Emotional processing and social cognition in alcohol use disorder

Reduced gray matter volume in limbic and cortical areas is associated with anxiety and depression in alcohol use disorder patients

Alcohol use disorder (AUD) is a multifactorial disease closely related to neurodevelopment and environmental factors that influence behavior. This study explored the relationships between brain volume and behavior from an Exploratory Structural Equation Modeling (ESEM) based on the Research Domain Criteria. High-resolution magnetic resonance imaging scans were acquired from recent patients with AUD (n = 50) and healthy controls (HC=50). Group differences were assessed by means of voxel-based morphometry (VBM) and regions of interest (ROIs). Participants completed a battery of neurocognitive tasks and emotional tests. When controlling for age, education levels, and total intracranial volume, we found lower gray matter volume in cortical and limbic areas, as well as significant impairments in the AUD group on cognition and affective status. This study demonstrated the importance of multifactorial analysis and complex models in order to better understand substance use disorders. The brain losses may have been the result of neurodevelopmental impairments due to biological and environmental factors that predisposed to AUD or the result of drug abuse. The ESEM indicated that limbic areas indirectly affected the alcohol severity through emotional dysfunction. These results suggest a more relevant involvement of limbic regions for the severity of alcohol use, showing a more significant association between AUD and mood disorders.

Childhood abuse and craving in methamphetamine-dependent individuals: the mediating role of alexithymia

Individuals with a history of childhood abuse (CA, including neglect and abuse by caregivers before the age of 18 years) have more severe substance dependence problems than those without a history of childhood abuse. However, whether a history of CA exacerbates craving and the mechanism of this effect remain largely unknown. The aim of this study was to explore the role of alexithymia in the effects of CA on craving in a large sample of methamphetamine-dependent individuals based on latent vulnerability theory. A total of 324 methamphetamine-dependent individuals who met DSM-5 criteria for substance use disorder were recruited. CA, alexithymia, and craving data were collected from the Childhood Trauma Questionnaire, the Toronto Alexithymia Scale-20, and the Obsessive Compulsive Drug Use Scale, respectively. t tests and ANCOVA were conducted to compare variables between the CA and non-CA groups, while partial correlation and mediation analyses were conducted to examine the potential mediating role of alexithymia in the relationship between CA and craving. Abused methamphetamine-dependent individuals reported higher levels of craving and higher levels of alexithymia than those of non-abused methamphetamine-dependent individuals. Alexithymia partially mediated the link between CA and craving, especially the effect of CA on craving frequency was fully mediated by alexithymia. Our findings reveal that a history of childhood abuse has a lasting effect on craving in stimulant-dependent individuals, and alexithymia contributes to some extent to the severity of substance abuse problems in abused methamphetamine-dependent individuals.

Clinical, Genomic, and Neurophysiological Correlates of Lifetime Suicide Attempts among Individuals with an Alcohol Use Disorder

Introduction

Research has identified multiple risk factors associated with suicide attempt (SA) among individuals with psychiatric illness. However, there is limited research among those with an alcohol use disorder (AUD), despite their disproportionately higher rates of SA.

Methods

We examined lifetime SA in 4,068 individuals with an AUD from the Collaborative Study on the Genetics of Alcoholism (23% lifetime SA; 53% female; mean age: 38). We explored risk for lifetime SA across other clinical conditions ascertained from a clinical interview, polygenic scores for comorbid psychiatric problems, and neurocognitive functioning.

Results

Participants with an AUD who attempted suicide had greater rates of trauma exposure, major depressive disorder, post-traumatic stress disorder, other substance use disorders (SUDs), and suicidal ideation. Polygenic scores for SA, depression, and PTSD were associated with increased odds of reporting an SA (ORs = 1.22-1.44). Participants who reported an SA also had decreased right hemispheric frontal-parietal theta and decreased interhemispheric temporal-parietal alpha electroencephalogram resting-state coherences relative to those who did not, but differences were small.

Conclusions

Overall, individuals with an AUD who report lifetime SA experience greater levels of trauma, have more severe comorbidities, and carry increased polygenic risk for other psychiatric problems. Our results demonstrate the need to further investigate SAs in the presence of SUDs.

ADHD and alcohol: Emotional regulation efforts pay off in quality of life points

The emotion dysregulation and impulsivity are highly associated with alcohol use disorder (AUD). This study explored the role of impulsivity and emotion dysregulation and the interaction with adult probable ADHD on alcohol-related quality of life (QoL). In this observational trial, we analyzed data from the randomized TRAIN study, which compared efficacy of two cognitive training programs in patients AUD recently detoxified at 5 centers in France from February 2019 to February 2023, and who completed child and adult ADHD screening data (WURS + ARSR, n = 206 of 226). We collected baseline data on AUD severity, age, sex, quality of life (AQoLS), cognitive impairment (MoCA), impulsive behavior (UPPS-P) and emotion dysregulation (ERQ expressive suppression subscore, DERS-impulse). Patients with probable and without ADHD were compared. We performed multiple linear regression explaining the total AQoLS score (dependent variable) by impulsivity (UPPS-P score), emotion regulation (DERS-impulse), and expressive suppression (ERQ expressive suppression subscore), and their interaction with ADHD, adjusted on MoCA, sex, age. Forty (19%) patients were above the screening threshold for ADHD. The impact of alcohol on QoL was greater in them than in those without ADHD (57.3 (21.9) vs. 46.4 (19.6), p = 0.002). High impulsivity and emotion dysregulation dimensions were both significantly associated with poorer QoL. ADHD interacted significantly with expressive suppression to worsen the impact of alcohol on QoL (p = 0.04). The dysfunctional attempts to compensate for the strong dysregulation of emotions in ADHD lowers QoL in AUD.

Examining social attention as a predictor of problem drinking behavior: A longitudinal study using eye-tracking

BACKGROUND

Researchers have long been interested in identifying objective markers for problem drinking susceptibility informed by the environments in which individuals drink. However, little is known of objective cognitive-behavioral indices relevant to the social contexts in which alcohol is typically consumed. Combining group-based alcohol administration, eye-tracking technology, and longitudinal follow-up over a 2-year span, the current study examined the role of social attention in predicting patterns of problem drinking over time.

METHODS

Young heavy drinkers (N = 246) were randomly assigned to consume either an alcoholic (target BAC 0.08%) or a control beverage in dyads comprising friends or strangers. Dyads completed a virtual video call in which half of the screen comprised a view of themselves ("self-view") and half a view of their interaction partner ("other-view"). Participants' gaze behaviors, operationalized as the proportion of time spent looking at "self-view" and "other-view," were tracked throughout the call. Problem drinking was assessed at the time of the laboratory visit and then every year subsequent for 2 years.

RESULTS

Significant interactions emerged between beverage condition and social attention in predicting binge drinking days. In cross-sectional analyses, among participants assigned to the control (but not alcohol) group, heightened self-focused attention was linked with increased binge days at baseline, B = 0.013, Exp(B) = 1.013, 95% CI = [0.004, 0.022], p = 0.005. In contrast, longitudinal models indicated that heightened self-focused attention among control participants while interacting with friends was linked with a more pronounced decline in binge drinking over time.

CONCLUSIONS

The relationship between social attention and problem drinking is complex and evolves over time. While dispositional self-consciousness may act as a risk factor at the cross-sectional level, it appears to serve a potentially protective function as participants mature into young adulthood. More broadly, results highlight potential utility for objective markers of self-consciousness in the understanding of problem drinking etiology.

