Facial emotion recognition in alcohol and substance use disorders: A meta-analysis

Assessment on interoceptive awareness on alcohol use and gambling disorders reveals dissociable interoceptive abilities linked to external and internal dependencies: Practical use of Body Perception Questionnaire Very Short Form (BPQ-VSF) in clinical settings

Interoception is one of the pivotal cognitive functions for mechanisms of our body awareness, and malfunction of the interoceptive network is thought to be associated with mental illness, including addiction. Within addictive disorders, substance-based and non-substance-based addictions are known to hold dissociable reward systems. However, little is known about how interoceptive awareness between these addiction sub-types would differ. Subjective interoceptive awareness was assessed among patients with alcohol use disorder (n = 50) who were subsequently hospitalized or remained out-patient and gambling addiction (n = 41) by the Body Awareness component of the Japanese version of the Body Perception Questionnaire (BPQ-VSFBA-J) and compared them against healthy control (n = 809). Both addiction groups showed significantly lower BPQ than the control, with no substantial differences between inpatients and outpatients for alcohol samples. Notably, BPQ scores for gambling patients were significantly lower than those for the alcohol group. This evidence may suggest a putative role of interoceptive ability on the severity of behavioral addiction over substance-based addiction.

Modeling social cognition in alcohol use disorder: lessons from schizophrenia

A better understanding of social deficits in alcohol use disorder (AUD) has the potential to improve our understanding of the disorder. Clinical research shows that AUD is associated with interpersonal problems and the loss of a social network which impedes response to treatment. Translational research between animal models and clinical research may benefit from a discussion of the models and methods that currently guide research into social cognition in AUD. We propose that research in AUD should harness recent technological developments to improve ecological validity while maintaining experimental control. Novel methods allow us to parse naturalistic social cognition into tangible components, and to investigate previously neglected aspects of social cognition. Furthermore, to incorporate social cognition as a defining element of AUD, it is critical to clarify the timing of these social disturbances. Currently, there is limited evidence to distinguish factors that influence social cognition as a consequence of AUD, and those that precede the onset of the disorder. Both increasing the focus on operationalization of social cognition into objective components and adopting a perspective that spans the clinical spectrum will improve our understanding in humans, but also possibly increase methodological consistency and translational dialogue across species. This commentary underscores current challenges and perspectives in this area of research.

Associations between alcohol consumption and empathy in a non-clinical sample: drinking motives as a moderator

People consume alcohol for multiple reasons. Negative motives are often associated with alcohol-related problems. These problems might be explained by negative effects of high alcohol consumption on empathy. Past studies have associated alcohol use disorder (AUD) with reduced cognitive and affective empathy. Few studies have focused on non-clinical samples and considered behavioral empathy. We examined the links between alcohol consumption and multiple aspects of empathy, and if these links were moderated by negative drinking motives. We collected online data of 520 unselected individuals. All completed the AUD Identification Test (AUDIT) and a Drinking Motives Questionnaire. Affective and cognitive empathy were assessed using the Empathy Quotient. Behavioral empathy was assessed by asking participants how likely they would help the person in each of 24 scenarios involving pain. Helping others in pain was positively predicted by affective and cognitive empathy. Higher AUDIT scores were associated with helping others less, particularly among participants who scored higher on drinking to cope with negative affect. People who drink more and do so to cope with negative affect appear to have less behavioral empathy. This supports the view that negative drinking motives contribute to AUD risk.

Emotion Recognition and Self-Reported Emotion Processing in Alcohol and Cannabis Co-Using Young Adults

Alcohol and cannabis use are each associated with impairments in emotion recognition accuracy, which may promote interpersonal problems. It is unclear if emotion recognition or self-reported emotion processing differs between young adult alcohol and cannabis co-users (ACCs) and healthy controls (HCs). This study examined whether ACCs and HCs differed in their emotion recognition across two different behavioral tasks with static or dynamic faces and determined if there were differences in self-reported socio-emotional processing and alexithymia. 22 ACCs (mean age = 21.27 ± 1.75) and 25 HCs (mean age = 21.48 ± 2.68), matched on age, sex, and IQ, completed the Metrisquare Emotion Recognition Task and CANTAB Emotion Recognition Task. The ACCs and HCs were compared on task accuracy and self-reported measures, including the Social Emotional Questionnaire (SEQ) and the Perth Alexithymia Questionnaire (PAQ). No significant main effects of the Group variable or the Emotion-Group interaction variable were present for either task. The ACCs had lower SEQ (p = 0.014) and higher PAQ (p = 0.024) scores relative to the HCs, indicating greater difficulties in socio-emotional processing and identifying one's own emotions, respectively. Understanding the behavioral correlates of the self-reported difficulties in emotion processing reported by ACCs is needed to develop interventions to reduce these symptoms and promote healthy socio-emotional functioning in this population.

Supraphysiological testosterone levels from anabolic steroid use and reduced sensitivity to negative facial expressions in men

RATIONALE

Anabolic-androgenic steroids (AAS) are used to improve physical performance and appearance, but have been associated with deficits in social cognitive functioning. Approximately 30% of people who use AAS develop a dependence, increasing the risk for undesired effects.

OBJECTIVES

To assess the relationship between AAS use (current/previous), AAS dependence, and the ability to recognize emotional facial expressions, and investigate the potential mediating role of hormone levels.

METHODS

In total 156 male weightlifters, including those with current (n = 45) or previous (n = 34) AAS use and never-using controls (n = 77), completed a facial Emotion Recognition Task (ERT). Participants were presented with faces expressing one out of six emotions (sadness, happiness, fear, anger, disgust, and surprise) and were instructed to indicate which of the six emotions each face displayed. ERT accuracy and response time were recorded and evaluated for association with AAS use status, AAS dependence, and serum reproductive hormone levels. Mediation models were used to evaluate the mediating role of androgens in the relationship between AAS use and ERT performance.

RESULTS

Compared to never-using controls, men currently using AAS exhibited lower recognition accuracy for facial emotional expressions, particularly anger (Cohen's d = -0.57, pFDR = 0.03) and disgust (d = -0.51, pFDR = 0.05). Those with AAS dependence (n = 47) demonstrated worse recognition of fear relative to men without dependence (d = 0.58, p = 0.03). Recognition of disgust was negatively correlated with serum free testosterone index (FTI); however, FTI did not significantly mediate the association between AAS use and recognition of disgust.

CONCLUSIONS

Our findings demonstrate impaired facial emotion recognition among men currently using AAS compared to controls. While further studies are needed to investigate potential mechanisms, our analysis did not support a simple mediation effect of serum FTI.

Sex differences in alcohol's effects on fronto-amygdalar functional connectivity during processing of emotional stimuli

BACKGROUND

Amygdala function underlying emotion processing has been shown to vary with an individuals' biological sex. Expanding upon functional magnetic resonance imaging (fMRI) findings reported previously where a low level of response was the focus, we examined alcohol and sex effects on functional connectivity between the amygdala and other brain regions. The central hypothesis predicted that sex would influence alcohol's effects on frontal-limbic functional circuits underlying the processing of negative and positive facial emotions.

METHODS

Secondary analyses were conducted on data from a double-blind, placebo controlled, within-subjects, cross-over study in 54 sex-matched pairs (N = 108) of 18- to 25-year-old individuals without an alcohol use disorder at baseline. Participants performed an emotional faces fMRI processing task after placebo or approximately 0.7 mL/kg of ethanol. Psychophysiological interaction analyses examined functional connectivity between the amygdala with other brain regions.

