Negative mood-induced alcohol-seeking is greater in young adults who report depression symptoms, drinking to cope, and subjective reactivity

Development and validation of the Compulsive Substance Use Questionnaire: Attending to substance use automaticity, craving, and continued use despite negative consequences

BACKGROUND

Compulsivity characterizes an important subtype of substance use disorders (SUDs), but there has been variability in how compulsive substance use is defined and measured. The current study was designed to (1) develop a new measure of substance use compulsivity, (2) validate this scale in a community sample of adults who drink alcohol, and (3) evaluate the association between this new measure of compulsivity and substance use severity. We hypothesize that compulsivity will be characterized by automaticity, craving and insensitivity to negative consequences, and greater substance use severity will be associated with higher levels of substance use compulsivity.

METHODS

A preliminary set of items were generated for the novel Compulsive Substance Use Questionnaire (CSUQ) to reflect three conceptual aspects of substance use compulsivity: automaticity, craving, and disregarding negative consequences. The study recruited a total of 253 adults who drink alcohol, with a range of severity. Participants answered online surveys on compulsivity, frequency of alcohol use, craving, and negative consequences of alcohol use.

RESULTS

We obtained a single-factor solution with 22 items that included 3 automaticity items, 10 craving items, and 9 disregarding negative consequences items. The resulting measure had excellent internal consistency (α = 0.96). The CSUQ was associated with substance use severity; specifically, greater compulsivity was associated with heavy alcohol use and higher frequency of negative consequences associated with alcohol use.

CONCLUSIONS

The current study supports the validity of a new measure of substance use compulsivity, composed of items that closely hew to the concept of substance use compulsivity. Future work investigating compulsivity in other substance use populations with varying levels of severity will further our understanding of compulsive substance use and SUD subtypes.

Depression, Drinking to Cope, and Alcohol Use Severity Among Latinos Who Drink: The Moderating Role of Sex

OBJECTIVES

The present study evaluated sex differences in the direct and indirect links between depressive symptoms, coping motives to drink, and alcohol use severity among Latinos who drink.

METHODS

A large and diverse panel sample of Latinos, who were strategically sampled to be reflective of the Latino demographics of the state of Texas, completed questionnaires assessing their depressive symptomatology, coping motives to drink, and alcohol use behaviors.

RESULTS

Direct effects were significant in hypothesized directions such that depressive symptoms was positively associated with both coping motives to drink and alcohol use severity, and drinking motives to cope were positively associated with alcohol use severity. Moderator analysis showed that, compared to Latina women, the association of depressive symptoms with both drinking to cope and alcohol use severity was significantly higher among Latino men. Regarding indirect effects, a moderated mediation analysis showed that the indirect effect of depressive symptoms on alcohol use severity through coping motives to drink was statistically significant for both Latino/a men and women; however, the index of moderated mediation showed that this indirect effect was significantly greater among Latino men.

CONCLUSION

Although both Latino/a men and women may consume alcohol and turn to alcohol to drink with negative affect associated with depressive symptoms, this process may be stronger among Latino men. Findings are discussed considering prior work and implications for practitioners.

Association between depressive symptom trajectories and unhealthy lifestyle factors among adolescents based on the China family panel studies

BACKGROUND

The prevalence of depressive symptom in adolescents has sharply increased over the past decade. Depressive symptom during adolescence could hinder the development of social, cognitive, and psychological competencies, potentially influencing young adults' lifestyle factors. This study aimed to identify trajectories of depressive symptom from adolescence to early adulthood and evaluated their association with lifestyle factors in early adulthood.

METHODS

Data was collected from the China Family Panel Studies (CFPS). The Center for Epidemiological Studies Depression Scale (CES-D) was assessed during the 2016, 2018, and 2020. Group - based trajectory modeling was used to identify trajectories of depressive symptom over a 5 - year follow - up. We used binary logistic regression analyze to explore the relationship between depressive symptom trajectories and lifestyle factors.

RESULTS

We identified four trajectories of depressive symptom, characterized by maintained low scores (non - symptom); moderately high scores (moderately high symptom); consistently high scores (persistently high symptom); and low starting scores that steadily increased (increasing symptom). After adjusting for potential confounding factors, the ORs for smoking were 2.95 (1.47, 5.97) for the "persistently high symptom" trajectory comparing to the "non - symptom" trajectory.

CONCLUSION

The depressive symptom trajectories was associated with unhealthy lifestyle factors. Future studies are needed to determine whether depressive symptom might serve as early indicators prompting adolescents to make psychological changes that could reduce the risk of unhealthy lifestyle factors in the later life.

Value-based decision-making in regular alcohol consumers following experimental manipulation of alcohol value

BACKGROUND

Devaluation of alcohol leads to reductions in alcohol choice and consumption; however, the cognitive mechanisms that underpin this relationship are not well-understood. In this study we applied a computational model of value-based decision-making (VBDM) to decisions made about alcohol and alcohol-unrelated cues following experimental manipulation of alcohol value.

METHOD

Using a pre-registered within-subject design, thirty-six regular alcohol consumers (≥14 UK units per week) completed a two-alternative forced choice task where they chose between two alcohol images (in one block) or two soft drink images (in a different block) after watching videos that emphasised the positive (alcohol value), and separately, the negative (alcohol devalue) consequences of alcohol. On each block, participants pressed a key to select the image depicting the drink they would rather consume. A drift-diffusion model (DDM) was fitted to reaction time and choice data to estimate evidence accumulation (EA) processes and response thresholds during the different blocks in each experimental condition.

FINDINGS

In the alcohol devalue condition, soft drink EA rates were significantly higher compared to alcohol EA rates (p = 0.04, d = 0.31), and compared to soft drink EA rates in the alcohol value condition (p = 0.01, d = 0.38). However, EA rates for alcoholic drinks and response thresholds (for either drink type) were unaffected by the experimental manipulation.

CONCLUSIONS

In line with behavioural economic models of addiction that emphasise the important role of alternative reinforcement, experimentally manipulating alcohol value is associated with changes in the internal cognitive processes that precede soft drink choice.

Randomized Controlled Trial on Imaginal Retraining for Problematic Alcohol Use: A Dismantling Study

Imaginal retraining (IR) is an approach-avoidance procedure that has shown promising results in previous studies. The aim of the present study was to dismantle the efficacy of IR's components in a randomized controlled trial (RCT). We conducted a RCT with nine conditions comprising eight intervention groups and a waitlist control group (WLC). Alcohol craving (primary outcome), consumption, depressive symptoms, quality of life, subjective appraisal, and side effects were assessed online at baseline, post intervention (6 weeks), and follow-up (12 weeks). The sample consisted of 426 participants (age: M = 47.22, SD = 11.82, women: 50.5%). The intervention groups received instructions for four different components of IR (mood induction, mental avoidance of unhealthy stimuli, motor avoidance of unhealthy stimuli, approach to healthy stimuli) that were each conveyed with or without prior psychoeducation (PE). The intervention was delivered online. At total of 163 individuals (42.9%) used the intervention at least once. No group differences were found for any primary or secondary outcome after Šidák correction. Uncorrected statistics showed effects of significantly decreased alcohol consumption for the approach + PE group in the intention-to-treat and the merged motor avoidance group in the per-protocol analyses at post assessment compared with the WLC. Exploratory moderation analyses revealed that individuals with high visualization skills benefited most. The authors conclude that visualization training and motivational components may increase the efficacy and adherence of IR.

