiological and emotional signals on alcohol use behaviour highlighting the necessity of comprehensive integration of the field of the study of emotion and interoception with impulsivity research.
Collapse
Affiliation(s)
- Aleksandra M Herman
- Department of Psychology, Royal Holloway, University of London, Egham, UK.,School of Psychology, University of Sussex, Falmer, UK.,Sussex Addiction Research and Intervention Centre, University of Sussex, Falmer, UK
| | - Theodora Duka
- School of Psychology, University of Sussex, Falmer, UK. .,Sussex Addiction Research and Intervention Centre, University of Sussex, Falmer, UK.
| |
Collapse
|
16
|
de la Fuente A, Sedeño L, Vignaga SS, Ellmann C, Sonzogni S, Belluscio L, García-Cordero I, Castagnaro E, Boano M, Cetkovich M, Torralva T, Cánepa ET, Tagliazucchi E, Garcia AM, Ibañez A. Multimodal neurocognitive markers of interoceptive tuning in smoked cocaine. Neuropsychopharmacology 2019; 44:1425-1434. [PMID: 30867552 PMCID: PMC6784987 DOI: 10.1038/s41386-019-0370-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 02/22/2019] [Accepted: 03/02/2019] [Indexed: 12/21/2022]
Abstract
Contemporary neurocognitive models of drug addiction have associated this condition with changes in interoception -namely, the sensing and processing of body signals that fulfill homeostatic functions relevant for the onset and maintenance of addictive behavior. However, most previous evidence is inconsistent, behaviorally unspecific, and virtually null in terms of direct electrophysiological and multimodal markers. To circumvent these limitations, we conducted the first assessment of the relation between cardiac interoception and smoked cocaine dependence (SCD) in a sample of (a) 25 participants who fulfilled criteria for dependence on such a drug, (b) 22 participants addicted to insufflated clorhidrate cocaine (only for behavioral assessment), and (c) 25 healthy controls matched by age, gender, education, and socioeconomic status. We use a validated heartbeat-detection (HBD) task and measured modulations of the heart-evoked potential (HEP) during interoceptive accuracy and interoceptive learning conditions. We complemented this behavioral and electrophysiological data with offline structural (MRI) and functional connectivity (fMRI) analysis of the main interoceptive hubs. HBD and HEP results convergently showed that SCD subjects presented ongoing psychophysiological measures of enhanced interoceptive accuracy. This pattern was associated with a structural and functional tuning of interoceptive networks (reduced volume and specialized network segregation). Taken together, our findings provide the first evidence of an association between cardiac interoception and smoked cocaine, partially supporting models that propose hyper-interoception as a key aspect of addiction. More generally, our study shows that multimodal assessments of interoception could substantially inform the clinical and neurocognitive characterization of psychophysiological and neurocognitive adaptations triggered by addiction.