RESULTS

There were significant alcohol-by-sex interactions when processing negatively valenced faces. Whereas intoxicated men exhibited decreased functional connectivity between the amygdala and ventral and dorsal anterior cingulate, angular gyrus, and middle frontal gyrus connectivity was increased in intoxicated women. There was also a main sex effect where women exhibited less functional connectivity in the middle insula than men regardless of whether they received alcohol or placebo. For happy faces, main effects of both sex and alcohol were observed. Women exhibited less amygdala functional connectivity in the right inferior frontal gyrus than men. Both men and women exhibited greater functional connectivity in the superior frontal gyrus in response to alcohol than placebo.

CONCLUSIONS

Alcohol's effects on amygdala functional circuits that underlying emotional processing vary by sex. Women had higher functional connectivity than men following exposure to a moderate dose of alcohol which could indicate that women are better than men at processing affectively laden stimuli when intoxicated.

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

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.

A systematic review of the acute effects of alcohol on emotion recognition of facial expressions

Alcohol has been linked to both positive (e.g., sociability) and negative (e.g., aggression) social outcomes, and researchers have proposed that alcohol-induced changes in emotion recognition may partially explain these effects. Here, we systematically review alcohol administration studies to clarify the acute effects of alcohol on emotion recognition. We also investigate various moderator variables (i.e., sex, study quality, study design, alcohol dosage, emotion recognition task and outcome measure). PsycINFO, PubMed and Google Scholar were searched following a pre-registered PROSPERO protocol (CRD42021225392) and PRISMA methodology. Analyses focused on differences in emotion recognition between participants consuming alcoholic and/or non-alcoholic (i.e., placebo or no-alcohol control) beverages. Nineteen unique samples (N = 1271 participants) were derived from 17 articles (two articles included two studies, each conducted on a unique sample). Data were extracted for sample characteristics, alcohol administration methods and emotion recognition tasks and outcomes. All studies compared an alcoholic beverage to a placebo beverage and used tasks that asked participants to identify emotions from images or videos of facial expressions. Otherwise, methodologies varied substantially across studies, including the alcohol dosage(s) tested, the specific emotion recognition task(s) used and the outcome variable(s) assessed. No consistent effects of alcohol on emotion recognition emerged for any emotion. None of the moderator variables affected the findings, except for some indication that alcohol may affect males' emotion recognition abilities more so than females. Alcohol does not appear to consistently affect positive or negative emotion recognition of facial expressions, at least with the tasks currently used in the field.

WOMEN'S USE OF ALCOHOL: NEUROBIOBEHAVIORAL CONCOMITANTS AND CONSEQUENCES

In this narrative review, we draw from historical and contemporary literature to explore the impact of alcohol consumption on brain and behavior among women. We examine three domains: 1) the impact of alcohol use disorder (AUD) on neurobiobehavioral outcomes, 2) its impact on social cognition/emotion processing, and 3) alcohol's acute effects in older women. There is compelling evidence of alcohol-related compromise in neuropsychological function, neural activation, and brain structure. Investigations of social cognition and alcohol effects in older women represent emerging areas of study. Initial analyses suggest that women with AUD show significant deficits in emotion processing, a finding also observed in older women who have consumed a moderate dose of alcohol. Critically, despite the long-recognized need for programmatic interrogation of alcohol's effect in women, studies with sufficient numbers of women for meaningful analysis represent a small proportion of the literature, constraining interpretation and generalization.

The acute effects of alcohol on social cognition: A systematic review of experimental studies

RATIONALE

Alcohol effects on social cognition have been studied by measuring facial emotion recognition, empathy, Theory of Mind (ToM) and other forms of information processing.

OBJECTIVES

Using the PRISMA guidelines, we reviewed experimental studies that examined acute effects of alcohol on social cognition.

METHODS

Scopus, PsycInfo, PubMed, and Embase were searched between July 2020 - January 2023. The PICO strategy was used for identifying participants, interventions, comparators, and outcomes. Participants (N = 2330) were adult social alcohol users. Interventions consisted of acute alcohol administration. Comparators included placebo or the lowest alcohol dose. Outcome variables were grouped into three themes: facial processing, empathy and ToM, and perceptions of inappropriate sexual behavior.

RESULTS

A total of 32 studies were reviewed. Studies measuring facial processing (67%) often found no effects of alcohol on the recognition of specific emotions, facilitated emotion recognition at lower doses and worsened emotion recognition at higher doses. In studies measuring empathy or ToM (24%), lower doses were more likely to lead to improvements while higher doses were generally impairing. Within the third group of studies (9%), moderate to high alcohol doses made it more difficult to perceive sexual aggression accurately.

CONCLUSIONS

Lower alcohol doses might sometimes help facilitate social cognition, but most data were in line with the idea that alcohol tends to worsen social cognition, particularly at higher doses. Future studies might focus on examining other moderators of the effects of alcohol on social cognition, particularly interpersonal characteristics such as trait emotional empathy, and participant and target gender.

Subcortical serotonin 5HT2c receptor-containing neurons sex-specifically regulate binge-like alcohol consumption, social, and arousal behaviors in mice

Binge alcohol consumption induces discrete social and arousal disturbances in human populations that promote increased drinking and accelerate the progression of Alcohol Use Disorder. Here, we show in a mouse model that binge alcohol consumption disrupts social recognition in females and potentiates sensorimotor arousal in males. These negative behavioral outcomes were associated with sex-specific adaptations in serotonergic signaling systems within the lateral habenula (LHb) and the bed nucleus of the stria terminalis (BNST), particularly those related to the receptor 5HT2c. While both BNST and LHb neurons expressing this receptor display potentiated activation following binge alcohol consumption, the primary causal mechanism underlying the effects of alcohol on social and arousal behaviors appears to be excessive activation of LHb5HT2c neurons. These findings may have valuable implications for the development of sex-specific treatments for mood and alcohol use disorders targeting the brain's serotonin system.

The Dopamine System in Mediating Alcohol Effects in Humans

Brain-imaging studies show that the development and maintenance of alcohol use disorder (AUD) is determined by a complex interaction of different neurotransmitter systems and multiple psychological factors. In this context, the dopaminergic reinforcement system appears to be of fundamental importance. We focus on the excitatory and depressant effects of acute versus chronic alcohol intake and its impact on dopaminergic neurotransmission. Furthermore, we describe alterations in dopaminergic neurotransmission as associated with symptoms of alcohol dependence. We specifically focus on neuroadaptations to chronic alcohol consumption and their effect on central processing of alcohol-associated and reward-related stimuli. Altered reward processing, complex conditioning processes, impaired reinforcement learning, and increased salience attribution to alcohol-associated stimuli enable alcohol cues to drive alcohol seeking and consumption. Finally, we will discuss how the neurobiological and neurochemical mechanisms of alcohol-associated alterations in reward processing and learning can interact with stress, cognition, and emotion processing.

Interpersonal problems and recognition of facial emotions in healthy individuals

Background

Recognition of emotions in faces is important for successful social interaction. Results from previous research based on clinical samples suggest that difficulties in identifying threat-related or negative emotions can go along with interpersonal problems. The present study examined whether associations between interpersonal difficulties and emotion decoding ability can be found in healthy individuals. Our analysis was focused on two main dimensions of interpersonal problems: agency (social dominance) and communion (social closeness).

Materials and methods

We constructed an emotion recognition task with facial expressions depicting six basic emotions (happiness, surprise, anger, disgust, sadness, and fear) in frontal and profile view, which was administered to 190 healthy adults (95 women) with a mean age of 23.9 years (SD = 3.8) along with the Inventory of Interpersonal Problems, measures of negative affect and verbal intelligence. The majority of participants were university students (80%). Emotion recognition accuracy was assessed using unbiased hit rates.

