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Moeller SJ, Abeykoon S, Dhayagude P, Varnas B, Weinstein JJ, Perlman G, Gil R, Fleming SM, Abi-Dargham A. Neural Correlates of Metacognition Impairment in Opioid Addiction. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024; 9:1211-1221. [PMID: 39059467 PMCID: PMC11540741 DOI: 10.1016/j.bpsc.2024.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 07/15/2024] [Accepted: 07/19/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Individuals with substance use disorder show impaired self-awareness of ongoing behavior. This deficit suggests problems with metacognition, which has been operationalized in the cognitive neuroscience literature as the ability to monitor and evaluate the success of one's own cognition and behavior. However, the neural mechanisms of metacognition have not been characterized in a population with drug addiction. METHODS Community samples of participants with opioid use disorder (OUD) (n = 27) and healthy control participants (n = 29) performed a previously validated functional magnetic resonance imaging metacognition task (perceptual decision-making task along with confidence ratings of performance). Measures of recent drug use and addiction severity were also acquired. RESULTS Individuals with OUD had lower metacognitive sensitivity (i.e., disconnection between task performance and task-related confidence) than control individuals. Trial-by-trial analyses showed that this overall group difference was driven by (suboptimally) low confidence in participants with OUD during correct trials. In functional magnetic resonance imaging analyses, the task engaged an expected network of brain regions (e.g., rostrolateral prefrontal cortex and dorsal anterior cingulate/supplementary motor area, both previously linked to metacognition); group differences emerged in a large ventral anterior cluster that included the medial and lateral orbitofrontal cortex and striatum (higher activation in OUD). Trial-by-trial functional magnetic resonance imaging analyses showed group differences in rostrolateral prefrontal cortex activation, which further correlated with metacognitive behavior across all participants. Exploratory analyses suggested that the behavioral and neural group differences were exacerbated by recent illicit opioid use and unexplained by general cognition. CONCLUSIONS With confirmation and extension of these findings, metacognition and its associated neural circuits could become new, promising therapeutic targets in addiction.
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Affiliation(s)
- Scott J Moeller
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York.
| | - Sameera Abeykoon
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York
| | - Pari Dhayagude
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Benjamin Varnas
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York
| | - Jodi J Weinstein
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York
| | - Greg Perlman
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York
| | - Roberto Gil
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York
| | - Stephen M Fleming
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College London, London, United Kingdom; Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom; Department of Experimental Psychology, University College London, London, United Kingdom
| | - Anissa Abi-Dargham
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York
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Galanter M, White WL, Khalsa J, Hansen H. A scoping review of spirituality in relation to substance use disorders: Psychological, biological, and cultural issues. J Addict Dis 2024; 42:210-218. [PMID: 36772834 DOI: 10.1080/10550887.2023.2174785] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
BACKGROUND Spirituality is a construct encompassing a diversity of strongly held beliefs and pursuits related to life's meaning and purpose. Empirical studies in key domains of spirituality related to substance use disorder (SUD) can be valuable in guiding research, and potentially clinical care. OBJECTIVES To conduct a scoping review of research on the psychological, biological, and cultural dimensions of spirituality and their role in relation to SUD. To identify limitations in empirical findings within these domains and identify promising areas for related research. DATA SOURCES, STUDY APPRAISAL, AND SYNTHESIS METHODS Illustrative studies available in the empirical literature are reviewed in order to characterize these three key domains. RESULTS Certain areas of importance stand out: On Psychology, attribution of SUD to a spiritual outlook; spiritual awakening; the relation of spirituality to drug craving; and spirituality in the context of psychedelic-assisted psychotherapy. On Biology, heritability of traits related to shared spiritual experience; neurophysiologic correlates of spiritually related experiences; and correlates in brain imaging; On Culture, spiritual aspects of SUD in different cultural settings; distinctions between spiritual and religious phenomena; roles that international organizations play; and context of acquiring recovery capital. The need for further research in each area is defined. CONCLUSIONS There is utility in examining the diversity of findings in the roles of psychology, biology, and culture in the SUD field. Further research, particularly applying randomization and clinical controls, would be useful in improving the effective application of the construct of spirituality in clinical care.
