Article

IMAGING STUDY: Modulation of brain response to emotional images by alcohol cues in alcohol‐dependent patients

Addiction Biology

June 2008
13(3-4):423-34

DOI:10.1111/j.1369-1600.2008.00111.x

Source
PubMed

Authors:

Jodi M Gilman

Massachusetts General Hospital/ Harvard Medical School

Daniel W Hommer

National Institutes of Health

Alcohol is often used to modulate mood states. Alcohol drinkers report that they use alcohol both to enhance positive affect and to reduce dysphoria, and alcohol-dependent patients specifically state reduction of negative affect as a primary reason for drinking. The current study proposes that alcohol cues may reduce negative affect in alcoholics. We used functional magnetic resonance imaging to examine brain activation in response to combination images that juxtaposed negative or positive International Affective Picture System (IAPS) images with an alcohol or non-alcohol-containing beverage. We found that in the absence of the alcohol cue, alcoholics showed more activation to negative than to positive images and greater activation than controls to negative images. When the IAPS images were presented with the alcohol cue, there was a decreased difference in activation between the positive and negative images among the alcoholics, and a decreased difference in response to the negative images between controls and alcoholics. Additionally, in the neutral-beverage conditions, anxiety ratings significantly predicted activation in the right parahippocampal gyrus but did not predict activation when the alcohol cues were presented. In conclusion, the alcohol cues may have modulated cortical networks involved in the processing of emotional stimuli by eliciting a conditioned response in the alcoholics, but not in the controls, which may have decreased responsiveness to the negative images.

Social cognition in severe alcohol use disorder

Chapter

Jan 2021

While severe alcohol use disorder (SAUD) is classically characterized as a compulsion to seek and consume alcohol and a reduced ability to control these behaviors, a growing number of studies shows social cognition difficulties among recently detoxified patients. The present chapter proposes an overview of this literature by presenting the main findings regarding emotional experience and emotion regulation, social cues processing, theory of mind, empathy and social emotions processing. From this literature, we propose that patients with SAUD show an increased sensibility to socio-emotional stimuli that directly concern them and a reduced ability to process those stimuli when they concern other individuals. We also propose new research avenues that may ultimately help to better understand social cognition deficits and their role in SAUD and to urge scientists and clinicians to consider rehabilitating these abilities in the early steps of detoxification programs.

Selective D3 receptor antagonism modulates neural response during negative emotional processing in substance dependence

Article

Full-text available

Oct 2022

Introduction Negative affective states contribute to the chronic-relapsing nature of addiction. Mesolimbic dopamine D3 receptors are well placed to modulate emotion and are dysregulated in substance dependence. Selective antagonists might restore dopaminergic hypofunction, thus representing a potential treatment target. We investigated the effects of selective D3 antagonist, GSK598809, on the neural response to negative emotional processing in substance dependent individuals and healthy controls. Methodology Functional MRI BOLD response was assessed during an evocative image task, 2 h following acute administration of GSK598809 (60 mg) or placebo in a multi-site, double-blind, pseudo-randomised, cross-over design. Abstinent drug dependent individuals (DD, n = 36) comprising alcohol-only (AO, n = 19) and cocaine-alcohol polydrug (PD, n = 17) groups, and matched controls (n = 32) were presented with aversive and neutral images in a block design (contrast of interest: aversive > neutral). Whole-brain mixed-effects and a priori ROI analyses tested for group and drug effects, with identical models exploring subgroup effects. Results No group differences in task-related BOLD signal were identified between DD and controls. However, subgroup analysis revealed greater amygdala/insular BOLD signal in PD compared with AO groups. Following drug administration, GSK598809 increased BOLD response across HC and DD groups in thalamus, caudate, putamen, and pallidum, and reduced BOLD response in insular and opercular cortices relative to placebo. Multivariate analyses in a priori ROIs revealed differential effects of D3 antagonism according to subgroup in substantia nigra; GSK598809 increased BOLD response in AO and decreased response in PD groups. Conclusion Acute GSK598809 modulates the BOLD response to aversive image processing, providing evidence that D3 antagonism may impact emotional regulation. Enhanced BOLD response within D3-rich mesolimbic regions is consistent with its pharmacology and with attenuation of substance-related hypodopaminergic function. However, the lack of group differences in task-related BOLD response and the non-specific effect of GSK598809 between groups makes it difficult to ascertain whether D3 antagonism is likely to be normalising or restorative in our abstinent populations. The suggestion of differential D3 modulation between AO and PD subgroups is intriguing, raising the possibility of divergent treatment responses. Further study is needed to determine whether D3 antagonism should be recommended as a treatment target in substance dependence.

Deficits in proactive avoidance and neural responses to drinking motives in problem drinkers

Preprint

Full-text available

Feb 2024

Physical pain and negative emotions represent two distinct drinking motives that contribute to harmful alcohol use. Proactive avoidance which can reduce problem drinking in response to these motives appears to be impaired in problem drinkers. However, proactive avoidance and its underlying neural deficits have not been assessed experimentally. How these deficits inter-relate with drinking motives to influence alcohol use also remains unclear. The current study leveraged neuroimaging data collected in forty-one problem and forty-one social drinkers who performed a probabilistic learning go/nogo task that involved proactive avoidance of painful outcomes. We characterized the regional brain responses to proactive avoidance and identified the neural correlates of drinking to avoid physical pain and negative emotions. Behavioral results confirmed problem drinkers’ proactive avoidance deficits in learning rate and performance accuracy, both which were associated with greater alcohol use. Imaging findings in problem drinkers showed that negative emotions as a drinking motive predicted attenuated right insula activation during proactive avoidance. In contrast, physical pain motive predicted reduced right putamen response. These regions’ activations as well as functional connectivity with the somatomotor cortex also demonstrated a negative relationship with drinking severity and positive relationship with proactive avoidance performance. Path modeling further delineated the pathways through which physical pain and negative emotions, along with alcohol use severity, influenced the neural and behavioral measures of proactive avoidance. Taken together, the current findings provide experimental evidence for proactive avoidance deficits in problem drinkers and establish the link between their neural underpinnings and alcohol misuse.

Changes in neural responses during affective and non-affective tasks and improvement of posttraumatic stress disorder symptoms following trauma-focused psychotherapy

Article

Full-text available

Mar 2023

At least one-third posttraumatic stress disorder (PTSD) patients do not respond to trauma-focused psychotherapy (TF-psychotherapy), which is the treatment of choice for PTSD. To clarify the change mechanisms that may be associated with treatment response, this study examined changes in neural activations during affective and non-affective processing that occur with improvement of symptoms after TF-psychotherapy. This study assessed PTSD treatment-seeking patients (n = 27) prior to and after TF-psychotherapy using functional magnetic resonance imaging when they completed three tasks: (a) passive viewing of affective faces, (b) cognitive reappraisal of negative images, and (c) non-affective response inhibition. Patients then underwent 9 sessions of TF-psychotherapy, and were assessed on the Clinician-Administered PTSD Scale following treatment. Changes in neural responses in affect and cognitive processing regions-of-interest for each task were correlated with reduction of PTSD severity from pretreatment to posttreatment in the PTSD cohort. Data from 21 healthy controls was used for comparison. Improvement of symptoms in PTSD were associated with increased activation of left anterior insula, reductions in the left hippocampus and right posterior insula during viewing of supraliminally presented affective images, and reduced connectivity between the left hippocampus with the left amygdala and rostral anterior cingulate. Treatment response was also associated with reduced activation in the left dorsolateral prefrontal cortex during reappraisal of negative images. There were no associations between response and activation change during response inhibition. This pattern of findings indicates that improvement of PTSD symptoms following TF-psychotherapy is associated with changes in affective rather than non-affective processes. These findings accord with prevailing models that TF-psychotherapy promotes engagement and mastery of affective stimuli. Clinical Trials Registration: Trial Registration: Prospectively registered at Australian and New Zealand Clinical Trials Registry, ACTRN12612000185864 and ACTRN12609000324213. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=83857

Comparison of Emotional Processing Between Patients with Substance Use Disorder and Those with Dual Diagnosis: Relationship with Severity of Dependence and Use During Treatment

Article

Feb 2023
J PSYCHOACTIVE DRUGS

This study analyzed, in a Spanish sample, the differences in emotional processing in patients diagnosed with substance use disorder (SUD) and patients with a dual diagnosis (DD), and tested whether alterations in emotional regulation were related to the severity of dependence and consumption during treatment. A descriptive follow-up study was conducted with 88 adult outpatients (83% men) who were receiving treatment for alcohol and cocaine SUD. Of the sample, 43.2% presented dual diagnosis according to DSM-IV-TR criteria. Emotional processing was assessed with the IAPS, and dependence severity with the SDSS. Consumption was determined with self-reports and toxicological tests. Regression analyses revealed that the DD group had more difficulties in identifying the valence and arousal of the images than patients with SUD. Patients with DD presented more difficulty in identifying images in which valence was manipulated, but not in those in which arousal was manipulated. Cocaine use during treatment was associated with difficulties in identifying unpleasant (U = 734.0; p < .05) and arousing (U = 723.5; p < .05) images. Although these results are preliminary, findings suggest that impaired emotional processing is aggravated in dual patients, although it may be a common transdiagnostic factor in SUD and other comorbid mental disorders. Findings highlight the importance of evaluating emotional regulation to better understand its possible role in the maintenance of substance use.