Effects of a Two-Month Exercise Training Program on Concurrent Non-Opiate Substance Use in Opioid-Dependent Patients during Substitution Treatment

BACKGROUND

This randomized controlled trial aimed to evaluate the effects of a two-month exercise intervention on the concurrent non-opiate substance use (alcohol, cocaine, cannabis, and benzodiazepines) in opioid users during their medication treatment.

METHODS

Ninety opioid users (41 females) in methadone and buprenorphine medication treatment were randomly divided into four groups: (a) buprenorphine experimental (BEX; n = 26, aged 41.9 ± 6.1 yrs); (b) buprenorphine control (BCON; n = 25, aged 41.9 ± 5.6 yrs); (c) methadone experimental (MEX; n = 20, aged 46.7 ± 6.6 yrs); and (d) methadone control (MCON; n = 19, aged 46.1 ± 7.5 yrs). The experimental groups (BEX and MEX) followed an aerobic exercise training program on a treadmill for 20 min at 70% HRmax, 3 days/week for 8 weeks. Socio-demographic, anthropometric, and clinical characteristics, as well as non-opioid drug use in days and quantity per week, were assessed before and after the intervention period.

RESULTS

Following the exercise training, the weekly non-opioid substance consumption (days) decreased (p < 0.05) in both exercise groups and was lower in BEX compared to MEX, while no differences were observed (p > 0.05) between the control groups (BCON vs. MCON) or compared to their baseline levels. Similarly, the daily amount of non-opiate substance intake was reduced (p < 0.05) post-training in BEX and MEX, whereas it did not differ (p > 0.05) in BCON and MCON compared to the baseline.

CONCLUSIONS

The two-month exercise intervention reduced the non-opioid drug use in both the methadone and buprenorphine substitution groups compared to the controls, suggesting that aerobic exercise training may be an effective strategy for treating patients with OUDs.

An experimental investigation into the effect of negative affect on the behavioral economic demand for alcohol

Influential theoretical models hypothesize that alcohol use is an especially potent reinforcer when used as a strategy to cope with negative affect. Although the evidence for this idea in observational data is weak, some experimental evidence suggests that the behavioral economic demand for alcohol increases immediately following a negative emotional event. Because existing studies testing the effect of negative mood inductions on the demand for alcohol have several methodological limitations and do not take inter- and intraindividual variability into account, we developed an improved experimental design to increase our confidence in any potential within-person effect of negative mood inductions on alcohol demand as well as to test whether this effect exhibits systematic inter- and intraindividual variability. We hypothesize that people will show a higher demand for alcohol following negative compared to neutral mood inductions and that this effect is stronger in heavy compared to light drinkers as well as stronger on days characterized by higher coping motives and negative urgency. Three hundred twenty college students will complete the alcohol purchase task (APT) after being subjected to 100 mood inductions (six negative, six neutral) on 20 separate days. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Cocaine and amphetamine regulated transcript (CART) mediates sex differences in binge drinking through central taste circuits

The neuropeptide cocaine- and amphetamine-regulated transcript (CART) has been implicated in alcohol consumption and reward behaviours, yet mechanisms mediating these effects have yet to be identified. Using a transgenic CART knockout (KO) mouse line we uncovered a sexually dimorphic effect of CART in binge drinking, with male CART KO mice increasing intake, whilst female CART KO mice decreased their alcohol intake compared to controls. Female CART KO mice show greater sensitivity to bitter solutions that can be overshadowed through addition of a sweetener, implicating taste as a factor. Further we identify that this is not driven through peripherally circulating sex hormones, but the central nucleus of the amygdala (CeA) is a locus where CART contributes to the regulation of alcohol consumption, with CeA CART neutralisation specifically reducing plain alcohol, but not sweetened alcohol consumption in female mice. These findings may have implications for the development of sex-specific treatment options for alcohol use disorders through targeting the CART system.

Associations of Alcohol Consumption and Smoking Behaviors with Depressed Mood According to Gender in Korean Young Adults

BACKGROUND

Recent studies have reported that chronic mental health problems often emerge in young adulthood. This study elucidated the independent effects of smoking and drinking on depressed mood in young adults by sex.

METHODS

We used Data from the Korea National Health and Nutrition Examination Surveys conducted in 2014, 2016, and 2018. A total of 3,391 participants aged 19-35 years, without serious chronic diseases, were recruited for this study. Depression was evaluated using the Patient Health Questionnaire (PHQ-9).

RESULTS

Smoking behavior, current smoking, and number of days smoked were significantly associated with higher PHQ-9 scores in both men and women (all P<0.05). However, past and ever smoking were positively associated with PHQ-9 scores only in women (all P<0.001). Regarding alcohol consumption, the age at which drinking first began was negatively associated with PHQ-9 scores in both men and women (all P<0.001), but the amount of alcohol consumed at 1 time was positively associated with PHQ-9 scores only in women (P=0.013). Men who drank 2-4 times a month and women who had not drunk during the past year had the lowest PHQ-9 scores.

CONCLUSION

Smoking and alcohol consumption were independently associated with depressed mood in young Korean adults, which was more pronounced in women, and exhibited sex-specific characteristics.

The moderating role of mental health on the association between COVID-related stress, isolation, and economic hardship and using substances to cope

Since young adulthood is a vulnerable period for adverse mental health experiences and high-risk substance use, it is critical to understand the impact of the COVID-19 pandemic on young adult mental health and substance use behaviors. Therefore, we determined whether the relationship between COVID-related stressors and using substances to cope with COVID-related social distancing and isolation was moderated by depression and anxiety among young adults. Data were from the Monitoring the Future (MTF) Vaping Supplement (total N = 1244). Logistic regressions assessed the relations between COVID-related stressors, depression, anxiety, demographic characteristics, and interactions between depression/anxiety and COVID-related stressors with vaping more, drinking more, and using marijuana to cope with COVID-related social distancing and isolation. Greater COVID-related stress due to social distancing was associated with vaping more to cope among those with more depression symptoms and drinking more to cope among those with more symptoms of anxiety. Similarly, COVID-related economic hardships were associated with using marijuana to cope among those with more symptoms of depression. However, feeling less COVID-related isolation and social distancing stress was linked to vaping and drinking more to cope, respectively, among those with more symptoms of depression. These findings suggest that the most vulnerable young adults are seeking substances to cope with the pandemic, while potentially experiencing co-occurring depression and anxiety along with COVID-related stressors. Therefore, intervention programs to support young adults who are struggling with their mental health in the aftermath of the pandemic as they transition into adulthood are critical.

Epidemiological characteristics of alcohol-related liver disease in China: a systematic review and meta-analysis

BACKGROUND

This meta-analysis aimed to explore the epidemiological characteristics of alcohol-related liver disease (ALD) in China.