Collapse
Affiliation(s)
- Alethia de la Fuente
- 0000 0004 0608 3193grid.411168.bInstitute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina ,0000 0001 1945 2152grid.423606.5National Scientific and Technical Research Council, Buenos Aires, Argentina
| | - Lucas Sedeño
- 0000 0004 0608 3193grid.411168.bInstitute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina ,0000 0001 1945 2152grid.423606.5National Scientific and Technical Research Council, Buenos Aires, Argentina
| | - Sofia Schurmann Vignaga
- 0000 0004 0608 3193grid.411168.bInstitute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | - Camila Ellmann
- 0000 0004 0608 3193grid.411168.bInstitute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | - Silvina Sonzogni
- 0000 0001 1945 2152grid.423606.5National Scientific and Technical Research Council, Buenos Aires, Argentina ,0000 0001 1945 2152grid.423606.5Laboratorio de Neuroepigenética, Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires e IQUIBICEN, CONICET, Buenos Aires, Argentina
| | - Laura Belluscio
- 0000 0001 1945 2152grid.423606.5National Scientific and Technical Research Council, Buenos Aires, Argentina ,0000 0001 1945 2152grid.423606.5Laboratorio de Neuroepigenética, Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires e IQUIBICEN, CONICET, Buenos Aires, Argentina
| | - Indira García-Cordero
- 0000 0004 0608 3193grid.411168.bInstitute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina ,0000 0001 1945 2152grid.423606.5National Scientific and Technical Research Council, Buenos Aires, Argentina
| | - Eugenia Castagnaro
- 0000 0004 0608 3193grid.411168.bInstitute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | - Magdalena Boano
- 0000 0004 0608 3193grid.411168.bInstitute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | - Marcelo Cetkovich
- 0000 0004 0608 3193grid.411168.bInstitute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | - Teresa Torralva
- 0000 0004 0608 3193grid.411168.bInstitute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | - Eduardo T. Cánepa
- 0000 0001 1945 2152grid.423606.5National Scientific and Technical Research Council, Buenos Aires, Argentina ,0000 0001 1945 2152grid.423606.5Laboratorio de Neuroepigenética, Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires e IQUIBICEN, CONICET, Buenos Aires, Argentina
| | - Enzo Tagliazucchi
- 0000 0001 1945 2152grid.423606.5National Scientific and Technical Research Council, Buenos Aires, Argentina ,0000 0001 0056 1981grid.7345.5Buenos Aires Physics Institute (IFIBA) and Physics Department, University of Buenos Aires, Buenos Aires, Argentina
| | - Adolfo M. Garcia
- 0000 0004 0608 3193grid.411168.bInstitute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina ,0000 0001 1945 2152grid.423606.5National Scientific and Technical Research Council, Buenos Aires, Argentina ,0000 0001 2185 5065grid.412108.eFaculty of Education, National University of Cuyo (UNCuyo), Mendoza, M5502JMA Argentina
| | - Agustín Ibañez
- Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina. .,National Scientific and Technical Research Council, Buenos Aires, Argentina. .,Universidad Autónoma del Caribe, Barranquilla, Colombia. .,Center for Social and Cognitive Neuroscience, School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile. .,Australian Research Council, Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, NSW, Australia.
| |
Collapse
|
17
|
Leganes-Fonteneau M, Cheang Y, Lam Y, Garfinkel S, Duka T. Interoceptive awareness is associated with acute alcohol-induced changes in subjective effects. Pharmacol Biochem Behav 2019; 181:69-76. [DOI: 10.1016/j.pbb.2019.03.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 03/11/2019] [Accepted: 03/25/2019] [Indexed: 12/25/2022]
|
18
|
Betka S, Harris L, Rae C, Palfi B, Pfeifer G, Sequeira H, Duka T, Critchley H. Signatures of alcohol use in the structure and neurochemistry of insular cortex: a correlational study. Psychopharmacology (Berl) 2019; 236:2579-2591. [PMID: 31011757 PMCID: PMC6695346 DOI: 10.1007/s00213-019-05228-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 03/18/2019] [Indexed: 12/16/2022]
Abstract
RATIONALE Insular cortex supports the representation of motivational feelings through the integration of interoceptive information concerning bodily physiology. Compromised insular integrity is implicated in alcohol and drug use disorders. Alcohol-associated insular dysfunction may arise through aberrant glutamatergic neurotransmission associated with selective neuronal death and atrophy. OBJECTIVE In a sample of alcohol users, we combined magnetic resonance spectroscopy (MRS) with voxel and surface-based morphometry (VBM, SBM) to test the hypothesis that the neurochemical and structural properties of the insula relate to alcohol use. METHODS Twenty-three healthy individuals were characterized by measures of alcohol use and subjective craving. Right mid-insula glutamate/glutamine (Glx) and total N-acetylaspartate/N-acetyl-aspartylglutamate (TNAA) concentrations were measured using MRS. Right insular structure was quantified using VBM and SBM parameters. We tested for predictive associations between these neuroimaging and behavioral/psychometric measures using Bayesian statistics. RESULTS Reduced insular Glx concentration was associated with increased alcohol compulsions and, to a lesser extent, with greater alcohol use severity. Anecdotal evidence for a negative relationship between alcohol use severity and levels of insular gyrification was also observed. CONCLUSIONS This study is, to date, the first characterization of the neurochemical and morphological integrity of insular cortex in alcohol users. Our data seem to reveal a negative relationship between alcohol use and the neurochemical and structural integrity of the insula, a critical substrate for motivational behavior. These neurobiological characteristics might contribute to loss of control toward compulsive drinking with prolonged and excessive alcohol use.
