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1.
Psychopharmacology (Berl) ; 234(15): 2289-2297, 2017 Aug.
Article in English | MEDLINE | ID: mdl-28551713

ABSTRACT

RATIONALE: Biased attention towards drug-related cues and reduced inhibitory control over the regulation of drug-intake characterize drug addiction. The noradrenaline system has been critically implicated in both attentional and response inhibitory processes and is directly affected by drugs such as cocaine. OBJECTIVES: We examined the potentially beneficial effects of the noradrenaline reuptake inhibitor atomoxetine in improving cognitive control during two tasks that used cocaine- and non-cocaine-related stimuli. METHODS: A double-blind, placebo-controlled, and cross-over psycho-pharmacological design was employed. A single oral dose of atomoxetine (40 mg) was administered to 28 cocaine-dependent individuals (CDIs) and 28 healthy controls. All participants performed a pictorial attentional bias task involving both cocaine- and non-cocaine-related pictures as well as a verbal go/no-go task composed of cocaine- and food-related words. RESULTS: As expected, CDIs showed attentional bias to cocaine-related cues whilst controls did not. More importantly, however, atomoxetine, relative to placebo, significantly attenuated attentional bias in CDIs (F 26 = 6.73, P = 0.01). During the go/no-go task, there was a treatment × trial × group interaction, although this finding only showed a trend towards statistical significance (F 26 = 3.38, P = 0.07). CONCLUSIONS: Our findings suggest that atomoxetine reduces attentional bias to drug-related cues in CDIs. This may result from atomoxetine's modulation of the balance between tonic/phasic activity in the locus coeruleus and the possibly parallel enhancement of noradrenergic neurotransmission within the prefrontal cortex. Studying how cognitive enhancers such as atomoxetine influence key neurocognitive indices in cocaine addiction may help to develop reliable biomarkers for patient stratification in future clinical trials.


Subject(s)
Adrenergic Uptake Inhibitors/administration & dosage , Atomoxetine Hydrochloride/administration & dosage , Attentional Bias/drug effects , Cocaine-Related Disorders/psychology , Cues , Administration, Oral , Adrenergic Uptake Inhibitors/blood , Adult , Atomoxetine Hydrochloride/blood , Attention/drug effects , Attention/physiology , Attentional Bias/physiology , Cocaine-Related Disorders/blood , Cocaine-Related Disorders/drug therapy , Cross-Over Studies , Double-Blind Method , Female , Humans , Male , Middle Aged , Photic Stimulation/methods , Psychomotor Performance/drug effects , Psychomotor Performance/physiology , Treatment Outcome
2.
Cogn Affect Behav Neurosci ; 16(5): 836-47, 2016 10.
Article in English | MEDLINE | ID: mdl-27165337

ABSTRACT

The effects of neuroticism and depressive symptoms on psychophysiological responses in a social judgment task were examined in a sample of 101 healthy young adults. Participants performed a social judgment task in which they had to predict whether or not a virtual peer presented on a computer screen liked them. After the prediction, the actual judgment was shown, and behavioral, electrocortical, and cardiac responses to this judgment were measured. The feedback-related negativity (FRN) was largest after unexpected feedback. The largest P3 was found after the expected "like" judgments, and cardiac deceleration was largest following unexpected "do not like" judgments. Both the P3 and cardiac deceleration were affected by gender-that is, only males showed differential P3 responses to social judgments, and males showed stronger cardiac decelerations. Time-frequency analyses were performed to explore theta and delta oscillations. Theta oscillations were largest following unexpected outcomes and correlated with FRN amplitudes. Delta oscillations were largest following expected "like" judgments and correlated with P3 amplitudes. Self-reported trait neuroticism was significantly related to social evaluative predictions and cardiac reactivity to social feedback, but not to the electrocortical responses. That is, higher neuroticism scores were associated with a more negative prediction bias and with smaller cardiac responses to judgments for which a positive outcome was predicted. Depressive symptoms did not affect the behavioral and psychophysiological responses in this study. The results confirmed the differential sensitivities of various outcome measures to different psychological processes, but the found individual differences could only partly be ascribed to the collected subjective measures.