Results

Negative correlations were observed between interpersonal agency and recognition of facial anger and disgust that were independent of participants' gender and negative affect. Interpersonal communion was not related to recognition of facial emotions.

Discussion

Poor identification of other people's facial signals of anger and disgust might be a factor contributing to interpersonal problems with social dominance and intrusiveness. Anger expressions signal goal obstruction and proneness to engage in conflict whereas facial disgust indicates a request to increase social distance. The interpersonal problem dimension of communion appears not to be linked to the ability to recognize emotions from facial expressions.

The brain in social context: A systematic review of substance use and social processing from adolescence to young adulthood

Substance use escalates between adolescence and young adulthood, and most experimentation occurs among peers. To understand underlying mechanisms, research has focused on neural response during relevant psychological processes. Functional magnetic resonance imaging (fMRI) research provides a wealth of information about brain activity when processing monetary rewards; however, most studies have used tasks devoid of social stimuli. Given that adolescent neurodevelopment is sculpted by the push-and-pull of peers and emotions, identifying neural substrates is important for intervention. We systematically reviewed 28 fMRI studies examining substance use and neural responses to stimuli including social reward, emotional faces, social influence, and social stressors. We found substance use was positively associated with social-reward activity (e.g., in the ventral striatum), and negatively with social-stress activity (e.g., in the amygdala). For emotion, findings were mixed with more use linked to heightened response (e.g., in amygdala), but also with decreased response (e.g., in insula). For social influence, evidence supported both positive (e.g., cannabis and nucleus accumbens during conformity) and negative (e.g., polydrug and ventromedial PFC during peers' choices) relations between activity and use. Based on the literature, we offer recommendations for future research on the neural processing of social information to better identify risks for substance use.

Recovery of neuropsychological function following abstinence from alcohol in adults diagnosed with an alcohol use disorder: Protocol for a systematic review of longitudinal studies

Background

Alcohol use disorders (AUD) associate with structural and functional brain differences, including impairments in neuropsychological functions; however, review level research (largely cross-sectional) is inconsistent with regards to recovery of such functions following abstinence. Such recovery is important, as these impairments associate with treatment outcomes and quality of life.

Objective(s)

To assess neuropsychological function recovery following abstinence in individuals with a clinical AUD diagnosis. The secondary objective is to assess predictors of neuropsychological recovery in AUD.

Methods

Four electronic databases (APA PsycInfo, EBSCO MEDLINE, CINAHL, Web of Science Core Collection) will be searched between 1999–2022, with search strategies adapted for each source. Study reporting will follow the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis, study quality will be assessed using the JBI Checklist for Cohort Studies. Eligible studies are those with a longitudinal design that assessed neuropsychological recovery following abstinence from alcohol in adults with a clinical diagnosis of AUD. Studies will be excluded if participant group is defined by another or co-morbid condition/injury, or by relapse.

Results

This is an ongoing review. As of July 2022, the review protocol is registered on PROSPERO (CRD42022308686), searches have been conducted, and screening is in progress. Results are predicted to be complete by October 2022.

Conclusions

Comparing data on neuropsychological recovery from AUD will improve understanding of the impact of alcohol on the brain, and the relationship between AUD recovery and quality of life/treatment outcomes. It may provide information that could one day inform aspects of treatment and aftercare (e.g., options for cognitive training of functions that do not improve on their own).

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.

Coordination of social behaviors by the bed nucleus of the stria terminalis

The bed nucleus of the stria terminalis (BNST) is a sexually dimorphic, neuropeptide-rich node of the extended amygdala that has been implicated in responses to stress, drugs of abuse, and natural rewards. Its function is dysregulated in neuropsychiatric disorders that are characterized by stress- or drug-induced alterations in mood, arousal, motivation, and social behavior. However, compared to the BNST's role in mood, arousal, and motivation, its role in social behavior has remained relatively understudied. Moreover, the precise cell types and circuits underlying the BNST's role in social behavior have only recently begun to be explored using modern neuroscience techniques. Here, we systematically review the existing literature investigating the neurobiological substrates within the BNST that contribute to the coordination of various sex-dependent and sex-independent social behavioral repertoires, focusing largely on pharmacological and circuit-based behavioral studies in rodents. We suggest that the BNST coordinates social behavior by promoting appropriate assessment of social contexts to select relevant behavioral outputs and that disruption of socially relevant BNST systems by stress and drugs of abuse may be an important factor in the development of social dysfunction in neuropsychiatric disorders.

Emotion recognition in individuals with cocaine use disorder: the role of abstinence length and the social brain network

RATIONALE

Emotion recognition is impaired in drug addiction. However, research examining the effects of cocaine use on emotion recognition yield mixed evidence with contradictory results potentially reflecting varying abstinence durations.

OBJECTIVES

Therefore, we investigated emotion recognition and its neural correlates in individuals with cocaine use disorder (CUD) parsed according to abstinence duration.

METHODS

Emotion recognition performance was compared between current cocaine users (CUD + , n = 28; cocaine-positive urine), short-term abstainers (CUD-ST, n = 23; abstinence < 6 months), long-term abstainers (CUD-LT, n = 20; abstinence ≥ 6 months), and controls (n = 45). A sample subset (n = 73) underwent structural magnetic resonance imaging to quantify regional gray matter volume (GMV) using voxel-based morphometry.

RESULTS

CUD + demonstrated greater difficulty recognizing happiness than CUD-ST and controls, and sadness and fear compared to controls (p < 0.01). For fear, CUD-ST also performed worse than controls (p < 0.01), while no differences emerged between CUD-LT and controls. Whole-brain analysis revealed lower GMV in the bilateral cerebellum in CUD + compared to CUD-LT and controls; a similar pattern was observed in the amygdala (CUD +  < CUD-LT) (p_FWE < 0.01). Collapsed across all participants, poorer recognition for happiness was associated with lower right cerebellar GMV (p_FWE < 0.05).

CONCLUSIONS

Emotion recognition is impaired with current cocaine use, and selective deficits (in fear) may persist with up to 6 months of abstinence. Lower cerebellar GMV may underlie deficits in positive emotion recognition. Interventions targeting emotional-social-cognitive deficits, especially among active users, may enhance treatment success for individuals with CUD.

A robust multivariate structure of interindividual covariation between psychosocial characteristics and arousal responses to visual narratives

People experience the same event but do not feel the same way. Such individual differences in emotion response are believed to be far greater than those in any other mental functions. Thus, to understand what makes people individuals, it is important to identify the systematic structures of individual differences in emotion response and elucidate how such structures relate to what aspects of psychological characteristics. Reflecting this importance, many studies have attempted to relate emotions to psychological characteristics such as personality traits, psychosocial states, and pathological symptoms across individuals. However, systematic and global structures that govern the across-individual covariation between the domain of emotion responses and that of psychological characteristics have been rarely explored previously, which limits our understanding of the relationship between individual differences in emotion response and psychological characteristics. To overcome this limitation, we acquired high-dimensional data sets in both emotion-response (8 measures) and psychological-characteristic (68 measures) domains from the same pool of individuals (86 undergraduate or graduate students) and carried out the canonical correlation analysis in conjunction with the principal component analysis on those data sets. For each participant, the emotion-response measures were quantified by regressing affective-rating responses to visual narrative stimuli onto the across-participant average responses to those stimuli, while the psychological-characteristic measures were acquired from 19 different psychometric questionnaires grounded in personality, psychosocial-factor, and clinical-problem taxonomies. We found a single robust mode of population covariation, particularly between the ’accuracy’ and ’sensitivity’ measures of arousal responses in the emotion domain and many ‘psychosocial’ measures in the psychological-characteristics domain. This mode of covariation suggests that individuals characterized with positive social assets tend to show polarized arousal responses to life events.