Loss and Frontal Striatal Reactivities Characterize Alcohol Use Severity and Rule-Breaking Behavior in Young Adult Drinkers

Article

Jun 2022

Background Alcohol misuse is associated with externalizing behaviors, including rule-breaking. Studies have implicated altered reward processing in externalizing behaviors and alcohol misuse. Here, we investigated whether reward or punishment reactivity more significantly influences alcohol use severity and rule-breaking behavior in young adult drinkers. Methods We curated the data of the Human Connectome Project and identified 181 binge (132 men) and 288 non-binge (97 men) drinkers performing a gambling task during brain imaging. Alcohol use severity was quantified by the first principal component (PC1) of principal component analysis of all drinking measures. We analyzed the imaging data with published routines and evaluated the results at a corrected threshold. We examined the inter-relationship between imaging and clinical metrics with mediation and path analyses. Results Bingers vs. non-bingers showed more severe rule-breaking behavior and responded significantly faster during post-loss than post-win trials. Bingers vs. non-bingers demonstrated greater inferior/middle frontal gyrus (IFG/MFG) and cerebellum activations in loss-predominating blocks but no differences in regional responses to win-predominating blocks, relative to an inter-block baseline. The right caudate body showed loss reactivity in positive correlation with rule-breaking score. No regional responses to wins were significantly correlated with rule-breaking score. Mediation and path analysis demonstrated significant models with IFG/MFG and caudate reactivity to loss inter-relating rule-breaking and alcohol use severity. Conclusions Punishment rather than reward reactivity is associated with alcohol use severity and rule-breaking in young adults. The findings highlight the roles of negative emotions in psychological models of externalizing behavior and alcohol misuse.

Better living through understanding the insula: Why subregions can make all the difference

Article

Aug 2021
NEUROPHARMACOLOGY

Insula function is considered critical for many motivated behaviors, with proposed functions ranging from attention, behavioral control, emotional regulation, goal-directed and aversion-resistant responding. Further, the insula is implicated in many neuropsychiatric conditions including substance abuse. More recently, multiple insula subregions have been distinguished based on anatomy, connectivity, and functional contributions. Generally, posterior insula is thought to encode more somatosensory inputs, which integrate with limbic/emotional information in middle insula, that in turn integrate with cognitive processes in anterior insula. Together, these regions provide rapid interoceptive information about the current or predicted situation, facilitating autonomic recruitment and quick, flexible action. Here, we seek to create a robust foundation from which to understand potential subregion differences, and provide direction for future studies. We address subregion differences across humans and rodents, so that the latter's mechanistic interventions can best mesh with clinical relevance of human conditions. We first consider the insula's suggested roles in humans, then compare subregional studies, and finally describe rodent work. One primary goal is to encourage precision in describing insula subregions, since imprecision (e.g. including both posterior and anterior studies when describing insula work) does a disservice to a larger understanding of insula contributions. Additionally, we note that specific task details can greatly impact recruitment of various subregions, requiring care and nuance in design and interpretation of studies. Nonetheless, the central ethological importance of the insula makes continued research to uncover mechanistic, mood, and behavioral contributions of paramount importance and interest. This article is part of the special Issue on ‘Neurocircuitry Modulating Drug and Alcohol Abuse'.

Longitudinal changes in within-salience network functional connectivity mediate the relationship between childhood abuse and neglect, and mental health during adolescence

Article

Aug 2021

Background Understanding the neurobiological underpinnings of childhood maltreatment is vital given consistent links with poor mental health. Dimensional models of adversity purport that different types of adversity likely have distinct neurobiological consequences. Adolescence is a key developmental period, during which deviations from normative neurodevelopment may have particular relevance for mental health. However, longitudinal work examining links between different forms of maltreatment, neurodevelopment, and mental health is limited. Methods In the present study, we explored associations between abuse, neglect, and longitudinal development of within-network functional connectivity of the salience (SN), default mode (DMN), and executive control network in 142 community residing adolescents. Resting-state fMRI data were acquired at age 16 (T1; M = 16.46 years, s.d. = 0.52, 66F) and 19 (T2; mean follow-up period: 2.35 years). Mental health data were also collected at T1 and T2. Childhood maltreatment history was assessed prior to T1. Results Abuse and neglect were both found to be associated with increases in within-SN functional connectivity from age 16 to 19. Further, there were sex differences in the association between neglect and changes in within-DMN connectivity. Finally, increases in within-SN connectivity were found to mediate the association between abuse/neglect and lower problematic substance use and higher depressive symptoms at age 19. Conclusions Our findings suggest that childhood maltreatment is associated with altered neurodevelopmental trajectories, and that changes in salience processing may be linked with risk and resilience for the development of depression and substance use problems during adolescence, respectively. Further work is needed to understand the distinct neurodevelopmental and mental health outcomes of abuse and neglect.

Alcohol Use Disorder and Cannabis Use Disorder Symptomatology in Adolescents and Aggression: Associations With Recruitment of Neural Regions Implicated in Retaliation

Article

Dec 2020

Background Alcohol and cannabis are commonly used by adolescents in the United States. Both Alcohol Use Disorder (AUD) and Cannabis Use Disorder (CUD) have been associated with an increased risk for aggression. One form of aggression seen during retaliation is reactive aggression to social provocation. The current study investigated the association between AUD and CUD symptom severity and recruitment of neural regions implicated in retaliation. Methods In this study, 102 youths aged 13-18 years (67 male; 84 in residential care) completed self-report measures of aggression-related constructs and participated in a retaliation task during functional magnetic resonance imaging to investigate the association between relative severity of AUD/CUD and atypical recruitment of regions implicated in retaliation. Results AUD Identification Test (AUDIT) scores were positively associated with irritability and reactive aggression scores. CUD Identification Test (CUDIT) scores were positively associated with callous-unemotional traits and both proactive and reactive aggression scores. In fMRI analyses, only AUDIT (not CUDIT) scores were associated with an exaggerated recruitment of regions implicated in retaliation (dorsomedial frontal, anterior insula cortices, caudate and, to a lesser extent, periaqueductal gray). Conclusions These data suggest that relative severity of AUD is associated with a disinhibited, exaggerated retaliation response that relates to an increased risk for reactive aggression. Similar findings were not related to severity of CUD.

The neural, behavioral, and epidemiological underpinnings of comorbid alcohol use disorder and post-traumatic stress disorder

Chapter

Nov 2020
INT REV NEUROBIOL

Alcohol use disorder (AUD) and (PTSD) frequently co-occur and individuals suffering from this dual diagnosis often exhibit increased symptom severity and poorer treatment outcomes than those with only one of these diseases. Although there have been significant advances in our understanding of the neurobiological mechanisms underlying each of these disorders, the neural underpinnings of the comorbid condition remain poorly understood. This chapter summarizes recent epidemiological findings on comorbid AUD and PTSD, with a focus on vulnerable populations, the temporal relationship between these disorders, and the clinical consequences associated with the dual diagnosis. We then review animal models of the comorbid condition and emerging human and non-human animal research that is beginning to identify maladaptive neural changes common to both disorders, primarily involving functional changes in brain reward and stress networks. We end by proposing a neural framework, based on the emerging field of affective valence encoding, that may better explain the epidemiological and neural findings on AUD and PTSD.

Altered resting functional connectivity patterns associated with problematic substance use and substance use disorders during adolescence

Article

Nov 2020

Background: Adolescence is typified by increasing rates of substance use and the development of substance use disorders (SUD). Aberrant connectivity between cortical regions involved in executive control, and subcortical regions has been suggested to be associated with SUD and problematic substance use among adolescents. Few studies, however, have investigated system-level or whole-brain functional connectivity (FC) in order to test this hypothesis. Methods: In a sample of 114 adolescents (mean age = 17.62 years, SD = 1.23, 61F) from the community, the present study used resting-state functional magnetic resonance imaging and independent component analysis to study executive control-subcortical network (ECN-SCN) coupling in adolescent SUD (n=18) and problematic substance use (n=34). In addition, whole-brain FC analyses were also conducted. Results: Problematic substance use, but not SUD was associated with increased negative ECN-SCN coupling (p = 0.026). The whole-brain FC analysis showed insula-associated hypoconnectivity in the SUD group (p = 0.037), which was negatively correlated with frequency of substance use. Conclusions: Findings implicate different neural circuitry underlying adolescent SUD versus problematic use. Greater negative coupling between the SCN and ECN in adolescents with problematic substance use could underlie risk for future development of SUD or other mental health problems. Although we cannot infer directionality, hypoconnectivity within the insula in adolescents with SUD may indicate addiction-related alterations in interoceptive awareness or impairments in decision-making.

Early-onset smoking theory of compulsivity development: a neurocognitive model for the development of compulsive tobacco smoking

Article

Full-text available

Jul 2023

According to the literature, individuals who start tobacco smoking during adolescence are at greater risk of developing severe tobacco addiction and heavier smoking behavior in comparison with individuals who uptake tobacco smoking during subsequent developmental stages. As suggested by animal models, this may be related to the unique neuroadaptive and neurotoxic effects of nicotine on adolescents' fronto-striatal brain regions modulating cognitive control and impulsivity. Previous research has proposed that these neuroadaptive and neurotoxic effects may cause a heightened reward-oriented impulsive behavior that may foster smoking relapses during quit attempts. However, developments in the field of addiction neuroscience have proposed drug addiction to represent a type of compulsive behavior characterized by the persistent use of a particular drug despite evident adverse consequences. One brain region that has received increased attention in recent years and that has been proposed to play a central role in modulating such compulsive drug-seeking and using behavior is the insular cortex. Lesion studies have shown that structural damages in the insular cortex may disrupt smoking behavior, while neuroimaging studies reported lower gray matter volume in the anterior insular cortex of chronic smokers compared with non-smokers, in addition to correlations between gray matter volume in the anterior insular cortex and measures of compulsive cigarette smoking. Based on the findings of our recent study reporting on early-onset smokers (mean age at regular smoking initiation = 13.2 years) displaying lower gray matter and white matter volume in the anterior insular cortex compared to late-onset smokers (mean age at regular smoking initiation = 18.0 years), we propose that the anterior insular cortex may play a central role in mediating the association between smoking uptake during adolescence and smoking heaviness/tobacco addiction during adulthood.

