Neurocognitive and neurobehavioral mechanisms of change following psychological treatment for alcohol use disorder.

BACKGROUND: Although modestly effective treatments exist for alcohol use disorder (AUD), many individuals return to heavy drinking after treatment, suggesting the need for better understanding of factors that contribute to maintaining abstinence or drinking reductions. Whereas past studies identified what treatments work for AUD, recent studies focus more on why particular treatments work, and the mechanisms by which treatment leads to change. This focus on mechanisms of behavior change (MOBC) may inform the process by which treatment leads to better outcomes, and also may lead to new treatments or modifications of existing treatments that target empirically supported mechanisms known to lead to change. There is a paucity of studies examining MOBC from a neurocognitive perspective. METHOD: To address this gap in knowledge, the study described here is examining emotional reactivity, alcohol cue reactivity, and cognitive control as potential MOBC at three levels of analysis - self-report, behavior, and neural. RESULTS: One hundred ten treatment-seeking individuals with an AUD are being randomized to receive 8 sessions of either Cognitive Behavioral Treatment (CBT) or Mindfulness Based Treatment (MBT) after up to 4 sessions of a platform treatment focused on enhancing motivation to change. To establish the temporal relationship between changes in drinking and changes in MOBC, patients are assessed at baseline, during and immediately after treatment, and 9- and 15-months post-baseline. Relationships between changes in drinking and changes in the proposed MOBC will be examined using advanced mixed modeling techniques. CONCLUSIONS: Results should advance AUD treatment by targeting treatments to neurocognitive MOBC.

Association between empathy and drinking among a community sample of heavy drinkers: Sex differences and neural correlates.

Alcohol use disorder (AUD) is a major health problem, yet most individuals with AUD do not perceive a need for formal treatment and do not receive treatment. The lack of treatment seeking among individuals with AUD may suggest a lack of self-awareness and insight into the seriousness of AUD related problems, as well as lack of empathy for the impact of one's drinking on others. Recent work has suggested that empathy may be impaired among individuals seeking treatment for AUD. Further these impairments may differ by sex such that males with lower empathy reported more drinking consequences and greater drinking intensity, but there was no association between empathy and drinking among females. The current study used regression analyses (alpha = 0.05) to examine the association between empathy (as measured by the four scales of the Interpersonal Reactivity Index), independent components of gray matter volume in regions associated with empathy, and drinking variables among non-treatment seeking drinkers with AUD (N = 136) and also examined these effects by sex. Results showed greater perspective taking was associated with less temporoparietal and frontotemporal gray matter volume (B(SE) = -0.912 (0.043), p = 0.034). An interaction between perspective taking and sex was associated with craving, such that higher perspective taking was associated with less craving for males only (B(SE) = -0.48 (0.243), p = 0.049; R2 = 0.087). Empathic concern was related to lower percent heavy drinking days for both males and females (B(SE) = -1.57 (0.743), p = 0.035; R2 = 0.11). The current study found empathy may be an important predictor of craving for males and frequency of heavy drinking for males and females. Future work should investigate whether empathy predicts treatment seeking.

Age dependent neural correlates of inhibition and control mechanisms in moderate to heavy drinkers.

BACKGROUND: Long-term, heavy alcohol consumption has been associated with impairments in control over alcohol use, but whether this extends to other areas of cognitive and behavioral control such as response inhibition remains unclear. Understanding individual differences in the neural correlates of response inhibition will provide further insight into the neurobiology of heavy drinking. The current study investigated response inhibition in a large sample of moderate to heavy drinkers METHODS: One hundred fifty-three individuals completed a stop signal task while undergoing functional magnetic resonance imaging. Multiple regression analyses focused on blood oxygen level-dependent (BOLD) response contrasts of correct inhibition and failed inhibition as dependent variables and included age, sex, and hazardous drinking (as measured by the Alcohol Use Disorders Identification Test (AUDIT)), and their interactions, as independent variables RESULTS: Age was negatively associated with BOLD response in lateral inferior and middle frontal gyri, anterior cingulate cortex, and inferior parietal lobe for both successful inhibition and failed inhibition contrasts. In addition, there was a significant age × AUDIT interaction in the successful inhibition contrast in the left middle frontal gyrus, with significant negative correlations between AUDIT and BOLD response in older participants, and a significant positive correlation between AUDIT and BOLD response in younger participants CONCLUSIONS: Age appears to be a particularly important factor in predicting BOLD response and may be a critical variable to include in future studies of heavy drinking and alcohol use disorder, particularly those that assess cognitive function. Finally, the age × AUDIT interaction observed in the current study may represent evidence for accelerated aging effects of alcohol on cognitive function.

Food intake in laboratory rats provided standard and fenbendazole-supplemented diets.

The benzimidazole anthelmintic fenbendazole (FBZ) is a common and effective treatment for pinworm infestation in laboratory animal colonies. Although many investigators have examined the potential for deleterious biologic effects of FBZ, more subtle aspects of the treatment remain untested. Accordingly, we evaluated differences in food intake when healthy male Sprague-Dawley rats were provided a standard nonmedicated laboratory rodent chow or the same chow supplemented with FBZ. We also tested for a preference for either food type when subjects were provided a choice of the 2 diets. Data from these experiments showed no differences in food intake or body weight when rats were maintained on either standard or FBZ-supplemented chow. When the rats were given access to both the standard and FBZ-supplemented diets, they showed a clear preference for the standard diet. The preference for the standard diet indicates that the rats can discriminate between the 2 foods and may avoid the FBZ-supplemented chow when possible. Investigators conducting experiments during treatment with FBZ in which differences in food preference are relevant should be aware of these data and plan their studies accordingly.