Dysfunctional parental styles perceived during childhood in outpatients with substance use disorders

Lack of mental integration and emotion dysregulation as a possible long-term effect of dysfunctional parenting: An EEG study of functional connectivity before and after the exposure to attachment-related stimuli

Dysfunctional parenting (DP) is a factor of vulnerability and a predictive risk factor for psychopathology. Although previous research has shown specific functional and structural brain alterations, the neural basis of DP remains understudied. We therefore investigated EEG functional connectivity changes within the Salience Network before and after the exposure to attachment-related stimuli in individuals with high and low perceived DP. Participants (N = 82) were asked to report sociodemographic variables, parenting styles in the first 16 years of life, and individual emotion regulation patterns. A double 5-min EEG recording was conducted with eyes closed, both before and after the Adult Attachment Projective (AAP). Increased connectivity between the anterior cingulate cortex (ACC) and the left supramarginal gyrus (lSMG) in the alpha frequency band was observed exclusively in participants with high perceived DP after the AAP. To understand the functional role of alpha frequency, this band was subdivided into low, medium, and upper alpha. A connectivity analysis was again conducted between the ACC and the lSMG and increased connectivity was observed only in the middle alpha component. A positive correlation was also observed between middle alpha index connectivity and emotional dysregulation exclusively after the activation of the attachment system in individuals with high perceived DP. Our results suggest that individuals with high levels of perceived DP develop specific neurophysiological alterations. These alterations may reflect a lack of mental integration and subsequent emotion dysregulation when exposed to attachment-related, emotionally charged stimuli.

An epigenetic candidate-gene association study of parental styles in suicide attempters with substance use disorders

Suicide attempts (SA) are prevalent in substance use disorders (SUD). Epigenetic mechanisms may play a pivotal role in the molecular mechanisms of environmental effects eliciting suicidal behaviour in this population. Hypothalamic-pituitary-adrenal axis (HPA), oxytocin and neurotrophin pathways have been consistently involved in SA, yet , their interplay with childhood adversity remains unclear, particularly in SUD. In 24 outpatients with SUDs, we examined the relation between three parental dysfunctional styles and history of SA with methylation of 32 genes from these pathways, eventually analysing 823 methylation sites. Extensive phenotypic characterization was obtained using a semi-structured interview. Parental style was patient-reported using the Measure of Parental Style (MOPS) questionnaire, analysed with and without imputation of missing items. Linear regressions were performed to adjust for possible confounders, followed by multiple testing correction. We describe both differentially methylated probes (DMPs) and regions (DMRs) for each set of analyses (with and without imputation of MOPS items). Without imputation, five DMRs in OXTR, CRH and NTF3 significantly interacted with MOPS father abuse to increase the risk for lifetime SA, thus covering the three pathways. After imputation of missing MOPS items, two other DMPs from FKBP5 and SOCS3 significantly interacted with each of the three father styles to increase the risk for SA. Although our findings must be interpreted with caution due to small sample size, they suggest implications of stress reactivity genes in the suicidal risk of SUD patients and highlight the significance of father dysfunction as a potential marker of childhood adversity in SUD patients.

Early parent-child interactions and substance use disorder: An attachment perspective on a biopsychosocial entanglement

This review aims to elucidate environmental and genetic factors, as well as their epigenetic and neuroendocrine moderators, that may underlie the association between early childhood experiences and Substance Use Disorders (SUD), through the lens of parental attachment. Here we review those attachment-related studies that examined the monoaminergic systems, the hypothalamic pituitary adrenal stress response system, the oxytoninergic system, and the endogenous opioid system from a genetic, epigenetic, and neuroendocrine perspective. Overall, the selected studies point to a moderating effect of insecure attachment between genetic vulnerability and SUD, reasonably through epigenetic modifications. Preliminary evidence suggests that vulnerability to SUDs is related with hypo-methylation (e.g. hyper-expression) of high-risk polymorphisms on the monoaminergic and hypothalamic pituitary adrenal system and hyper-methylation (e.g. hypo-expressions) of protective polymorphisms on the opioid and oxytocin system. These epigenetic modifications may induce a cascade of neuroendocrine changes contributing to the subclinical and behavioural manifestations that precede the clinical onset of SUD. Protective and supportive parenting could hence represent a key therapeutic target to prevent addiction and moderate insecure attachment.

Associations différentielles de différents dysfonctionnements parentaux avec un début plus précoce d’usage de substances chez des patients stabilisés sous méthadone

Contexte

Dans une cohorte de patients traités par méthadone, nous avons retrouvé 35 % de tentatives de suicide (TS) sur la vie, 53 % un trouble anxieux et 61 % un trouble de l’humeur. Presque tous étaient fumeurs quotidiens de tabac, les trois quart avaient soit une dépendance au cannabis, à l’alcool ou à la cocaïne associée sur la vie. Dans ce contexte, l’identification de facteurs de variabilité interindividuelle de sévérité et de comorbidité pourrait prédire le risque d’évolution péjorative chez les sujets jeunes ou moins comorbides. Outre les traumas dans l’enfance [1], les styles parentaux [2] semblent avoir un rôle important dans ces trajectoires, tout comme un âge de début (ADD) plus précoce des consommations de substances [3].