Applications of fMRI to Psychiatry

Chapter

May 2023

Recent neuroimaging techniques, including functional magnetic resonance imaging (fMRI), electroencephalography (EEG), and magnetoencephalography (MEG), allow us to probe the brain at unprecedentedly high temporal or spatial resolution without the use of invasive techniques. fMRI plays a key role and has gained popularity in modern psychiatric research due to its noninvasiveness, lack of radiation exposure, a relatively good spatial and temporal resolution, and ease of acquisition.KeywordsFunctional magnetic resonance imagingMood disordersMajor depressive disorderBipolar disorderPost-traumatic stress disorderSubstance use disordersMachine learning

Structural imaging of obsessive–compulsive disorder

Chapter

Dec 2010

An informative and comprehensive review from the leading researchers in the field, this book provides a complete one-stop guide to neuroimaging techniques and their application to a wide range of neuropsychiatric disorders. For each disorder or group of disorders, separate chapters review the most up-to-date findings from structural imaging, functional imaging and/or molecular imaging. Each section ends with an overview from a internationally-renowned luminary in the field, addressing the question of 'What do we know and where are we going?' Richly illustrated throughout, each chapter includes a 'summary box', providing readers with explicit take-home messages. This is an essential resource for clinicians, researchers and trainees who want to learn how neuroimaging tools lead to new discoveries about brain and behaviour associations in neuropsychiatric disorders.

Neuroimaging of other dementing disorders

Chapter

Dec 2010

Neuroimaging of anorexia and bulimia

Chapter

Dec 2010

Molecular imaging of substance abuse

Chapter

Dec 2010

Molecular imaging of Alzheimer's disease

Chapter

Dec 2010

Norbert Schuff

Neuroimaging of substance abuse: commentary

Chapter

Dec 2010

Adolf Pfefferbaum

Structural imaging of post-traumatic stress disorder

Chapter

Dec 2010

Mark W. Gilbertson

Structural imaging of other anxiety disorders

Chapter

Dec 2010

Functional imaging of other anxiety disorders

Chapter

Dec 2010

Molecular imaging of post-traumatic stress disorder

Chapter

Dec 2010

James Douglas Bremner

Neuroimaging of developmental disorders: commentary

Chapter

Dec 2010

Nancy J. Minshew

Functional imaging of Alzheimer's disease

Chapter

Dec 2010

Molecular imaging of other anxiety disorders

Chapter

Dec 2010

Neuroimaging of Williams–Beuren syndrome

Chapter

Dec 2010

Structural imaging of substance abuse

Chapter

Dec 2010

Neuroimaging of obesity

Chapter

Dec 2010

Functional imaging of substance abuse

Chapter

Dec 2010

Spectroscopic imaging of schizophrenia

Chapter

Dec 2010

Neuroimaging of cognitive disorders: commentary

Chapter

Dec 2010

Functional imaging of bipolar illness

Chapter

Dec 2010

Structural imaging of major depression

Chapter

Dec 2010

Structural imaging of Alzheimer's disease

Chapter

Dec 2010

Neuroimaging of eating disorders: commentary

Chapter

Dec 2010

Janet Treasure

Neuroimaging of anxiety disorders: commentary

Chapter

Dec 2010

Scott L Rauch

Structural imaging of bipolar illness

Chapter

Dec 2010

Stephen M. Strakowski

Functional imaging of schizophrenia

Chapter

Dec 2010

Godfrey D. Pearlson

Neuroimaging of schizophrenia: commentary

Chapter

Dec 2010

Nancy Andreasen

Functional imaging of major depression

Chapter

Dec 2010

Molecular imaging of obsessive–compulsive disorder

Chapter

Dec 2010

Molecular imaging of major depression

Chapter

Dec 2010

Neuroimaging of Parkinson's disease

Chapter

Dec 2010

Functional imaging of post-traumatic stress disorder

Chapter

Dec 2010

Molecular imaging of bipolar illness

Chapter

Dec 2010

Neuroimaging of mood disorders: commentary

Chapter

Dec 2010

Music therapy for people with substance use disorders

Article

May 2022
COCHRANE DB SYST REV

Background: Substance use disorder (SUD) is the continued use of one or more psychoactive substances, including alcohol, despite negative effects on health, functioning, and social relations. Problematic drug use has increased by 10% globally since 2013, and harmful use of alcohol is associated with 5.3% of all deaths. Direct effects of music therapy (MT) on problematic substance use are not known, but it may be helpful in alleviating associated psychological symptoms and decreasing substance craving. Objectives: To compare the effect of music therapy (MT) in addition to standard care versus standard care alone, or to standard care plus an active control intervention, on psychological symptoms, substance craving, motivation for treatment, and motivation to stay clean/sober. Search methods: We searched the following databases (from inception to 1 February 2021): the Cochrane Drugs and Alcohol Specialised Register; CENTRAL; MEDLINE (PubMed); eight other databases, and two trials registries. We handsearched reference lists of all retrieved studies and relevant systematic reviews. Selection criteria: We included randomised controlled trials comparing MT plus standard care to standard care alone, or MT plus standard care to active intervention plus standard care for people with SUD. Data collection and analysis: We used standard Cochrane methodology. Main results: We included 21 trials involving 1984 people. We found moderate-certainty evidence of a medium effect favouring MT plus standard care over standard care alone for substance craving (standardised mean difference (SMD) -0.66, 95% confidence interval (CI) -1.23 to -0.10; 3 studies, 254 participants), with significant subgroup differences indicating greater reduction in craving for MT intervention lasting one to three months; and small-to-medium effect favouring MT for motivation for treatment/change (SMD 0.41, 95% CI 0.21 to 0.61; 5 studies, 408 participants). We found no clear evidence of a beneficial effect on depression (SMD -0.33, 95% CI -0.72 to 0.07; 3 studies, 100 participants), or motivation to stay sober/clean (SMD 0.22, 95% CI -0.02 to 0.47; 3 studies, 269 participants), though effect sizes ranged from large favourable effect to no effect, and we are uncertain about the result. There was no evidence of beneficial effect on anxiety (mean difference (MD) -0.17, 95% CI -4.39 to 4.05; 1 study, 60 participants), though we are uncertain about the result. There was no meaningful effect for retention in treatment for participants receiving MT plus standard care as compared to standard care alone (risk ratio (RR) 0.99, 95% 0.93 to 1.05; 6 studies, 199 participants). There was a moderate effect on motivation for treatment/change when comparing MT plus standard care to another active intervention plus standard care (SMD 0.46, 95% CI -0.00 to 0.93; 5 studies, 411 participants), and certainty in the result was moderate. We found no clear evidence of an effect of MT on motivation to stay sober/clean when compared to active intervention, though effect sizes ranged from large favourable effect to no effect, and we are uncertain about the result (MD 0.34, 95% CI -0.11 to 0.78; 3 studies, 258 participants). There was no clear evidence of effect on substance craving (SMD -0.04, 95% CI -0.56 to 0.48; 3 studies, 232 participants), depression (MD -1.49, 95% CI -4.98 to 2.00; 1 study, 110 participants), or substance use (RR 1.05, 95% CI 0.85 to 1.29; 1 study, 140 participants) at one-month follow-up when comparing MT plus standard care to active intervention plus standard care. There were no data on adverse effects. Unclear risk of selection bias applied to most studies due to incomplete description of processes of randomisation and allocation concealment. All studies were at unclear risk of detection bias due to lack of blinding of outcome assessors for subjective outcomes (mostly self-report). We judged that bias arising from such lack of blinding would not differ between groups. Similarly, it is not possible to blind participants and providers to MT. We consider knowledge of receiving this type of therapy as part of the therapeutic effect itself, and thus all studies were at low risk of performance bias for subjective outcomes. We downgraded all outcomes one level for imprecision due to optimal information size not being met, and two levels for outcomes with very low sample size. AUTHORS' CONCLUSIONS: Results from this review suggest that MT as 'add on' treatment to standard care can lead to moderate reductions in substance craving and can increase motivation for treatment/change for people with SUDs receiving treatment in detoxification and short-term rehabilitation settings. Greater reduction in craving is associated with MT lasting longer than a single session. We have moderate-to-low confidence in our findings as the included studies were downgraded in certainty due to imprecision, and most included studies were conducted by the same researcher in the same detoxification unit, which considerably impacts the transferability of findings.

A unifying translational framework to advance treatment research for comorbid PTSD and substance use disorders

Article

May 2021
NEUROSCI BIOBEHAV R

We provide a translational unifying framework that can be used to synthesize extant lines of human laboratory research in four neurofunctional domains that underlie the co-occurrence of Posttraumatic Stress and Substance Use Disorders (PTSD + SUD). We draw upon the Alcohol and Addiction Research Domain Criteria (AARDOC) to include executive functioning, negative emotionality, reward, and added social cognition from the National Institute of Mental Health (NIMH) Research Domain Criteria into our framework. We review research findings across each of the four domains, emphasizing human experimental studies in PTSD, SUD, and PTSD + SUD for each domain. We also discuss the implications of research findings for treatment development by considering new ways of conceptualizing risk factors and outcomes at the level of the individual patient, which will enhance treatment matching and advance innovations in intervention.