METHODS

Studies published between January 2000 and January 2023 were searched from 3 databases in English and 3 databases in Chinese. DerSimonian-Laird's random-effects model was adopted to calculate the pooled prevalence.

RESULTS

A total of 21 studies were included. The pooled prevalence of ALD was 4.8% (95% CI, 3.6%-6.2%) in the general population, 9.3% (95% CI, 4.4%-16.0%) in males, and 2.0% (95% CI, 0.0%-6.7%) in females. The prevalence was the highest in western China (5.0% [95% CI, 3.3%-6.9%]) and the lowest in central China (4.4% [95% CI, 4.0%-4.8%]). The prevalence among people with different drinking histories (less than 5 years, 5 to 10 years, and over 10 years) was 0.9% (95% CI, 0.2%-1.9%), 4.6% (95% CI, 3.0%-6.5%), and 9.9% (95% CI, 6.5%-14.0%), respectively. The prevalence in 1999-2004 was 4.7% (95% CI, 3.0%-6.7%) and then changed from 4.3% (95% CI, 3.5%-5.3%) in 2005-2010 to 6.7% (95% CI, 5.3%-8.3%) in 2011-2016.

CONCLUSIONS

The prevalence of ALD in China has increased in recent decades, with population-related variations. Targeted public health strategies are needed, especially in high-risk groups, such as male with long-term alcohol drinking.

TRIAL REGISTRATION

The registration number on PROSPERO is CRD42021269365.

The relationship between depression, self-efficacy, social support, and health-promoting behaviors in Korean single-household women

This descriptive, cross-sectional study purposed to identify the relationship between depression, self-efficacy, social support, and health-promoting behaviors in adult single-household women in Korea. An online survey was completed by 204 adult single-household women in Korea from November to December 2019. The structured questionnaire included items measuring depression, health-related self-efficacy, social support, health-promoting behaviors, and demographic and health-related characteristics. Descriptive statistics were computed, and mediation, moderation, and moderated mediation analyses were conducted. The average age of the participants was 34.38, and the average duration of living alone was 7.13 years. The health-promoting behavior of single-household women scored 125.85 in average within the possible score range of 52-208. It was verified that social support has a moderated mediating effect that regulates the mediating effect in the pathway by which depression affects health-promoting behaviors through self-efficacy. In conclusion, self-efficacy was found to play a mediating role between depression and health-promoting behaviors, and social support had a moderated mediating effect on the path from depression to health-promoting behaviors through self-efficacy. To encourage the health-promoting behaviors of single-household women, interventions targeting both increased social support and self-efficacy are suggested.

Food-restricted alcohol consumption: relation to psychopathology in college students

Objective: Food-restricted alcohol consumption (FRAC) is a growing concern among college students. We investigated demographic and lifestyle characteristics and psychiatric symptoms associated with FRAC. Participants: College students (n = 561) at a large southeastern university in the United States. Methods: Participants completed online self-reported questionnaires assessing past-year FRAC, demographic and lifestyle characteristics, and psychiatric symptoms. Results: The past-year prevalence of FRAC was 23.89%. In the bivariate analyses, students engaging in FRAC had higher mean scores of multiple psychiatric symptoms, reported more harmful or hazardous drinking and suicidality, and were more likely to report a history of an eating disorder than their peers without FRAC. In a hierarchical regression model, binge eating, cognitive restraint, self-reported history of an eating disorder, and harmful or hazardous drinking were significantly associated with FRAC (ps < 0.05) after other psychiatric symptoms were included in the model. Conclusion: Our findings stress the importance of heightened awareness of FRAC in college.

Pavlovian-to-Instrumental Transfer across Mental Disorders: A Review

A mechanism known as Pavlovian-to-instrumental transfer (PIT) describes a phenomenon by which the values of environmental cues acquired through Pavlovian conditioning can motivate instrumental behavior. PIT may be one basic mechanism of action control that can characterize mental disorders on a dimensional level beyond current classification systems. Therefore, we review human PIT studies investigating subclinical and clinical mental syndromes. The literature prevails an inhomogeneous picture concerning PIT. While enhanced PIT effects seem to be present in non-substance-related disorders, overweight people, and most studies with AUD patients, no altered PIT effects were reported in tobacco use disorder and obesity. Regarding AUD and relapsing alcohol-dependent patients, there is mixed evidence of enhanced or no PIT effects. Additionally, there is evidence for aberrant corticostriatal activation and genetic risk, e.g., in association with high-risk alcohol consumption and relapse after alcohol detoxification. In patients with anorexia nervosa, stronger PIT effects elicited by low caloric stimuli were associated with increased disease severity. In patients with depression, enhanced aversive PIT effects and a loss of action-specificity associated with poorer treatment outcomes were reported. Schizophrenic patients showed disrupted specific but intact general PIT effects. Patients with chronic back pain showed reduced PIT effects. We provide possible reasons to understand heterogeneity in PIT effects within and across mental disorders. Further, we strengthen the importance of reliable experimental tasks and provide test-retest data of a PIT task showing moderate to good reliability. Finally, we point toward stress as a possible underlying factor that may explain stronger PIT effects in mental disorders, as there is some evidence that stress per se interacts with the impact of environmental cues on behavior by selectively increasing cue-triggered wanting. To conclude, we discuss the results of the literature review in the light of Research Domain Criteria, suggesting future studies that comprehensively assess PIT across psychopathological dimensions.

Do lifestyle risk behaviors affect anxiety, depressive symptoms, and suicidal ideation among adolescents?

Cultivating and maintaining good mental health and a healthy lifestyle during adolescence-the period when physical and psychological development occurs-is important. Further, an unhealthy lifestyle can have long-term effects on health. Few studies have examined the multiple effects of lifestyle risk behavior on mental health, and the behaviors that interact with this relationship remain unclear. This study aimed to explore the associations between anxiety, depressive symptoms, and suicidal ideation and a cumulative unhealthy lifestyle. The study included 54,948 participants from the 2020 Korea Youth Risk Behavior Web-Based Survey. The generalized anxiety disorder-7 scale was used to define the disorder. Depressive symptoms and suicidal ideation were evaluated using a self-reported questionnaire. The relationship between mental health and lifestyle risk scores was examined using multiple logistic regression analysis. There was a significantly positive relationship of a high lifestyle risk score with the risk of generalized anxiety disorder, depressive symptoms, and suicidal ideation. There were interaction effects between sex and academic achievement. Insufficient/prolonged sleep was strongly associated with poor mental health among Korean adolescents. Our findings showed an association between poor mental health and high lifestyle risk scores. Longitudinal studies to identify potential risk behaviors and to reveal causal relationships are warranted.

Differential Pathways of Risky Drinking via Coping Motives in College and Noncollege Young Adults

The current study tested a mediation model of psychological functioning (i.e., perceived stressors, psychological distress, and self-regulation) and risky drinking through a drinking to cope pathway comparing college and noncollege young adults. Participants were 623 young adult drinkers (M age = 21.46) who completed an online survey. Multigroup analyses examined the proposed mediation model for college students and nonstudents. For nonstudents, the indirect effects of psychological distress to alcohol use outcomes (i.e., alcohol quantity, binge drinking frequency, and alcohol-related problems) via coping motives was significant. Further, coping motives significantly mediated the positive effects of self-regulation on alcohol quantity, binge drinking frequency, and alcohol-related problems. For students, greater psychological distress was associated with greater coping motives, which in turn, related to greater alcohol-related problems. Coping motives significantly mediated the positive effect of self-regulation on binge drinking frequency. Findings highlight the different pathways that may result in risky drinking and alcohol problems based on young adult's educational attainment. These results have important clinical implications, particularly for those who have not attended college.