Objectif/méthodes

Nous avons ainsi recherché chez 85 patients stabilisés sous méthadone des associations entre les scores à la Measure of Parental Style (MOPS) [4] (séparés pour chaque parent) et l’ADD de tabac, alcool, cannabis, sédatifs et cocaïne ainsi que la présence de comorbidités addictives. Les caractéristiques sociodémographiques, les conduites suicidaires et les comorbidités addictives et psychiatriques (DSM IV) étaient évaluées par entretien semi-structuré.

Résultats

Nous avons retrouvé des associations significatives (p < 0,00625) après corrections de Bonferroni pour huit tests effectués) entre indifférence paternelle et ADD inférieur du tabac, et entre abus maternel et ADD inférieur des sédatifs, mais pas entre MOPS et présence d’un TA comorbide. Après ajustement sur âge, sexe, dépression majeure et troubles anxieux en régression linéaire, l’abus maternel restait prédictif d’un ADD plus précoce des sédatifs (bêta = –0,24, p = 0,039), tout comme la dépression (bêta = –0,24, p = 0,045).

Discussion

Malgré des limites dues à notre évaluation rétrospective et à la faible taille de l’échantillon, ces résultats soulignent l’importance de l’environnement précoce dans la variabilité des trajectoires addictives. Cela suggère l’intérêt d’une prévention primaire chez des patients jeunes présentant ces dysfonctionnements parentaux.

The possible role of maternal bonding style and CHRNB2 gene polymorphisms in nicotine dependence and related depressive phenotype

OBJECTIVES

Neuronal nicotinic acetylcholinergic receptors (nAChR) and especially α4β2 nAChRs are the major targets for cessation medications and also for some promising antidepressant agents. Furthermore, depressive symptoms pose multifacet difficulties during cessation therapy. However, gene encoding for the β2 subunit of nAChRs has been poorly investigated in association with depression. Since both nicotine dependence (ND) and depressive phenotype are complex disorders, we investigated the effects of a significant early life experience, maternal bonding style (MB) and CHRNB2 gene SNPs on smoking-related depression.

METHODS

We recruited two hundred and thirty-two treatment-seeking smokers in our study. Phenotypic variants were evaluated using the Fagerstrom Test for Nicotine Dependence (FTND), the Zung Self-Rating Depression Scale (ZSDS) and the Parental Bonding Instrument (PBI). Besides the total score (TS) of ZSDS, impulsivity (ZSDS-I) and suicidal ideation (ZSDS-S) were distinguished as phenotypic variable. DNAs were extracted from buccal mucosa samples and one SNP in promoter and two SNPs in 3' UTR of CHRNB2 gene were genotyped. GLM and ANOVA tests were performed for genotype associations and interaction analyses.

RESULTS

Maternal bonding had a significant impact on depressive phenotypes. Low care, high protection and affectionless control (ALC) were associated with ZSDS-TS and all subphenotypes of ZSDS. One SNP, the rs2072660 in 3' UTR, had a significant effect on the FTND score (p=0.010). Direct association of CHRNB2 variants and depressive phenotypes were not significant. However, in interaction with ALC, rs2072660 was significantly associated with ZSDS-S (p=0.005). MB had no significant effect on smoking-related phenotype.

CONCLUSIONS

Our results highlight the important role of 3' UTR in the CHRNB2 gene in the shared molecular background of ND and depressive phenotype. Parental bonding style can be suggested as a significant environmental factor in further GxE studies of depression. The presented significant GxE interaction on smoking-related suicidal subphenotype may help establish further investigations on development of more effective and safer smoking cessation and antidepressant agents.

Injection drug use is associated with suicide attempts but not ideation or plans in a sample of adolescents with depressive symptoms

OBJECTIVE

Based on the interpersonal theory of suicide, pain habituation that occurs with injection substance use may raise risk for a suicide attempt. The current study tested whether injection substance use, relative to painless routes of substance administration, was related to greater risk for suicide attempts. We also assessed whether this risk was specific to suicide attempts and not suicidal ideation or suicide plans.

METHODS

Data on 2095 substance-using adolescents aged 12-17 who endorsed clinically significant depression symptoms and answered questions on suicidal thoughts and behavior were drawn from the 2004-2011 National Survey on Drug Use and Health, a nationally representative household survey. Logistic regression analyses were conducted to assess the associations between injection substance use and suicidal ideation, plans, and attempts.

RESULTS

Injection substance use was associated with suicide attempts (OR = 3.02, 95% CI = 1.75-5.23) but not ideation or plans. These findings were not accounted for by sex, age, race/ethnicity, family income, abuse and dependence symptoms, and depression symptoms. Among ideators, injection substance use was associated with suicide attempts (OR = 2.92, 95% CI = 1.58-5.06), but not plans. Among suicide planners, injection substance use was associated with suicide attempts (OR = 5.16, 95% CI = 1.88-14.17).

CONCLUSION

Consistent with the interpersonal theory of suicide, adolescent injection drug use was associated with specific risk for suicide attempts but not ideation or planning. Hence, consideration of the manner in which adolescents use substances is important in evaluating suicide risk in this population.