Music therapy for people with substance use disorders (Protocol)

Article

Full-text available

Oct 2020

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: Main objective To compare the effect of music therapy (MT) in addition to standard care versus standard care alone, or to standard care plus an active control intervention, on psychological symptoms, substance craving, motivation for treatment, and motivation to stay clean/sober. Secondary objective To assess the impact of the number of MT sessions on study outcomes.

Development and Validation of Brief Measures of Positive and Negative Affect: The PANAS Scales

Article

Full-text available

Jun 1988

In recent studies of the structure of affect, positive and negative affect have consistently emerged as two dominant and relatively independent dimensions. A number of mood scales have been created to measure these factors; however, many existing measures are inadequate, showing low reliability or poor convergent or discriminant validity. To fill the need for reliable and valid Positive Affect and Negative Affect scales that are also brief and easy to administer, we developed two 10-item mood scales that comprise the Positive and Negative Affect Schedule (PANAS). The scales are shown to be highly internally consistent, largely uncorrelated, and stable at appropriate levels over a 2-month time period. Normative data and factorial and external evidence of convergent and discriminant validity for the scales are also presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)

Drinking to Regulate Positive and Negative Emotions: A Motivational Model of Alcohol Use

Article

Full-text available

Nov 1995

The present study proposed and tested a motivational model of alcohol use in which people are hypothesized to use alcohol to regulate both positive and negative emotions. Two central premises underpin this model: (a) that enhancement and coping motives for alcohol use are proximal determinants of alcohol use and abuse through which the influence of expectancies, emotions, and other individual differences are mediated and (b) that enhancement and coping motives represent phenomenologically distinct behaviors having both unique antecedents and consequences. This model was tested in 2 random samples (1 of adults, 1 of adolescents) using a combination of moderated regression and path analysis corrected for measurement error. Results revealed strong support for the hypothesized model in both samples and indicate the importance of distinguishing psychological motives for alcohol use.

Nicotine abstinence produces content-specific Stroop interference

Article

Full-text available

Feb 1993

Adult, male smokers were randomly assigned to be nicotine abstinent for 12 h (n = 10) or to smoke normally for the same period of time (n = 10). Performance on a modified version of the Stroop (1935) color-naming task, where subjects named the color of ink in which each of a series of words was written, showed that abstinent smokers took significantly longer to color-name words related to cigarette smoking (e.g., Lighter) than to color-name neutral control words (e.g., Pennant). Non-abstinent smokers showed a significant difference in the opposite direction. These results suggest that nicotine abstinence decreases the ability to ignore the meaning of smoking-related information. This finding supports the hypothesis that abstinence produces a content-specific shift in attentional focus. The present pattern of results cannot be explained by a general decrease in cognitive function due to nicotine abstinence.

Activation of memory circuits during cue-elicited cocaine craving

Article

Full-text available

Nov 1996

Evidence accumulated over more than 45 years has indicated that environmental stimuli can induce craving for drugs of abuse in individuals who have addictive disorders. However, the brain mechanisms that subserve such craving have not been elucidated. Here a positron emission tomographic study shows increased glucose metabolism in cortical and limbic regions implicated in several forms of memory when human volunteers who abuse cocaine are exposed to drug-related stimuli. Correlations of metabolic increases in the dorsolateral prefrontal cortex, medial temporal lobe (amygdala), and cerebellum with self-reports of craving suggest that a distributed neural network, which integrates emotional and cognitive aspects of memory, links environmental cues with cocaine craving.

Functional Magnetic Resonance Imaging of Human Brain Activation During Cue-Induced Cocaine Craving

Article

Full-text available

Feb 1998

Functional magnetic resonance imaging (MRI) was used to test whether brain activation was detectable in regions previously associated with cocaine cue-induced craving. Blood oxygenation level dependent (BOLD) functional activation was measured during presentation of audiovisual stimuli containing alternating intervals of drug-related and neutral scenes to six male subjects with a history of crack cocaine use and six male comparison subjects. Significant activation was detected in the anterior cingulate and left dorsolateral prefrontal cortex in the cocaine-using group. In addition, a correlation between self-reported levels of craving and activation in these regions was found. These results suggest that functional MRI may be a useful tool to study the neurobiological basis of cue-induced craving.

Limbic Activation During Cue-Induced Cocaine Craving

Article

Full-text available

Feb 1999

Since signals for cocaine induce limbic brain activation in animals and cocaine craving in humans, the objective of this study was to test whether limbic activation occurs during cue-induced craving in humans. Using positron emission tomography, the researchers measured relative regional cerebral blood flow (CBF) in limbic and comparison brain regions of 14 detoxified male cocaine users and six cocaine-naive comparison subjects during exposure to both non-drug-related and cocaine-related videos and during resting baseline conditions. During the cocaine video, the cocaine users experienced craving and showed a pattern of increases in limbic (amygdala and anterior cingulate) CBF and decreases in basal ganglia CBF relative to their responses to the non-drug video. This pattern did not occur in the cocaine-naive comparison subjects, and the two groups did not differ in their responses in the comparison regions (i.e., the dorsolateral prefrontal cortex, cerebellum, thalamus, and visual cortex). These findings indicate that limbic activation is one component of cue-induced cocaine craving. Limbic activation may be similarly involved in appetitive craving for other drugs and for natural rewards.

Cue-Induced Cocaine Craving: Neuroanatomical Specificity for Drug Users and Drug Stimuli

Article

Full-text available

Dec 2000

Cocaine-related cues have been hypothesized to perpetuate drug abuse by inducing a craving response that prompts drug-seeking behavior. However, the mechanisms, underlying neuroanatomy, and specificity of this neuroanatomy are not yet fully understood. To address these issues, experienced cocaine users (N=17) and comparison subjects (N=14) underwent functional magnetic resonance imaging while viewing three separate films that portrayed 1 ) individuals smoking crack cocaine, 2) outdoor nature scenes, and 3) explicit sexual content. Candidate craving sites were identified as those that showed significant activation in the cocaine users when viewing the cocaine film. These sites were then required to show significantly greater activation when contrasted with comparison subjects viewing the cocaine film (population specificity) and cocaine users viewing the nature film (content specificity). Brain regions that satisfied these criteria were largely left lateralized and included the frontal lobe (medial and middle frontal gyri, bilateral inferior frontal gyrus), parietal lobe (bilateral inferior parietal lobule), insula, and limbic lobe (anterior and posterior cingulate gyrus). Of the 13 regions identified as putative craving sites, just three (anterior cingulate, right inferior parietal lobule, and the caudate/lateral dorsal nucleus) showed significantly greater activation during the cocaine film than during the sex film in the cocaine users, which suggests that cocaine cues activated similar neuroanatomical substrates as naturally evocative stimuli in the cocaine users. Finally, contrary to the effects of the cocaine film, cocaine users showed a smaller response than the comparison subjects to the sex film. These data suggest that cocaine craving is not associated with a dedicated and unique neuroanatomical circuitry; instead, unique to the cocaine user is the ability of learned, drug-related cues to produce brain activation comparable to that seen with nondrug evocative stimuli in healthy comparison subjects.

Functional Magnetic Resonance Imaging of Cocaine Craving

Article

Full-text available

Feb 2001

Identification of brain activity associated with craving is important for understanding the neurobiology of addiction. Brain activity was measured in cocaine addicts and healthy subjects by functional magnetic resonance imaging (fMRI) while the subjects watched videotapes designed to elicit happy feelings, sad feelings, or the desire to use cocaine. The subjects indicated the onset of drug craving or emotional response, allowing comparison of groups before and after such feelings. Robust activation of the anterior cingulate was evident in patients watching cocaine-cue tapes but not in patients watching happy or sad tapes or in healthy subjects under any condition. Anterior cingulate activation preceded the reported onset of craving and was evident in patients who did not report craving. In contrast, patients showed less activation than healthy subjects during the cocaine-cue tapes in areas of the frontal lobes. After the reported onset of craving, cocaine-dependent subjects showed greater activity than healthy subjects in regions that are more active in healthy subjects when they watch sad tapes than when they watch happy tapes, suggesting a physiologic link between cocaine-cue responses and normal dysphoric states. Dynamic aspects of regional brain activations, but not the location of activations, were abnormal in cocaine-dependent subjects watching sad tapes, suggesting more general affective dysregulation. Patients showed low activation of sensory areas during initial viewing of all videotapes, suggesting generalized alteration in neuroresponsiveness. Cocaine cues lead to abnormally high cingulate and low frontal lobe activation in cocaine addicts. Addicts also show more general abnormalities in affect-related brain activation.

Selective cognitive processing of drug cues in heroin dependence

Article

Full-text available

Feb 2000
J PSYCHOPHARMACOL

Previous studies provide evidence for the selective processing of disorder related stimuli on anxiety, depression, and eating disorders. There exist some preliminary indications that selective processing of drug cues may be involved in drug craving and relapse that deserve further investigation. In order to investigate the role of processing bias in an abnormal motivational system, the attentional bias for drug related stimuli was studied in a heroin dependent population. Heroin dependent participants (n = 21) and control participants (n = 30) performed a supra- and subliminal heroin Stroop task and heroin craving was assessed. Heroin dependent participants showed a considerable attentional bias for supraliminally presented heroin cues. However, there was no evidence for a preattentive bias on the subliminal presented cues. Reaction time on heroin cues was significantly predicted by heroin craving-levels. Results indicate that selective processing may be related to motivational induced states in general. The finding are discussed in the context of selective information processing in general psychopathology and in motivational processes as addiction specifically.