Collapse
Affiliation(s)
- Sophie Betka
- Trafford Centre, Brighton and Sussex Medical School, Clinical Imaging Science Centre, Brighton, BN1 9RY, UK.
- Behavioural and Clinical Neuroscience, School of Psychology, University of Sussex, Brighton, BN1 9QH, UK.
- University of Lille, SCALab, CNRS UMR 9193, 59045, Lille, France.
| | - Lisa Harris
- Radiological Science, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - Charlotte Rae
- Trafford Centre, Brighton and Sussex Medical School, Clinical Imaging Science Centre, Brighton, BN1 9RY, UK
- Sackler Centre for Consciousness Science, University of Sussex, Brighton, UK
| | - Bence Palfi
- Sackler Centre for Consciousness Science, University of Sussex, Brighton, UK
- School of Psychology, University of Sussex, Brighton, UK
| | - Gaby Pfeifer
- Trafford Centre, Brighton and Sussex Medical School, Clinical Imaging Science Centre, Brighton, BN1 9RY, UK
| | | | - Theodora Duka
- Behavioural and Clinical Neuroscience, School of Psychology, University of Sussex, Brighton, BN1 9QH, UK
- Sussex Addiction Research and Intervention Centre (SARIC), University of Sussex, Brighton, UK
| | - Hugo Critchley
- Trafford Centre, Brighton and Sussex Medical School, Clinical Imaging Science Centre, Brighton, BN1 9RY, UK
- Sackler Centre for Consciousness Science, University of Sussex, Brighton, UK
| |
Collapse
|
19
|
Rochat L, Maurage P, Heeren A, Billieux J. Let's Open the Decision-Making Umbrella: A Framework for Conceptualizing and Assessing Features of Impaired Decision Making in Addiction. Neuropsychol Rev 2018; 29:27-51. [PMID: 30293096 DOI: 10.1007/s11065-018-9387-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Accepted: 09/21/2018] [Indexed: 12/17/2022]
Abstract
Decision-making impairments play a pivotal role in the emergence and maintenance of addictive disorders. However, a sound conceptualization of decision making as an umbrella construct, encompassing its cognitive, affective, motivational, and physiological subcomponents, is still lacking. This prevents an efficient evaluation of the heterogeneity of decision-making impairments and the development of tailored treatment. This paper thus unfolds the various processes involved in decision making by adopting a critical approach of prominent dual- or triadic-process models, which postulate that decision making is influenced by the interplay of impulsive-automatic, reflective-controlled, and interoceptive processes. Our approach also focuses on social cognition processes, which play a crucial role in decision making and addictive disorders but were largely ignored in previous dual- or triadic-process models. We propose here a theoretical framework in which a range of coordinated processes are first identified on the basis of their theoretical and clinical relevance. Each selected process is then defined before reviewing available results underlining its role in addictive disorders (i.e., substance use, gambling, and gaming disorders). Laboratory tasks for measuring each process are also proposed, initiating a preliminary process-based decision-making assessment battery. This original approach may offer an especially informative view of the constitutive features of decision-making impairments in addiction. As prior research has implicated these features as risk factors for the development and maintenance of addictive disorders, our processual approach sets the scene for novel and transdiagnostic experimental and applied research avenues.