Dopamine mediates a directionally opposite correlation between empathy and the reinforcing effects of amphetamine and gambling in people with gambling disorder vs. healthy controls

Understanding the relationship between empathy, subjective effects of addictive reinforcers and dopamine function in people with gambling disorder (PGD) vs. healthy controls (HCs) may inform GD treatment. The current investigation addressed this issue via retrospective analysis of data from three studies using amphetamine and a slot machine (SLOTS) as reinforcers in PGD and HCs. The Empathy scale of Eysenck's Impulsiveness Questionnaire assessed trait Empathy. The Gamblers Beliefs Questionnaire assessed cognitive distortions. The Eysenck Lie scale assessed socially desirable responding. PET scans quantified dopamine receptor expression and amphetamine-induced dopamine release in Study 1. Pre-treatment with the D2-receptor (D2R)-preferring antagonist, haloperidol or D1R-D2R antagonist, fluphenazine before SLOTS tested the role of D2 autoreceptors and post-synaptic D2R in Study 2. Pre-treatment with the multi-system indirect dopamine agonist, modafinil before SLOTS assessed the reliability of correlations in PGD. Striatal D2R expression predicted greater Empathy and lower amphetamine 'Liking' in HCs, and predicted greater symptom severity in PGD. Empathy predicted lower 'Exciting' effects of SLOTS under placebo in HCs; no correlation emerged under either antagonist. Relative to placebo, haloperidol decreased, whereas fluphenazine increased, the positive correlation between Empathy and Exciting effects of SLOTS in PGD. Modafinil markedly reduced the positive correlation between Empathy and Exciting effects of SLOTS seen under placebo in PGD. Empathy predicted greater cognitive distortions in PGD in all studies. Lie scale variance influenced several primary effects. Prior research linking the insula with Empathy, reactivity to interoceptive signals for risky rewards (uncertainty), and cognitive distortions, provides a parsimonious account for these results.

Differential impact of emotional and social loneliness on daily alcohol consumption in individuals with alcohol use disorder

BACKGROUND

Loneliness is a predisposing and maintaining factor of alcohol use behavior. Several studies have linked loneliness to daily drinking and elevated alcohol use disorder (AUD) risk; however, operationalizations of both loneliness and drinking have varied greatly.

METHODS

The current study adopted a multidimensional framework of loneliness (i.e., emotional and social subtypes) to examine daily prospective relations between loneliness and drinking among non-treatment seeking individuals with AUD. Participants (N= 60) reported on current loneliness and drinking twice daily for 14-days. Scores on emotional and social loneliness were disaggregated into within- and between-person predictors, and a multilevel hurdle model proxy was fitted with drinking likelihood (logistic) and quantity (zero truncated negative binomial) specified as separate outcomes.

RESULTS

Emotional loneliness (within-person) was associated with increased drinking likelihood (OR=1.05, 95 % BCI [1.01, 1.10]) and quantity (IRR=1.05, 95 % BCI [1.02, 1.09]), while social loneliness (within-person) was associated with decreases in both drinking likelihood (OR=.94, 95 % BCI [.89,.99]) and quantity (IRR=.96, 95 % BCI [.93,.99]). Between-person loneliness scores were unrelated to both outcomes.

CONCLUSIONS

These discrepant findings by loneliness subtype may be ascribed to differences in subjective manifestations, in that emotional loneliness is a more severe form of loneliness that overlaps significantly with other negative affective states and promotes a coping response, while social loneliness may be readily alleviated by adaptive behavioral strategies for some, and social withdrawal for others. These findings offer insight into the nuances of loneliness-drinking relations and their clinical implications.

Compensation patterns and altered functional connectivity in alcohol use disorder with and without Korsakoff's syndrome

Alcohol use disorder is a chronic disease characterized by an inappropriate pattern of drinking, resulting in negative consequences for the individual's physical, mental and social health. Korsakoff's syndrome is a complication of alcohol use disorder and is characterized by severe memory and executive deficits. The fronto-cerebellar and Papez circuits are structurally affected in patients with alcohol use disorder with and without Korsakoff's syndrome. The first objective of the present study was to measure the effect of chronic and excessive alcohol consumption on resting-state functional connectivity of these two functional brain networks. The second objective was to identify, for the first time, resting-state functional connectivity abnormalities specific to amnesic patients with Korsakoff's syndrome. In the present study, a neuropsychological assessment and a resting-state functional magnetic resonance imaging examination were conducted in 31 healthy controls (43.6 ± 6.1 years) and 46 patients (46.6 ± 9.1 years) with alcohol use disorder including 14 patients with Korsakoff's syndrome (55.5 ± 5.3 years) to examine the effect of chronic and heavy alcohol consumption on functional connectivity of the fronto-cerebellar and the Papez circuits at rest and the specificity of functional connectivity changes in Korsakoff's syndrome compared to alcohol use disorder without Korsakoff's syndrome. The resting-state functional connectivity analyses focused on the nodes of the fronto-cerebellar and Papez circuits and combined region of interest and graph theory approaches, and whether these alterations are associated with the neuropsychological profile. In patients pooled together compared to controls, lower global efficiency was observed in the fronto-cerebellar circuit. In addition, certain regions of the fronto-cerebellar and Papez circuits were functionally hyperconnected at rest, which positively correlated with executive functions. Patients with Korsakoff's syndrome showed lower resting-state functional connectivity, lower local and global efficiency within the Papez circuit compared to those without Korsakoff's syndrome. Resting-state functional connectivity positively correlated with several cognitive scores in patients with Korsakoff's syndrome. The fronto-cerebellar and Papez circuits, two normally well-segregated networks, are functionally altered by alcohol use disorder. The Papez circuit attempts to compensate for deficits in the fronto-cerebellar circuit, albeit insufficiently as evidenced by patients' overall lower cognitive performance. Korsakoff's syndrome is characterized by altered functional connectivity in the Papez circuit known to be centrally involved in memory.

Effects of alcohol problem discrepancy on relationship adjustment: The moderating role of conflict negotiation among couples with alcohol use disorder and intimate partner violence

Alcohol use disorder (AUD) has well-known negative effects on romantic relationship functioning, including the occurrence of intimate partner violence (IPV). A separate literature focused on community couples indicates that relationship functioning is more likely to suffer when partners report greater discrepancies in alcohol consumption. It is important to expand this literature to couples with AUD and to examine the role of impactful AUD domains in dyadic functioning. Furthermore, few studies have examined adaptive, treatment-malleable factors that could potentially offset the negative impact of alcohol discrepancies on relationship functioning. This study examined the association between couples' alcohol problem discrepancies and relationship adjustment, as well as the moderating effect of self-reported adaptive conflict negotiation behaviors. Participants were 100 couples (N = 200 individual participants) with intimate partner violence wherein at least one partner met diagnostic criteria for AUD. Actor-Partner Interdependence Models indicated that greater alcohol problem discrepancy was associated with lower dyadic adjustment. Moderation analyses revealed that the highest level of relationship adjustment was observed among couples with lower alcohol problem discrepancy and greater negotiation behaviors, while relationship adjustment was similar for couples with larger alcohol problem discrepancy, regardless of negotiation behaviors. Although further study is needed to clarify under what specific conditions adaptive negotiation behaviors are most helpful, they appear to be beneficial for some couples in this sample. We found no evidence that negotiation behaviors may be harmful among these high-risk couples.

Agreement for Recovery: First Spanish Consensus on the Concept of Alcohol Addiction Recovery

INTRODUCTION

Current literature does not dispose from a widely accepted definition of recovery in alcohol use disorder (AUD), and most proposals originate from anglophone countries. This study introduces a pioneering consensus in Spain on the definition of recovery in AUD.

METHOD

The Delphi method was used. The expert panel, comprising 54 multidisciplinary professionals from the Community of Madrid.

RESULTS

A high level of consensus (≥80% agreement) was reached for 45% of the items and majority (≥60%) for 84%. Recovery is understood as a dynamic, personalized, and voluntary process, potentially enduring throughout one's lifespan. It entails a transformative lifestyle shift aimed at achieving a significant improvement in overall quality of life, encompassing physical and mental health, interpersonal relationships, and environmental factors. The journey of recovery is marked by heightened psychological well-being, is characterized by empowerment, personal growth, existential purpose, and positive identity reconstruction. Recovery is supported by substance use management, requires proactive individual agency and involves both personal and societal responsibilities.

CONCLUSIONS

This study represents a milestone as it is the first consensus in the Community of Madrid on the meaning of recovery in AUD. The proposed definition of recovery could be a potential reference for similar regions within Spain or even for other countries with cultural similarities. The elucidation of a clear framework of recovery provides a solid basis for future research efforts and clinical interventions in the Spanish AUD landscape.