Activation of Prefrontal Cortex and Anterior Thalamus in Alcoholic Subjects on Exposure to Alcohol-Specific Cues

Article

Full-text available

May 2001
ARCH GEN PSYCHIAT

Functional imaging studies have recently demonstrated that specific brain regions become active in cocaine addicts when they are exposed to cocaine stimuli. To test whether there are regional brain activity differences during alcohol cue exposure between alcoholic subjects and social drinkers, we designed a functional magnetic resonance imaging (fMRI) protocol involving alcohol-specific cues. Ten non-treatment-seeking adult alcoholic subjects (2 women) (mean [SD] age, 29.9 [9.9] years) as well as 10 healthy social drinking controls of similar age (2 women) (mean [SD] age, 29.4 [8.9] years) were recruited, screened, and scanned. In the 1.5-T magnetic resonance imaging scanner, subjects were serially rated for alcohol craving before and after a sip of alcohol, and after a 9-minute randomized presentation of pictures of alcoholic beverages, control nonalcoholic beverages, and 2 different visual control tasks. During picture presentation, changes in regional brain activity were measured with the blood oxygen level-dependent technique. Alcoholic subjects, compared with the social drinking subjects, reported higher overall craving ratings for alcohol. After a sip of alcohol, while viewing alcohol cues compared with viewing other beverage cues, only the alcoholic subjects had increased activity in the left dorsolateral prefrontal cortex and the anterior thalamus. The social drinkers exhibited specific activation only while viewing the control beverage pictures. When exposed to alcohol cues, alcoholic subjects have increased brain activity in the prefrontal cortex and anterior thalamus-brain regions associated with emotion regulation, attention, and appetitive behavior.

Attentional bias associated with alcohol cues: Differences between heavy and occasional social drinkers

Article

Full-text available

Sep 2001

Previous research has shown an attentional bias toward drug-related stimuli in opiate addicts and toward emotionally threatening words in anxiety patients. The primary aim of this study was to investigate whether non-dependent heavy social drinkers would differ in their selective attention towards alcohol-related stimuli in comparison with a group of occasional social drinkers. Attentional bias was assessed using alcohol-related pictures and words in a dot probe detection task. Picture and word pairs were visually presented, followed by a dot probe that replaced one of the items. Attentional bias was determined from latencies in responding to the dot probe. Questionnaires were used to examine the relationships among attention, outcome expectancies after alcohol consumption, and personality traits. Higher-order executive function was also measured with two cognitive tasks, recognition memory and attentional shift. The heavy social drinkers showed an attentional bias towards the alcohol-related stimuli when compared to the occasional social drinkers. The heavy social drinkers also scored more highly on expectancy factors of sociability and sexuality and lower on the personality traits of self-directedness and persistence. Conclusion: The results support cognitive theories of addictive behaviour in which the ability of drug-related stimuli to capture attention is suggested to play a part in drug dependence, craving and relapse.

Do threatening stimuli draw or hold attention in subclinical anxiety?

Article

Full-text available

Dec 2001

Biases in information processing undoubtedly play an important role in the maintenance of emotion and emotional disorders. In an attentional cueing paradigm, threat words and angry faces had no advantage over positive or neutral words (or faces) in attracting attention to their own location, even for people who were highly state-anxious. In contrast, the presence of threatening cues (words and faces) had a strong impact on the disengagement of attention. When a threat cue was presented and a target subsequently presented in another location, high state-anxious individuals took longer to detect the target relative to when either a positive or a neutral cue was presented. It is concluded that threat-related stimuli affect attentional dwell time and the disengage component of attention, leaving the question of whether threat stimuli affect the shift component of attention open to debate.

Limbic activation during cue-induced craving for cocaine and for natural rewards

Article

Apr 1999
BIOL PSYCHIAT

The neural basis of drug craving: An incentive-sensitization theory of addiction

Article

Nov 1993
BRAIN RES REV

This paper presents a biopsychological theory of drug addiction, the 'Incentive-Sensitization Theory'. The theory addresses three fundamental questions. The first is: why do addicts crave drugs? That is, what is the psychological and neurobiological basis of drug craving? The second is: why does drug craving persist even after long periods of abstinence? The third is whether 'wanting' drugs (drug craving) is attributable to 'liking' drugs (to the subjective pleasurable effects of drugs)? The theory posits the following. (1) Addictive drugs share the ability to enhance mesotelencephalic dopamine neurotransmission. (2) One psychological function of this neural system is to attribute 'incentive salience' to the perception and mental representation of events associated with activation of the system. Incentive salience is a psychological process that transforms the perception of stimuli, imbuing them with salience, making them attractive, 'wanted', incentive stimuli. (3) In some individuals the repeated use of addictive drugs produces incremental neuroadaptations in this neural system, rendering it increasingly and perhaps permanently, hypersensitive ('sensitized') to drugs and drug-associated stimuli. The sensitization of dopamine systems is gated by associative learning, which causes excessive incentive salience to be attributed to the act of drug taking and to stimuli associated with drug taking. It is specifically the sensitization of incentive salience, therefore, that transforms ordinary 'wanting' into excessive drug craving. (4) It is further proposed that sensitization of the neural systems responsible for incentive salience ('for wanting') can occur independently of changes in neural systems that mediate the subjective pleasurable effects of drugs (drug 'liking') and of neural systems that mediate withdrawal. Thus, sensitization of incentive salience can produce addictive behavior (compulsive drug seeking and drug taking) even if the expectation of drug pleasure or the aversive properties of withdrawal are diminished and even in the face of strong disincentives, including the loss of reputation, job, home and family. We review evidence for this view of addiction and discuss its implications for understanding the psychology and neurobiology of addiction.

Psychopathology in Hospitalized Alcoholics

Article

Nov 1985
ARCH GEN PSYCHIAT

Michie N. Hesselbrock

• This study utilized the DSM-III criteria and the National Institute of Mental Health Diagnostic Interview Schedule to assess the prevalence of lifetime psychopathology among hospitalized alcoholics. Antisocial personality (ASP) and substance-use disorder were common psychopathologies among male alcoholics and major depression and phobia were common among female alcoholics. The onset of most psychopathologies preceded the abuse of alcohol among women. In men, however, with the exception of ASP and panic disorder, the onset of psycopathology was subsequent to that of alcohol abuse and/or dependence. Diagnoses of ASP and substance abuse were characterized by early onset of regular intoxication and alcohol abuse. Gender and the presence of specific psychopathology appeared to modify the course and symptom picture of alcoholism. In general, alcoholic women showed a later onset of regular intoxication and a more rapid progression to alcohol abuse and dependence than alcoholic men.

The Prevalence of Psychiatric Disorders in Patients With Alcohol and Other Drug Problems

Article

Nov 1988
ARCH GEN PSYCHIAT

Helen E. Ross

• A survey evaluated the lifetime and current prevalence of mental disorders in 501 patients seeking assistance with alcohol and other drug problems at an addiction research and treatment facility. Information was gathered using the National Institute of Mental Health Diagnostic Interview Schedule (DIS) and computer diagnoses were generated according to DSM-III criteria. Four fifths (78%) of the sample had a DIS lifetime psychiatric disorder in addition to substance use, and two thirds (65%) had a current DIS mental disorder. Excluding the unreliably diagnosed generalized anxiety disorder, the most common lifetime disorders were antisocial personality disorder, phobias, psychosexual dysfunctions, major depression, and dysthymia. Patients who abused both alcohol and other drugs were the most psychiatrically impaired. Patients with DIS psychiatric disorders had more severe alcohol and other drug problems. Barbiturate/sedative/hypnotic, amphetamine, and alcohol abusers were the most likely to have a DIS mental disorder.

Common effects of emotional valence, arousal and attention on neural activation during visual processing of pictures

Article

Dec 1999
NEUROPSYCHOLOGIA

Emotion and attention heighten sensitivity to visual cues. How neural activation patterns associated with emotion change as a function of the availability of attentional resources is unknown. We used positron emission tomography (PET) and 15O-water to measure brain activity in male volunteers while they viewed emotional picture sets that could be classified according to valence or arousal. Subjects simultaneously performed a distraction task that manipulated the availability of attentional resources. Twelve scan conditions were generated in a 3 x 2 x 2 factorial design involving three levels of valence (pleasant, unpleasant and neutral), two levels of arousal and two levels of attention (low and high distraction). Extrastriate visual cortical and anterior temporal areas were independently activated by emotional valence, arousal and attention. Common areas of activation derived from a conjunction analysis of these separate activations revealed extensive areas of activation in extrastriate visual cortex with a focus in right BA18 (12, -88, -2) (Z=5.73, P < 0.001 corrected) and right anterior temporal cortex BA38 (42, 14, -30) (Z=4.03, P < 0.05 corrected). These findings support an hypothesis that emotion and attention modulate both early and late stages of visual processing.