Low versus high level of response to alcohol affects amygdala functional connectivity during processing of emotional stimuli

BACKGROUND

Low levels of response (low LR) to alcohol predict heavy drinking and alcohol problems. Functional magnetic resonance imaging (fMRI) studies of emotion processing have shown that low LR individuals exhibit lower activation in task-related brain regions following both placebo and alcohol administration, but these studies did not examine functional brain networks that might contribute to the phenomena. The current study expands upon the earlier results by evaluating whether functional connectivity differences between the amygdala and other brain regions modulated by emotional face processing are associated with LR. Based on prior findings, we hypothesized that low LR is related to lower functional connectivity in fronto-amygdalar functional circuits, which underlie the processing of emotional stimuli.

METHODS

Secondary analyses were conducted on data from a double-blind, placebo-controlled, within-subjects, cross-over study in 108 18-to-25-year-old low and high LR sex-matched pairs without alcohol use disorder at baseline. Participants performed modified emotional faces processing tasks after receiving placebo or approximately 0.7 ml/kg of ethanol. Psychophysiological interaction analyses examined functional connectivity between left and right amygdalae and related brain circuits using LR-by-alcohol general linear models. The data included 54 sex-matched pairs with 216 fMRI scans comprising alcohol and placebo conditions.

RESULTS

Compared with individuals with high LR, low LR subjects demonstrated lower functional connectivity between the amygdala and the frontal lobes, insula, and parietal regions, while processing angry and happy faces. Interactions showed lower connectivity following alcohol in low LR and higher connectivity in high LR groups.

CONCLUSIONS

Low LR individuals demonstrated lower functional connectivity in response both to placebo and a modest dose of ethanol. Attenuated connectivity among low LR individuals when processing emotional faces may contribute to an impaired ability to recognize alcohol intoxication in social situations and to appraise angry and happy emotions irrespective of whether alcohol is consumed.

Cognitive behavioral intervention for improving emotion recognition among individuals with substance use disorders: A randomized-controlled pilot study in a naturalistic setting

Individuals with substance use disorders (SUD) experience impaired facial emotion recognition. This pilot study explored the efficacy of a cognitive behavioral therapy (CBT) intervention to improve facial cues interpretation. Twenty-four men with SUD were randomized into an equal-size experimental and control groups and were evaluated by a cognitive-assessment battery at baseline and post-intervention. Post-intervention individuals in the experimental group recognized happy expressions with higher accuracy, and their response times were slower in sadness/disgust/neutral expressions. Interventions focused at improving social cues interpretation may facilitate social interactions and treatment outcomes for SUD population.

Alcohol and Cannabis Use Disorder Symptom Severity, Conduct Disorder, and Callous-Unemotional Traits and Impairment in Expression Recognition

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 reduced emotion expression recognition ability. However, this work has primarily occurred in adults and has not considered neuro-cognitive risk factors associated with conduct problems that commonly co-occur with, and precede, substance use. Yet, conduct problems are also associated with reduced emotion expression recognition ability. The current study investigated the extent of negative association between AUD and CUD symptom severity and expression recognition ability over and above any association of expression recognition ability with conduct problems [conduct disorder (CD) diagnostic status]. Methods: In this study, 152 youths aged 12.5-18 years (56 female; 60 diagnosed with CD) completed a rapid presentation morphed intensity facial expression task to investigate the association between relative severity of AUD/CUD and expression recognition ability. Results: Cannabis use disorder identification test (CUDIT) scores were negatively associated with recognition accuracy for higher intensity (particularly sad and fearful) expressions while CD diagnostic status was independently negatively associated with recognition of sad expressions. Alcohol use disorder identification test (AUDIT) scores were not significantly associated with expression recognition ability. Conclusions: These data indicate that relative severity of CUD and CD diagnostic status are statistically independently associated with reduced expression recognition ability. On the basis of these data, we speculate that increased cannabis use during adolescence may exacerbate a neuro-cognitive risk factor for the emergence of aggression and antisocial behavior.

Protocol for magnetic resonance imaging acquisition, quality assurance, and quality check for the Accelerator program for Discovery in Brain disorders using Stem cells

OBJECTIVE

The Accelerator program for Discovery in Brain disorders using Stem cells (ADBS) is a longitudinal study on five cohorts of patients with major psychiatric disorders from genetically high-risk families, their unaffected first-degree relatives, and healthy subjects. We describe the ADBS protocols for acquisition, quality assurance (QA), and quality check (QC) for multimodal magnetic resonance brain imaging studies.

METHODS

We describe the acquisition and QC protocols for structural, functional, and diffusion images. For QA, we acquire proton density and functional images on phantoms, along with repeated scans on human volunteer. We describe the analysis of phantom data and test-retest reliability of volumetric and diffusion measures.

RESULTS

Analysis of acquired phantom data shows linearity of proton density signal with increasing proton fraction, and an overall stability of various spatial and temporal QA measures. Examination of dice coefficient and statistical analyses of coefficient of variation in test-retest data on the human volunteer showed consistency of volumetric and diffusivity measures at whole-brain, regional, and voxel-level.

CONCLUSION

The described acquisition and QA-QC procedures can yield consistent and reliable quantitative measures. It is expected that this longitudinal neuroimaging dataset will, upon its release, serve the scientific community well and pave the way for interesting discoveries.

Gender moderates the association between acute alcohol intoxication and facial emotion recognition in a naturalistic field study setting

BACKGROUND

Alcohol intoxication is associated with significant negative social consequences. Social information processing theory provides a framework for understanding how the accurate decoding and interpretation of social cues are critical for effective social responding. Acute intoxication has the potential to disrupt facial emotion recognition. If alcohol impairs the processing and interpretation of emotional cues, then the resultant behavioral responses may be less effective. The current study tested the association between alcohol intoxication and facial emotion recognition in a naturalistic field study of intoxicated participants.

METHODS

114 participants (59.4% men; M_age  = 24.2 years) who had been consuming alcohol were recruited in the downtown area of a mid-size town surrounded by several drinking establishments in the mid-southern United States. Participants were shown images depicting 5 facial displays of emotions (happy, sad, anger, disgust, and no emotion) portrayed by 1 male and 1 female actor per emotion and breath alcohol concentration (BrAC) was measured by the field breathalyzer test (M = 0.078%, SD = 0.052).

RESULTS

BrAC was significantly negatively associated with emotion recognition accuracy when controlling for average alcohol use, B = -.35, t = -2.08, p < 0.05, F(3, 110) = 5.28, p < 0.01, R²  = 0.13. A significant BrAC × gender interaction was revealed, B = -0.39, t = -2.07, p = 0.04, ΔR²  = 0.033, p = 0.04, such that men (but not women) displayed a significant negative association between BrAC and emotion recognition accuracy.

CONCLUSIONS

Acute intoxication was associated with impaired facial emotion recognition, particularly for men, in a field study context. Findings support and extend some previous experimental laboratory-based research and suggest that intoxication can impair the decoding stage of social information processing.

