Inhibitory Control and Emotional Stress Regulation: Neuroimaging Evidence for Frontal-Limbic Dysfunction in Psycho-Stimulant Addiction

Department of Psychiatry, Yale University School of Medicine, Connecticut Mental Health Center S103, New Haven, CT 06519, USA.
Neuroscience & Biobehavioral Reviews (Impact Factor: 8.8). 02/2008; 32(3):581-97. DOI: 10.1016/j.neubiorev.2007.10.003
Source: PubMed


This review focuses on neuroimaging studies that examined stress processing and regulation and cognitive inhibitory control in patients with psycho-stimulant addiction. We provide an overview of these studies, summarizing converging evidence and discrepancies as they occur in the literature. We also adopt an analytic perspective and dissect these psychological processes into their sub-components, to identify the neural pathways specific to each component process and those that are more specifically involved in psycho-stimulant addiction. To this aim we refer frequently to studies conducted in healthy individuals. Despite the separate treatment of stress/affect regulation, stress-related craving or compulsive drug seeking, and inhibitory control, neural underpinnings of these processes overlap significantly. In particular, the ventromedial prefrontal regions including the anterior cingulate cortex, amygdala and the striatum are implicated in psychostimulant dependence. Our overarching thesis is that prefrontal activity ensures intact emotional stress regulation and inhibitory control. Altered prefrontal activity along with heightened striatal responses to addicted drug and drug-related salient stimuli perpetuates habitual drug seeking. Further studies that examine the functional relationships of these neural systems will likely provide the key to understanding the mechanisms underlying compulsive drug use behaviors in psycho-stimulant dependence.

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    • "We found no support for our primary hypothesis, that acute stress would impair inhibitory control. The absence of any effect of stress on inhibitory control is surprising given theoretical predictions that emotional regulation of stress responses and inhibitory control compete for resources (Li and Sinha 2008), and previous findings that acute stress and alcohol-related cues reliably impaired inhibitory control in male problem drinkers (Zack et al. 2011). However, closer examination of the existing literature suggests that these inconsistencies could be attributable to heterogeneity of the stress response: the effect of stress on executive functioning may be 'u-shaped', with high and low stress impairing executive function, but moderate stress improving it (Henderson et al. 2012). "
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    ABSTRACT: Rationale Stress increases alcohol consumption and the risk of relapse, but little is known about the psychological mechanisms that underlie these effects. One candidate mechanism is inhibitory control, which may be impaired by acute stress and is believed to exert a causal influence on alcohol consumption. Objectives We investigated if acute stress would impair inhibitory control and if impaired inhibitory control would be associated with subsequent ad-libitum alcohol consumption in a naturalistic laboratory setting. Materials and methods One hundred heavy drinkers took part in an experimental study in a naturalistic ‘bar laboratory’. Participants were randomly assigned to an acute stress (n = 50) or control (n = 50) group. In the stress group, participants were exposed to the social evaluative threat of giving a self-critical presentation, whereas the control group completed simple anagrams. Prior to and following the manipulation, participants completed the stop signal task as a measure of inhibitory control. Finally, participants completed a bogus taste test, as a measure of ad-libitum alcohol consumption. Results The stress manipulation had no effect on performance on the stop signal task. However, there was a small but significant increase in ad-libitum alcohol consumption in the acute stress group compared to that in the control group. Conclusions Acute stress increased alcohol consumption in heavy drinkers, in a semi-naturalistic setting. However, this was not through the hypothesised mechanism of a transient impairment in inhibitory control.
    Preview · Article · Jan 2016 · Psychopharmacology
    • "Certainly, clarification is needed as to which subfacets of impulsivity are most relevant to food addiction as well as insight into the potential association between emotion regulation and food addiction. Emotion regulation also likely plays a part in food addiction as it does in drug use disorders (Aldao, Nolen-Hoeksema, & Schweizer, 2010; Fox, Hong, & Sinha, 2008; Li & Sinha, 2008). Emotion regulation is the extent to which individuals influence, experience and express their emotions (Hofmann, Sawyer, Fang, & Asnaani, 2012). "
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    ABSTRACT: Food addiction is the clinical occurrence in which individuals develop physical and psychological dependencies on high fat, high sugar, and highly palatable foods. Past research has demonstrated a number of similarities between food addiction and drug use disorders including the activation of specific brain regions and neurotransmitters, disrupted neuronal circuitry, and behavioral indicators of addiction such as continued use despite negative consequences. The present study examined the role of impulsivity and emotion dysregulation in food addiction as both play salient roles in drug use disorders. Poisson regression analyses using data from 878 undergraduate students revealed negative urgency, the tendency to act impulsively when under distress, and emotion dysregulation positively predicted symptom count on the Yale Food Addiction Scale (Gearhardt, Corbin, & Brownell, 2009) whereas a lack of premeditation negatively predicted symptom count (all ps<0.05). Future research is needed to confirm precursors to eating episodes in food addiction, elucidate causal mechanisms, and support an explanatory model of food addiction. Copyright © 2015 Elsevier Ltd. All rights reserved.
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    • "Prominent biological theories of addiction implicate the brain reward system: the genes, neurotransmitters, transporters, and enzyme targets of the dopamine, serotonin, and glutamate systems of the brain (C.-S. R. Li & Sinha, 2008; Nestler, 2005; Schnoll, Johnson, & Lerman, 2007). The most recent studies include genomewide association studies and meta-analyses of genomewide association studies (Bierut et al., 2007; GENEVA Consortium, 2012; C.-Y. Li et al., 2011; Thorgeirsson et al., 2010), which have implicated a number of genes in predisposition to addiction , as well as difficulty remaining abstinent. "
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    ABSTRACT: The cost of addiction in the United States, in combination with a host of new tools and techniques, has fueled an explosion of genetic research on addiction. Because the media has the capacity to reflect and influence public perception, there is a need to examine how treatments and preventive approaches projected to emerge from addiction genetic research are presented to the public. The authors conducted a textual analysis of 145 news articles reporting on genetic research on addiction from popular print media in the United States and from popular news and medical internet sites. In articles that report on prevention, the media emphasize vaccine development and identifying individuals at genetic risk through population screening. Articles that emphasize treatment often promote current pharmaceutical solutions and highlight the possibility of tailoring treatments to specific genetic variants. The authors raise concerns about the tendency of this coverage to focus on the benefits of pharmaceutical treatments and genetic-based approaches to prevention while neglecting or downplaying potential risks and ethical issues. This analysis suggests a need for more balanced, evidence-based media reporting on the potential outcomes of genetic research.
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