INCENTIVE-SENSITIZATION AS THE BASIS OF DRUG CRAVING

Article

Aug 1993
BEHAV PHARMACOL

International Affective Picture System (IAPS): Technical Manual and Affective Ratings

Article

Jan 1999

The Many Paths to Drug Dependence

Article

Jan 1992

in the normal course of treating patients, therapists hear many versions about how dependence begins, and they also have the opportunity to interview and observe patients who have relapsed after extended drug-free periods / when seen from a clinical perspective, these retrospective accounts indicate that there are many paths to drug dependence / this paper will illustrate some of these paths, using clinical examples, and will discuss their importance for designing prevention efforts diagnosing drug dependence: strength and persistence of drug-seeking behavior / treatment as a means to reduce or manage the strength and persistence of drug-seeking behavior / clinical vignettes / factors that contribute to the development of addiction (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Functional Magnetic Resonance Imaging of Brain Reward Circuitry in the Human

Article

Jun 1999
ANN NY ACAD SCI

To produce behavior, motivational states necessitate at least three fundamental operations, including (1) selection of objectives focused on goal-objects, (2) compilation of goal-object information, and (3) determination of physical plans for securing goal-objects. The second of these general operations has been theorized to involve three subprocesses: (a) feature detection and other perceptual processing of putative goal-object “rewards,” (b) valuation of goal-object worth in the context of potential hedonic deficit states, and (c) extraction of incidence and temporal data regarding the goal-object. A number of subcortical brain regions appear to be involved in these three informational subprocesses, in particular, the amygdala, sublenticular extended amygdala (SLEA) of the basal forebrain, and nucleus accumbens/subcallosal cortex (NAc/SCC). Components of the amygdala, SLEA, and NAc/SCC together constitute the larger anatomic structure of the extended amygdala. Functional magnetic resonance imaging (fMRI) studies of humans have recently begun to localize these subcortical regions within the extended amygdala during specific experimental conditions. In this manuscript, two human cocaine- infusion studies and one cognitive psychology experiment are reviewed in relation to their pattern of fMRI activation within regions of the extended amygdala. Activation in the NAc/SCC, in particular, is evaluated in relation to a hypothesis that one function of the NAc/SCC and associated brain regions is the evaluation of goal-object incidence data for the computation of conditional probabilities regarding goal-object availability. Further work is warranted to test hypothesized functions for all regions within the extended amygdala and integrate them toward an understanding of motivated behavior.

Cox WM, Yeates GN, Regan CM. Effects of alcohol cues on cognitive processing in heavy and light drinkers. Drug Alcohol Depend 55: 85-89

Article

Jul 1999
DRUG ALCOHOL DEPEN

The effects of alcohol-related visual cues on cognitive processing in heavy and light social drinkers were assessed. Participants were exposed to either alcohol or control cues while they completed a cognitively demanding emotional Stroop task that used alcohol-related and control words as potential distracters. Heavy drinkers exposed to alcohol cues had significantly slower reaction times on the Stroop task than: (a) heavy drinkers exposed to control cues; and (b) light drinkers exposed to either alcohol or control cues. Results indicate that the effects of alcohol cues on automatic cognitive processes previously found in dependent drinkers’ also occur in social drinkers. The magnitude of these effects varies directly with social drinkers’ level of habitual alcohol use.

Attentional bias in active smokers, abstinent smokers, and nonsmokers

Article

Nov 1997
ADDICT BEHAV

Attentional bias was studied with a modified version of the Stroop test in active smokers, abstinent smokers, and nonsmokers. The task was color-naming of incongruent color-words, smoking-related words, and neutral words. The results showed that the active smokers used longer verbal reaction time (VRT) to smoking-related words compared to abstinent smokers i.e., indicating stronger attentional bias in the active smokers. Furthermore, longer VRTs to the Stroop words compared to the smoking words and the neutral words were found only in nonsmokers and abstinent smokers. Finally, a significant negative correlation was found between attitudes against smoking and VRTs to the smoking-related words. Taken together the main finding was that the active smokers showed no differential response to the stimuli. This could be caused by a lack of ability to modulate attentional processes in active smokers.

Robinson TE, Berridge KC. The neural basis of drug craving: an Incentive-Sensitization Theory of Addiction. Brain Res Reviews 18: 247-291

Article

Dec 1993

This paper presents a biopsychological theory of drug addiction, the ‘Incentive-Sensitization Theory’. The theory addresses three fundamental questions. The first is: why do addicts crave drugs? That is, what is the psychological and neurobiological basis of drug craving? The second is: why does drug craving persist even after long periods of abstinence? The third is whether ‘wanting’ drugs (drug craving) is attributable to ‘liking’ drugs (to the subjective pleasurable effects of drugs)? The theory posits the following.

Common effects of emotional valence, arousal and attention on neural activation during visual processing of pictures

Article

Sep 1999
NEUROPSYCHOLOGIA

Emotion and attention heighten sensitivity to visual cues. How neural activation patterns associated with emotion change as a function of the availability of attentional resources is unknown. We used positron emission tomography (PET) and 15O-water to measure brain activity in male volunteers while they viewed emotional picture sets that could be classified according to valence or arousal. Subjects simultaneously performed a distraction task that manipulated the availability of attentional resources. Twelve scan conditions were generated in a 3×2×2 factorial design involving three levels of valence (pleasant, unpleasant and neutral), two levels of arousal and two levels of attention (low and high distraction).Extrastriate visual cortical and anterior temporal areas were independently activated by emotional valence, arousal and attention. Common areas of activation derived from a conjunction analysis of these separate activations revealed extensive areas of activation in extrastriate visual cortex with a focus in right BA18 (12, −88, −2) (Z=5.73, P<0.001 corrected) and right anterior temporal cortex BA38 (42, 14, −30) (Z=4.03, P<0.05 corrected). These findings support an hypothesis that emotion and attention modulate both early and late stages of visual processing.

Evidence of attention to threatening stimuli in depression

Article

Oct 1996
BEHAV RES THER

A modified version of the attentional deployment task developed by MacLeod, Mathews and Tata (1986) [Journal of Abnormal Psychology, 95, 15–20] was used to examine two issues: first, whether there was any evidence of attentional bias in depressed subjects, rather than in anxious subjects alone; and second, whether attentional effects would occur in the location of stimuli that could not be identified. Subjects were presented with pairs of words, one above the other, and the extent to which attention favored threatening rather than neutral words was assessed from the latency to detect a dot in the same location of one them. These detection latencies showed that depressed, but not anxious subjects, were selectively attentive to socially threatening words. There was also evidence for attentional effects in the anxious subjects favoring physically threatening words. Furthermore, panic disorder patients were preferentially attentive to the location of physically-threatening stimuli that could not be accurately identified. Overall, the results provide further evidence that emotionally disturbed subjects tend to orient attention towards personally-relevant emotional stimuli. However, the previous hypothesis that this attentional bias occurs only in anxiety, and not in depression, was not supported.

Additional psychiatric illness by Diagnostic Interview Schedule in male alcoholics

Article

Feb 1990
COMPR PSYCHIAT

Seventy-four male veterans entering an alcohol abuse treatment program were screened for additional psychiatric diagnoses using the Diagnostic Interview Schedule (DIS). Fifty-four of these also completed a questionnaire on personal and family drinking history. Over half (54.1%) had another diagnosis. The most common syndromes other than substance abuse were antisocial personality disorder, phobic disorder, and depression. In each of these cases, the presence of the additional disorder accelerated the course of the alcohol problem significantly. The difference in course between syndromes was dwarfed by the time of presentation by the difference between "pure" alcoholism and alcoholism with another diagnosis. The primary versus secondary distinction appeared to account for only a part of this effect.

The prevalence of psychiatric disorders in patient with alcohol and other drug problems

Article

Dec 1988
ARCH GEN PSYCHIAT

A survey evaluated the lifetime and current prevalence of mental disorders in 501 patients seeking assistance with alcohol and other drug problems at an addiction research and treatment facility. Information was gathered using the National Institute of Mental Health Diagnostic Interview Schedule (DIS) and computer diagnoses were generated according to DSM-III criteria. Four fifths (78%) of the sample had a DIS lifetime psychiatric disorder in addition to substance use, and two thirds (65%) had a current DIS mental disorder. Excluding the unreliably diagnosed generalized anxiety disorder, the most common lifetime disorders were antisocial personality disorder, phobias, psychosexual dysfunctions, major depression, and dysthymia. Patients who abused both alcohol and other drugs were the most psychiatrically impaired. Patients with DIS psychiatric disorders had more severe alcohol and other drug problems. Barbiturate/sedative/hypnotic, amphetamine, and alcohol abusers were the most likely to have a DIS mental disorder.

Watson D, Clark LA, Tellegen A. Development and Validation of Brief Measures of Positive and Negative Affect - the Panas Scales. J Pers Soc Psychol 54: 1063-1070

Article

Jul 1988

Treatment and outcome in secondary depression: A naturalistic study of 1087 patients

Article

Dec 1987

In a naturalistic study, the treatment response and outcome of 1087 patients with nonbipolar primary (N = 763) and secondary (N = 324) depression were compared by a chart review. The patients were divided into four treatment groups, based on the primary mode of therapy received during the index hospitalization: ECT, adequate antidepressant, inadequate antidepressant, and neither treatment. Primary depressives were more likely to have received ECT, and secondary depressives were more likely to have received inadequate antidepressant or neither treatment. A total of 436 (57.1%) primary depressives received adequate therapy, but only 113 (34.9%) secondary depressives did (p less than .001). Overall, primary depressives responded better to treatment (both ECT and antidepressants) than did secondary depressives. A total of 470 (61.6%) primary depressives but only 140 (43.2%) secondary depressives were recovered at discharge (p less than .001). The conclusion is that secondary depressives are more likely to receive inadequate treatment and are less likely to respond to adequate treatment than are primary depressives.

Primary and secondary depression in alcoholic men: An important distinction?

Article

Apr 1987

The primary-secondary depression distinction was investigated in male alcoholic patients from five Veterans Administration Medical Centers. The Psychiatric Diagnostic Interview, a DSM-III-compatible, criterion-referenced, structured interview, was administered to 565 patients admitted to the Alcoholism and Drug Treatment Units. Seventy-eight patients (13.8%) who exhibited only alcoholism and depression were divided into three subgroups based on the temporal onset of depression relative to the onset of alcoholism. Although few statistical differences were found, observed trends suggested more impairment in alcoholic patients with primary depression than in those with concurrent or secondary depression. The findings indicate that the primary-secondary depression distinction may have important clinical relevance and should be made whenever possible.