Social Networks and Sexual and Gender Minority Disparities in Alcohol Use and Consequences Among First-Year College Students

Purpose: In this work, we investigate the association between social relationships and alcohol use and the related consequences of sexual and gender minority (SGM) college students, and we highlight the importance of SGM social networks as a potential protective factor among SGM college students. Methods: The study used data from 1340 students (47.2% White and non-Hispanic, 55.4% assigned female at birth, 16.3% SGM), which were collected during the 2016 fall semester of the first year of college at one university. The study collected information about alcohol use and related consequences and about the social networks of participants through a peer nomination survey. Results: Regardless of SGM status, students who nominated at least one SGM peer reported significantly lower drinks per week (β = -0.69, p = 0.04) and heavy drinking frequency (β = -0.38, p = 0.02) after adjusting for relevant covariates including peer drinking. SGM participants showed a significantly stronger negative association between having an SGM peer and heavy drinking frequency and alcohol-related consequences than their cisgender heterosexual counterparts (β = -0.90, p = 0.04; β = -1.32, p = 0.03). Conclusion: These findings highlight the importance of SGM social networks as a potential protective factor for reducing alcohol use and related consequences among SGM college students. College campuses should identify ways to support connections among SGM students. Clinical trials registration number is NCT02895984.

Associations between Mental Resilience, Mood, Coping, Personality, and Hangover Severity

Extensive research exists on relationships between psychological constructs and alcohol consumption. However, research on relationships with hangover severity remains limited. This study aimed to assess the associations between mental resilience, mood (i.e., depression, anxiety, and stress), coping, personality, and hangover severity. A total of N = 690 participants completed an online survey by answering questions regarding their demographics, alcohol use, hangover prevalence and severity, and several psychological assessments (Brief Resilience Scale, DASS-21, Brief Cope, and Brief Version of the Big Five Personality Inventory). Significant associations were found between hangover severity and mental resilience, mood, and avoidant coping. Higher levels of mental resilience were associated with less severe hangovers, whereas poorer mood was associated with more severe hangovers. No significant associations were found with personality traits. These findings demonstrate that several associations between psychological constructs and hangover severity exist and suggest a role of psychological factors in the pathology of the alcohol hangover. As our findings contrast with the results of previous studies that did not report an association between mental resilience and the presence and severity of hangovers, further research is warranted.

Unique and cumulative effects of lifestyle-related behaviors on depressive symptoms among Chinese adolescents

BACKGROUND

It is well known that some lifestyle-related behaviors are related to depressive symptoms, but the unique and cumulative effects of lifestyle-related behaviors on depressive symptoms among Chinese adolescents are still controversial.

AIMS

The aims of this study were to examine the unique and cumulative effects of lifestyle-related behaviors on depressive symptoms among Chinese adolescents, and explored the potential influences of gender difference on these associations.

METHODS

We conducted a cross-sectional study among 3967 Chinese adolescents aged 11 to 19 from Jilin, China during September and October of 2018. Students reported their lifestyle factors including sleep duration, time spent on computer, time spent on television, time spent on homework, eating breakfast, smoking, drinking, physical activity, and outdoor activity. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CES-D).

RESULTS

The prevalence of depressive symptoms was 28.2% among Chinese adolescents. Multivariate logistic regression analysis revealed that sleep duration <8 hour/day, time spent on homework ⩾3 hour/day, skipping breakfast, alcohol use, physical activity <3 days/week, and outdoor activity <2 hour/day were positively associated with depressive symptoms in both girls and boys. Time spent on computer ⩾2 hour/day was an independent risk predictor for depressive symptoms in males, while smoking only showed higher risk of depressive symptoms in females. There was an additive relationship between the lifestyle risk index scores and the risk of depressive symptoms for both genders, the relationship being strongest among females.

CONCLUSION

The important role of lifestyle factors should be taking into consideration when create intervention programs to prevent and reduce depressive symptoms among adolescents. In addition, preventive interventions may need to focus on gender-informed approaches when targeting multiple lifestyle factors.

Brief Negative Affect Focused Functional Imagery Training Abolishes Stress-Induced Alcohol Choice in Hazardous Student Drinkers

Introduction

Imagery-based stress management therapies are effective at reducing alcohol use. To explore the therapeutic mechanism, the current study tested whether brief functional imagery training linked to personal negative affect drinking triggers would attenuate sensitivity to noise stress-induced alcohol seeking behaviour in a laboratory model.

Methods

Participants were UK-based hazardous student drinkers (N = 61, 80.3% women, aged 18–25) who reported drinking to cope with negative affect. Participants in the active intervention group (n = 31) were briefly trained to respond to personal negative drinking triggers by retrieving an adaptive strategy to mitigate negative affect, whereas participants in the control group (n = 30) received risk information about binge drinking at university. The relative value of alcohol was then measured by preference to view alcohol versus food pictures in two-alternative choice trials, before (baseline) and during noise stress induction.

Results

There was a significant two-way interaction (p < .04) where the control group increased their alcohol picture choice from baseline to the noise stress test (p < .001), whereas the active intervention group did not (p=.33), and the control group chose alcohol more frequently than the active group in the stress test (p=.03), but not at baseline (p=.16).

Conclusions

These findings indicate that imagery-based mood management can protect against the increase in the relative value of alcohol motivated by acute stress in hazardous negative affect drinkers, suggesting this mechanism could underpin the therapeutic effect of mood management on drinking outcomes.

Mood and Changes in Alcohol Consumption in Young Adults during COVID-19 Lockdown: A Model Explaining Associations with Perceived Immune Fitness and Experiencing COVID-19 Symptoms

The aim of this study was to explore the effects of the 2019 Coronavirus (COVID-19) lockdown on mood states, stress, alcohol consumption and perceived immune fitness in a Dutch sample. Analysis included a subsample from the “Corona Lockdown: how fit are you?” (CLOFIT) study, comprising N = 761 participants who reported consuming alcohol in 2020. Results show that, compared to pre-lockdown, the first COVID-19 lockdown (March 2020) was associated with experiencing poorer mood (e.g., anxiety, depression, loneliness, fatigue) and increased stress levels. Among younger participants (18 to 35 years old), a significant decrease in weekly alcohol consumption was found during COVID-19 lockdown, which was not significant in older individuals. For the younger age cohort (18 to 35 years old), increased stress significantly correlated to increased weekly alcohol consumption (r = 0.163, p = 0.003), which in turn, correlated significantly to reporting a poorer perceived immune fitness (r = −0.165, p = 0.002). Poorer perceived immune fitness correlated significantly with increases in the presence and severity of COVID-19 symptoms (r = −0.313, p < 0.001, and r = −0.325, p < 0.001, respectively). The data provides evidence for significant relationships between changes in mood, stress and alcohol consumption during COVID-19 lockdown, and supports a model that links these changes to perceived immune fitness and susceptibility to experiencing COVID-19 symptoms.