Subject(s)
Anxiety Disorders/physiopathology , Anxiety Disorders/psychology , Brain/physiopathology , Depression/physiopathology , Depression/psychology , Psychological Distance , Electroencephalography , Evoked Potentials , Feedback, Psychological/physiology , Female , Heart Rate/physiology , Humans , Judgment/physiology , Male , Neuropsychological Tests , Neuroticism , Peer Group , Surveys and Questionnaires , User-Computer Interface , Young Adult
3.
Genes Brain Behav ; 13(7): 618-25, 2014 Sep.
Article in English | MEDLINE | ID: mdl-24902721

ABSTRACT

Substance use often starts in adolescence and poses a major problem for society and individual health. The dopamine system plays a role in substance use, and catechol-O-methyltransferase (COMT) is an important enzyme that degrades dopamine. The Val(108/158) Met polymorphism modulates COMT activity and thus dopamine levels, and has been linked to substance use. COMT gene methylation, on the other hand, may affect expression and thus indirectly COMT activity. We investigated whether methylation of the COMT gene was associated with adolescents' substance use. Furthermore, we explored whether the COMT Val(108/158) Met polymorphism interacts with COMT gene methylation in association with substance use. In 463 adolescents (mean age=16, 50.8% girls), substance use (cigarette smoking, alcohol and cannabis use) was assessed with self-report questionnaires. From blood samples, COMT Val(108/158) Met genotype and methylation rates of membrane bound (MB) and soluble (S) COMT promoters were assessed. MB-COMT promoter methylation was associated with non-daily smoking [odds ratio (OR)=1.82, P=0.03], but not with daily smoking (OR=1.20, P=0.34), MB-COMT promoter methylation was not associated with alcohol use. Adolescents with the Met/Met genotype and high rates of MB-COMT promoter methylation were less likely to be high-frequent cannabis users than adolescents with the Val/Val or Val/Met genotype. S-COMT promoter methylation was not associated with substance use. These results indicate that there is an association between substance use and COMT gene methylation. Although this association is complex, combining genetic and epigenetic variation of the COMT gene may be helpful in further elucidating the influence of the dopamine system on substance use in adolescence.


Subject(s)
Alcohol Drinking/genetics , Catechol O-Methyltransferase/genetics , DNA Methylation , Marijuana Smoking/genetics , Smoking/genetics , Adolescent , Case-Control Studies , Female , Humans , Male , Polymorphism, Single Nucleotide , Promoter Regions, Genetic
4.
Biol Psychol ; 96: 150-7, 2014 Feb.
Article in English | MEDLINE | ID: mdl-24374241

ABSTRACT

Snakes were probably the first predators of mammals and may have been important agents of evolutionary changes in the primate visual system allowing rapid visual detection of fearful stimuli (Isbell, 2006). By means of early and late attention-related brain potentials, we examined the hypothesis that more early visual attention is automatically allocated to snakes than to spiders. To measure the early posterior negativity (EPN), 24 healthy, non-phobic women watched the random rapid serial presentation of 600 snake pictures, 600 spider pictures, and 600 bird pictures (three pictures per second). To measure the late positive potential (LPP), they also watched similar pictures (30 pictures per stimulus category) in a non-speeded presentation. The EPN amplitude was largest for snake pictures, intermediate for spider pictures and smallest for bird pictures. The LPP was significantly larger for both snake and spider pictures when compared to bird pictures. Interestingly, spider fear (as measured by a questionnaire) was associated with EPN amplitude for spider pictures, whereas snake fear was not associated with EPN amplitude for snake pictures. The results suggest that ancestral priorities modulate the early capture of visual attention and that early attention to snakes is more innate and independent of reported fear.


Subject(s)
Attention/physiology , Brain/physiology , Evoked Potentials, Visual/physiology , Fear/physiology , Visual Perception/physiology , Adolescent , Adult , Animals , Electroencephalography , Fear/psychology , Female , Humans , Photic Stimulation , Snakes , Spiders , Young Adult
5.
Tijdschr Psychiatr ; 55(11): 833-40, 2013.
Article in Dutch | MEDLINE | ID: mdl-24242142

ABSTRACT

BACKGROUND: Motivational processes play an important role in addictive behaviours. Craving is mainly an explicit or conscious process that can motivate individuals to continue alcohol, take drugs or smoke cigarettes. Craving also plays a role in relapse; self-reported craving has often been associated with relapse. However, craving cannot explain all addictive behaviours. In addition to craving, implicit cognitive processes play an important part in motivating individuals to become involved in substance use. AIM: To describe some of these implicit cognitive processes, namely the role of salience, attention bias, automatic memory associations and action tendencies. METHOD: A description is given of recent research results and the implications of these implicit processes for clinical practice. RESULTS: Oversensitive/hypersensitive motivational processes and a lack of control over these processes both play an important role in addiction. This can be expressed by an uncontrollable urge to inject the drug or substance again, in spite of the fact that it is unwise for the person in question to do so. Recent research has shown that there are various very promising methods for dealing with these two problems (oversensitive/hypersensitive motivational processes and a lack of control over these processes), either separately or together. The methods involve behavioural training programmes, medication and neural stimulation. CONCLUSION: The research results are very promising, but more research is needed.