Collapse
Affiliation(s)
- Lucien Rochat
- Cognitive Psychopathology and Neuropsychology Unit, Department of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Pierre Maurage
- Laboratory for Experimental Psychopathology, Psychological Science Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
- Clinical Neuroscience Division, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - Alexandre Heeren
- Laboratory for Experimental Psychopathology, Psychological Science Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
- Clinical Neuroscience Division, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - Joël Billieux
- Addictive and Compulsive Behaviours Lab (ACB-Lab), Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg.
- Centre for Excessive Gambling, Lausanne University Hospitals (CHUV), Lausanne, Switzerland.
- Addiction Division, Department of Mental Health and Psychiatry, University Hospitals of Geneva, Geneva, Switzerland.
| |
Collapse
|
20
|
Betka S, Gould Van Praag C, Paloyelis Y, Bond R, Pfeifer G, Sequeira H, Duka T, Critchley H. Impact of intranasal oxytocin on interoceptive accuracy in alcohol users: an attentional mechanism? Soc Cogn Affect Neurosci 2018; 13:440-448. [PMID: 29618101 PMCID: PMC5928407 DOI: 10.1093/scan/nsy027] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 02/16/2018] [Accepted: 03/19/2018] [Indexed: 02/07/2023] Open
Abstract
Interoception, i.e. the perception and appraisal of internal bodily signals, is related to the phenomenon of craving, and is reportedly disrupted in alcohol use disorders. The hormone oxytocin influences afferent transmission of bodily signals and, through its potential modulation of craving, is proposed as a possible treatment for alcohol use disorders. However, oxytocin's impact on interoception in alcohol users remains unknown. Healthy alcohol users (n = 32) attended two laboratory sessions to perform tests of interoceptive ability (heartbeat tracking: attending to internal signals and, heartbeat discrimination: integrating internal and external signals) after intranasal administration of oxytocin or placebo. Effects of interoceptive accuracy, oxytocin administration and alcohol intake, were tested using mixed-effects models. On the tracking task, oxytocin reduced interoceptive accuracy, but did not interact with alcohol consumption. On the discrimination task, we found an interaction between oxytocin administration and alcohol intake: Oxytocin, compared with placebo, increased interoceptive accuracy in heavy drinkers, but not in light social drinkers. Our study does not suggest a pure interoceptive impairment in alcohol users but instead potentially highlights reduced flexibility of internal and external attentional resource allocation. Importantly, this impairment seems to be mitigated by oxytocin. This attentional hypothesis needs to be explicitly tested in future research.
Collapse
Affiliation(s)
- Sophie Betka
- Clinical Imaging Science Centre, Brighton and Sussex Medical School, Brighton BN1 9RY, UK
- Psychology Department, University of Sussex, Brighton BN1 9RR, UK
- SCALab, CNRS UMR 9193, University of Lille, Lille 59045, France
| | | | - Yannis Paloyelis
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
| | - Rod Bond
- Psychology Department, University of Sussex, Brighton BN1 9RR, UK
| | - Gaby Pfeifer
- Clinical Imaging Science Centre, Brighton and Sussex Medical School, Brighton BN1 9RY, UK
| | | | - Theodora Duka
- Psychology Department, University of Sussex, Brighton BN1 9RR, UK
- Sussex Addiction Research and Intervention Centre (SARIC), University of Sussex, BN1 9RR, UK
| | - Hugo Critchley
- Clinical Imaging Science Centre, Brighton and Sussex Medical School, Brighton BN1 9RY, UK
- Sackler Centre for Consciousness Science, University of Sussex, BN1 9QJ, UK
| |
Collapse
|
21
|
Vergara VM, Weiland BJ, Hutchison KE, Calhoun VD. The Impact of Combinations of Alcohol, Nicotine, and Cannabis on Dynamic Brain Connectivity. Neuropsychopharmacology 2018; 43:877-890. [PMID: 29134961 PMCID: PMC5809800 DOI: 10.1038/npp.2017.280] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 10/07/2017] [Accepted: 11/02/2017] [Indexed: 01/05/2023]
