Theodora Duka

University of Sussex · School of Psychology

Purpose Dependent alcohol use is a severe addictive disorder with significant enduring consequences for health and social functioning. This study aims to inductively explore the process of identity change for alcohol dependent people progressing through a “pre-habilitation” intervention, alcohol detoxification and post-detoxification recovery suppo...

This study investigated how different mood states affect distinct subtypes of impulsivity: motor impulsivity [measured with the Stop Signal (SST) and the 5-Choice Serial Reaction Time Task (5-CSRTT)], reflection impulsivity [assessed with the Information Sampling Task (IST)], and temporal impulsivity (the Delay Discounting Questionnaire). Eighty he...

Background Individuals who are ‘moderately’ or ‘severely’ dependent consume alcohol at levels that are likely to have a severe impact on their own health and mortality, the health and behaviours of others (family members) and to have economic and social implications. Treatment guidelines suggest that treatment needs to be planned with medically ass...

Research on implicit processes has revealed problems with awareness categorizations based on nonsignificant results. Moreover, post hoc categorizations result in regression to the mean (RTM), by which aware participants are wrongly categorized as unaware. Using Bayes factors to obtain sensitive evidence for participants’ lack of knowledge may deal...

Binge drinking is a widespread alcohol consumption pattern commonly engaged by youth. Here, we present the first systematic review focusing on emotional processes related to binge drinking. Capitalizing on a theoretical model describing three emotional processing steps (emotional appraisal/identification, emotional response, emotional regulation) a...

Literature on implicit Pavlovian conditioning has generated a long-standing debate, and evidence for implicit aversive learning effects has often been criticized for its lack of experimental rigor and statistical reliability. We set out to investigate whether attentional emotional responses to aversive conditioned stimuli can occur implicitly. Acro...

Background Opioid-related deaths are at record levels in the UK and contribute to over half of all drug-related deaths. The prevalence of psychiatric disorders within people who uses substances is known to be considerably higher than the general population, yet only 4% of people accessing treatment are thought to receive integrated care for coexist...

Fear is coupled to states of physiological arousal. We tested how learning and memory of threat, specifically conditioned fear, is influenced by interoceptive signals. Forty healthy individuals were exposed to two threat (conditioned stimuli [CS+], paired with electrocutaneous shocks) and two safety (CS-) stimuli, time-locked to either cardiac vent...

Research on implicit processes has revealed problems with awareness categorizations based on non-significant results. Moreover, post-hoc categorizations result in regression to the mean (RTM), by which aware participants are wrongly categorized as unaware. Using Bayes factors to obtain sensitive evidence for participants’ lack of knowledge may deal...

Research on implicit processes has revealed problems with awareness categorizations based on non-significant results. Moreover, post-hoc categorizations result in regression to the mean (RTM), by which aware participants are wrongly categorized as unaware. Using Bayes factors to obtain sensitive evidence for participants’ lack of knowledge may deal...

Introduction The relevance of both emotion processing and impulsivity to alcohol use and misuse is increasingly recognised, yet there is a scarcity of studies addressing their reciprocal interaction. The present study aimed to examine the role that difficulties in emotion processing and trait impulsivity play in explaining binge drinking pattern of...

RationalThe ability of conditioned stimuli to affect instrumental responding is a robust finding from animal as well as human research and is assumed as a key factor regarding the development and maintenance of addictive behaviour.Objectives While it is well known that stress is an important factor for relapse after treatment, little is known about...

Knowledge of brain mechanisms underlying self-regulation can provide valuable insights into how people regulate their thoughts, behaviors, and emotional states, and what happens when such regulation fails. Self-regulation is supported by coordinated interactions of brain systems. Hence, behavioral dysregulation, and its expression as impulsivity, c...

Individuals who engage in binge drinking behaviors may show evidence of impaired cognitive function and emotional dysregulation. Impaired empathy, characterized by a reduced ability to understand and respond appropriately to feelings of others, is increasingly recognized for its role in Alcohol Use Disorders (AUD). The present study examined a popu...

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 ar...

Background Individuals who are ‘moderately’ or ‘severely’ dependent consume alcohol at levels that are likely to have a severe impact on their own health and mortality, the health and behaviours of others (family members), and to have economic and social implications. Treatment guidelines suggest that treatment needs to be planned with medically as...