BCI Improves Alcohol-Induced Cognitive and Emotional Impairments by Restoring pERK-BDNF

Binge drinking causes a range of problems especially damage to the nervous system, and the specific neural mechanism of brain loss and behavioral abnormalities caused by which is still unclear. Extracellular regulated protein kinases (ERK) maintain neuronal survival, growth, and regulation of synaptic plasticity by phosphorylating specific transcription factors to regulate expression of brain-derived neurotrophic factor (BDNF). Dual-specific phosphatase 1 (DUSP1) and DUSP6 dephosphorylate tyrosine and serine/threonine residues in ERK1/2 to inactivate them. To investigate the molecular mechanism by which alcohol affects memory and emotion, a chronic intermittent alcohol exposure (CIAE) model was established. The results demonstrated that mice in the CIAE group developed short-term recognition memory impairment and anxiety-like behavior; meanwhile, the expression of DUSP1 and DUSP66 in the mPFC was increased, while the levels of p-ERK and BDNF were decreased. Micro-injection of DUSP1/6 inhibitor BCI into the medial prefrontal cortex (mPFC) restored the dendritic morphology by reversing the activity of ERK-BDNF and ultimately improved cognitive and emotional impairment caused by CIAE. These findings indicate that CIAE inhibits ERK-BDNF by increasing DUSP1/6 in the mPFC that may be associated with cognitive and emotional deficits. Consequently, DUSP1 and DUSP6 appear to be potential targets for the treatment of alcoholic brain disorders.

A Systematic Review and Meta-Analysis of Social Cognition Among People Living with HIV: Implications for Non-Social Cognition and Social Everyday Functioning

Social cognition-the complex mental ability to perceive social stimuli and negotiate the social environment-has emerged as an important cognitive ability needed for social functioning, everyday functioning, and quality of life. Deficits in social cognition have been well documented in those with severe mental illness including schizophrenia and depression, those along the autism spectrum, and those with other brain disorders where such deficits profoundly impact everyday life. Moreover, subtle deficits in social cognition have been observed in other clinical populations, especially those that may have compromised non-social cognition (i.e., fluid intelligence such as memory). Among people living with HIV (PLHIV), 44% experience cognitive impairment; likewise, social cognitive deficits in theory of mind, prosody, empathy, and emotional face recognition/perception are gradually being recognized. This systematic review and meta-analysis aim to summarize the current knowledge of social cognitive ability among PLHIV, identified by 14 studies focused on social cognition among PLHIV, and provides an objective consensus of the findings. In general, the literature suggests that PLHIV may be at-risk of developing subtle social cognitive deficits that may impact their everyday social functioning and quality of life. The causes of such social cognitive deficits remain unclear, but perhaps develop due to (1) HIV-related sequelae that are damaging the same neurological systems in which social cognition and non-social cognition are processed; (2) stress related to coping with HIV disease itself that overwhelms one's social cognitive resources; or (3) may have been present pre-morbidly, possibly contributing to an HIV infection. From this, a theoretical framework is proposed highlighting the relationships between social cognition, non-social cognition, and social everyday functioning.

Impairments of Sociocognitive Functions in Individuals with Behavioral Addictions: A Review Article

Since little is known about the exact pattern of social cognitive impairments related to behavioral addictions, the aim of the PRISMA-oriented review was to (i) provide an overview of relevant empirical publications, and to (ii) to elucidate which specific aspects of social cognition (i.e., emotion recognition, empathy, and theory of mind (ToM)) are impaired in different types of behavioral addictions. Behavioral addictions have been associated with cognitive deficits which may contribute to impaired social cognitive functioning. More recently, this domain has been investigated in patients with behavioral addictions as impaired social cognition detrimentally affects daily functioning and thus forms a relevant target for treatment. A systematic search in the PubMed and Web of Science databases was performed focusing on social cognitive functions in behavioral addictions. Studies focusing on the same social cognitive component were grouped together, this was done based on the used assessment measures. In total, 18 studies met the specified inclusion criteria. Five studies focusing on emotion recognition concluded that individuals with behavioral addictions show impairments in this domain. As for the 13 studies focusing on empathy and/or ToM, most of them found deficits linked to different types of behavioral addictions. Only two studies, one of which was investigating a distinct population (multiplayer online role-playing gamers) did not link empathy to behavioral addictions. The results show that the majority of studies focusing on social cognition and behavioral addictions found some deficits. Additional research focusing on this topic is urgently needed in behavioral addictions, addressing several methodological issues.

Enhancing Emotion Regulation and Overcoming Craving in Alcohol Dependence Syndrome Through Mindfulness-based Relapse Prevention

Background

Alcohol dependence syndrome (ADS) is a significant challenge for psychologists due to relapse and its impacts on well-being. Mindfulness-based relapse prevention (MBRP) has emerged as a potential solution, receiving increasing attention in the field of psychological interventions for ADS. This study aimed to evaluate the impact of MBRP, specifically on emotion regulation and alcohol craving as primary outcomes, alongside the secondary consideration of assessing changes in mindfulness levels.

Methods

In this quasi-experimental study utilizing a pre-test/post-test design, 50 patients (aged 18-55) with ADS were enrolled in the intervention group (MBRP + usual care) and the usual care alone (UCA) group. The outcome assessment employed the Difficulties in Emotion Regulation Scale-18 (DERS-18) and Alcohol Craving Questionnaire-Short Form Revised (ACQ-SF-R) at three time points: pre-intervention (T1), mid-intervention (T2, four weeks after MBRP initiation), and post-intervention (T3, MBRP completion). Post-intervention comparisons between the intervention and UCA groups utilized repeated measures ANOVA (p < .05).

Result

In the intervention group, significant within-group improvements were observed in mean scores of emotion regulation and craving at T1 (56.8 ± 7.6 and 41.6 ± 7.3), T2 (61.7 ± 10.5 and 41.5 ± 7.4), and T3 (61.5 ± 10.6 and 35.6 ± 5.4), with p values of .006 and .001, respectively. In comparison, the UCA group showed significant post-intervention differences in emotion regulation (46.9 ± 16.4) and craving (34 ± 11.82) scores, with a p value of .004. The effect sizes for emotion regulation (0.42) and craving (1.43) in the intervention group and for emotion regulation (0.50) and craving (0.47) in the UCA group further demonstrated more favorable outcomes in the intervention group, especially in reducing craving.

Conclusion

Our research indicates that intervention and UCA yields moderate enhancements in emotion regulation; however, intervention demonstrates superior efficacy in diminishing craving, which is pivotal for relapse prevention. Incorporating MBRP with bespoke interventions might optimize the long-term treatment of ADS.

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.

Clinical, genomic, and neurophysiological correlates of lifetime suicide attempts among individuals with an alcohol use disorder

Research has identified clinical, genomic, and neurophysiological markers associated with suicide attempts (SA) among individuals with psychiatric illness. However, there is limited research among those with an alcohol use disorder (AUD), despite their disproportionately higher rates of SA. We examined lifetime SA in 4,068 individuals with DSM-IV alcohol dependence from the Collaborative Study on the Genetics of Alcoholism (23% lifetime suicide attempt; 53% female; mean age: 38). Within participants with an AUD diagnosis, we explored risk across other clinical conditions, polygenic scores (PGS) for comorbid psychiatric problems, and neurocognitive functioning for lifetime suicide attempt. Participants with an AUD who had attempted suicide had greater rates of trauma exposure, major depressive disorder, post-traumatic stress disorder, and other substance use disorders compared to those who had not attempted suicide. Polygenic scores for suicide attempt, depression, and PTSD were associated with reporting a suicide attempt (ORs = 1.22 - 1.44). Participants who reported a SA also had decreased right hemispheric frontal-parietal theta and decreased interhemispheric temporal-parietal alpha electroencephalogram resting-state coherences relative to those who did not, but differences were small. Overall, individuals with an AUD who report a lifetime suicide attempt appear to experience greater levels of trauma, have more severe comorbidities, and carry polygenic risk for a variety of psychiatric problems. Our results demonstrate the need to further investigate suicide attempts in the presence of substance use disorders.