Psychopathology in Hospitalized Alcoholics

Article

Dec 1985
ARCH GEN PSYCHIAT

This study utilized the DSM-III criteria and the National Institute of Mental Health Diagnostic Interview Schedule to assess the prevalence of lifetime psychopathology among hospitalized alcoholics. Antisocial personality (ASP) and substance-use disorder were common psychopathologies among male alcoholics and major depression and phobia were common among female alcoholics. The onset of most psychopathologies preceded the abuse of alcohol among women. In men, however, with the exception of ASP and panic disorder, the onset of psychopathology was subsequent to that of alcohol abuse and/or dependence. Diagnoses of ASP and substance abuse were characterized by early onset of regular intoxication and alcohol abuse. Gender and the presence of specific psychopathology appeared to modify the course and symptom picture of alcoholism. In general, alcoholic women showed a later onset of regular intoxication and a more rapid progression to alcohol abuse and dependence than alcoholic men.

Effects of Disease-Related Cues in Alcoholic Inpatients: Results of a Controlled "Alcohol Stroop" Study

Article

Jul 1995

We tested the hypothesis that alcoholics develop a disease-related attentional bias. Therefore, alcohol-related, but task-irrelevant, words should cause a specific perceptual-processing bias. We investigated this by using a special color-naming task. We subjected 40 male alcohol-dependent inpatients and 40 healthy male controls (matched according to age and verbal IQ) to a modified card version of the Stroop color-naming task that consisted of a neutral and an alcohol word condition ("Alcohol Stroop"). Alcoholic inpatients performed significantly poorer than the control group under the critical experimental condition (color-naming of disease-related words), as compared with the noncritical condition (color-naming of neutral words; p = 0.03). Concerning the possible neuropsychological impairment of the patients, no effects could be found on the reaction time of the "Standard Stroop" using only neutral words (i.e., color-naming of incongruent color words administered without time limitation). The information processing bias on the "Alcohol Stroop" thus qualifies as a cognitive process, which is independent from putative neuropsychological deficits of alcoholic patients and might represent an essential feature of alcoholic psychopathology. The "Alcohol Stroop" contributes to the experimental psychopathology of alcoholism.

A new self-rating scale for depression and anxiety states based on the Comprehensive Psychopathological Rating Scale

Article

Feb 1994

Self-assessment scales have long been used in psychiatric research even if their validity has often been questioned, one reason being poor the concordance of expert ratings. In clinical practice the use of rating scales is restricted, since they are considered to be time-consuming and perhaps even to disrupt the clinician's rapport with the patient. In the present study, a self-assessment scale, the CPRS Self-rating Scale for Affective Syndromes (CPRS-S-A), was constructed by re-phrasing in a self-rating format 19 items from the original Comprehensive Psychopathological Rating Scale (CPRS) and covering depression, anxiety and obsessional symptoms. In a group of 30 patients with depression syndromes and anxiety syndromes, the CPRS-S-A and the original CPRS were both used on 2 occasions. The patient's Global Assessment of Functioning scores ranged from 30 to 76 (mean 58), which suggests a moderate severity of illness, as does the fact that the majority were outpatients. There was a high degree of concordance between the instruments for most items and for the scores on the subscales for both diagnostic groups (i.e., the Montgomery-Asberg Depression Rating Scale and the Brief Anxiety Scale, which are both subscales drawn from the CPRS). The time taken to complete the CPRS-S-A varied from 5 to 30 min (mean 19 min for depressive and 16 min for anxiety patients on the first occasion, 13 min for both groups on the second), and the self-rating procedure was readily accepted by both groups of patients. The CPRS-S-A would thus seem to be a promising instrument for quantitative rating of symptoms in ambulatory patients, both in clinical practice and in research.

Measures of visual scanning as a predictor of cocaine cravings and urges

Article

May 1993
BIOL PSYCHIAT

A nationwide representative sample of treatment-seeking alcoholics: A study of psychiatric comorbidity

Article

Dec 1995

In order to elucidate the psychiatric comorbidity of patients in alcohol and other substance use disorder treatment we examined a representative sample of such patients in Iceland (249 men and 102 women). Over 70% of pure alcoholics and over 90% of polysubstance users had comorbid diagnoses, a prevalence higher than in the Epidemiological Catchment Area study in the United States, but similar to clinical studies from North America. The most prevalent disorders were: affective (33%), anxiety (65%), antisocial personality disorder (28%) and psychosexual dysfunction (20%). Pure alcoholics and polysubstance users in studies on psychiatric comorbidity should be separated. Anxiety and affective disorders influence treatment seeking. Findings concerning the impact of psychiatric comorbidity on course should be comparable between North America and Europe.

AFNI: Software for Analysis and Visualization of Functional Magnetic Resonance Neuroimages

Article

Jul 1996

Robert W. Cox

A package of computer programs for analysis and visualization of three-dimensional human brain functional magnetic resonance imaging (FMRI) results is described. The software can color overlay neural activation maps onto higher resolution anatomical scans. Slices in each cardinal plane can be viewed simultaneously. Manual placement of markers on anatomical landmarks allows transformation of anatomical and functional scans into stereotaxic (Talairach-Tournoux) coordinates. The techniques for automatically generating transformed functional data sets from manually labeled anatomical data sets are described. Facilities are provided for several types of statistical analyses of multiple 3D functional data sets. The programs are written in ANSI C and Motif 1.2 to run on Unix workstations.

Preattentive and attentive eye movements during visual scanning of a cocaine cue: Correlation with intensity of cocaine cravings

Article

Feb 1997

The visual scanning of 19 recently abstinent crack cocaine-dependent men was assessed while they viewed a picture of a cocaine cue and a picture of a neutral cue. Cocaine craving scores were inversely correlated with the number of preattentive fixations and saccades and were positively correlated with the number of attentive fixations.

Parametric Analysis of fMRI Data Using Linear Systems Methods

Article

Sep 1997

Mark S Cohen

Using a model of the functional MRI (fMRI) impulse response based on published data, we have demonstrated that the form of the fMRI response to stimuli of freely varied timing can be modeled well by convolution of the impulse response with the behavioral stimulus. The amplitudes of the responses as a function of parametrically varied behavioral conditions are fitted well using a piecewise linear approximation. Use of the combined model, in conjunction with correlation analysis, results in an increase in sensitivity for the MRI study. This approach, based on the well-established methods of linear systems analysis, also allows a quantitative comparison of the response amplitudes across subjects to a broad range of behavioral conditions. Fit parameters, derived from the amplitude data, are relatively insensitive to a variety of MRI-related artifacts and yield results that are compared readily across subjects.

Attentional bias for negative information in induced and naturally occurring dysphoria

Article

Nov 1997
BEHAV RES THER

Two studies investigated the relationship between attentional biases for negative information and dysphoria--both induced (Study 1) and naturally occurring (Study 2). In a modified dot probe task a series of word pairs was presented, and Ss responded to probes that replaced one of the words in each pair. The stimuli included depression-related, anxiety-related and neutral words. To examine the time course of the attentional biases, there were three exposure durations of the word pairs: 14 ms (+ 186 ms mask); 500 ms and 1000 ms. In Study 1, the depressed mood induction procedure was associated with greater vigilance for depression-related words at 500 ms, with a similar trend at 1000 ms. In Study 2, measures of depressed mood and vulnerability correlated positively with vigilance for negative words in the 1000 ms condition. There was no evidence from either study that depressed mood was associated with a pre-conscious bias for negative words (i.e. in the 14 ms masked exposure condition). However, this pre-conscious bias was associated with high trait anxiety in Study 2, consistent with previous research. The results are discussed in relation to theoretical and empirical work on cognitive biases in clinical and non-clinical anxiety and depression.

Article

Nov 1998

To compare alcohol abusers' and non-abusers' distraction for alcohol-related and emotional words, controlling for emotional valence of those words. The experiment compared 20 alcohol abusers and 20 non-abusers in terms of performance on a computerized Stroop colour-naming test using alcohol-related and non-alcohol-related words. Abusers rated the alcohol stimuli greater in emotional valence than the emotional stimuli. Therefore, differences in emotional-valence ratings between the two groups were statistically controlled. Against expectation, both alcohol abusers and non-abusers were more distracted by alcohol stimuli than by positive or negative emotional stimuli. The results indicate that alcohol words are distracting for drinkers in general, and this may indicate a high level of salience for these kinds of stimuli.

Functional magnetic resonance imaging of brain reward circuitry in the human

Article

Jul 1999

To produce behavior, motivational states necessitate at least three fundamental operations, including (1) selection of objectives focused on goal-objects, (2) compilation of goal-object information, and (3) determination of physical plans for securing goal-objects. The second of these general operations has been theorized to involve three subprocesses: (a) feature detection and other perceptual processing of putative goal-object "rewards," (b) valuation of goal-object worth in the context of potential hedonic deficit states, and (c) extraction of incidence and temporal data regarding the goal-object. A number of subcortical brain regions appear to be involved in these three informational subprocesses, in particular, the amygdala, sublenticular extended amygdala (SLEA) of the basal forebrain, and nucleus accumbens/subcallosal cortex (NAc/SCC). Components of the amygdala, SLEA, and NAc/SCC together constitute the larger anatomic structure of the extended amygdala. Functional magnetic resonance imaging (fMRI) studies of humans have recently begun to localize these subcortical regions within the extended amygdala during specific experimental conditions. In this manuscript, two human cocaine- infusion studies and one cognitive psychology experiment are reviewed in relation to their pattern of fMRI activation within regions of the extended amygdala. Activation in the NAc/SCC, in particular, is evaluated in relation to a hypothesis that one function of the NAc/SCC and associated brain regions is the evaluation of goal-object incidence data for the computation of conditional probabilities regarding goal-object availability. Further work is warranted to test hypothesized functions for all regions within the extended amygdala and integrate them toward an understanding of motivated behavior.