Rationale Gambling and alcohol use are recreational behaviours that share substantial commonalities at a phenomenological, clinical and neurobiological level. Past studies have shown that alcohol can have a disinhibiting effect on gambling behaviour, in terms of bet size and persistence. Objectives This study was conducted in order to characterise...

Fear is coupled to states of physiological arousal. We tested how learning and memory of threat, i.e. conditioned fear, is influenced by interoceptive signals. Forty healthy individuals were exposed to two threat (CS+, paired with electrocutaneous shocks) and two safety (CS-) stimuli, specifically time-locked to either cardiac ventricular systole (...

Alcohol misuse is a major public concern. Impulsivity has been recognised as a significant risk factor predisposing for the initiation of alcohol use, continuation and excessive alcohol use. Evidence suggests that impulsivity is also a result of both acute alcohol intoxication and long-term alcohol abuse. The multifaceted character of impulsivity a...

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 w...

Binge drinking is associated with increased impulsivity and altered emotional processing. The current study investigated, in a group of university students who differed in their level of binge drinking, whether the ability to inhibit a pre‐potent response and to delay gratification is disrupted in the presence of emotional context. We further teste...

Environmental stimuli, when paired with reward, can influence behaviour in maladaptive ways, for example, by encouraging overeating or addiction. Such behaviour can be sensitive to reward value manipulations, under circumscribed conditions, but whether reward-seeking is also sensitive to stimulus value manipulations remains unclear. Thus, the curre...

Even at low to moderate doses, ingestion of the widely used recreational drug alcohol (ethanol) can impact cognitive and emotional processing. Recent studies show that the sense of agency (SoA; ie, the subjective experience of voluntary control over actions) can be modulated by specific pharmacological manipulations. The SoA, as quantified by the i...

Background The U.S. National Institutes of Mental Health Research Domain Criteria (RDoC) seek to stimulate research into biologically validated neuropsychological dimensions across mental illness symptoms and diagnoses. The RDoC framework comprises 39 functional constructs designed to be revised and refined, with the overall goal to improve diagnos...

Rationale State-dependent changes in physiological arousal may influence impulsive behaviours. Objectives To examine the relationship between arousal and impulsivity, we assessed the effects of yohimbine (an α2-adrenergic receptor antagonist, which increases physiological arousal via noradrenaline release) on performance on established laboratory-...

In this review paper, we discuss how the overarching concept of prehabilitation is applicable to alcohol dependence. Central to prehabilitation are the concepts of expected harm, risks, and proactive planning to eliminate the harm or cope with the risks. We review the evidence from animal models, psychological experimental studies, as well as pharm...

Interoception, the sensing of bodily signals, is related to emotional reactivity and may contribute to the pathophysiology of addiction. Evidence is accumulating that individuals with alcohol use disorders and other substance-dependences show altered interoceptive processing, however little is known about the acute effects of alcohol on interocepti...

Background Alcohol-related harm is currently estimated to cost the National Health Service (NHS) in England £3.5 bn a year. Of the estimated 1.6 million people with some degree of alcohol dependence, some 600,000 are believed to be moderately or severely dependent and may benefit from intensive treatment. Outcomes from medically assisted withdrawal...

Stimuli conditioned with a substance can generate drug-approach behaviors due to their acquired motivational properties. According to implicit theories of addiction, these stimuli can decrease cognitive control automatically. The present study (n = 49) examined whether reward-associated stimuli can interfere with cognitive processes in the absence...

The aim of the present study was to investigate spontaneous recovery of reward-expectancies and a reward-associated response in humans and to assess individual factors affecting spontaneous recovery. We therefore implemented an experimental procedure comprising three separate test-sessions. In the first test-session, participants underwent instrume...

Influential theories concerning personality argue that many impulsive individuals show physiological underarousal at rest. This interoceptive state is proposed to be egodystonic, motivating impulsive maladaptive actions to enhance arousal. However, there is little empirical research on this matter. The current study tested the relationship between...

In clinical populations, olfactory abilities parallel executive function, implicating shared neuroanatomical substrates within the ventral prefrontal cortex. In healthy individuals, the relationship between olfaction and personality traits or certain cognitive and behavioural characteristics remains unexplored. We therefore tested if olfactory func...

Objectives: The consequences of impulsive decisions and actions represent a major source of concern to the health and well-being of individuals and society. It is, therefore, crucial to understand the factors which contribute to impulsive behaviors. Here, we examined how personality traits of behavioral tendencies, interoceptive sensibility as well...