Abstract
Alcohol, nicotine, and cannabis are among the most commonly used drugs. A prolonged and combined use of these substances can alter normal brain wiring in different ways depending on the consumed cocktail mixture. Brain connectivity alterations and their change with time can be assessed using functional magnetic resonance imaging (fMRI) because of its spatial and temporal content. Here, we estimated dynamic functional network connectivity (dFNC) as derived from fMRI data to investigate the effects of single or combined use of alcohol, nicotine, and cannabis. Data from 534 samples were grouped according to their substance use combination as controls (CTR), smokers (SMK), drinkers (DRN), smoking-and-drinking subjects (SAD), marijuana users (MAR), smoking-and-marijuana users (SAM), marijuana-and-drinking users (MAD), and users of all three substances (ALL). The DRN group tends to exhibit decreased connectivity mainly in areas of sensorial and motor control, a result supported by the dFNC outcome and the alcohol use disorder identification test. This trend dominated the SAD group and in a weaker manner MAD and ALL. Nicotine consumers were characterized by an increment of connectivity between dorsal striatum and sensorimotor areas. Where possible, common and separate effects were identified and characterized by the analysis of dFNC data. Results also suggest that a combination of cannabis and nicotine have more contrasting effects on the brain than a single use of any of these substances. On the other hand, marijuana and alcohol might follow an additive effect trend. We concluded that all of the substances have an impact on brain connectivity, but the effect differs depending on the dFNC state analyzed.
Collapse
Affiliation(s)
- Victor M Vergara
- The Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA,The Mind Research Network, Lovelace Biomedical and Environmental Research Institute, 1101 Yale Boulevard, Albuquerque, NM 87106, USA, Tel: +1 505 272 5028, Fax: +1 505 272 8002, E-mail:
| | - Barbara J Weiland
- Departments of Psychology and Neuroscience, University of Colorado, Boulder, CO, USA
| | - Kent E Hutchison
- Departments of Psychology and Neuroscience, University of Colorado, Boulder, CO, USA
| | - Vince D Calhoun
- The Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA
| |
Collapse
|
22
|
Betka S, Pfeifer G, Garfinkel S, Prins H, Bond R, Sequeira H, Duka T, Critchley H. How Do Self-Assessment of Alexithymia and Sensitivity to Bodily Sensations Relate to Alcohol Consumption? Alcohol Clin Exp Res 2017; 42:81-88. [DOI: 10.1111/acer.13542] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 10/25/2017] [Indexed: 12/21/2022]
Affiliation(s)
- Sophie Betka
- Brighton and Sussex Medical School; Clinical Imaging Science Centre; Brighton United Kingdom
- Behavioural and Clinical Neuroscience; School of Psychology; University of Sussex; Brighton United Kingdom
- SCALab; CNRS UMR 9193; University of Lille; Lille France
| | - Gaby Pfeifer
- Brighton and Sussex Medical School; Clinical Imaging Science Centre; Brighton United Kingdom
| | - Sarah Garfinkel
- Brighton and Sussex Medical School; Clinical Imaging Science Centre; Brighton United Kingdom
- Sackler Centre for Consciousness Science; University of Sussex; Brighton United Kingdom
| | - Hielke Prins
- Brighton and Sussex Medical School; Clinical Imaging Science Centre; Brighton United Kingdom
- Sackler Centre for Consciousness Science; University of Sussex; Brighton United Kingdom
| | - Rod Bond
- Behavioural and Clinical Neuroscience; School of Psychology; University of Sussex; Brighton United Kingdom
| | | | - Theodora Duka
- Behavioural and Clinical Neuroscience; School of Psychology; University of Sussex; Brighton United Kingdom
| | - Hugo Critchley
- Brighton and Sussex Medical School; Clinical Imaging Science Centre; Brighton United Kingdom