Mindfulness in Treatment Approaches for Addiction — Underlying Mechanisms and Future Directions

Purpose of Review

While the treatment of addictive disorders proves to be challenging, new treatment approaches that evolved around the concepts of mindfulness and acceptance have been utilized and investigated in recent years. Our goal is to summarize the efficacy and possible underlying mechanisms of mindfulness-based interventions (MBI) in addictive disorders.

Recent Findings

Various meta-analyses have suggested that MBIs show clinical efficacy in the treatment of addictive disorders. Considering the factors that impact addictive disorders, MBIs have been indicated to augment responsiveness to natural rewards in contrast to addiction-related cues as well as to increase top-down cognitive control, decrease subjective and physiological stress perception, and enhance positive affect.

Summary

In summary, MBIs hold promise in treating addictive disorders while larger randomized controlled trials with longitudinal study designs are needed to confirm their utility. Newest clinical endeavors strive to enhance the clinical utility of MBIs by augmentation or personalization.

Depression Symptoms, Problem Gambling and the Role of Escape and Excitement Gambling Outcome Expectancies

The relationship between problem gambling and depression is well documented. However, there are few studies that have explored the mechanisms that may help maintain the association between depression symptoms and problem gambling. This study tests the assumption that gambling for escape and excitement may either mediate or moderate the relationship between depression and problem gambling. To test these propositions, 282 adults who gambled at least once a month were recruited to complete an online survey that assessed depression severity, the gambling outcomes expectancies of escape and excitement and problem gambling. The study did not find evidence for a mediation effect for either escape or excitement, although escape moderated the relationship between depression and problem gambling. In particular, there was not a relationship between depression and problem gambling when there was low endorsement of the escape gambling outcomes expectancies. However, the relationship between depression and problem gambling strengthened when endorsement of gambling as an escape increased. This indicates that individuals with elevated levels of depression symptoms, and who view gambling as a way to moderate mood states, may be at higher risk for problem gambling than those who hold less favourable views towards gambling as a mood modifier. This suggests it may be helpful to consider the gambling expectancies of gamblers experiencing problems when formulating educational and treatment initiatives, especially with those experiencing heightened levels of depressive symptoms.

Immune Fitness and the Psychosocial and Health Consequences of the COVID-19 Pandemic Lockdown in The Netherlands: Methodology and Design of the CLOFIT Study

This article provides an overview of the design and methodology of the "Corona lockdown: how fit are you?" (CLOFIT) study, including the questionnaires and scales that were included in the online survey. The aim of the CLOFIT study was to investigate the psychosocial and health consequences of the coronavirus disease 2019 (COVID-19) pandemic in the Netherlands. The survey was conducted among the Dutch population to collect data on immune fitness and the psychological and health consequences of the 2019 coronavirus disease (COVID-19) pandemic lockdown in the Netherlands. The CLOFIT dataset contains measures from N = 1910 participants and is broadly representative of the Dutch general population. The dataset represents both sexes, a range of ages including the elderly, different education levels, and ethnic backgrounds. The cohort also includes people with a diverse health status and range of medication use.

State anxiety and alcohol choice: Evidence from experimental and online observational studies

BACKGROUND

Experimental studies have investigated the effects of physical, psychological and pharmacological stressors (that induce state anxiety) on alcohol outcomes. However, no study has investigated the effects of state anxiety on alcohol outcomes, and the moderating role of drinking to cope (DTC) motives, using the 7.5% carbon dioxide (CO2) challenge.

AIMS

We aimed to investigate the relationships between state anxiety and alcohol-related outcomes (primarily alcohol choice). We also explored whether DTC motives moderated these relationships.

METHODS

We conducted two experiments using the 7.5% CO2 challenge (Studies 1 and 2) and an observational study (Study 3) (ns = 42, 60 and 219, respectively), to triangulate findings.

RESULTS

In Study 1, experimentally induced state anxiety increased alcohol choice (p < .001, ηp2 = .29). This finding was replicated in Study 2, but the effect was weaker (p = .076, ηp2 = .06). Furthermore, DTC moderated the effect (p = .013, ηp2= .11). However, in Study 3 there was no clear evidence of an association between naturally occurring state anxiety and alcohol choice (b = 0.05, p = .655), or a moderating role of DTC (b = 0.01, p = .852).

CONCLUSIONS

Experimentally induced, but not naturally occurring, state anxiety increases alcohol choice, although state anxiety levels were lower in the non-manipulated sample.

The Impact of Mood and Subjective Intoxication on Hangover Severity

The aim of this study was to investigate whether baseline mood and/or mood while drinking have an impact on alcohol hangover severity. A survey was held among N = 331 young adults (mean age = 23.6 years, range = 18-35 years). Demographics, alcohol consumption, subjective intoxication, and hangover severity were assessed for the past three days. In addition, mood (baseline, while drinking, and during hangover) was also assessed. N = 143 participants reported to be hungover on the day of assessment, N = 122 participants reported to have been hungover the previous day ('yesterday'), and N = 87 participants reported to have been hungover two days before the assessment ('2 days ago'). The analyses revealed that baseline mood and mood while drinking had no relevant effect on the amount of consumed alcohol and did not significantly contribute to hangover severity. However, hangover severity was associated with significantly increased negative affect, particularly with higher levels of subjective stress on the day of the hangover.

Relative expected value of drugs versus competing rewards underpins vulnerability to and recovery from addiction

Behavioural economic theories of addiction contend that greater expected value of drug relative to alternative non-drug rewards is the core mechanism underpinning vulnerability to and recovery from addiction. To evaluate this claim, we exhaustively review studies with human drug users that have measured concurrent choice between drugs vs. alternative rewards, and explored individual differences. These studies show that drug choice can be modulated by drug cues, drug devaluation, imposition of costs/punishment and negative mood induction. Regarding individual differences, dependence severity was reliably associated with overall drug preference, and self-reported drug use to cope with negative affect was reliably associated with greater sensitivity to mood induced increases in drug choice. By contrast, there were no reliable individual differences in sensitivity to the effect of drug cues, drug devaluation or punishment on drug choice. These findings provide insight into the mechanisms that underpin vulnerability to dependence: vulnerability is conferred by greater relative value ascribed to drugs, and relative drug value is further augmented by negative affective states in those who report drug use coping motives. However, dependence does not appear to be characterised by abnormal cue-reactivity, habit learning or compulsion. We then briefly review emerging literature which demonstrates that therapeutic interventions and recovery from addiction might be attributed to changes in the expected relative value of drug versus alternative rewards. Finally, we outline a speculative computational account of the distortions in decision-making that precede action selection in addiction, and we explain how this account provides a blueprint for future research on the determinants of drug choice, and mechanisms of treatment and recovery from addiction. We conclude that a unified economic decision-making account of addiction has great promise in reconciling diverse addiction theories, and neuropsychological evaluation of the underlying decision mechanisms is a fruitful area for future research and treatment.

