Impulsivity, impulsive and reflective processes and the development of alcohol use and misuse in adolescents and young adults

Happy Hour: The association between trait hedonic capacity and motivation to drink alcohol

The (over)consumption of alcohol and other addictive substances is often conceptualized as a problem of low self-control (i.e., people's inability to inhibit unwanted impulses). According to that view, people drink because they cannot resist. In the present studies, we approached this from a different perspective and tested whether alcohol consumption might also be a problem of low hedonic capacity (i.e., people's inability to experience pleasure and relaxation, often due to intrusive thoughts). According to that view, people drink because it helps them enjoy or cope with negative thoughts or emotions. In two studies among individuals at low risk of harmful alcohol use (e.g., AUDIT < 7) we consistently found that trait hedonic capacity was unrelated to alcohol consumption but negatively related to coping motivation (drinking alcohol to cope with negative thoughts and feelings; Study 1: N = 348; Study 2: N = 302, preregistered). Exploratory analyses in study 2 (conducted during the COVID-19 pandemic) also showed that people with low, but not high, trait hedonic capacity drank more alcohol in response to stress. Our findings are in line with the notion that people's drinking motivation and behavior might not only be a problem of poor self-control but also of low trait hedonic capacity. They align with a new direction in addiction prevention and treatment research, which explores ways to help people to seek out and savor hedonic experiences from non-drug related reinforcers (e.g., engaging in leisure activities).

Attentional Biases and Their Association with Substance-Use-Related Problems and Addictive Behaviors: The Utility of a Gamified Value-Modulated Attentional Capture Task

Background

Attentional biases towards reward stimuli have been implicated in substance use-related problems. The value-modulated attentional capture (VMAC) task assesses such reward-related biases. The VMAC task widely used in lab studies tends to be monotonous and susceptible to low effort. We therefore tested a gamified online version of the VMAC that aimed to increase participant engagement. Our goal was to examine how VMAC is associated with substance use-related problems and addictive behaviors, and whether this association is moderated by cognitive control.

Methods

We recruited 285 participants from an online community, including heavy alcohol users. All participants completed a novel gamified version of the VMAC task, measures of substance use and addictive behaviors (addictive-like eating behavior, problematic smartphone use), the WebExec measure of problems with executive functions, and the Stroop Adaptive Deadline Task (SDL) as a measure of cognitive control.

Results

The gamified VMAC task successfully identified value-modulated attentional capture effects towards high-reward stimuli. We found no significant associations between VMAC scores, problematic alcohol or cannabis use, addictive behaviors, or any moderation by a behavioral measure of cognitive control. Exploratory analyses revealed that self-reported cognitive problems were associated with more alcohol-, and cannabis-related problems, and addictive behaviors. Greater attentional capture (VMAC) was associated with more cannabis use-related problems among individuals with higher levels of self-reported cognitive problems.

Conclusions

Our study is one of the first to demonstrate the utility of the gamified version of the VMAC task in capturing attentional reward biases. Self-reported problems with cognitive functions represent a key dimension associated with substance use-related problems and addictive behaviors.

Decision making and executive functions in problematic pornography use

Introduction

Previous research on cognitive functions in Compulsive Sexual Behavior Disorder (CSBD) and problematic pornography use (PPU) reported inconsistent findings and mostly included sexual pictures in the used tasks. The role of general executive functions and cognitive competences (without the presence of appetitive stimuli) in the context of PPU is largely unexplored.

Methods

This study investigated differences between individuals with high versus low problem severity of PPU regarding decision making and executive functions. The sample of the laboratory study consisted of N = 102 male adults. Besides measures of trait impulsivity, we used standard neuropsychological tests (Trail Making Test and three-back working memory task) and an intertemporal risky choice paradigm, the Cards & Lottery Task (CLT).

Results

The results show heightened impulsivity (urgency and deficits in perseverance) in individuals with high PPU, but no differences regarding performance in the CLT and executive function tasks.

Discussion

The findings indicate that PPU might be associated with impulsive behavior when experiencing strong emotions (urgency) and deficient cognitive performance especially in the presence of sexual stimuli but not in general.