- Sackler Centre for Consciousness Science; University of Sussex; Brighton United Kingdom
| |
Collapse
|
23
|
Vergara VM, Liu J, Claus ED, Hutchison K, Calhoun V. Alterations of resting state functional network connectivity in the brain of nicotine and alcohol users. Neuroimage 2017; 151:45-54. [PMID: 27864080 PMCID: PMC5420342 DOI: 10.1016/j.neuroimage.2016.11.012] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 07/17/2016] [Accepted: 11/08/2016] [Indexed: 12/29/2022] Open
Abstract
Alcohol and nicotine intake result in neurological alterations at the circuit level. Resting state functional connectivity has shown great potential in identifying these alterations. However, current studies focus on specific seeds and leave out many brain regions where effects might exist. The present study uses a data driven technique for brain segmentation covering the whole brain. Functional magnetic-resonance-imaging (fMRI) data were collected from 188 subjects:51 non-substance consumption controls (CTR), 36 smoking-and-drinking subjects (SAD), 28 drinkers (DRN), and 73 smokers (SMK). Data were processed using group independent component analysis to derive resting state networks (RSN). The resting state functional network connectivity (rsFNC) was then calculated through correlation between time courses. One-way ANOVA tests were used to detect rsFNC differences among the four groups. A total of 50 ANOVA tests were significant after multi-comparison correction. Results delineate a general pattern of hypo-connectivity in the substance consumers. Precuneus, postcentral gyrus, insula and visual cortex were the main brain areas with rsFNC reduction suggesting reduced interoceptive awareness in drinkers. In addition, connectivity reduction between postcentral and one RSN covering right fusiform and lingual gyri showed significant association with severity of hazardous drinking. In smokers, connectivity changes agreed with the idea of a shift towards endogenous information processing, represented by the DMN. Hypo-connectivity between thalamus and putamen was observed in smokers. In contrast, the angular gyrus showed hyper-connectivity with the precuneus linked to smoking and significantly correlated with nicotine dependence severity. In spite of the presence of common effects, our results suggest that particular effects of alcohol and nicotine can be separated and identified. Results also suggest that concurrent use of both substances affects brain connectivity in a complex manner, requiring careful consideration of interaction effects.
Collapse
Affiliation(s)
- Victor M Vergara
- The Mind Research Network and Lovelace Biomedical and Environmental Research Institute, 1101 Yale Blvd. NE, Albuquerque, NM 87106, USA.
| | - Jingyu Liu
- The Mind Research Network and Lovelace Biomedical and Environmental Research Institute, 1101 Yale Blvd. NE, Albuquerque, NM 87106, USA
| | - Eric D Claus
- The Mind Research Network and Lovelace Biomedical and Environmental Research Institute, 1101 Yale Blvd. NE, Albuquerque, NM 87106, USA
| | - Kent Hutchison
- Department of Psychology and Neuroscience, University of Colorado, Boulder, CO 80302, USA
| | - Vince Calhoun
- The Mind Research Network and Lovelace Biomedical and Environmental Research Institute, 1101 Yale Blvd. NE, Albuquerque, NM 87106, USA
| |
Collapse
|
24
|
Sönmez MB, Kahyacı Kılıç E, Ateş Çöl I, Görgülü Y, Köse Çınar R. Decreased interoceptive awareness in patients with substance use disorders. JOURNAL OF SUBSTANCE USE 2016. [DOI: 10.3109/14659891.2016.1143048] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | - Evnur Kahyacı Kılıç
- Department of Psychiatry, Trakya University, School of Medicine, Edirne, Turkey
| | - Işıl Ateş Çöl
- Department of Psychiatry, İnegöl State Hospital, İnegöl, Turkey
| | - Yasemin Görgülü
- Department of Psychiatry, Trakya University, School of Medicine, Edirne, Turkey
| | - Rugul Köse Çınar
- Department of Psychiatry, Trakya University, School of Medicine, Edirne, Turkey
| |
Collapse
|