Contribution of alcohol- and cigarette-related cues to concurrent reinforcer choice in humans

Drug-related cues have been extensively studied for their contributions to decision-making processes involving drug consumption. Less studied is how drug-related stimuli may impact decisions involving outcomes not directly related to substance use. Studies using concurrent choice tasks have demonstrated that cocaine and cannabis cues result in robust and selective biases for monetary reinforcers contiguous with those cues. The purpose of this study was to provide a conceptual replication of these findings with alcohol and cigarettes. Participants recruited using crowdsourcing completed a cued concurrent choice task involving presentation of two cues (one drug and one neutral) followed by concurrent monetary offers below each image. Alcohol (Experiment 1; N = 103) and cigarette (Experiment 2; N = 256) visual cues were evaluated. Participants with hazardous alcohol use and current cigarette use showed greater-than-indifference selection for the alcohol- (p = .004) and cigarette-cued (p = .02) monetary choices, respectively. Qualitative responses indicated that the most popular rationale for responding was "image quality" despite images having no explicit impact on the reinforcer received. Low alcohol use (p = .03) and non-cigarette using controls (p < .001) showed an avoidance bias with lower-than-indifference selection for drug-cued choices. These findings replicate and extend observations that spatially contiguous drug-related cues can bias decisions involving concurrently presented non-drug reinforcers.

Hormonal responses in gambling versus alcohol abuse: A review of human studies

The endocrine system plays an essential role in communication between various organs of the body to maintain homeostasis. Both substance use disorders (SUDs) and non-substance abuse disrupt this system and lead to hormonal dysregulations. Here, we focus on the comparison between the function of the endocrine system in gambling disorders and alcohol addiction to understand the commonalities and differences in their neurobiological and psychological underpinnings. We review human research to compare findings on gambling addiction and alcohol dependence pertaining to the dynamic interplay between testosterone and cortisol. Understanding and classifying similarities in hormonal responses between behavioural addiction and SUDs may facilitate development of treatments and therapeutic interventions across different types of addictive disorders, while describing differences may shed light on therapeutic interventions for specific disorders. Although research on gambling addiction is in its infancy, such evaluation may still have a positive effect for addiction research, thereby stimulating discovery of "crossover" pharmacotherapies with benefits for both SUDs and nonsubstance addictions.

Probing the Manipulated Neurochemical Drive in Alcohol Addiction and Novel Therapeutic Advancements

Alcohol addiction is one of the highly prevalent neurological disorders and a major threat to public health in the 21st century. Alcohol addiction affects people from all age groups and often leads to other serious comorbidities. The pathophysiology of alcohol addiction involves imbalance between the excitatory and inhibitory neurotransmitters in the brain. These changes occur in various regions of the brain including reward circuit such as the ventral tegmental area (VTA), nucleus accumbens (NAc), and prefrontal cortex. In this review, we have discussed several neurochemical circuitries which get manipulated and maladapted during alcohol addiction. To date there is no effective therapeutic intervention in clinics devoid of side effects that can successfully treat the patients suffering from alcohol addiction. Understanding the neurobiological intricacies of alcohol addiction is critical for the development of novel anti-addiction therapeutics. Apart from this, we have also discussed the recent therapeutic milestones for the management of alcohol addiction including vasopressin receptors, corticotrophin-releasing factor, GABA receptors, glucocorticoid receptors, brain stimulation and mindfulness-oriented recovery enhancement.

Addiction is driven by excessive goal-directed drug choice under negative affect: translational critique of habit and compulsion theory

Drug addiction may be a goal-directed choice driven by excessive drug value in negative affective states, a habit driven by strong stimulus-response associations, or a compulsion driven by insensitivity to costs imposed on drug seeking. Laboratory animal and human evidence for these three theories is evaluated. Excessive goal theory is supported by dependence severity being associated with greater drug choice/economic demand. Drug choice is demonstrably goal-directed (driven by the expected value of the drug) and can be augmented by stress/negative mood induction and withdrawal-effects amplified in those with psychiatric symptoms and drug use coping motives. Furthermore, psychiatric symptoms confer risk of dependence, and coping motives mediate this risk. Habit theory of addiction has weaker support. Habitual behaviour seen in drug-exposed animals often does not occur in complex decision scenarios, or where responding is rewarded, so habit is unlikely to explain most human addictive behaviour where these conditions apply. Furthermore, most human studies have not found greater propensity to habitual behaviour in drug users or as a function of dependence severity, and the minority that have can be explained by task disengagement producing impaired explicit contingency knowledge. Compulsion theory of addiction also has weak support. The persistence of punished drug seeking in animals is better explained by greater drug value (evinced by the association with economic demand) than by insensitivity to costs. Furthermore, human studies have provided weak evidence that propensity to discount cost imposed on drug seeking is associated with dependence severity. These data suggest that human addiction is primarily driven by excessive goal-directed drug choice under negative affect, and less by habit or compulsion. Addiction is pathological because negative states powerfully increase expected drug value acutely outweighing abstinence goals.

Ultra-brief breath counting (mindfulness) training promotes recovery from stress-induced alcohol-seeking in student drinkers

The therapeutic effect of mindfulness interventions on problematic drinking is thought to be driven by increased resilience to the impact of stress on negative mood and alcohol-seeking behaviour, but this claim needs empirical support. To address this hypothesis, the current study tested whether brief training of one component of mindfulness - breath counting - would reduce drinkers' sensitivity to the effect of noise stress on subjective mood and alcohol-seeking behaviour. Baseline alcohol-seeking was measured by choice to view alcohol versus food thumbnail pictures in 192 student drinkers. Participants then received a 6-minute audio file which either trained breath counting or recited a popular science extract, in separate groups. All participants were then stressed by a loud industrial noise and alcohol-seeking was measured again simultaneously to quantify the change from baseline. Subjective mood was measured after all three stages (baseline, post intervention, post stress test). The breath counting group were instructed to deploy this technique during the stress test. Results showed that the breath counting versus control intervention improved subjective mood relative to baseline, attenuated the worsening of subjective mood produced by stress induction, and accelerated recovery from a stress induced increase in alcohol-seeking behaviour. Exploratory moderation analysis showed that this accelerated recovery from stress induced alcohol-seeking by breath counting was weaker in more alcohol dependent participants. Mindfulness therapies may improve problematic drinking by increasing resilience to stress induced negative mood and alcohol-seeking, as observed in this study. The weaker therapeutic effect of breath counting in more dependent drinkers may reveal limitations to this intervention strategy.

An examination of the extent to which mood and context are associated with real-time alcohol consumption

AIM

To assess the effects of mood, social and environmental contexts and alcohol-related beliefs on alcohol consumption.

METHOD

Participants (N = 69) recorded their positive and negative outcome expectancies and self-reported mood prior to drinking (Time 1 mood). A Smartphone App then enabled alcohol consumption (total number of drinks aggregated from reports throughout a drinking occasion, current mood (Time 2 mood), social context e.g., with friends and environmental location e.g., in a bar/pub to be documented in de facto real-time a total of 3009 data points.