Altered States and Social Bonds: Effects of MDMA and Serotonergic Psychedelics on Social Behavior as a Mechanism Underlying Substance-Assisted Therapy

There has been renewed interest in the use of 3,4-methylenedioxy-methamphetamine (MDMA) and serotonergic psychedelics in the treatment of multiple psychiatric disorders. Many of these compounds are known to produce prosocial effects, but how these effects relate to therapeutic efficacy and the extent to which prosocial effects are unique to a particular drug class is unknown. In this article, we present a narrative overview and compare evidence for the prosocial effects of MDMA and serotonergic psychedelics to elucidate shared mechanisms that may underlie the therapeutic process. We discuss 4 categories of prosocial effects: altered self-image, responses to social reward, responses to negative social input, and social neuroplasticity. While both categories of drugs alter self-perception, MDMA may do so in a way that is less related to the experience of mystical-type states than serotonergic psychedelics. In the case of social reward, evidence supports the ability of MDMA to enhance responses and suggests that serotonergic psychedelics may also do so, but more research is needed in this area. Both drug classes consistently dampen reactivity to negative social stimuli. Finally, preclinical evidence supports the ability of both drug classes to induce social neuroplasticity, promoting adaptive rewiring of neural circuits, which may be helpful in trauma processing. While both MDMA and serotonergic psychedelics produce prosocial effects, they differ in the mechanisms through which they do this. These differences affect the types of psychosocial interventions that may work best with each compound.

The role of brain serotonin signaling in excessive alcohol consumption and withdrawal: A call for more research in females

Alcohol Use Disorder (AUD) is a leading cause of death and disability worldwide, but current treatments are insufficient in fully addressing the symptoms that often lead to relapses in alcohol consumption. The brain's serotonin system has been implicated in AUD for decades and is a major regulator of stress-related behaviors associated with increased alcohol consumption. This review will discuss the current literature on the association between neurobiological adaptations in serotonin systems and AUD in humans as well as the effectiveness of serotonin receptor manipulations on alcohol-related behaviors like consumption and withdrawal. We will further discuss how these findings in humans relate to findings in animal models, including a comparison of systemic pharmacological manipulations modulating alcohol consumption. We next provide a detailed overview of brain region-specific roles for serotonin and serotonin receptor signaling in alcohol-related behaviors in preclinical animal models, highlighting the complexity of forming a cohesive model of serotonin function in AUD and providing possible avenues for more effective therapeutic intervention. Throughout the review, we discuss what is known about sex differences in the sequelae of AUD and the role of serotonin in these sequelae. We stress a critical need for additional studies in women and female animals so that we may build a clearer path to elucidating sex-specific serotonergic mechanisms and develop better treatments.

Hazardous drinking in young adults with co-occurring PTSD and psychosis symptoms: A network analysis

BACKGROUND

Existing literature suggests the co-occurrence of post-traumatic stress disorder (PTSD) and psychosis among young adults is related to hazardous drinking. However, the influencing mechanisms among these co-occurrences are inconclusive. Thus, this study aimed to investigate the symptomatic associations between PTSD, psychosis, and hazardous drinking.

METHODS

This study included 96,218 young Chinese adults, divided into three groups (PTSD, Psychosis, and co-occurring PTSD-Psychosis). PTSD, psychosis, and hazardous drinking were measured by the ten-item Trauma Screening Questionnaire, the seven-item Psychosis Screener Scale, and the four-item Alcohol Use Disorders Identification Test, respectively. Network analysis was utilized to explore and compare the symptomatic correlation between PTSD, psychosis, and hazardous drinking.

RESULTS

In this study, the most crucial symptom (both central and bridge) was "delusion of control" among the three networks. Hazardous drinking was another main bridge symptom. Compared to the Psychosis group and the co-occurring PTSD-Psychosis group, "Delusion of reference or persecution" to "Grandiose delusion" was the strongest edge in "the network structure of the PTSD group".

LIMITATIONS

The cross-sectional study cannot determine the causal relationship. Applying self-reporting questionnaires may cause inherent bias. Young adult participants limited the generalization of the results to other groups.

CONCLUSIONS

Among the three network structures, delusion of control was the most crucial symptom, and hazardous drinking was another bridge symptom; the edge of delusion of reference or persecution and grandiose delusion was strongest in the PTSD group's network. Efforts should be taken to develop diverse targeted interventions for these core symptoms to relieve PTSD, psychosis, and hazardous drinking in young adults.

Neural activations during cognitive and affective theory of mind processing in healthy adults with a family history of alcohol use disorder

BACKGROUND

Social cognition impairments are a common feature of alcohol use disorders (AUD). However, it remains unclear whether these impairments are solely the consequence of chronic alcohol consumption or whether they could be a marker of vulnerability.

METHODS

The present study implemented a family history approach to address this question for a key process of social cognition: theory of mind (ToM). Thirty healthy adults with a family history of AUD (FH+) and 30 healthy adults with a negative family history of AUD (FH-), matched for age, sex, and education level, underwent an fMRI cartoon-vignette paradigm assessing cognitive and affective ToM. Participants also completed questionnaires evaluating anxiety, depressive symptoms, childhood trauma, and alexithymia.

RESULTS

Results indicated that FH+ individuals differed from FH- individuals on affective but not cognitive ToM processing, at both the behavioral and neural levels. At the behavioral level, the FH+ group had lower response accuracy for affective ToM compared with the FH- group. At the neural level, the FH+ group had higher brain activations in the left insula and inferior frontal cortex during affective ToM processing. These activations remained significant when controlling for depressive symptoms, anxiety, and childhood trauma.

CONCLUSIONS

These findings highlight difficulties during affective ToM processing among first-degree relatives of AUD patients, supporting the idea that some of the impairments exhibited by these patients may already be present before the onset of AUD and may be considered a marker of vulnerability.

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.

Metadehumanization, fundamental needs and coping strategies: A comparison of drinkers at low versus high risk of alcohol use disorder

The interpersonal difficulties documented in chronic excessive drinking might foster the progression toward severe alcohol use disorder (SAUD). Characterizing these interpersonal difficulties and their commonalities with patients already presenting a diagnosed SAUD is needed to develop targeted prophylactic interventions. Patients with SAUD present metadehumanization (i.e., the perception of being considered as less than human by others), which is associated with deleterious consequences (e.g., reduced fundamental needs satisfaction, increased negative emotions, reduced self-esteem, disrupted coping strategies) involved in the persistence of this disorder. No study has investigated metadehumanization among individuals not diagnosed with SAUD but at high risk of alcohol use disorder. We measured metadehumanization, emotions, self-esteem, coping strategies, and fundamental needs threat among such high-risk drinkers (N = 86; AUDIT score higher than 15), and matched low-risk drinkers (N = 100, AUDIT score <8). Compared to low-risk drinkers, high-risk drinkers felt more dehumanized and reported increased fundamental needs threat, negative emotions, anxiety, depression, and more frequent use of both adaptive and maladaptive coping strategies, including alcohol use. Mediation analyses controlling for anxiety/depression revealed that the differences in emotions and coping strategies were explained by metadehumanization and fundamental needs threat. Despite not being diagnosed with SAUD and being untreated, high-risk drinkers are more similar to patients with SAUD than to low-risk drinkers. In view of its links with factors favoring SAUD, metadehumanization should be considered in experimental studies among high-risk drinkers and treated by specific interventions.

Neural correlates of altered emotional responsivity to infant stimuli in mothers who use substances

Mothers who use substances during pregnancy and postpartum may have altered maternal behavior towards their infants, which can have negative consequences on infant social-emotional development. Since maternal substance use has been associated with difficulties in recognizing and responding to infant emotional expressions, investigating mothers' subjective responses to emotional infant stimuli may provide insight into the neural and psychological processes underlying these differences in maternal behavior. In this study, 39 mothers who used substances during the perinatal period and 42 mothers who did not underwent functional magnetic resonance imaging while viewing infant faces and hearing infant cries. Afterwards, they rated the emotional intensity they thought each infant felt ('think'-rating), and how intensely they felt in response to each infant stimulus ('feel'-rating). Mothers who used substances had lower 'feel'-ratings of infant stimuli compared to mothers who did not. Brain regions implicated in affective processing (e.g., insula, inferior frontal gyrus) were less active in response to infant stimuli, and activity in these brain regions statistically predicted maternal substance-use status. Interestingly, 'think'-ratings and activation in brain regions related to cognitive processing (e.g., medial prefrontal cortex) were comparable between the two groups of mothers. Taken together, these results suggest specific neural and psychological processes related to emotional responsivity to infant stimuli may reflect differences in maternal affective processing and may contribute to differences in maternal behavior in mothers who use substances compared to mothers who do not. The findings suggest potential neural targets for increasing maternal emotional responsivity and improving child outcomes.