Alcoholics' selective attention to alcohol stimuli: Automated processing?

Article

Feb 2000

This study investigated alcoholics' selective attention to alcohol words in a version of the Stroop color-naming task. Alcoholic subjects (n = 23) and nonalcoholic control subjects (n = 23) identified the color of Stroop versions of alcohol, emotional, neutral and color words. Manual reaction times (RTs), skin conductance responses (SCRs) and heart rate (HR) were recorded. Alcoholics showed overall longer RTs than controls while both groups were slower in responding to the incongruent color words than to the other words. Alcoholics showed longer RTs to both alcohol (1522.7 milliseconds [ms]) and emotional words (1523.7 ms) than to neutral words (1450.8 ms) which suggests that the content of these words interfered with the ability to attend to the color of the words. There was also a negative correlation (r = -.41) between RT and response accuracy to alcohol words for the alcoholics, reflecting that the longer time the alcoholics used to respond to the color of the alcohol words, the more incorrect their responses were. The alcoholics also showed significantly greater SCRs to alcohol words (0.16 microSiemens) than to any of the other words (ranging from 0.04-0.08 microSiemens), probably reflecting the emotional significance of the alcohol words. Finally, the alcoholics evidenced smaller HR acceleration to alcohol (1.9 delta bpm) compared to neutral (2.8 delta bpm), which could be related to difficulties alcoholics experience in terminating their attention to the alcohol words. These findings indicate that it is difficult for alcoholics to regulate their attention to alcohol stimuli, suggesting that alcoholics' processing of alcohol information is automated.

Influence of individual differences in craving and obsessive cocaine thoughts on attentional processes in cocaine abuse patients

Article

Feb 2000
ADDICT BEHAV

In the present pilot-study, the relation between craving, obsessive thoughts about cocaine, experienced control, and attentional bias for cocaine related words is investigated. Sixteen cocaine abuse patients participated in a reaction time (RT) experiment which was employed to measure the ability of subjects to shift their attention away from cocaine related words. Postexperiment craving was found to be positively correlated with reaction times on drug related cues, in contrast to RT on neutral cues. Furthermore, obsessive thoughts about cocaine use and the experienced cocaine use control, in the week before the experiment, were correlated in a higher degree with RTs on drug cues than postexperiment craving. Attentional bias for drug cues was evidenced in patients with higher scores on obsessive cocaine thoughts and higher craving scores. This study shows that individual differences on information processing, within a cocaine abuse patient population, are present.

Attentional bias for drug cues in opiate dependence

Article

Jan 2000

In a number of theories of compulsive drug use conditioned responses to stimuli associated with drug taking play a pivotal role. For example, according to incentive-sensitization theory (Robinson & Berridge, 1993), drug-related stimuli selectively capture attention, and the neural mechanisms underlying this attentional bias play a key role in the development and maintenance of drug dependence, and in relapse. However, there has been little work that assesses attentional biases in addiction. We used a pictorial probe detection task to investigate whether there is an attentional bias to stimuli associated with drug use in opiate dependence. Stimuli presented included pairs of drug-related and matched neutral pictures. Methadone-maintained opiate addicts (N = 16) were compared with age-matched controls (N = 16). A mixed design analysis of variance of response times to probes revealed a significant three-way interaction of group x drug picture location x probe location. Opiate addicts had relatively faster reaction times to probes that replaced drug pictures rather than neutral pictures, consistent with the predicted attentional bias to drug-related stimuli. These results support the idea that an attentional bias for drug-related stimuli occurs in opiate dependence. This is consistent with the concept of a central role for such salient stimuli in compulsive drug use.

Generalized expectancies for negative mood regulation and problem drinking among college students

Article

Apr 2000

Motivational models of alcohol use often invoke constructs derived from social-learning theory, including coping styles, drinking motives and affective distress. To date, no study has assessed the potential role of negative mood regulation (NMR) expectancies (the extent to which one holds positive expectations of one's ability to cope with negative affect) in promoting problematic drinking behavior. This study evaluated the relationship between NMR expectancies and problem-related drinking while controlling for the influence of alcohol consumption, coping behaviors, drinking motives, demographic variables and affective distress. Participants (N = 136, 80% female) were college undergraduates who completed a battery of self-report questionnaires on two occasions that were separated by 8 weeks. Initial correlational analyses indicated a strong (negative) association between NMR expectancies and problem drinking behavior. Findings from separate hierarchical regression analyses demonstrated that NMR expectancies add significantly to the variance in predicting problem drinking, even when accounting for age and gender, alcohol consumption and, in respective analyses, coping styles, affective distress and drinking motives. Finally, simultaneous regression analyses showed that when all variables were considered together, only NMR expectancies, alcohol consumption and drinking-to-cope emerged as significant predictors of problem drinking. These findings highlight the potential importance of NMR expectancies as a risk factor for problem drinking, above and beyond the risk posed by traditionally studied variables (e.g., depression and anxiety, coping repertoire and drinking motives). Results are interpreted within a self-regulation framework of alcohol consumption.

Selective attentional bias to alcohol related stimuli in problem drinkers and non-problem drinkers

Article

Mar 2001

The issues explored in this study were whether a patient group of problem drinkers selectively attend to alcohol-related stimuli and the time course of any interference from alcohol-related stimuli in comparison with two control groups of non-problem drinkers. A 3 x 2 x 2 x 5 factorial design was used. Drinking group (low, high and problem) and word order (alcohol-neutral, neutral-alcohol) were between-participant factors, and word type (alcohol, neutral) and presentation block (1-5) were within participant factors. Three groups were used, 20 participants from a local community alcohol Service (CAS) and 40 participants (student volunteers) in two control groups. The two control groups were differentiated as scoring high or low on the Alcohol Use Disorders Identification Test (AUDIT). A modified computerized Stroop colour naming test was used to measure response latencies. Anxiety was measured using the State-Trait Anxiety Inventory. The CAS group showed significantly longer reaction times to respond to the colour of alcohol-related words than to neutral category words. Although the interference was smaller for the high AUDIT group it was significant. No significant interference was found in the low AUDIT group. There was no statistical evidence that the interference habituated in the three groups. The present study showed it is possible to use a modified Stroop task as a measure of implicit processing of alcohol stimuli. Despite the fact that all participants were asked to ignore the words, they were unable to do so. Alcohol-related words produced more interference than neutral category words in a group of problem drinkers and a control group of high alcohol drinkers.

Subcortical Correlates of Craving in Recently Abstinent Alcoholic Patients

Article

Aug 2001

This study investigated functional cerebral correlates of craving in alcoholic patients and examined the state/trait characteristics of the regional cerebral network implicated in craving. Functional magnetic resonance imaging (fMRI) was used to map cerebral response elicited by ethanol odor in 10 male patients with alcohol dependence who had undergone detoxification and 10 matched nonpatients. After 3 weeks, during which the patients underwent standardized behavioral therapy with psychopharmacological intervention, all subjects were studied a second time with fMRI to evaluate the effects of therapy on the functional cerebral correlates of craving. In the alcoholic patients, cue-induced craving before treatment elicited activation primarily in the subcortical-limbic region of the right amygdala/hippocampal area and in the cerebellum. After treatment, activation was found in the superior temporal sulcus, while subcortical or cerebellar participation was no longer present. Comparison subjects showed no comparable amygdala or cerebellar activation during ethanol stimulation and demonstrated no change in activation pattern between measurements. This investigation points to state-dependent neurobiological correlates of cue-induced craving in alcoholic patients and suggests that these correlates can be influenced by therapeutic interventions. The presence of emotional aspects of craving is suggested by amygdala activation.

Alcohol-associated stimuli activate the ventral striatum in abstinent alcoholics

Article

Feb 2001

Alcohol-associated cues may act as conditioned stimuli that activate the brain reward system and motivate alcohol intake in alcoholics. Alcohol-associated visual stimuli were presented during functional magnetic resonance imaging. An activation of the ventral putamen was observed in alcoholics but not in control subjects. Patients with a strong activation of the ventral putamen relapsed during the next three months. This observation supports the hypothesis that alcohol use affects areas involved in brain reward circuits and that their stimulus-induced activation may be associated with an increased risk for relapse.

Attentional bias and alcohol dependence: a controlled study using the modified stroop paradigm

Article

Jul 2002
ADDICT BEHAV

Frank Ryan

Detoxified clients at an alcohol treatment centre (n = 34) were administered a modified Stroop test, an index of attentional bias or distraction. Their performance was compared to controls (n = 33) who were staff recruited from specialist substance misuse clinics based on the presumption of familiarity with the alcohol and addiction related terms of the Stroop task. The card-format Stroop test contained words such as "alcohol" and "relapse" and neutral, semantically homogenous words such as "table" and "chair." Analysis of variance (ANOVA) revealed significant main effects for word type with both the clinic attendees and controls taking longer to colour-name alcohol-related words. Predicted interactions between word type and subject status were not observed. These findings suggest that both problem drinkers and clinic staff did not differ significantly in the degree of Stroop interference displayed, although a trend towards greater distraction by clinic attendees with alcohol-related terms was noted. The statistically significant results were nonetheless consistent with findings that expertise or familiarity can be influential factors in Stroop performance. Multiple regression analyses with the entire sample (n = 65) showed that psychometric and self-reported indices of alcohol dependence and consumption were predictive of Stroop interference. This is consistent with the existence of a acquired information processing bias related to escalating alcohol use and dependence such as that proposed by Tiffany [Psychol. Rev. 97 (1990) 147.].

IMAGING STUDY: Modulation of brain response to emotional images by alcohol cues in alcohol‐dependent patients

Abstract

No full-text available

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