RESULTS

Feeling unhappy prior to consumption onset was associated with a significant increase in drinking. During a drinking occasion, feeling happy was a significant predictor of drinking larger quantities. Interestingly, however, an interaction between T1 and T2 mood suggested it is not mood prior to consumption which drives drinking, but rather that alcohol consumption elevates mood. Being with two or more friends (relative to being alone) also predicted increased consumption. Positive and negative expectancies were not found to be significant predictors within these models.

CONCLUSION

By showing that both mood and social context may shape alcohol behaviors distinctly, the current study suggests that alcohol research and intervention efforts may benefit from greater consideration of the temporally-mediated contextual influences on alcohol consumption.

Risk Factors Associated with Alcohol Use in Early Adolescence among American Inner-City Youth: A Longitudinal Study

Background: Early alcohol use is associated with an increased risk for later alcohol dependence, as well as social and mental health problems. In this study, we investigate the risk factors (internalizing and externalizing behaviors) associated with early alcohol consumption over a period of 1 year, and examine whether the association is sex-specific. Methods: U.S. inner-city adolescents (N = 1785, Mean age = 12.11) were assessed and reassessed in the sixth and seventh grades (Mean age = 13.10). Self-reported information was obtained on the lifetime level of alcohol consumption, internalizing (depression, anxiety and posttraumatic stress [PTS]), and externalizing behaviors (sensation seeking, conduct problems and affiliation with delinquent peers). Associations between the variables were examined using structural equation modeling (SEM). Results: In an adjusted SEM analysis drinking by the sixth grade was primarily associated with externalizing behaviors, whereas PTS was linked to lower levels of alcohol consumption. In addition, alcohol consumption and greater externalizing behaviors by the sixth grade predicted higher alcohol consumption by the seventh grade, whereas anxiety and African American ethnicity were associated with less alcohol consumption. No sex differences were found in the association between internalizing and externalizing behaviors and drinking. However, in the adjusted SEM analysis female sex predicted higher lifetime consumption by the seventh grade. Conclusion: Sensation seeking behavior, conduct problems and affiliation with delinquent peers should be regarded as risk factors and taken into consideration when planning prevention efforts in order to decrease alcohol use in early adolescence.

Does acute stress influence the Pavlovian-to-instrumental transfer effect? Implications for substance use disorders

RATIONAL

The ability of conditioned stimuli to affect instrumental responding is a robust finding from animal as well as human research and is assumed as a key factor regarding the development and maintenance of addictive behaviour.

OBJECTIVES

While it is well known that stress is an important factor for relapse after treatment, little is known about the impact of stress on conditioned substance-associated stimuli and their influence on instrumental responding.

METHODS

We administered in the present study a Pavlovian-to-instrumental transfer (PIT) paradigm with stimuli associated with smoking- and chocolate-related rewards using points in a token economy to light to moderate smokers who also indicated to like eating chocolate. After completion of the first two phases of the PIT paradigm (i.e. Pavlovian training and instrumental trainings), participants were randomly allocated to the socially evaluated cold pressor test or a control condition before the final phase of the PIT paradigm, the transfer phase, was administered.

RESULTS

The presentation of a smoking-related stimulus enhanced instrumental responding for a smoking-related reward (i.e. 'smoking-PIT' effect) and presentation of a chocolate-related stimulus for a chocolate-related reward (i.e. 'chocolate-PIT' effect) in participants aware of the experimental contingencies as indicated by expectancy ratings. However, acute stress did not change (i.e. neither enhanced nor attenuated) the 'smoking-PIT' effect or the 'chocolate-PIT' effect, and no overall effect of acute stress on tobacco choice was observed in aware participants.

CONCLUSIONS

The established role of stress in addiction appears not to be driven by an augmenting effect on the ability of drug stimuli to promote drug-seeking.

A concurrent pictorial drug choice task marks multiple risk factors in treatment-engaged smokers and drinkers

Concurrent choice tasks, where participants choose between a drug versus natural reward, predict dependence vulnerability in animals and humans. However, the sensitivity of concurrent choice tasks to multiple risk factors in treatment-engaged drug users has not been comprehensively tested. In experiment 1, 33 recently hospitalized smokers who were engaged with the smoking cessation service made forced choices between enlarging pictures of people smoking versus not smoking. In experiment 2, 48 drinkers who were engaged in an outpatient alcohol treatment service made forced choices between enlarging pictures of alcohol versus food. In these experiments, percent drug picture choice was significantly associated with dependence severity, craving, self-reported reasons for drug use (negative coping and cued craving), depression, anxiety, withdrawal intolerance, drug use frequency prior to treatment, and current abstinence status (coefficients ranged from r=0.39 to 0.66). The concurrent pictorial drug choice task is sensitive to multiple risk factors in clinical, treatment-engaged drug users, and may be used to identify individuals requiring more support, to test experimental treatment manipulations, and to translate to animal concurrent self-administration procedures.

Does morning affect contribute to daily Cannabis use?

Several theories posit that cannabis and other substances are used to reduce negative affect. This daily report study considered whether variations in positive and negative affect, reported each morning, contributed to the likelihood of cannabis use later that day. We also explored whether levels of positive and negative affect reported immediately after cannabis use improved, relative to that day's morning levels. The sample included 183 men and 183 women representing heterosexual, cannabis-using couples from the community. Participants made independent, daily reports of affect and cannabis use episodes for 30 consecutive days. Using multilevel modeling, we modeled men's and women's use of cannabis on a given day as a function of morning levels of positive, hostile, and anxious affect, accounting for partner cannabis use that day, and mean levels of positive and negative affect. Men and women were more likely to use cannabis on a given day when morning positive affect was lower than typical for the person and when partner used cannabis that day. Neither hostile nor anxious affect contributed to later use of cannabis. Immediately after cannabis use, positive affect increased, and hostile and anxious affect decreased relative to that day's morning levels. The improved affect immediately after use suggests a mechanism of positive reinforcement.

Network analysis of the relationship between depressive symptoms, demographics, nutrition, quality of life and medical condition factors in the Osteoarthritis Initiative database cohort of elderly North-American adults with or at risk for osteoarthritis

AIMS

A complex interaction exists between age, body mass index, medical conditions, polypharmacotherapy, smoking, alcohol use, education, nutrition, depressive symptoms, functioning and quality of life (QoL). We aimed to examine the inter-relationships among these variables, test whether depressive symptomology plays a central role in a large sample of adults, and determine the degree of association with life-style and health variables.

METHODS

Regularised network analysis was applied to 3532 North-American adults aged ⩾45 years drawn from the Osteoarthritis Initiative. Network stability (autocorrelation after case-dropping), centrality of nodes (strength, M, the sum of weight of the connections for each node), and edges/regularised partial correlations connecting the nodes were assessed.

RESULTS

Physical and mental health-related QoL (M = 1.681; M = 1.342), income (M = 1.891), age (M = 1.416), depressive symptoms (M = 1.214) and education (M = 1.173) were central nodes. Depressive symptoms' stronger negative connections were found with mental health-related QoL (-0.702), income (-0.090), education (-0.068) and physical health-related QoL (-0.354). This latter was a 'bridge node' that connected depressive symptoms with Charlson comorbidity index, and number of medications. Physical activity and Mediterranean diet adherence were associated with income and physical health-related QoL. This latter was a 'bridge node' between the former two and depressive symptoms. The network was stable (stability coefficient = 0.75, i.e. highest possible value) for all centrality measures.