Clinical, genomic, and neurophysiological correlates of lifetime suicide attempts among individuals with alcohol dependence

Research has identified clinical, genomic, and neurophysiological markers associated with suicide attempts (SA) among individuals with psychiatric illness. However, there is limited research among those with an alcohol use disorder (AUD), despite their disproportionately higher rates of SA. We examined lifetime SA in 4,068 individuals with DSM-IV alcohol dependence from the Collaborative Study on the Genetics of Alcoholism (23% lifetime suicide attempt; 53% female; 17% Admixed African American ancestries; mean age: 38). We 1) conducted a genome-wide association study (GWAS) of SA and performed downstream analyses to determine whether we could identify specific biological pathways of risk, and 2) explored risk in aggregate across other clinical conditions, polygenic scores (PGS) for comorbid psychiatric problems, and neurocognitive functioning between those with AD who have and have not reported a lifetime suicide attempt. The GWAS and downstream analyses did not produce any significant associations. Participants with an AUD who had attempted suicide had greater rates of trauma exposure, major depressive disorder, post-traumatic stress disorder, and other substance use disorders compared to those who had not attempted suicide. Polygenic scores for suicide attempt, depression, and PTSD were associated with reporting a suicide attempt (ORs = 1.22-1.44). Participants who reported a SA also had decreased right hemispheric frontal-parietal theta and decreased interhemispheric temporal-parietal alpha electroencephalogram resting-state coherences relative to those who did not, but differences were small. Overall, individuals with alcohol dependence who report SA appear to experience a variety of severe comorbidities and elevated polygenic risk for SA. Our results demonstrate the need to further investigate suicide attempts in the presence of substance use disorders.

Affective and cognitive Theory of Mind in patients with alcohol use disorder: Associations with symptoms of depression, anxiety, and somatization

INTRODUCTION

Theory of Mind (ToM) is the ability to ascribe thoughts (cognitive ToM) and feelings (affective ToM) to others. Ample evidence exists for impairments of affective and cognitive ToM in individuals with alcohol use disorder (AUD); however, evidence regarding changes of these impairments during AUD treatment and their possible relationship to comorbid symptoms is ambiguous. The current study analyzed changes in ToM during treatment and tested associations with comorbid symptoms of depression, anxiety, somatization, and social functioning.

METHODS

We analyzed data from 175 individuals with AUD. The study assessed ToM and comorbid symptoms of depression, anxiety, somatization, and social functioning at the time of admission and at the time of discharge from an approximately 60 days long abstinence-oriented inpatient treatment. We assessed affective and cognitive ToM using the Movie for the Assessment of Social Cognition, a measure with high ecological validity.

RESULTS

All symptoms, total and cognitive ToM improved following treatment; however, affective ToM did not improve. Moreover, cognitive ToM at the beginning of treatment was associated with improved symptoms of depression and somatization, while affective ToM was not.

CONCLUSIONS

Our study shows improvements in total and cognitive ToM as well as symptoms of depression, anxiety, somatization, and social functioning following long-term treatment. Furthermore, cognitive ToM was related to improvements in comorbid symptoms. This finding suggests that ToM may be an important treatment target in patients with AUD.

Involuntary social isolation and alcohol consumption: an ecological momentary assessment in Germany amid the COVID-19 pandemic

AIMS

Alcohol consumption often occurs in a social setting, which was affected by social distancing measures amid the coronavirus disease-2019 (COVID-19) pandemic. In this study, we examine how involuntary social isolation (i.e. comparing a no-lockdown stage with a lockdown stage) affects the association between loneliness, social activities, and drinking behavior.

METHOD

We performed an ecological momentary assessment eight times per day for 7 days amid the COVID-19 pandemic in Germany. We recruited 280 participants and assessed their trait loneliness, daily state loneliness, social activities, and drinking behaviors.

RESULTS

We found that a lockdown condition moderates the association between trait and daily state loneliness and alcohol consumption. During a lockdown stage, trait loneliness was positively associated, whereas state loneliness was negatively associated with alcohol consumption. During a no-lockdown stage, trait and state loneliness were both negatively associated with alcohol consumption. For both no-lockdown and lockdown stages, duration of social interaction, male gender, and weekends was positively associated with alcohol consumption.

CONCLUSION

Our study suggests that an involuntary social isolation condition (i.e. a lockdown stage) changes how trait loneliness is associated with alcohol consumption.

Adaptor protein complex 2 in the orbitofrontal cortex predicts alcohol use disorder

Alcohol use disorder (AUD) is a life-threatening disease characterized by compulsive drinking, cognitive deficits, and social impairment that continue despite negative consequences. The inability of individuals with AUD to regulate drinking may involve functional deficits in cortical areas that normally balance actions that have aspects of both reward and risk. Among these, the orbitofrontal cortex (OFC) is critically involved in goal-directed behavior and is thought to maintain a representation of reward value that guides decision making. In the present study, we analyzed post-mortem OFC brain samples collected from age- and sex-matched control subjects and those with AUD using proteomics, bioinformatics, machine learning, and reverse genetics approaches. Of the 4,500+ total unique proteins identified in the proteomics screen, there were 47 proteins that differed significantly by sex that were enriched in processes regulating extracellular matrix and axonal structure. Gene ontology enrichment analysis revealed that proteins differentially expressed in AUD cases were involved in synaptic and mitochondrial function, as well as transmembrane transporter activity. Alcohol-sensitive OFC proteins also mapped to abnormal social behaviors and social interactions. Machine learning analysis of the post-mortem OFC proteome revealed dysregulation of presynaptic (e.g., AP2A1) and mitochondrial proteins that predicted the occurrence and severity of AUD. Using a reverse genetics approach to validate a target protein, we found that prefrontal Ap2a1 expression significantly correlated with voluntary alcohol drinking in male and female genetically diverse mouse strains. Moreover, recombinant inbred strains that inherited the C57BL/6J allele at the Ap2a1 interval consumed higher amounts of alcohol than those that inherited the DBA/2J allele. Together, these findings highlight the impact of excessive alcohol consumption on the human OFC proteome and identify important cross-species cortical mechanisms and proteins that control drinking in individuals with AUD.

Adaptor protein complex 2 in the orbitofrontal cortex predicts alcohol use disorder

Alcohol use disorder (AUD) is a life-threatening disease characterized by compulsive drinking, cognitive deficits, and social impairment that continue despite negative consequences. The inability of individuals with AUD to regulate drinking may involve functional deficits in cortical areas that normally balance actions that have aspects of both reward and risk. Among these, the orbitofrontal cortex (OFC) is critically involved in goal-directed behavior and is thought to maintain a representation of reward value that guides decision making. In the present study, we analyzed post-mortem OFC brain samples collected from age- and sex-matched control subjects and those with AUD using proteomics, bioinformatics, machine learning, and reverse genetics approaches. Of the 4,500+ total unique proteins identified in the proteomics screen, there were 47 proteins that differed significantly by sex that were enriched in processes regulating extracellular matrix and axonal structure. Gene ontology enrichment analysis revealed that proteins differentially expressed in AUD cases were involved in synaptic and mitochondrial function, as well as transmembrane transporter activity. Alcohol-sensitive OFC proteins also mapped to abnormal social behaviors and social interactions. Machine learning analysis of the post-mortem OFC proteome revealed dysregulation of presynaptic (e.g., AP2A1) and mitochondrial proteins that predicted the occurrence and severity of AUD. Using a reverse genetics approach to validate a target protein, we found that prefrontal Ap2a1 expression significantly correlated with voluntary alcohol drinking in male and female genetically diverse mouse strains. Moreover, recombinant inbred strains that inherited the C57BL/6J allele at the Ap2a1 interval consumed higher amounts of alcohol than those that inherited the DBA/2J allele. Together, these findings highlight the impact of excessive alcohol consumption on the human OFC proteome and identify important cross-species cortical mechanisms and proteins that control drinking in individuals with AUD.