Subject(s)
Behavior, Addictive/psychology , Cognition , Motivation , Substance-Related Disorders/psychology , Autonomic Nervous System/physiopathology , Behavior, Addictive/physiopathology , Conditioning, Classical , Humans , Models, Psychological , Recurrence , Substance Withdrawal Syndrome/physiopathology , Substance Withdrawal Syndrome/psychology
6.
Am J Drug Alcohol Abuse ; 39(1): 57-60, 2013 Jan.
Article in English | MEDLINE | ID: mdl-22571644

ABSTRACT

BACKGROUND: The relationship between the use of alcohol and aggression is complex and represents major public health issues. Delving into the nature of this association is vital, since various underlying factors may contribute to the expression of aggression. OBJECTIVE: This study examined trait aggression by assessing correlates and, subsequently, the unique contribution of alcohol craving, and dysfunctional impulsivity, by means of correlational and mediational analyses. METHODS: Forty inpatient detoxified alcohol-dependent patients were recruited. These participants completed the Desire for Alcohol Questionnaire (DAQ), Dickman Impulsivity Inventory (DII), and the Aggression Questionnaire (AQ). RESULTS: The findings indicated that aggression, dysfunctional impulsivity, and alcohol craving were all positively intercorrelated. The association between dysfunctional impulsivity and aggression was robust. The mediational analyses yielded that craving partially mediated this relationship, although not very substantial. CONCLUSION: It was shown that impulsivity, as a personality characteristic, is strongly associated with aggressive behaviors, whereby the impact of craving on the relationship between impulsivity and trait aggression in alcohol-dependent inpatients was weak. SCIENTIFIC SIGNIFICANCE: Since it has been posited that factors such as impulsivity and craving may contribute to the lucid association between substance use and aggression, these findings mirror previous research on stimulant users and, subsequently, substantiates that craving exerts only a minor weight on the strong impulsivity-aggression relationship.


Subject(s)
Aggression/psychology , Alcoholism/rehabilitation , Impulsive Behavior/psychology , Adult , Alcoholism/psychology , Humans , Impulsive Behavior/epidemiology , Inpatients , Male , Middle Aged , Surveys and Questionnaires
7.
Am J Addict ; 10(1): 30-9, 2001.
Article in English | MEDLINE | ID: mdl-11268826

ABSTRACT

The aims of this study are (1) to study the prevalence of anxiety and mood disorders in a clinical substance abuse population, (2) to asses the pre- and post-detoxification change in SCL-90 score in this population for subjects with psychopathology compared to subjects without psychopathology, and (3) to asses the value of the SCL-90 and the Addiction Severity Index-psychiatric problems scale as clinical diagnostic screening instrument for psychopathology. The design was a longitudinal prospective cohort study with pre-detoxification ASI and SCL-90 data and post-detoxification CIDI and SCL-90 data on a clinical sample of 116 substance abuse patients. The present results indicate that the ASI-Psychiatric problems score is a limited indicator of psychiatric comorbidity. When a pre-detoxification screening for psychopathology is warranted, the present results show that the use of the SCL-90 is preferable above the ASI-PSY scale. Of the screening scores under study, the post-detoxification SCL-90 score is found to be the most valid screening instrument for diagnosis of anxiety and mood disorders in a clinical substance abuse population. Although the post-detoxification SCL-90 score holds moderate specificity combined with high sensitivity, applying this instrument in clinical substance abuse practice will result in a substantial reduction of patients unnecessarily referred for further psychiatric diagnostic evaluation. Further studies aimed at improvement of screening instruments in this population are needed.