Social Information Processing in Substance Use Disorders: Insights From an Emotional Go-Nogo Task

Positive social connections are crucial for recovery from Substance Use Disorder (SUD). Of interest is understanding potential social information processing (SIP) mediators of this effect. To explore whether persons with different SUD show idiosyncratic biases toward social signals, we administered an emotional go-nogo task (EGNG) to 31 individuals with Cocaine Use Disorder (CoUD), 31 with Cannabis Use Disorder (CaUD), 79 with Opioid Use Disorder (OUD), and 58 controls. Participants were instructed to respond to emotional faces (Fear/Happy) but withhold responses to expressionless faces in two task blocks, with the reverse instruction in the other two blocks. Emotional faces as non-targets elicited more "false alarm" (FA) commission errors as a main effect. Groups did not differ in overall rates of hits (correct responses to target faces), but participants with CaUD and CoUD showed reduced rates of hits (relative to controls) when expressionless faces were targets. OUD participants had worse hit rates [and slower reaction times (RT)] when fearful faces (but not happy faces) were targets. CaUD participants were most affected by instruction effects (respond/"go" vs withhold response/"no-go" to emotional face) on discriminability statistic A. Participants were faster to respond to happy face targets than to expressionless faces. However, this pattern was reversed in fearful face blocks in OUD and CoUD participants. This experiment replicated previous findings of the greater salience of expressive face images, and extends this finding to SUD, where persons with CaUD may show even greater bias toward emotional faces. Conversely, OUD participants showed idiosyncratic behavior in response to fearful faces suggestive of increased attentional disruption by fear. These data suggest a mechanism by which positive social signals may contribute to recovery.

A systematic review and meta-analysis of 'Systems for Social Processes' in borderline personality and substance use disorders

Deficits in social processing (SP) have been proposed to underpin interpersonal dysfunction in both Borderline Personality Disorder (BPD) and Substance Use Disorders (SUD). This study aimed to explore potential transdiagnostic cognitive and behavioral phenotypes of these disorders utilizing the NIMH Research Domain Criteria 'Systems for Social Processes'. A systematic review and meta-analysis of the published research was conducted on 134 studies identified through our database searches. Four meta-analyses were conducted, which revealed significant overlapping deficits in the ability to identify facial emotions and infer the mental states of others in both BPD and SUD. Further, people with BPD displayed a higher ostracism effect following perceived social exclusion. Systematically reviewed studies also revealed significant dysfunction amongst individuals with BPD and SUD across both self and other SP constructs, which were broadly similar in magnitude. Taken together, these results support the proposition that SP dysfunction may be considered a core transdiagnostic phenotype of BPD and SUD.

The role of metacognitions and emotion recognition in problematic SNS use among adolescents

BACKGROUND AND AIMS

Problematic social networking sites (SNS) use is associated with important psychological problems among adolescents. Nevertheless, research on the aetiology of problematic SNS use is limited. Our aim was to investigate the role of metacognitions and emotion recognition in predicting problematic SNS use during the late adolescence period.

METHODS

Eight hundred and sixty-one high school students were recruited for the study. Participants completed the Bergen Social Media Addiction Scale (BSMAS), the Metacognitions Questionnaire for Children (MCQ-C), and the Children's Version of Reading the Mind in the Eyes Test (RMET).

RESULTS

A stepwise multiple linear regression analysis showed that all subdimensions of metacognitions (positive meta-worry, negative meta-worry, superstition, punishment, and responsibility beliefs, and cognitive monitoring), but not emotion recognition, independently predicted the BSMAS total score controlling for daily SNS use.

CONCLUSIONS

Our findings indicate that maladaptive metacognitions are associated, independently frequency of daily SNS use, to problematic SNS use among late adolescents. Interventions targeting dysfunctional metacognitions may aid adolescents who suffer from the detrimental effects of problematic SNS use.

Training emotion regulation processes in alcohol-abstinent individuals: A pilot study

The study aimed to assess whether abstinent individuals with alcohol use disorders (AUD) would benefit from enhanced emotional regulation (ER) strategies using the affect regulation training (ART) program based on weekly sessions comprising psycho-education, muscle and respiratory relaxation, awareness, acceptance and tolerance, compassionate personal support, emotion analysis and modification. Seventy-two participants with AUD benefited from ART and were compared on their ER ability, mindfulness, and their experience of abstinence to 40 participants not receiving the program, before it, at the end, and 6 months after. Improvements in ER were observed, particularly in positive centration, action centration or self-blame and in mindfulness abilities after the program and six months later. In addition, by comparing participants who received the program with a short (<18 months) or long (>18 months) abstinence duration, the results showed a greater decrease in the use of non-adaptive strategies, a greater increase in adaptive strategies and mindfulness abilities in short-term abstinent individuals. These results demonstrate improvement in ER skills after training in people who were abstinent from alcohol. ART is effective for consolidating abstinence and should be used especially at the beginning of withdrawal to promote the rapid implementation of new ER strategies.

Tackling heterogeneity: Individual variability of emotion decoding deficits in severe alcohol use disorder

BACKGROUND

Severe alcohol use disorder (SAUD) is associated with social cognition deficits. Patients with SAUD are impaired for the recognition of emotional facial expressions, particularly at early stages of abstinence. These deficits damage interpersonal relations and increase relapse risk. However, uncertainties still abound on their variation across emotions and on the heterogeneity of emotional impairments across patients. We addressed these questions by exploring how the deficit varies according to emotions' type/intensity and patients' heterogeneity.

METHODS

Sixty-five recently detoxified patients with SAUD and 65 matched healthy controls performed the Facial Emotion Recognition Test, assessing the ability to identify six emotions (anger, contempt, disgust, fear, happiness, sadness) displayed by morphed faces with various intensities. Accuracy scores and detection thresholds were collected for each emotion. Beyond group comparisons, multiple single-case analyses determined the percentage of patients presenting decoding deficits for each emotion.

RESULTS

When current depression and anxiety symptoms were controlled for, patients did not present a general emotion decoding deficit, but were rather characterized by specific deficits for disgust/contempt in accuracy, and for disgust in detection threshold scores. Single-case analyses showed that only a third of patients presented a clinically significant emotional deficit.

CONCLUSIONS

Patients with SAUD only present emotional decoding deficits for specific interpersonal emotions (disgust/contempt) when subclinical psychopathological states are controlled for, and show no general emotional impairment. This goes against the proposal of a generalized social cognition deficit in this population. This group effect moreover masks a massive heterogeneity across patients, which has implications at experimental and clinical levels.

Delta Event-Related Oscillations Are Related to a History of Extreme Binge Drinking in Adolescence and Lifetime Suicide Risk

Alcohol exposure typically begins in adolescence, and heavy binge drinking is associated with health risk behaviors. Event-related oscillations (EROs) may represent sensitive biomarkers or endophenotypes for early alcohol exposure as well as other risk behaviors such as suicidal thoughts and actions. In this study, young adults (age 18–30 years) of American Indian (AI) (n = 479) and Mexican American (MA) (n = 705) ancestry were clinically assessed, and EROs were generated to happy, sad and neutral faces. Extreme adolescent binge drinking (10+ drinks) was common (20%) in this population of AI/MA and associated with a significantly increased risk of a lifetime history of suicidal acts (SA, suicide attempts, deaths) but not suicidal thoughts (ST, ideation, plans). ST were reported among MA participants, whereas SA were more common among AI young adults. Extreme adolescent binge drinking was also associated with errors in detection of sad and neutral faces, increases in delta ERO energy, and decreases in phase locking (PL), particularly in parietal areas. A lifetime history of ST was associated with increases in delta ERO energy and PL, whereas SA were associated with decreases in both. These studies suggest that ERO measures may represent important potential biomarkers of adolescent extreme binge drinking and risk for suicidal behaviors.