Prevalence, Perpetrators, and Factors Associated With Intimate Partner Violence Among Adolescents Living in Urban Slums of Kampala, Uganda

Intimate partner violence (IPV) poses a public health burden, yet few studies have assessed co-existence of physical, emotional, and sexual IPV among adolescents. We assessed recent IPV victimization and associated factors and described IPV patterns and perpetrators among young people from urban slums in Kampala, Uganda. We conducted a prospective cohort study among 14 to 19-year-old individuals enrolled from March 2019 to March 2020 and followed quarterly for 12 months. We collected data on socio-demographics, sexual behavior, and substance use through interviews. Recent IPV victimization was documented at all visits if a participant reported experiencing physical, emotional, and/or sexual IPV in the past 3 months. Baseline factors associated with recent IPV victimization were determined using multivariable logistic regression. We enrolled 490 adolescents (60.6% female) with median age 18 years (Interquartile range (IQR) 17-18 years), 91.0% had less than secondary level education. Females mainly engaged in sex work (17.5%) and selling fruits/snacks (9.1%) while males commonly earned from sale of metal scrap or plastic waste (28.5%), 41% reported ≥10 life-time sexual partners, 16.1% were high-risk alcohol drinkers and 34.9% used illicit drugs in the past 3 months. Overall, 27.8% reported recent IPV victimization (20.0% females) with emotional IPV being common (17.8%). At baseline, recent IPV victimization was associated with high-risk alcohol consumption (adjusted odds ratio [aOR] 2.57; 95% confidence interval [CI] [1.44, 4.58]), reported paid sex in the past 3 months (aOR 1.82; [1.02, 3.22]) and being separated (aOR 2.47; [1.29, 4.73]). Recent IPV victimization declined from baseline to month 9 and increased at month 12 visits which coincided with the COVID-19 pandemic. IPV victimization is high among young people living in urban slums with emotional IPV being prevalent. IPV interventions are needed and should also address excessive alcohol consumption.

Distinct dynamic behavioural response to social exclusion in male patients with a history of alcohol dependence

Social exclusion contributes to alcohol consumption, whereas the development of alcohol dependence (AD) can in turn lead to the social exclusion of people with AD. Previous research observed altered neural responses to experimentally induced social exclusion (i.e., Cyberball game) in patients with AD. In addition, inflammation has been associated with both social behaviours and AD. Our study aimed to investigate the dynamic behavioural response and the inflammatory effects of social exclusion in male patients with a history of AD. To this end, we analysed dynamic changes in ball tossing during a partial exclusion Cyberball game and the cytokine interleukin (IL)-1b in saliva in 31 male patients who had a history of AD and 29 gender-matched healthy controls without AD. Participants were included in the first 2 min of the Cyberball game and then excluded by one of the two co-players in the proceeding 5 min. Saliva was collected three times: one before and two after the Cyberball game. Across groups, participants passed the ball more often to the excluder during the partial exclusion period. Analysis using piece-wise linear mixed models showed that patients rapidly increased ball tosses to the excluder upon exclusion, which lasted to the late response phase, whereas the early behavioural response to exclusion took longer for controls. There was no significant change of salivary IL-1b level to exclusion in either patients or controls. The results indicate a distinct dynamic behavioural response to social exclusion in male patients with a history of AD.

Chronic Intermittent Ethanol Vapor Exposure Paired with Two-Bottle Choice to Model Alcohol Use Disorder

Alcohol use disorder (AUD) is a chronic alcohol-related disorder that typically presents as uncontrolled drinking and preoccupation with alcohol. A key component of AUD research is using translationally relevant preclinical models. Over the past several decades, a variety of animal models have been used to study AUD. One prominent model of AUD is the chronic intermittent ethanol vapor exposure (CIE) model, which is a well-established approach for inducing alcohol dependence in rodents through repeated cycles of ethanol exposure via inhalation. To model AUD in mice, the CIE exposure is paired with a voluntary two-bottle choice (2BC) of alcohol drinking and water to measure the escalation of alcohol drinking. The 2BC/CIE procedure involves alternating weeks of 2BC drinking and CIE, which repeat until the escalation of alcohol drinking is achieved. In the present study, we outline the procedures for performing 2BC/CIE, including the daily use of the CIE vapor chamber, and provide an example of escalated alcohol drinking in C57BL/6J mice using this approach.

The effects of cigarette smoking and alcohol drinking on salty taste preferences based on Korean Community Health Survey data

BACKGROUND/OBJECTIVES

Excessive sodium intake, cigarette smoking, and alcohol consumption are risk factors for a wide range of diseases. This study aimed to determine whether smokers and drinkers are more likely to enjoy their food with more salt, and whether the combination of smoking and drinking is associated with salty taste preferences.

SUBJECTS/METHODS

This study analyzed the data of over 16 million Koreans from two four-year Korean Community Health Survey cycles (i.e., 2010 to 2013 and 2014 to 2017). The respondents' preferences for salty foods (i.e., their salt intake levels, whether they added salt or soy sauce to foods served on the table, and whether they dipped fried foods in salt or soy sauce), and the odds ratio (OR) of their preference were examined among smokers and drinkers when adjusted for sex, age, body mass index, educational level, household income, marital status, and cigarette smoking or alcohol consumption status.

RESULTS

Cigarette smoking and alcohol consumption were correlated with the consumption of salty food. Based on the adjusted model, cigarette smokers and alcohol drinkers preferred adding salt or soy sauce or dipping fried foods in soybean more than non-smokers and non-drinkers. In addition, people who smoked and consumed alcohol reported a more significant stacking effect regarding the salty taste preference.

CONCLUSION

This large population-based study found that both cigarette smoking and alcohol consumption were correlated with salty taste preferences, which may cause excessive sodium intake.

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.

Decreased inter-brain synchronization in the right middle frontal cortex in alcohol use disorder during social interaction: An fNIRS hyperscanning study

BACKGROUND

Alcohol use disorder (AUD) is a widespread mental disorder and has thrust a heavy burden on the health system all over the world. Social cognition and function are reported to be impaired in AUD, but its neural mechanism is rarely investigated. The current study attempts to fill this gap.

METHODS

28 subjects with AUD and 36 healthy controls (HC) were recruited in this study and were paired into 14 AUD dyads and 18 HC dyads. The drinking problems, depression, anxiety, and impulsivity of subjects were measured. Each dyad completed cooperation and competition tasks with simultaneous frontal functional near-infrared spectroscopy (fNIRS) hyperscanning recording. The inter-brain synchronization (IBS) in the frontal cortex was calculated for each dyad and compared between AUD and HC. The significantly altered IBS in AUD was correlated with clinical measures to explore possible influencing factors.

RESULTS

The IBS in the right middle frontal cortex was significantly decreased in AUD under both cooperation (t = -2.257, P = 0.028) and competition (t = -2.488, P = 0.016) task. The IBS during the cooperation task in the right middle frontal cortex in AUD was negatively correlated with non-planning impulsivity (r = -0.673, P = 0.006).

LIMITATIONS

This study used cross-sectional data, which limited the causal inference. The synchronization between other brain regions besides the frontal cortex should be further explored in patients with AUD.

CONCLUSION

The current study could provide new insights into the neural mechanism of social dysfunction in AUD and facilitate clinical intervention in future practice.

The Relationship between Mindfulness and Readiness to Change in Alcohol Drinkers

Mindfulness is a multi-faceted construct that involves paying attention to thoughts and emotions without automatically reacting and being critical of them. Recent research has suggested that mindfulness might play an important role in reducing problematic alcohol use. Further, Readiness to Change (RTC) is related to motivation to change drinking behaviours. The RTC scale identifies motivation to change drinking behaviours including Precontemplation, Contemplation, and Action stages. The current study investigated, for the first time, the relationship between mindfulness (and its facets) and RTC in relation to drinking behaviours. Undergraduate students from Western Sydney University (N = 279) were screened for drinking levels using the Alcohol Use Disorder Identification Test (AUDIT) and then completed the Readiness to Change Questionnaire (RCT) and the Five Facets Mindfulness Questionnaire (FFMQ), which includes the following facets: Acting with Awareness, Non-Judging of Inner Experience, Non-Reactivity to Inner Experience, Describing, and Observing. Results show that overall, mindfulness and its facets negatively correlated with RTC. Multiple regression analysis further showed that Awareness and Non-Judgement facets negatively predicted RTC. These findings provide insight into how the facets of mindfulness interact with the drinking motives of individuals and their intentions to change drinking behaviours. Based on these findings, we recommend the incorporation of mindfulness techniques in interventions targeting problematic drinking.