CONCLUSIONS

A stable network exists between life-style behaviors and social, environmental, medical and psychiatric variables. QoL, income, age and depressive symptoms were central in the multidimensional network. Physical health-related QoL seems to be a 'bridge node' connecting depressive symptoms with several life-style and health variables. Further studies should assess such interactions in the general population.

Negative Mood Induction Increases Choice of Heroin Versus Food Pictures in Opiate-Dependent Individuals: Correlation With Self-Medication Coping Motives and Subjective Reactivity

Acute growth in negative affect is thought to play a major role in triggering relapse in opiate-dependent individuals. Consistent with this view, three lab studies have demonstrated that negative mood induction increases opiate craving in opiate-dependent individuals. The current study sought to confirm these effects with a behavioral measure of heroin seeking, and test whether the effect is associated with self-reported opiate use to cope with negative affect and subjective reactivity to mood induction. Participants were heroin-dependent individuals engaged with treatment services (n = 47) and control participants (n = 25). Heroin users completed a questionnaire assessing reasons for using heroin: negative affect, social pressure, and cued craving. Baseline heroin choice was measured by preference to enlarge heroin versus food thumbnail pictures in two-alternative forced-choice trials. Negative mood was then induced by depressive statements and music before heroin choice was tested again. Subjective reactivity was indexed by negative and positive mood reported at the pre-induction to post-test timepoints. Heroin users chose heroin images more frequently than controls overall ( p = .001) and showed a negative mood-induced increase in heroin choice compared to control participants (interaction p < .05). Mood-induced heroin choice was associated with self-reported heroin use to cope with negative affect ( p < .05), but not social pressure ( p = .39) or cued craving ( p = .52), and with subjective mood reactivity ( p = .007). These data suggest that acute negative mood is a trigger for heroin seeking in heroin-dependent individuals, and this effect is pronounced in those who report using heroin to cope with negative affect, and those who show greater subjective reactivity to negative triggers. Interventions should seek to target negative coping motives to build resilience to affective triggers for relapse.

Contribution of cocaine-related cues to concurrent monetary choice in humans

RATIONALE

Theoretical accounts highlight the importance of drug-related cues for the development and persistence of drug-taking behavior. Few studies have evaluated the ability of spatially contiguous drug cues to bias decisions between two concurrently presented non-drug reinforcers.

OBJECTIVE

Evaluate the contribution of spatially contiguous cocaine cues to choice between two concurrently presented monetary reinforcers METHODS: Participants with cocaine use disorder completed a cued concurrent choice task. Two cues (one cocaine and one control image) were presented side-by-side followed by concurrent monetary offers below each image. Concurrent choice was measured for cocaine-side advantageous, equal, and disadvantageous concurrent monetary offers. The primary dependent measure was bias for selecting cocaine-cued monetary reinforcers. Three experiments tested selectivity of cocaine-cued bias in individuals with a cocaine use history (Experiment 1), replication when including additional control trials (Experiment 2), and a potential attentional mechanism evaluated using eye-tracking technology (Experiment 3).

RESULTS

Significant and robust cocaine-cued bias at equal monetary value was observed in three experiments (mean percent choice = 65-77%) and higher Drug Abuse Screening Test (DAST) scores were associated with greater cocaine-choice bias. These experiments demonstrated that cocaine-cued bias was (1) selective to individuals with a cocaine use history, (2) specific to trials involving a cocaine cue, and (3) partially associated with attentional bias.

CONCLUSIONS

These experiments provide evidence that drug-related cues can influence choice and potentially promote maladaptive decision making during concurrent choice events. Future research evaluating prospective associations of drug-cued bias with drug-associated behaviors will help reveal the clinical relevance for substance use disorder.

The Risk Factors of the Alcohol Use Disorders-Through Review of Its Comorbidities

Alcohol use disorders (AUDs) represent a severe, world-wide problem, and are usually comorbid with psychiatric disorders, comorbidity increases the risks associated with AUDs, and results in more serious consequences for patients. However, currently the underlying mechanisms of comorbid psychiatric disorders in AUDs are not clear. Studies investigating comorbidity could help us understand the neural mechanisms of AUDs. In this review, we explore three comorbidities in AUDs, including schizophrenia, major depressive disorder (MDD), and personality disorders (PDs). They are all co-morbidities of AUDs with rate of 33.7, 28, and 50–70%, respectively. The rate is significantly higher than other diseases. Therefore we review and analyze relevant literature to explore whether these three diseases are the risk factors of AUDs, focusing on studies assessing cognitive function and those using neural imaging. We found that memory deficits, impairment of cognitive control, negative emotion, and impulsivity may increase an individual's vulnerability to AUDs. This comorbidity may indicate the neural basis of AUDs and reveal characteristics associated with different types of comorbidity, leading to further development of new treatment approaches for AUDs.

Alcohol use disorder symptoms are associated with greater relative value ascribed to alcohol, but not greater discounting of costs imposed on alcohol

RATIONALE

Alcohol dependence is characterised by persistent drinking despite health, social and economic costs. Behavioural economics has proposed two explanations for the persistence of alcohol use despite costs. Dependent individuals may (a) ascribe excessively high value to alcohol, such that costs associated with alcohol are exceeded, and/or (b) they may discount (neglect) the costs associated with alcohol.

METHODS

To test these predictions, the current study recruited 127 student drinkers who reported varied alcohol use disorder symptom severity in the Alcohol Use Disorders Inventory Test (AUDIT; mean = 11.17, 69% above the hazardous cutoff). Participants made concurrent forced choices between alcohol and food points under conditions that manipulated the magnitude of points (1, 2 or 3) and the delay to receive points (0 or 3 s). Alcohol value was indexed by preferential choice of alcohol versus food points, whereas sensitivity to costs was indexed by the decrease in alcohol choice when food points were of greater magnitude (sensitivity to opportunity costs) and when alcohol points were delayed (sensitivity to delay costs).

RESULTS

Percent choice of alcohol over food varied consistently with the relative magnitude of reward points offered (p < .001) and with time delays imposed on reward points (p < .001). AUDIT scores were associated with greater alcohol versus food choice across all conditions (p = .001). As alcohol use disorder symptom severity increased, the sensitivity of alcohol choice to the relative magnitude of points (p = .29) and time delays (p = .62) remained unchanged, suggesting no differential discounting of opportunity or delay costs imposed on alcohol. In contrasts of AUDIT categories, there was comparable sensitivity to costs across groups defined as low-risk (N = 39), hazardous (n = 57), harmful (n = 20) and possible dependent drinkers (n = 11).

CONCLUSIONS

Alcohol use disorder symptom severity is associated with greater relative value ascribed to alcohol, but not with greater discounting of opportunity or delay costs imposed on alcohol. Despite limitations of the current study, it may be concluded that cost discounting plays a lesser role in dependence than previously thought.