Children's excessive digital media use, mental health problems and the protective role of parenting during COVID-19

COVID-19's outbreak in March 2020 and the social distancing measures that followed it changed the lives of children worldwide. Studies assessing the pandemic's implications for children have reported an alarming increase in the use of digital media (DM) and warned of its adverse impacts on children's functioning and development. The current study aimed to assess the relationship between excessive and problematic DM use and emotional, behavioral, and academic functioning among Israeli adolescents during COVID-19 and to identify adolescents at elevated risk of developing problematic DM use. Three hundred forty-seven Israeli parent-child dyads (M age = 11.81, SD = 1.41) separately completed measures assessing children's DM use (time and addiction), functioning (academic, social, emotional, and behavioral), behavioral dysregulation, and the parents' parenting practices. The results showed that DM addiction, but not DM use, was related to children's emotional, behavioral, and academic difficulties. Moreover, the results indicated that negative parenting and behavioral dysregulation increased the risk of DM addiction, which in turn increased emotional, behavioral, and academic difficulties. The results underscored parents' role in preventing problematic DM use and highlighted the need to treat DM use and problematic DM use as distinct constructs.

Reward sensitivity and hazardous alcohol consumption in women: The parallel mediation effect of self-control and impulsivity traits

Introduction: Little research has been carried out on the associations between several individual factors and hazardous alcohol use in women. The aim of this study was first, to study the relationship between reward sensitivity (RS) and alcohol use in both women with and without hazardous drinking separately. Second, to explore the potential mediating roles of the impulsivity and self-control traits in this relationship. Method: The study was analytical and cross-sectional and included 645 female participants (mean age = 19.14; standard deviation (SD)=1.60). All women were divided into two groups (286, 44.3%, with hazardous drinking, HDW; and 359, 55.7%, with light drinking, LDW). Correlation analyses were carried out to explore the associations between the variables, and parallel mediation analyses were performed to investigate the potential mediating roles of impulsivity and self-control in the RS-alcohol use associations in each group separately. Results: A significant association was observed between RS and alcohol use in HDW, contrary to that observed in their counterparts. In addition, both higher impulsivity and less self-control mediated the association between RS and alcohol use only in HDW. Conclusions: Impulsivity and self-control differently affect alcohol use under the condition of high reward sensitivity, only in HDW, suggesting alterations of the dual top-down and bottom-up mechanisms and a possible imbalance between the competing reflexive and impulsive brain systems. More research is needed regarding the individual factors that affect women's drinking to develop sensitive measures for the assessment of alcohol use and more efficient interventions for women.

Association between Parent-Reported Executive Functions and Self-Reported Emotional Problems among Adolescent Offspring of Fathers with Alcohol-Dependence

Objectives  To compare the executive functions in adolescents of fathers with alcohol dependence (AOFADs) with a control group of adolescents without a paternal history of alcohol dependence and examine the association between executive functioning problems and behavioral and emotional problems.

Materials and Methods  The study included 39 AOFADs and 45 adolescent offspring of fathers without a history of alcohol-use disorders, who were matched for age and sex. They were assessed using standardized measures of executive functions and emotional and behavioral problems.

Statistical Analysis  A comparison was made between the two groups about the parental report of adolescents' executive functions and adolescents' self-reported emotional and behavioral problems. ANCOVA was performed to understand the covariance of educational and socio-economic status on executive functions. Correlation between executive functions, emotional and behavioral problems, and the duration of father's alcohol dependence was examined with Spearman's rho.

Results  AOFAD group showed significant impairment on all subdomains of executive functions and emotional and behavioral disturbances ( p  < 0.01) but not on the prosocial behavioral dimension ( p  < 0.01). The group differences were independent of child's education and family income. Executive functional impairments positively correlated with psychopathology ( p  < 0.01). Problems with executive functions and psychopathology correlated with the duration of the father's alcohol dependence.

Conclusions  AOFADs are at risk for executive function impairments which in turn are strongly associated with emotional and behavioral problems. The association is independent of child's education and family economic status. The duration of alcohol dependence in fathers is associated with these problems. It has implications for targeted interventions for both adolescents and families.

State impulsivity amplifies urges without diminishing self-control

A disproportionate amount of research on impulsivity has focused on trait-related aspects rather than state fluctuations. As a result, the relationship between state impulsivity and moment-to-moment behaviour is unclear. Impulsivity is assumed to negatively affect self-control, but an alternative explanation, yet to be tested, could be that changes in state impulsivity and its homeostatic drivers influence the intensity of urges. We tested whether state impulsivity and hunger affected behaviour through a dual-process model, affecting both the experience of various urges, and self-control, using a smartphone-based experience sampling approach. We found that state impulsivity is associated with stronger urges, but we found no evidence of an association with diminished self-control. Being hungry amplifies urges across different types of urges, and both hunger and late hours are negatively related to the likelihood of controlling urges. These findings imply that the influence of hunger is not limited to the food domain, and provide new insight into the role of state impulsivity in daily life.