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.

Neurobiology of Aggression-Review of Recent Findings and Relationship with Alcohol and Trauma

Aggression can be conceptualized as any behavior, physical or verbal, that involves attacking another person or animal with the intent of causing harm, pain or injury. Because of its high prevalence worldwide, aggression has remained a central clinical and public safety issue. Aggression can be caused by several risk factors, including biological and psychological, such as genetics and mental health disorders, and socioeconomic such as education, employment, financial status, and neighborhood. Research over the past few decades has also proposed a link between alcohol consumption and aggressive behaviors. Alcohol consumption can escalate aggressive behavior in humans, often leading to domestic violence or serious crimes. Converging lines of evidence have also shown that trauma and posttraumatic stress disorder (PTSD) could have a tremendous impact on behavior associated with both alcohol use problems and violence. However, although the link between trauma, alcohol, and aggression is well documented, the underlying neurobiological mechanisms and their impact on behavior have not been properly discussed. This article provides an overview of recent advances in understanding the translational neurobiological basis of aggression and its intricate links to alcoholism and trauma, focusing on behavior. It does so by shedding light from several perspectives, including in vivo imaging, genes, receptors, and neurotransmitters and their influence on human and animal behavior.

Age as a potential modulator of alcohol-related deficits

Although their individual significance is well-documented, the interaction effects of age, sex, and alcohol use disorder (AUD) have undergone little systematic investigation. Here, we extend prior work interrogating sex and group (AUD vs. community comparison [CC]) by probing the main and interaction effects of age on emotion processes as well as two conventional neuropsychological tests. Main effects for age and group were anticipated; however, interaction effects comprise our primary focus. While sex differences in AUD prevalence are commonly reported, sex differences within AUD samples are inconsistently found. Therefore, we pose our inquiry regarding sex as exploratory. In this study, 54 CC (n = 30 women) and 55 AUD (n = 14 women) subjects completed a battery that included an emotional face discrimination task, the Trail-Making Test-B (TMT-B), and the Digit Symbol Substitution Test (DSST). The initial/full models included the main and interaction effects of age (as a continuous variable; 25-59 years of age), sex, and group (AUD, CC). In analysis of the emotional face discrimination task, performance on a non-affective face discrimination task was entered as a covariate. Analysis of emotion identification revealed group and age main (p = .02; d = .53 & .003; d = .50, respectively) and interaction effects (p = .05; d = .41). The latter suggested that age and emotion processing performance were positively correlated in the AUD group, but unrelated in the CC group. Notably, neither sex, main, nor interaction effects achieved significance. Using the full model, analysis of the TMT-B and DSST failed to show sex effects or reveal expected performance decrement in the AUD group. To clarify the latter, simple models including only group as well as correlations between age and performance by group for each task were conducted. These analyses demonstrated the expected AUD-related deficits and suggested differential relationships between age and neurocognitive performance as a function of both group and task. Outcomes across tasks emphasize the need to reframe aging effects, particularly in the context of AUD.

An eye-tracking study of biased attentional processing of emotional faces in severe alcohol use disorder

BACKGROUND

Social cognition impairments in severe alcohol use disorder (SAUD) are increasingly established. However, fundamental aspects of social cognition, and notably the attentional processing of socio-affective information, remain unexplored, limiting our understanding of underlying mechanisms. Here, we determined whether patients with SAUD show attentional biases to specific socio-affective cues, namely emotional faces.

METHOD

In a modified dot-probe paradigm, 30 patients with SAUD and 30 demographically matched healthy controls (HC) were presented with pairs of neutral-emotional (angry, disgusted, happy, sad) faces while having their eye movements recorded. Indices of early/automatic (first fixations, latency to first fixations) and later/controlled (number of fixations, dwell-time) processes were computed.

RESULTS

Patients with SAUD did not differ from HC in their attention to angry/disgusted/sad vs. neutral faces. However, patients with SAUD fixated/dwelled less on happy vs. neutral faces in the first block of stimuli than HC, who presented an attentional bias to happy faces.

LIMITATIONS

Sample-size was determined to detect medium-to-large effects and subtler ones may have been missed. Further, our cross-sectional design provides no explanation as to whether the evidenced biases precede or are a consequence of SAUD.

CONCLUSIONS

These results extend the social cognition literature in SAUD to the attentional domain, by evidencing the absence of a controlled attentional bias toward positive social cues in SAUD. This may reflect reduced sensitivity to social reward and could contribute to higher order social cognition difficulties and social dysfunction.

Psychosocial Life Aspects among Substance Misuse Clients who are at Rehabilitation Phase: A Narrative Review

Objective

The present study aimed at exploring the psychosocial life aspects among substance misuse clients through conducting a review of the literature related to the research topic. A scoping search in the literature revealed the significant lack of both local, regional and international studies exploring the psychosocial life aspects among substance misuse clients who are at the rehabilitation stage.

Method

A comprehensive literature search was performed using the keywords: "psychosocial, "psychological", "social", "life", "rehabilitation" and "substance misuse". The search process was performed in the following electronic databases "MEDLINE, PubMed, CINAHL, PsycINFO". Full text articles, published in English during the period between 2016 and 2021 were included in the literature.

Results

A total of 7 studies were found to be in relation with the topic addressed in this study, which is the psychosocial life aspects of substance misuse clients at rehabilitation phase. The results showed that there is a significant weakness of psychosocial life aspects among substance misuse clients, in addition to a significant lack of both educational and training program that aim at enhancing and improving the psychosocial life aspects among substance misuse clients who are at the rehabilitation phase.

Conclusion

The study concluded that there should be concise and clear measurement tools to be used in assessing the psychosocial life aspects of substance misuse clients who are the rehabilitation phase.

Emotional face expression recognition in problematic Internet use and excessive smartphone use: task-based fMRI study

Growing literature indicates that problematic Internet use (PIU) and excessive smartphone use (ESU) are associated with breakdown of functional brain networks. The effects of PIU&ESU on emotional face expression (EFE) recognition are not well understood, however behavioural investigations and fMRI studies of different addiction forms indicated the impairment of this function. The Facial Emotion Recognition Paradigm was used to probe cortico-limbic responses during EFE recognition. Combined fMRI and psychophysiological analysis were implemented to measure EFE-related functional brain changes in PIU&ESU. Self-reported questionnaires were used to assess PIU&ESU. Positive associations were found between the extent of PIU&ESU and functional connections related to emotional cognitive control and social brain networks. Our findings highlight the involvement of social functioning, especially EFE recognition in PIU&ESU. Therefore, we emphasize that besides the brain's executive and reward systems, the social brain network might be the next candidate to be involved in the pathogenesis of PIU&ESU.

Lack of amygdala habituation to negative emotional faces in alcohol use disorder and the relation to adverse childhood experiences

Aberrant limbic circuit reactivity to negative stimuli might be related to alterations in emotion processing and regulation in alcohol use disorder (AUD). The current study tested for the first time in AUD the hypothesis of aberrant amygdala habituation to repeated aversive stimuli-a robust and reliable neuroimaging marker for emotion processing. We explored the link between deficits in habituation to adverse childhood experience (ACE), a common risk factor for impaired emotion regulation and AUD. AUD individuals (N = 36) and healthy controls (HC; N = 26) participated in an observational case-control functional magnetic resonance imaging (fMRI) study. An established habituation index was used to investigate processing of aversive emotional faces of the amygdala. AUD individuals showed an overall deficit in amygdala habituation (right: t = 4.26, pFWE = 0.004; left: t = 4.79, pFWE ≤ 0.001). Amygdala habituation was significantly related to increased exposure to ACE in HC (t = 3.88, pFWE = 0.012), whereas this association was not observed in AUD individuals (T = 1.80, pFWE = 0.662). Further, a significant association between higher alcohol consumption and reduced amygdala habituation (right: R²  = -0.356, F = 8.736, p = 0.004; left: R²  = -0.309, F = 6.332, p = 0.015) was observed. We found novel evidence for neural alterations in emotion processing in AUD individuals, indexed by deficient amygdala habituation to negative emotional content. We replicated a prior report on a link between ACE and amygdala habituation, a well-established environmental risk factor for mental disorders and emotion dysregulation, in our control sample. Additionally, deficient amygdala habituation related to the amount of alcohol consumption in the overall sample might indicate a short-term substance effect.