Previous research has found that the attention of social drinkers is preferentially oriented towards alcohol-related stimuli (attentional capture). This is argued to play a role in escalating craving for alcohol that can result in hazardous drinking. According to incentive theories of drug addiction, the stimuli associated with the drug reward acqu...

Background: Conventionally, involuntary attentional capture by tobacco cues in smokers are seen as an implicit bias, operating independently of current search goals. Prominent attention research, however, has suggested that search goals can induce an involuntary attentional capture. In the current investigation, we tested whether appetitive and av...

Motor actions can be facilitated or hindered by psychophysiological states of readiness, to guide rapid adaptive action. Cardiovascular arousal is communicated by cardiac signals conveying the timing and strength of individual heartbeats. Here, we tested how these interoceptive signals facilitate control of motor impulsivity. Participants performed...

Background Impulsivity is considered a crucial factor in substance misuse; therefore, it is essential to understand modulators of impulsive behaviour. This study investigated how emotional task-independent context affects performance on the motor impulsivity task in binge drinking (BD) and underlying neural mechanisms. Methods Thirty healthy volun...

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 diso...

At present, there is a considerable lack of human studies that investigated the impact of conditioned cues on instrumental responding although these processes are considered as core mechanisms contributing to the development and maintenance of addictive behaviours. No studies are available that assessed these processes with regard to Internet gamin...

Motor actions can be facilitated or hindered by psychophysiological states of readiness, to guide rapid adaptive action. Cardiovascular arousal is communicated by cardiac signals conveying the timing and strength of individual heartbeats. Here, we tested how these interoceptive signals facilitate control of motor impulsivity. Participants performed...

Impulsivity received considerable attention in the context of drug misuse and certain neuropsychiatric conditions. Because of its great health and well-being importance, it is crucial to understand factors which modulate impulsive behaviour. As a growing body of literature indicates the role of emotional and physiological states in guiding our acti...

Classical conditioning theories of addiction suggest that stimuli associated with rewards acquire incentive salience, inducing emotional and attentional conditioned responses. It is not clear whether those responses occur without contingency awareness (CA), i.e. are based on explicit or implicit learning processes. Examining implicit aspects of sti...

Background: Alexithymia describes an abnormality of emotional experience that is commonly expressed among individuals with addiction and alcohol abuse disorders. Alexithymic individuals are characterized by difficulties in identifying and describing their emotions. This impairment is linked to the development and maintenance of addiction. Moreover...

Background: Temperament and character dimensions of personality remain largely unexplored in young adults exhibiting binge drinking patterns. Moreover, the available studies do not consider gender differences, and dismiss possible personality heterogeneity among binge drinkers. In the present study, we aimed to compare temperament and character di...

Objective: To explore neural correlates of interoception and empathy for pain in social drinkers, using functional Magnetic Resonance Imaging (fMRI), Voxel-Based Morphometry (VBM) and Magnetic Resonance Spectroscopy (MRS).

Interoception refers to the sensory processing of internal bodily signals, guiding cognitive and motivational behaviours. People suffering from alcohol related problems feel and report their bodily sensations less accurately than healthy controls. Oxytocin facilitates empathy and is associated with the homeostatic regulation of internal bodily stat...

Variations in genes encoding several GABAA receptors have been associated with human drug and alcohol abuse. Among these, a number of human studies have suggested an association between GABRB1, the gene encoding GABAA receptor β1 subunits, with Alcohol dependence (AD), both on its own and comorbid with other substance dependence and psychiatric ill...

Variations in genes encoding several GABAA receptors have been associated with human drug and alcohol abuse. Among these, a number of human studies have suggested an association between GABRB1, the gene encoding GABAA receptor β1 subunits, with Alcohol dependence (AD), both on its own and comorbid with other substance dependence and psychiatric ill...

Reward-predictive stimuli augment instrumental reward-seeking in humans, an effect denoted Pavlovian-to-instrumental transfer (PIT), but the role of differential reward value of these stimuli and of emotional conditioned responses in PIT remains unknown. Fifty one participants experienced a Pavlovian phase that associated two stimuli with either 10...

Interoception refers to the sensory processing of internal bodily signals, guiding cognitive and motivational behaviours. In addiction, disturbances of interoception are expressed as altered insular cortex activation and have been described, for example through the phenomenon of craving. Studies focusing on substance use disorders report aberrant a...