Hostile attributional bias in severe alcohol use disorder

Impairments in social cognition have been documented in severe alcohol use disorder (SAUD) over the past two decades. They have been linked with lower social functioning and poor treatment outcomes, illustrating their key role in the disorder. However, studies investigating social cognition in SAUD have largely focused on emotional decoding and theory of mind abilities, neglecting other important processes. We expand this line of research by exploring the association between SAUD and hostile attributional biases (i.e., the tendency to attribute hostile intentions to others), another clinically relevant subcomponent of social cognition. Thirty-five patients with SAUD and thirty-five matched healthy controls completed the short version of the Ambiguous Intentions Hostility Questionnaire, a validated measure assessing participants' perceived hostility, blame attribution and aggression in relation to vignettes depicting social situations with negative outcomes and ambiguous intent. Patients with SAUD attributed more hostile intentions to others than did healthy controls. Moreover, this hostile attributional bias was associated with increased interpersonal problems in SAUD, as measured through the Inventory of Interpersonal Problems. We thus evidence hostile attributional bias in SAUD and extend the growing literature on social cognition impairments in this population. Furthermore, these findings corroborate the recent proposal that patients with SAUD exhibit biases toward socially threatening information. The association between hostile attributional bias and interpersonal problems suggests that targeting this bias in treatment may reduce the relapse risk resulting from interpersonal deficits. Recommendations are made to further explore the clinical relevance of hostile attributional bias in SAUD.

A Distinct Neurophenotype of Fearful Face Processing in Alcohol Use Disorder With and Without Comorbid Anxiety

BACKGROUND

Individuals with alcohol use disorder (AUD) can present with comorbid anxiety symptoms and often have deficits in emotional processing. Previous research suggests brain response is altered during facial affect recognition tasks, especially in limbic areas, due to either AUD or anxiety symptomology; however, the impact of both AUD and clinically significant anxiety symptoms during these tasks has not yet been examined.

METHODS

In this study, we investigated neural activation differences during an emotional face-matching task. Participants (N = 232) underwent fMRI scanning, as part of a larger study. Three groups were investigated: individuals with diagnosed AUD and elevated anxiety traits (AUD + ANX, n = 90), individuals with diagnosed AUD but non-clinically significant levels of anxiety (AUD-ANX, n = 39), and healthy controls (HC, n = 103).

RESULTS

Our results illustrate distinct neurophenotypes of AUD, where individuals with comorbid anxiety symptomology have blunted emotional face processing while those with singular AUD are hyperresponsive.

CONCLUSIONS

This suggests AUD with anxiety symptomology may have a unique neurobiological underpinning, and treatment and intervention should be tailored to individual constellations of symptoms.

Facial emotion recognition in people with schizophrenia and a history of violence: a mediation analysis

Evidence for an association between impaired facial emotion recognition and violence in people with schizophrenia is inconclusive. In particular, the role of misidentification patterns involving specific emotions such as anger and the influence of clinical characteristics on this association remain unclear. In this study, we compared facial emotion recognition performance in age- and gender-matched schizophrenia spectrum disorders subjects with (N = 52) and without (N = 52) a history of violence. Data on current symptom severity, Cluster B personality status, past victimization, and alcohol and substance misuse were also collected. Compared to those without, subjects with a history of violence showed worse facial emotion recognition performances, involving anger, fear, disgust, sadness, and happiness. When formally testing the reporting of angry faces, evidence of enhanced sensitivity to anger was not supported. Finally, when the impact of current symptoms was assessed, higher severity of activation symptoms, including motor hyperactivity, elevated mood, excitement and distractibility, mediated the relationship between history of violence and poor facial emotion recognition performance. As a whole, our findings seem to support the role of perceptual deficits involving different emotions as well as of a mediation played by activation symptoms. Facial emotion recognition deficits associated with the propensity to violence, as well certain symptoms mediating their relationship, should be targeted by specific treatment approaches.

Socio-affective processing biases in severe alcohol use disorders: Experimental and therapeutic perspectives

Previous literature has consistently reported socio-affective information processing impairments in patients with severe alcohol use disorder (SAUD). Some recent studies have also suggested that these patients might exhibit biases toward stimuli indicating social threat, such as angry or disgusted faces. Such biases have been largely documented in other psychopathological disorders like anxiety, where they play a critical role in the emergence and maintenance of the disorder. A comprehensive understanding of these biases in SAUD would thus deepen the understanding of interpersonal difficulties and relapse-related factors. However, to date, no study has directly explored these biases in SAUD. In order to initiate efforts to address this issue, we first review preliminary evidence supporting the hypothesis of biased processing of social threat in SAUD. Then, we identify possible pathways through which such biases might negatively impact the course of the disorder. Finally, we provide precise recommendations and available materials to develop research in this promising field, and underline the related theoretical and clinical perspectives.

Impact of polysubstance use on social and non-affective cognitive performance among treatment-seeking individuals with alcohol use disorders

BACKGROUND

Individuals with alcohol use disorder (AUD) display deficits across a range of cognitive processes. Decrements in social cognition may be particularly important for interpersonal functioning and post-treatment adaptation. Although social cognitive deficits are associated with chronic use of numerous substances, the role of polysubstance use in AUD-associated deficits remains largely unaddressed.

METHODS

Community volunteers (n = 49; 22 men) and inpatient treatment-seekers with AUD were administered neurocognitive tasks indexing emotion processing and non-affective cognitive functioning. Tasks included an emotion discrimination task, a working memory task with affective stimuli, a general face processing (control) task, two measures of executive function, and two measures of visual spatial function. AUD subgroups included individuals with no recent (6-month) polysubstance use (AUD-Only; n = 22; 15 men), and those with at least weekly use (Poly-SU; n = 22; 18 men).

RESULTS

Poly-SU individuals evinced disadvantaged performance relative to other groups on the emotion discrimination task [ps ≤ 0.001], affective working memory task [ps ≤ 0.050], and two executive function measures [ps ≤ 0.051]. No differences were observed for visual spatial functioning [ps ≥ 0.498] or general face processing [ps ≥ 0.190]. No performance differences between AUD-Only and community volunteers were noted.

CONCLUSIONS

Results extend the emerging literature exploring emotion processing in AUD and add to the established literature regarding cognitive deficits in this population. The data suggest that among individuals with AUD, those with polysubstance use may be particularly vulnerable to deficits in decoding emotional face content. The current work highlights the need to incorporate more nuanced and careful considerations of polysubstance use in the design and analysis for future investigations of alcohol-associated deficits in emotion processing.

Dysfunctional personality beliefs and emotion recognition in individuals with methamphetamine dependence

Previous studies have demonstrated that individuals with methamphetamine dependence have impaired emotion recognition. However, heterogeneity in results from these studies may indicate that individual factors such as personality beliefs moderate emotion recognition deficits. Thus, we aimed to examine the relationship between dimensional estimates of dysfunctional personality beliefs and facial emotion recognition in 86 Australian treatment seekers with methamphetamine dependence. Dysfunctional beliefs were measured using the Personality Beliefs Questionnaire, and emotion recognition was measured with the Ekman's Faces Test. We applied hierarchical regression analyses to test the relationship between beliefs and emotion recognition after accounting for the effects of intelligence. Results indicated that personality beliefs reflecting antisocial and paranoid schemas together accounted for a significant increase in the variance in fear recognition (higher levels of beliefs associated with poorer fear recognition). Further, high levels of passive-aggressive personality beliefs were associated with a tendency to misclassify faces as disgust. Our findings suggest that antisocial, paranoid, and passive-aggressive dysfunctional personality beliefs may underlie inter-individual differences in emotion recognition in methamphetamine dependent individuals. Additional research is required to better understand the relationship between personality and social processing biases, and investigate the direct impact these have on the significant psychosocial impairments present in individuals with methamphetamine dependence.