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Affiliation(s)
- Marc Galanter
- Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
| | | | - Jag Khalsa
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - Helena Hansen
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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Nigg JT. Considerations toward an epigenetic and common pathways theory of mental disorder. JOURNAL OF PSYCHOPATHOLOGY AND CLINICAL SCIENCE 2023; 132:297-313. [PMID: 37126061 PMCID: PMC10153068 DOI: 10.1037/abn0000748] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Psychopathology emerges from the dynamic interplay of physiological and mental processes and ecological context. It can be seen as a failure of recursive, homeostatic processes to achieve adaptive re-equilibrium. This general statement can be actualized with consideration of polygenic liability, early exposures, and multiunit (multi-"level") analysis of the psychological action and the associated physiological and neural operations, all in the context of the developmental exposome. This article begins by identifying key principles and clarifying key terms necessary to mental disorder theory. It then ventures a sketch of a model that highlights epigenetic dynamics and proposes a common pathways hypothesis toward psychopathology. An epigenetic perspective elevates the importance of developmental context and adaptive systems, particularly in early life, while opening the door to new mechanistic discovery. The key proposal is that a finite number of homeostatic biological and psychological mechanisms are shared across most risky environments (and possibly many genetic liabilities) for psychopathology. Perturbation of these mediating mechanisms leads to development of psychopathology. A focus on dynamic changes in these homeostatic mechanisms across multiple units of analysis and time points can render the problem of explaining psychopathology tractable. Key questions include the mapping of recursive processes over time, at adequate density, as mental disorders unfold across development. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Joel T Nigg
- Department of Psychiatry, Oregon Health & Science University
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Soutschek A, Bulley A, Wittekind CE. Metacognitive deficits are associated with lower sensitivity to preference reversals in nicotine dependence. Sci Rep 2022; 12:19787. [PMID: 36396945 PMCID: PMC9671892 DOI: 10.1038/s41598-022-24332-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 11/14/2022] [Indexed: 11/19/2022] Open
Abstract
Deficits in impulse control belong to the core profile of nicotine dependence. Smokers might thus benefit from voluntarily self-restricting their access to the immediate temptation of nicotine products (precommitment) in order to avoid impulse control failures. However, little is known about how smokers' willingness to engage in voluntary self-restrictions is determined by metacognitive insight into their general preferences for immediate over delayed rewards. Here, with a series of monetary intertemporal choice tasks, we provide empirical evidence for reduced metacognitive accuracy in smokers relative to non-smokers and show that smokers overestimate the subjective value of delayed rewards relative to their revealed preferences. In line with the metacognitive deficits, smokers were also less sensitive to the risk of preference reversals when deciding whether or not to restrict their access to short-term financial rewards. Taken together, the current findings suggest that deficits not only in impulse control but also in metacognition may hamper smokers' resistance to immediate rewards and capacity to pursue long-term goals.