Subject(s)
Anxiety Disorders/epidemiology , Mass Screening , Mood Disorders/epidemiology , Substance-Related Disorders/complications , Substance-Related Disorders/psychology , Adolescent , Adult , Anxiety Disorders/diagnosis , Cohort Studies , Comorbidity , Female , Humans , Male , Middle Aged , Mood Disorders/diagnosis , Prevalence , Psychiatric Status Rating Scales , Sensitivity and Specificity
8.
J Clin Psychol ; 57(3): 299-306, 2001 Mar.
Article in English | MEDLINE | ID: mdl-11241361

ABSTRACT

The authors studied the coping style of substance-abuse patients during clinical cognitive-behavioral group therapy, and the effects of mood and anxiety disorders on changes in coping style. Change in coping style was studied prospectively in a cohort of 132 residential-drug-abuse patients. In addition to pretreatment assessments, which included diagnosis of mood and anxiety disorders and addiction severity, repeated measurements of coping style were performed at predetoxification, pretreatment, and after three and six months of treatment. Considerable change in coping style between predetoxification and pretreatment was found, suggesting that coping assessment in a predetoxification phase is confounded by state factors surrounding treatment entry. Coping style of detoxified substance abusers is related to the presence of mood and anxiety disorders. Coping style was not found to be related to the severity of drug abuse. Furthermore, maladaptive coping styles decreased after three months of inpatient-substance-abuse treatment, and more-adaptive coping styles remained stable for another three months of inpatient treatment. Patients with an anxiety disorder improved less on coping style when compared to non-anxiety patients. Presence of a mood disorder had no impact on coping-style improvement. The results indicate that more attention should be focused on anxiety disorders during substance-abuse treatment in order to improve coping style. Furthermore, more studies are needed on the relation between substance abuse, coping style, and psychopathology.


Subject(s)
Adaptation, Psychological , Anxiety Disorders/psychology , Cocaine-Related Disorders/psychology , Cognitive Behavioral Therapy , Heroin Dependence/psychology , Internal-External Control , Mood Disorders/psychology , Adolescent , Adult , Anxiety Disorders/rehabilitation , Cocaine-Related Disorders/rehabilitation , Combined Modality Therapy , Comorbidity , Female , Follow-Up Studies , Heroin Dependence/rehabilitation , Humans , Male , Middle Aged , Mood Disorders/rehabilitation , Patient Admission , Treatment Outcome
11.
Addict Behav ; 25(1): 99-102, 2000.
Article in English | MEDLINE | ID: mdl-10708323

ABSTRACT

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.


Subject(s)
Attention/drug effects , Cocaine-Related Disorders/psychology , Individuality , Motivation , Thinking/drug effects , Adult , Arousal/drug effects , Cocaine/adverse effects , Cocaine-Related Disorders/rehabilitation , Female , Hospitals, Psychiatric , Humans , Internal-External Control , Male , Patient Admission , Reaction Time/drug effects , Substance Withdrawal Syndrome/psychology
12.
J Psychopharmacol ; 14(4): 395-400, 2000.
Article in English | MEDLINE | ID: mdl-11198058

ABSTRACT

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.


Subject(s)
Cognition/physiology , Cues , Heroin Dependence/psychology , Adult , Attention/physiology , Emotions/drug effects , Female , Humans , Male , Motivation , Neuropsychological Tests , Psychiatric Status Rating Scales , Reaction Time/drug effects
14.
Psychiatr Serv ; 50(6): 813-7, 1999 Jun.
Article in English | MEDLINE | ID: mdl-10375152

ABSTRACT

OBJECTIVE: Variables that have been identified as predictors of outcome of substance abuse treatment--coping style, addiction severity and addiction-related problems, psychopathology, and treatment motivation--were examined as predictors of outcome of inpatient detoxification. METHODS: A cohort of 175 drug abuse patients consecutively admitted to an inpatient detoxification clinic in the Netherlands were assessed. Baseline data were obtained on psychopathology using the Symptom Checklist-90, on severity and addiction-related problems using the Addiction Severity Index (ASI), on personal coping style using the Utrecht Coping List, on motivation using the CMRS scales, and on sociodemographic background. Positive detoxification outcome was defined as transfer to inpatient rehabilitation treatment. RESULTS: Of the 175 admissions, 81 (46 percent) had a positive outcome, and 94 (54 percent) had a negative outcome. Severe drug use and severe medical problems, as measured by the ASI, were the best predictors of a negative outcome of detoxification. Self-rated suitability of postdetoxification treatment was also a predictor of positive outcome, although to a lesser degree than the ASI variables. Established predictors of residential drug abuse treatment outcome, such as psychopathology, coping style, and sociodemographic variables, did not predict outcome of detoxification. CONCLUSIONS: Caution is necessary when applying results of inpatient treatment outcome studies to inpatient detoxification programs. Different factors may play a role in the outcome of detoxification. To improve the rate at which patients in detoxification programs are transferred to longer-term rehabilitation, more attention should be paid to medical conditions and to the direct consequences of drug use, such as withdrawal symptoms and craving during detoxification.