Towards the automatic detection of social biomarkers in autism spectrum disorder: introducing the simulated interaction task (SIT)

Social interaction deficits are evident in many psychiatric conditions and specifically in autism spectrum disorder (ASD), but hard to assess objectively. We present a digital tool to automatically quantify biomarkers of social interaction deficits: the simulated interaction task (SIT), which entails a standardized 7-min simulated dialog via video and the automated analysis of facial expressions, gaze behavior, and voice characteristics. In a study with 37 adults with ASD without intellectual disability and 43 healthy controls, we show the potential of the tool as a diagnostic instrument and for better description of ASD-associated social phenotypes. Using machine-learning tools, we detected individuals with ASD with an accuracy of 73%, sensitivity of 67%, and specificity of 79%, based on their facial expressions and vocal characteristics alone. Especially reduced social smiling and facial mimicry as well as a higher voice fundamental frequency and harmony-to-noise-ratio were characteristic for individuals with ASD. The time-effective and cost-effective computer-based analysis outperformed a majority vote and performed equal to clinical expert ratings.

Emotional Face Processing among Treatment-Seeking Individuals with Alcohol Use Disorders: Investigating Sex Differences and Relationships with Interpersonal Functioning

BACKGROUND

Individuals in treatment for alcohol use disorder (AUD) display deficits across a broad range of cognitive processes. Disruptions in affective processing are understudied, but may be particularly important for interpersonal functioning and post-treatment adaptation. In particular, the role of sex in AUD-associated emotion processing deficits remains largely unaddressed and was a focus of the current investigation.

METHODS

Fifty-six treatment seekers with AUD and 54 healthy community controls (N = 110) were administered an emotional face discrimination task. Non-affective tasks included a sex-discrimination task and two brief measures of executive functioning. Two measures of interpersonal function were included.

RESULTS

Emotion processing deficits were evident among women with AUD relative to other groups. This sex-contingent relationship was not observed in measures of executive function, sex-discrimination or interpersonal problems, although individuals with AUD performed more poorly on these measures.

CONCLUSIONS

Results were consistent with extant literatures examining cognitive, affective and interpersonal functioning among individuals with AUD, and provided novel evidence of vulnerability to alcohol-associated deficits in emotion processing among women. While similar sex-contingent effects were not apparent among other measures, results support modest interrelationships, specifically including the import of emotion processing to interpersonal functioning in AUD. These data offer guidance for further systematic investigation and highlight important considerations for future relapse-prevention and recovery-facilitation efforts.

Alcohol use disorder and cannabis use disorder symptomatology in adolescents are differentially related to dysfunction in brain regions supporting face processing

Despite extensive behavioral evidence of impairments in face processing and expression recognition in adults with alcohol or cannabis use disorders (AUD/CUD), neuroimaging findings have been inconsistent. Moreover, relatively little work has examined the relationship of AUD or CUD symptoms with face or expression processing within adolescents. Given the high prevalence of alcohol and cannabis use during adolescence, understanding how these usage behaviors interact with neural mechanisms supporting face and expression processing could have important implications for youth social and emotional functioning. In this study, adolescents (N = 104) responded to morphed fearful and happy expressions during fMRI and their level of AUD and/or CUD symptoms were related to the BOLD response data. We found that AUD and CUD symptom severity were both negatively related to responses to faces generally. However, whereas this relationship was shown for AUD within ventromedial prefrontal cortex and lingual gyrus, it was shown for CUD within rostromedial prefrontal cortex including anterior cingulate cortex. Additionally, AUD symptom levels were associated with differential responses within medial temporal pole and inferior parietal lobule as a function of expression. These results have potential implications for understanding the social and emotional functioning of adolescents with AUD and CUD symptoms.

Emotional processing and social cognition in alcohol use disorder

OBJECTIVE

To review deficits in emotional processing and social cognition potentially contributing to the dysfunctional emotion regulation and difficulties with interpersonal relationships observed in individuals with alcohol use disorder (AUD) and to provide directions for future research.

METHOD

First is presented a review of emotional and social-cognitive impairments in recently detoxified AUD individuals that include alexithymia, difficulties in decoding others' emotions, and reduced theory of mind and empathy skills. Social cognition disorders in AUD pose different issues discussed, such as whether (1) these deficits are consequences of excessive alcohol consumption or premorbid risk factors for addiction, (2) emotional and social impairments impede positive treatment outcome, (3) recovery of social abilities is possible with sustained abstinence, and (4) AUD patients are unaware of their emotional and social dysfunctions. Finally, current knowledge on structural and functional brain correlates of these deficits in AUD are reviewed.

RESULTS

Emotional and social-cognitive functions affected in AUD can potentially compromise efforts to initiate and maintain abstinence by hampering efficacy of clinical treatment. Such dysfunction can obstruct efforts to enable or reinstate higher-order abilities such as emotional self-regulation, motivation to change, success in interpersonal/social interactions, and emotional insight and awareness of social dysfunctions (i.e., accurate metacognition).

CONCLUSIONS

The present review highlights the need to account for emotional processing and social cognition in the evaluation and rehabilitation of alcohol-related neurocognitive disorders and to consider psychotherapeutic treatment involving remediation of emotional and social skills as implemented in psychiatric and neurological disorders. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

A Patient-Tailored Evidence-Based Approach for Developing Early Neuropsychological Training Programs in Addiction Settings

Substance use disorders (SUDs) are associated with impairments of cognitive functions, and cognitive training programs are thus rapidly developing in SUD treatment. However, neuropsychological impairments observed early after withdrawal (i.e., early impairments), that is, approximately in the first six months, may be widespread. Consequently, it might not be possible to train all the identified early impairments. In these situations, we propose that the priority of cognitive training should be given to the early impairments found to be associated with early dropout or relapse (i.e., relapse-related impairments). However, substance-specific relapse-related impairments have not been singled out among all early impairments so far. Using a systematic literature search, we identified the types of established early impairments for all SUDs, and we assessed the extent to which these early impairments were found to be associated with relapse-related impairments. All cognitive functions were investigated according to a classification based on current neuropsychological models, distinguishing classical cognitive, substance-bias, and social cognition systems. According to the current evidence, demonstrated relapse-related impairments in alcohol use disorder comprised impulsivity, long-term memory, and higher-order executive functions. For cannabis use disorder, the identified relapse-related impairments were impulsivity and working memory. For stimulant use disorder, the identified relapse-related impairments were attentional abilities and higher-order executive functions. For opioid use disorder, the only identified relapse-related impairments were higher executive functions. However, many early impairments were not explored with respect to dropout/relapse, particularly for stimulant and opioid use disorders. The current literature reveals substance-specific relapse-related impairments, which supports a pragmatic patient-tailored approach for defining which early impairments should be prioritized in terms of training among patients with SUDs.

Dysfunctional Personality Beliefs Linked to Emotion Recognition Deficits in Individuals With Cocaine Addiction and Personality Disorders

Background: Facial emotion recognition is impaired in addiction and personality disorders. Dysfunctional personality beliefs reflect negative interpersonal schemas that may underpin emotion recognition deficits. We aimed to examine the association between personality beliefs and emotion recognition among participants with cocaine use disorder including those with comorbid personality disorders. Methods: We recruited 70 participants with cocaine use disorder aged between 19 and 52 who had used 14 g of cocaine over 4.8 years on average. Thirty-eight participants had an additional personality disorder (11 Borderline, 7 Histrionic, 5 Antisocial, 10 Avoidant, and 5 Obsessive-Compulsive). Dysfunctional beliefs were indicated with the Personality Belief Questionnaire, and facial emotion recognition was indicated with the Ekman's Test. We applied correlations/multiple regressions to test the relationship between beliefs and emotion recognition. Results: Personality beliefs reflecting paranoid, borderline, and antisocial schemas were negatively associated with emotion recognition. Antisocial beliefs were associated with poorer recognition of fear, and paranoid beliefs with poorer recognition of disgust. Antisocial beliefs were significantly associated with emotion recognition after adjusting for cocaine use. Conclusion: Dysfunctional personality beliefs are associated with poorer emotion recognition in cocaine addiction. Personality-related negative schemas about the self and others can impact social cognition and interaction during cocaine treatment.