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Affiliation(s)
- Alexander Soutschek
- grid.5252.00000 0004 1936 973XChair of Experimental and General Psychology, Department of Psychology, Ludwig Maximilian University Munich, Leopoldstr. 13, 80802 Munich, Germany
| | - Adam Bulley
- grid.1013.30000 0004 1936 834XThe University of Sydney, School of Psychology and Brain and Mind Centre, Sydney, Australia ,grid.38142.3c000000041936754XDepartment of Psychology, Harvard University, Cambridge, USA
| | - Charlotte E. Wittekind
- grid.5252.00000 0004 1936 973XChair of Clinical Psychology, Department of Psychology, Ludwig Maximilian University Munich, Munich, Germany
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McCabe BE, McConaha CD, Falcon AL. Social norms and club drug use of young adult college students during Music Week. J Addict Dis 2022; 41:149-155. [PMID: 35713275 DOI: 10.1080/10550887.2022.2086424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Background: Young adult college students have high rates of substance use, theoretically related to social norms. Behavioral norms refer to the quantity of substances that students think others use, and attitudes refer to how much students or others approve of substance use. Prior research has shown a relationship between behavioral norms, student attitudes, and perceived parental attitudes and alcohol and marijuana use. However, the relationship between social norms and use of club drugs (e.g., MDMA) has not been studied.Objective: The purpose of this cross-sectional study was to expand knowledge about young adult college student social norms and club drug use.Methods: 200 young adult undergraduates (Women = 97, 49%) were recruited from a campus recreational facility on a large private Southeastern university in April 2019. Students self-reported behavioral norms, student attitudes, parental perceived attitudes, club drug use during a typical week and during music week, and substance use consequences.Results: Logistic and negative binomial regressions showed that student attitudes were significantly related to club drug use in a typical week (OR = 2.07, p = .005), during music week (OR = 2.08, p = .001), and consequences of use (RR = 1.23, p < .001), but behavioral norms and perceived parental attitudes were not.Conclusions: Findings build on social norms research with alcohol and marijuana use. Attitudes may be more important to consider than behavioral norms or perceived parental attitudes for interventions to reduce club drug use.Young adults (18-25 years old) have a high risk for substance use; both alcohol and drug use increase throughout adolescence and peak in young adulthood.1-3 Young adults have high heavy episodic drinking (35% past month) and illicit drug use (25% past month), with greater MDMA use (10% vs 7%) and marijuana use (35% vs. 15%) than other adults.4 Alcohol and marijuana use has been linked to many negative consequences, such as blackouts, physical injuries, unprotected sex, and even death.5,6 Club drug use is also linked to negative consequences, such as memory lapse, headaches, loss of energy, trouble sleeping, depression, confusion, anxiety, irritability, nausea, and changes in heart rate and blood pressure.7,8.
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Affiliation(s)
- Brian E McCabe
- Department of Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, AL, USA
| | - Candace D McConaha
- Department of Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, AL, USA
| | - Ashley L Falcon
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
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Kang X, Handayani DOD, Chong PP, Acharya UR. Profiling of pornography addiction among children using EEG signals: A systematic literature review. Comput Biol Med 2020; 125:103970. [PMID: 32892114 DOI: 10.1016/j.compbiomed.2020.103970] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 08/09/2020] [Accepted: 08/09/2020] [Indexed: 01/15/2023]
Abstract
Nowadays human behavior has been affected with the advent of new digital technologies. Due to the rampant use of the Internet by children, many have been addicted to pornography. This addiction has negatively affected the behaviors of children including increased impulsiveness, learning ability to attention, poor decision-making, memory problems, and deficit in emotion regulation. The children with porn addiction can be identified by parents and medical practitioners as third-party observers. This systematic literature review (SLR) is conducted to increase the understanding of porn addiction using electroencephalogram (EEG) signals. We have searched five different databases namely IEEE, ACM, Science Direct, Springer and National Center for Biotechnology Information (NCBI) using addiction, porn, and EEG as keywords along with 'OR 'operation in between the expressions. We have selected 46 studies in this work by screening 815,554 papers from five databases. Our results show that it is possible to identify children with porn addiction using EEG signals.
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Affiliation(s)
- Xiaoxi Kang
- Master of Computer Science, Taylor's University, 1, Jalan Taylors, 47500, Subang Jaya, Selangor, Malaysia.
| | - Dini Oktarina Dwi Handayani
- School of Computer Science & Engineering, Faculty of Innovation & Technology, Taylor's University, 1, Jalan Taylors, 47500, Subang Jaya, Selangor, Malaysia.
| | - Pei Pei Chong
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University, 1 Jalan Taylors, 47500, Subang Jaya, Selangor, Malaysia.
| | - U Rajendra Acharya
- Ngee Ann, Singapore University of Social Science, University of Malaya, Malaysia; Department of Bioinformatics and Medical Engineering, Asia University, Taiwan.
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