Alexithymia is an emotion dysfunction characterised by difficulties in describing and identifying one’s own emotions. A recent theory suggests a link between alexithymia and interoception (i.e. sensitivity to internal bodily signals) which is supported by the insular cortex (IC) and guides emotional feeling states. In studies using functional magne...

GABAA receptors form the major class of inhibitory neurotransmitter receptors in the mammalian brain. This review sets out to summarise the evidence that variations in genes encoding GABAA receptor isoforms are associated with aspects of addictive behaviour in humans, while animal models of addictive behaviour also implicate certain subtypes of GAB...

Background Youths with family history (FH) of alcoholism are at greater risk of developing alcohol use disorder (AUD); heightened impulsive behavior may underlie such increased vulnerability. Here, we studied waiting impulsivity (previously suggested to predispose to alcohol drinking) in young moderate-to-heavy social drinkers (18 to 33years old) c...

There is no consensus regarding the diagnostic criteria of cybersex addiction. Some approaches postulate similarities to substance dependencies, for which associative learning is a crucial mechanism. In this study, 86 heterosexual males completed a Standard Pavlovian to Instrumental Transfer Task modified with pornographic pictures to investigate a...

Binge drinking is associated with impaired cognitive functioning, but the relationship of cognitive impairments and white matter integrity is less known. We used diffusion tensor imaging (DTI) to investigate the relationships of binge drinking, whole brain white matter integrity and cognitive performance during young adulthood (18 to 25 years), a p...

Background: Variations in the GABRA2 gene, encoding α2 subunits of GABAA receptors, have been associated with risk for addiction to several drugs, but the mechanisms by which variations in non-coding regions of GABRA2 increase risk for addictions are not understood. Mice with deletion of GABRA2 show deficits in the ability of psychostimulants to fa...

Les conséquences à court terme et à long terme du binge drinking sur le cerveau et son fonctionnement commencent à être bien appréhendés. Sa pratique est banalisée et donc courante chez les jeunes. Nous avons initié une série d’études dans le cadre du projet européen AlcoBinge visant à mesurer les conséquences cérébrales morphologiques et fonctionn...

The present experiment adapted the “Voluntary Facial Action” (VFA) technique (Dimberg & Söderkvist, 2011) to study the effect of facial expressions on the interpretation of ambiguity. This required participants to react with either the zygomatic major muscles (smile) or the corrugator supercilii muscles (frown) when exposed to different stimuli, so...

Einleitung: Die Klassifikation des Phanomens Internetsucht, im Rahmen derer Internetsexsucht eine spezifische Form darstellt, wird kontrovers diskutiert. Vermehrt wird jedoch auf Ahnlichkeiten zwischen Internetsexsucht und Substanzabhangigkeiten sowie anderen Verhaltenssuchten hingewiesen. Gut dokumentiert ist, dass assoziatives Lernen und Konditio...

A substantial number of university students exceed alcohol guidelines. Impulsivity has been repeatedly implicated in heavy alcohol use, yet despite knowledge that impulsivity is multifaceted, there have previously been few studies applying multiple measures of self-report and behavioural impulsivity to examine the relationship with excessive studen...

‘Impulsivity’ refers to a range of behaviours including preference for immediate reward (temporal-impulsivity) and the tendency to make premature decisions (reflection-impulsivity) and responses (motor-impulsivity). The current study aimed to examine how different behavioural and self-report measurements of impulsivity can be categorised into disti...

Binge drinking is associated with impaired cognitive functioning, but the relationship of cognitive impairments and white matter integrity is less known. We used diffusion tensor imaging (DTI) to investigate the relationships of binge drinking, whole brain white matter integrity and cognitive performance during young adulthood (18 to 25 years), a p...

Alcoholic patients with multiple detoxifications/relapses show cognitive and emotional deficits. We performed structural magnetic resonance imaging and examined performance on a cognitive flexibility task (intra-extradimensional set shift and reversal; IED). We also presented subjects with fearful, disgust and anger facial emotional expressions. Pa...

Stress is known to play an important role in alcohol abuse, whereas binge drinking may increase individuals' susceptibility to the development of alcohol dependence. We set out to investigate whether binge drinkers (BDs) or non-BDs (NBDs) are at a greater risk of an increase in their desire for alcohol following experimental stress induction (modif...

There are well-established links between impulsivity and alcohol use in humans and animal models; however, whether exaggerated impulsivity is a premorbid risk factor or a consequence of alcohol intake remains unclear. In a first approach, human young (18-25 years) social binge and non-binge drinkers were tested for motor impulsivity and attentional...