Emotion Recognition and Impulsive Choice in Relation to Methamphetamine Use and Psychosis Symptoms

Introduction: The cognitive profiles of people with methamphetamine use disorder are characterized by impulsivity and impairment in social cognition. However, previous studies have not fully accounted for the presence and impact of co-occurring mental health problems on these domains. For instance, psychotic symptoms are commonly experienced by people who use methamphetamine and may influence cognitive performance. We aimed to examine decision making and emotion recognition in individuals with methamphetamine use, compared to healthy controls, to map the nature and degree of impairments in relation to the presence of psychotic symptoms. Method: In this naturalistic study, we assessed reward-based decision-making and facial emotion recognition across three groups, methamphetamine-using individuals with (MAP, n = 29) and without psychotic symptoms (MNP, n = 70), and healthy controls (HC, n = 32). Results: In comparison to healthy controls, methamphetamine-using individuals presented with poorer performance on tasks of decision-making and emotion recognition. Emotion recognition was impaired across all methamphetamine-using individuals, with significantly poorer recognition of anger and sadness in those with psychotic symptoms. Conclusion: We found specific impairments in emotion recognition in relation to psychotic symptoms in people who use methamphetamine regularly. This builds on previous evidence on cognitive profiles in methamphetamine use disorder, highlighting the need to assess co-morbid mental health and psychotic symptoms. Our finding that methamphetamine-using individuals with psychotic symptoms present with particular difficulties recognizing anger has implications for frontline clinicians.

Relationship Between Attachment Style in Adulthood, Alexithymia, and Dissociation in Alcohol Use Disorder Inpatients. Mediational Model

Background: Attachment theory is a widely used framework for understanding emotion regulation as well as alexithymia, and dissociation and this perspective has also been applied to understand alcohol use disorders. Apart from these theoretical suggestions, there has been scarce empirical research on this subject-matter. Therefore, the objective of the present study was to investigate potential associations between attachment style in adulthood, alexithymia, and dissociation in alcohol use disorder inpatients. Methods: The Revised Adult Attachment Scale (RAAS), the Toronto Alexithymia Scale-20 (TAS-20), the Michigan Alcoholism Screening Test (MAST), and the Curious Experiences Survey (CES) were administered to a sample of 97 alcohol use disorder inpatients recruited from drug and alcohol treatment centers in Warsaw, and 104 persons in control groups, Poland. Results: A comparative analysis between the group of alcohol addicts and non-addicts showed statistically significant differences related to: alexithymia, dissociation, and attachment styles. The analysis of models related to the impact of attachment styles on the level of alcohol addiction with regard to a mediatory role of alexithymia and dissociation showed that all models are well fitted to data and statistically significant: intimacy F(3.197) = 34.41; p < 0.001 and explains 34% (R ² = 0.3438); depend F(3.197) = 36.55; p < 0.001, and explains 36% (R ² = 0.3576); anxiety F(3.197) = 34.71; p < 0.001, and explains 35% (R ² = 0.3458) of the variability of alcohol addiction scores. Mediation analysis found that alexithymia and dissociation enhance the fear of intimacy and rejection in a romantic relationship. Conclusion: These findings support the broad attachment theory suggesting that attachment is associated with and predicts alexithymia and dissociation in the sample of substance use disorder inpatients. Alexithymia and dissociation, by inhibiting the processes of emotions' identification and verbalization, cause that language does not serve for the purpose of changing self or others, as the communication is distorted. Absent are common meanings and accurate mutual understanding in a relationship.

Let's Open the Decision-Making Umbrella: A Framework for Conceptualizing and Assessing Features of Impaired Decision Making in Addiction

Decision-making impairments play a pivotal role in the emergence and maintenance of addictive disorders. However, a sound conceptualization of decision making as an umbrella construct, encompassing its cognitive, affective, motivational, and physiological subcomponents, is still lacking. This prevents an efficient evaluation of the heterogeneity of decision-making impairments and the development of tailored treatment. This paper thus unfolds the various processes involved in decision making by adopting a critical approach of prominent dual- or triadic-process models, which postulate that decision making is influenced by the interplay of impulsive-automatic, reflective-controlled, and interoceptive processes. Our approach also focuses on social cognition processes, which play a crucial role in decision making and addictive disorders but were largely ignored in previous dual- or triadic-process models. We propose here a theoretical framework in which a range of coordinated processes are first identified on the basis of their theoretical and clinical relevance. Each selected process is then defined before reviewing available results underlining its role in addictive disorders (i.e., substance use, gambling, and gaming disorders). Laboratory tasks for measuring each process are also proposed, initiating a preliminary process-based decision-making assessment battery. This original approach may offer an especially informative view of the constitutive features of decision-making impairments in addiction. As prior research has implicated these features as risk factors for the development and maintenance of addictive disorders, our processual approach sets the scene for novel and transdiagnostic experimental and applied research avenues.

Emotion Recognition Biases in Alcohol Use Disorder

BACKGROUND

Alcohol use disorder (AUD) has been associated with impairments in cognitive and emotional function, including difficulty identifying emotional facial expressions. However, it is unclear whether these deficits are associated with alcohol consumption or related anxious and depressive symptoms.

METHODS

We compared the recognition of emotional faces expressing happiness, surprise, sadness, fear, anger, and disgust in 19 AUD participants and 19 healthy volunteers using the Cambridge Neuropsychological Test Automated Battery Emotion Recognition Task. We analyzed group differences in response latency, accuracy, and misidentification patterns (as defined by the tendency to mislabel facial expressions as exhibiting specific emotions). To assess whether misidentification patterns were associated with drinking severity, we also examined associations with alcohol consumption over the past 90 days.

RESULTS

There were no differences in response latency or accuracy between groups. However, there were group differences in misidentification patterns. While controls tended to misidentify emotional expressions as happy, those with AUD tended to misidentify expressions as angry or disgusted. In AUD participants, the degree to which individuals were biased toward anger or disgust was positively correlated with the number of drinks they consumed in the past 90 days but was not associated with depression or anxiety scores.

CONCLUSIONS

Our findings suggest that individuals with AUD have a bias toward misidentifying emotional facial expressions as hostile, which is not mediated by associated mood changes. This provides further evidence of disrupted social cognition in AUD.

Mind reading abilities in opiate-dependent patients: An exploratory study

OBJECTIVES

Impairments in social cognition have been described as playing a major role in the maintenance of addictive behavior in substance abusers. This study aimed to investigate the Theory of Mind (ToM) ability of opiate-dependent (OD) patients and to explore whether TOM ability was correlated with length of substance abuse, age at onset of substance abuse and length of abstinence.

METHODS

OD patients (N = 29) and non-dependent individuals (NDI) (N = 29) were submitted to the Theory of Mind Assessment Scale (Th.o.m.a.s.), a semi-structured interview, and to the Versailles-Lecture Intentionnelle en Situation (V-LIS), a movie paradigm in which participants have to infer the characters' intentions.

RESULTS

The results confirmed a deficit in ToM ability in OD patients, with OD patients demonstrating poorer performance than NDI on both the V-LIS and the Th.o.m.a.s. The combination of perspective taking and reflecting on others' mental states was particularly difficult for OD patients. Furthermore, impairments in ToM abilities were not correlated with the age at onset of substance abuse or to the duration of substance abuse or abstinence.

CONCLUSIONS

The results suggest OD patients may have impaired social cognition, demonstrating deficits in even basic social interaction skills, which may constitute a risk factor for addiction. These findings underline the importance of developing interventions to improve social cognition ability during the rehabilitation of OD patients.