The intersection of empathy and addiction

Empathy, the ability to perceive the affective state of another, is a complex process that is integral to many of the prosocial behaviors expressed in humans and across the animal kingdom. Research into the behavioral and neurobiological underpinnings of empathic behaviors has increased in recent years. Growing evidence suggests changes in empathy may contribute to a myriad of psychiatric illnesses, including substance use disorder (SUD). Indeed, both clinical and preclinical research in SUD demonstrates a strong relationship between drug taking or relapse events and changes to empathic behavior. Further, there is significant overlap in the underlying neural substrates of these complex behaviors, including the insula, paraventricular nucleus of thalamus (PVT), and the paraventricular nucleus of the hypothalamus (PVN). In this review, we will discuss our current understanding of the interplay between empathic behaviors and SUD. We will also examine the underlying neurobiology that may regulate this interaction, focusing specifically on the insula, PVT, and PVN. Finally, we discuss the biologic and therapeutic importance of taking empathic processes into consideration when discussing SUD.

The preliminary efficacy of virtual agent-assisted intelligent rehabilitation treatment (Echo app v2.0) in patients with alcohol use disorders: Study protocol for a randomized controlled trial

Background

Alcohol use disorder (AUD) is one of the most common substance use disorders. People with AUD are in great need of highly accessible and comprehensive management, involving medicine, exercise, and psychotherapy. However, due to limited resources, providing comprehensive treatment for every patient is challenging. Virtual agent-assisted intelligent rehabilitation treatment can improve the accessibility of comprehensive management.

Objectives

This randomized controlled trial aims to test whether the virtual agent-assisted intelligent rehabilitation treatment (Echo-app-v2.0) plus treatment as usual (TAU) has greater efficacy than only TAU in AUD.

Methods

One hundred participants with AUD will be recruited and randomly assigned to either TAU or virtual agent-assisted intelligent rehabilitation treatment plus TAU based on the 1:1 ratio. The virtual agent-assisted intelligent rehabilitation treatment is delivered by the Echo app v2.0 developed by our research team. Participants will be assessed at baseline, week 4 of treatment, one month, and three months after the end of treatment. The primary outcome is the participants' craving for alcohol, measured by Visual Analogue Scale. Other outcomes include the use of alcohol, motivation for treatment, coping style, depression, anxiety, impulsivity, stress, and sleep quality.

Discussion

The virtual agent, with vivid human image, high privacy, and the ability to interact with users, has the potential to play an important role in the delivery of digital psychotherapy. The development of Echo app v2.0 has the possibility to raise the availability of comprehensive treatment for people with AUD.

Determinants of health-related quality of life in recently detoxified patients with severe alcohol use disorder

Background

Health-related quality of life (HRQoL) is an important clinical outcome in Alcohol Use Disorder (AUD) and is considered as a relevant indicator of treatment success. While a better understanding of the factors affecting HRQoL would enable to adjust patients’ care to favour treatment outcome, the determinants of HRQoL in AUD remain unclear. This study aims at describing HRQoL in AUD patients and at identifying its best predictors.

Methods

53 recently detoxified patients with severe AUD (sAUD) underwent a cognitive assessment and filled in a HRQoL questionnaire dedicated to AUD patients (Alcohol Quality of Life Scale; AQoLS), as well as questionnaires concerning socio-demographics, alcohol history, sleep quality, depression, anxiety and impulsivity. 38 healthy controls (HC) underwent the same assessment (except AQoLS) in order to identify the altered cognitive and clinical variables that could potentially be determinants of HRQoL in sAUD.

Results

sAUD patients reported that alcohol affects their HRQoL mainly in the “negative emotions”, “control”, “relationships”, and “sleep” domains. Compared to HC, they were impaired on episodic memory, working memory, executive functions, and processing speed tasks. They also reported lower sleep quality, higher depression, anxiety and impulsivity. No association was found between AQoLS total score and socio-demographics, cognitive performance, or sleep quality in patients. We found a significant correlation between HRQoL and depression/anxiety as well as impulsivity. Anxiety and impulsivity were indeed the only significant predictors of HRQoL, explaining 47.7% of the variance.

Conclusion

Anxiety and impulsivity are crucial determinants of HRQoL in recently detoxified sAUD patients. Since anxiety and impulsivity are frequent issues in addiction and especially in AUD, they should be particularly considered by clinicians to favour treatment outcomes.

Underlying mechanisms in the relationship between stress and alcohol consumption in regular and risky drinkers (MESA): methods and design of a randomized laboratory study

BACKGROUND

Excessive alcohol consumption and alcohol use disorders (AUD) are among the leading preventable causes of premature morbidity and mortality and are considered a major public health concern. In order to reduce the individual and societal burden of excessive alcohol use, it is crucial to identify high-risk individuals at earlier stages and to provide effective interventions to prevent further progression. Stressful experiences are important risk factors for excessive alcohol consumption and AUDs. However, the underlying biological and psychological mechanisms are still poorly understood.

METHODS

The project "Underlying mechanisms in the relationship between stress and alcohol consumption in regular and risky drinkers (MESA)" is a randomized controlled study that started in December 2018 and is conducted in a laboratory setting, which aims to identify moderators and mediators of the relationship between acute stress and alcohol consumption among regular and risky drinkers. Regular and risky drinkers are randomly assigned to a stress induction or a control condition. Several processes that may mediate (emotional distress, endocrine and autonomic stress reactivity, impulsivity, inhibitory control, motivational sensitization) or moderate (trait impulsivity, childhood maltreatment, basal HPA-axis activity) the relation between stress and alcohol consumption are investigated. As primary dependent variable, the motivation to consume alcohol following psychosocial stress is measured.

DISCUSSION

The results of this study could help to provide valuable targets for future research on tailored interventions to prevent stress-related alcohol consumption.

Loss and Frontal Striatal Reactivities Characterize Alcohol Use Severity and Rule-Breaking Behavior in Young Adult Drinkers

BACKGROUND

Alcohol misuse is associated with externalizing behaviors, including rule breaking. Studies have implicated altered reward processing in externalizing behaviors and alcohol misuse. Here, we investigated whether reward or punishment reactivity more significantly influenced alcohol use severity and rule-breaking behavior in young adult drinkers.

METHODS

We curated data from the Human Connectome Project and identified 181 binge (132 men) and 288 nonbinge (97 men) drinkers performing a gambling task during brain imaging. Alcohol use severity was quantified by the first principal component of principal-component analysis of all drinking measures. We analyzed the imaging data using published routines and evaluated the results at a corrected threshold. We examined the interrelationship between imaging and clinical metrics with mediation and path analyses.

RESULTS

Compared with nonbingers, bingers showed more severe rule-breaking behavior and responded significantly faster during post-loss than during post-win trials. Compared with nonbingers, bingers demonstrated greater inferior/middle frontal gyrus and cerebellum activations in loss-predominating blocks but no differences in regional responses to win-predominating blocks, relative to an interblock baseline. The right caudate body showed loss reactivity that was positively correlated with the rule-breaking score. No regional responses to wins were significantly correlated with the rule-breaking score. Mediation and path analyses demonstrated significant models with inferior/middle frontal gyrus and caudate reactivity to loss interrelating rule breaking and alcohol use severity.

CONCLUSIONS

Punishment rather than reward reactivity was associated with alcohol use severity and rule breaking in young adults. The findings highlight the roles of negative emotions in psychological models of externalizing behaviors and alcohol misuse.