Subject(s)
Opioid-Related Disorders/rehabilitation , Adaptation, Psychological , Adolescent , Adult , Female , Hospitalization , Humans , Inactivation, Metabolic , Male , Middle Aged , Opioid-Related Disorders/diagnosis , Opioid-Related Disorders/psychology , Predictive Value of Tests , Retrospective Studies , Severity of Illness Index , Treatment Outcome
15.
J Subst Abuse Treat ; 16(1): 81-5, 1999 Jan.
Article in English | MEDLINE | ID: mdl-9888125

ABSTRACT

After 12 months of inpatient treatment, 16 opiate-addicted patients were exposed to drug-related stimuli. The results of this study indicate that cue reactivity in opiate-addicted subjects is still present after 12 months of intensive inpatient treatment. After exposing subjects to drug-related stimuli, there is an increase in craving, feelings of depression, and anger. Because posttreatment subjects are likely to be confronted with these stimuli following discharge, a reduction of this reactivity is desirable. In the present study, cue reactivity (feelings of depression, anger, tension, craving, and physical symptoms) reduced after protocolized cue exposure treatment. This effect maintained for at least 6 weeks after the last cue exposure session.


Subject(s)
Behavior, Addictive , Cues , Extinction, Psychological , Heroin Dependence/psychology , Heroin Dependence/therapy , Adult , Anger , Depression , Female , Follow-Up Studies , Humans , Male , Time Factors
16.
AIDS Educ Prev ; 9(2): 161-80, 1997 Apr.
Article in English | MEDLINE | ID: mdl-9167801

ABSTRACT

Using targeted sampling, self-reported data of 1,767 drug users in the Euregion Maas-Rhein were collected over 3 years. Forty-two percent of the injection drug users shared syringes with sexual partners and 47.8% with friends. Eighty-one percent of the total sample had sexual contact in the last 6 months, half of whom with one person and half with two or more. Significant predictors of high-risk drug use were injecting in the presence of others, injection onset before the age of 20, female gender, and not living in The Netherlands. Participation in needle exchange or methadone programs and sufficient knowledge of risk factors was not significantly related to a reduction of high-risk drug use behavior. High-risk sexual behavior was found to be related to male gender, under the age of 30 and to multiple sexual partners. We conclude that in a social context where needle exchange, methadone programs, and sufficient knowledge of risk factors among the drug user population exist, AIDS prevention can be improved through behavioral skills training and developing specific interventions that target the peer group environments, rituals, partner relationships, and lifestyles of drug users.


PIP: A 3-year (1992-94) prospective study of 1767 drug users from the Euregion Maas-Rhein evaluated a peer counseling intervention for reducing risk behaviors associated with HIV transmission. The HIV prevalence among drug users in this diverse Dutch, German, and Belgian area ranges from 10% to 30%. Duties of the paid peer counselors included promotion of HIV risk reduction in drug use and sexual behavior; administration of questionnaires; distribution of educational materials, condoms, and clean needles; identification of hidden subgroups in the target population; and the development of prevention materials. 50% of those reached by peer counselors had no prior contact with drug abuse services. Although drug users claimed syringes and condoms were readily available, high-risk drug and sexual behaviors were widespread. 52% were injecting drugs and 24.4% had traded drugs for sex. Condoms were used by 24.8% during sexual contacts with a main partner and by 73.5% during sex with casual partners. 47.8% of injecting drug users had shared their syringes with friends. Condom use was significantly higher among drug users residing in South Limburg, women, those over 30 years of age, and those with multiple sex partners. These findings suggest that existing HIV risk-reduction interventions such as methadone treatment and needle exchange may not be sufficient. More emphasis must be placed on personal skills training (e.g., assertiveness training) and peer-driven, lifestyle-oriented processes.


Subject(s)
Acquired Immunodeficiency Syndrome/prevention & control , Needle Sharing , Risk-Taking , Sexual Behavior , Substance Abuse, Intravenous , Acquired Immunodeficiency Syndrome/transmission , Adult , Belgium , Female , Germany , Humans , Logistic Models , Male , Needle-Exchange Programs , Netherlands , Research Design , Risk Factors , Sampling Studies
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