An evaluation of the effect of methylphenidate on working memory, time perception, and choice impulsivity in children with ADHD

Individuals with Attention-Deficit Hyperactivity Disorder (ADHD) consistently exhibit a stronger preference for immediate rewards than for larger rewards available following a delay on tasks measuring choice impulsivity (CI). Despite this, however, there remains a dearth of studies examining the impact of stimulant treatment on CI as well as associated higher order (e.g., working memory [WM]) and perceptual (e.g., time perception) cognitive processes. The present study examines the effect of osmotic release oral system methylphenidate (OROS-MPH) on CI, WM and time perception processes as well as the relation among these processes before and after taking a regimen of OROS-MPH. Thirty-five children (aged 7-12 years) with a diagnosis of ADHD participating in a concurrent stimulant medication study were recruited to complete computerized assessments of CI, WM, and time perception. Children completed the assessments after administration of a placebo as well as their lowest effective dose of OROS-MPH following a 2-week titration period. The results from one-sample t-tests indicated that OROS-MPH improves both CI and WM in youth with ADHD but does not impact time perception. Further, results revealed no significant association among the various indices of cognitive performance while taking placebo or OROS-MPH. Overall, the findings suggest that while OROS-MPH improves both CI and WM in youth with ADHD, improvements in CI as a result of OROS-MPH are unlikely to be associated with the improvements in WM given the lack of association among the two. Future studies should consider alternate cognitive, emotional, and motivational mechanisms that may account for the impact of OROS-MPH on CI. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The effect of N-acetylcysteine and working memory training on glutamate concentrations in the dACC and rACC in regular cocaine users - A randomized proof of concept study

INTRODUCTION

Current treatments for cocaine use disorder (CUD) are not very effective and better treatments are needed. This study investigates the effectiveness of a combined intervention that targets the assumed underlying glutamate pathology in cocaine users. To this end, the combined effects of N-acetylcysteine (NAC) and working memory (WM) training on glutamate concentrations in the dorsal and rostral ACC were investigated in a randomized, double-blind placebo-controlled design.

METHODS

In this study, 38 regular cocaine-using men were randomized to either 25-days with 2400 mg/day NAC and WM-training or 25 days with placebo with WM-training. Cocaine use, impulsivity, and glutamate concentrations in the dACC and rACC using proton Magnetic Resonance Spectroscopy were assessed at baseline and after treatment.

RESULTS

Twenty-four participants completed the study, of which 9 received NAC and 15 received placebo. There were no baseline correlations of glutamate concentrations in the dACC or rACC with cocaine use measures or impulsivity. Additionally, there were no effects of NAC, WM-training, or the combination thereof on (changes in) glutamate concentrations in the dACC or rACC.

DISCUSSION

This randomized proof of concept study could not confirm our hypotheses. Possible explanations are insufficient power and the possible absence of deviant baseline glutamate concentrations in the included participants. Future studies should consider larger samples and a non-using control group to confirm baseline deviations in glutamate in cocaine users.

Diagnostic and Classification Considerations Related to Compulsive Sexual Behavior Disorder and Problematic Pornography Use

Purpose of Review

There are ongoing debates about specific features of compulsive sexual behavior disorder (CSBD) relating to classification and diagnoses. We aim to address current discussions relating to potential subtypes of CSBD, the aspect of compulsivity in CSBD, and the aspect of moral incongruence and CSBD.

Recent Findings

CSBD includes multiple specific sexual behaviors that might be related to specific psychological processes. Problematic pornography use may be considered a subtype of CSBD, which may have multiple parallels with addictive behaviors. The feature of compulsivity in CSBD may be different from compulsivity in other disorders and may be differently involved in early versus later stages of CSBD. Moral incongruence is important to consider in the context of CSBD, although moral disapproval is not a general exclusion criterion for diagnosing CSBD.

Summary

Considering the current debates of specific features of CSBD, future research and clinical practice may benefit from a trans-diagnostic approach to contribute to a more fine-grained understanding of the multiple facets of CSBD.

Social-networks-related stimuli interferes decision making under ambiguity: Interactions with cue-induced craving and problematic social-networks use

BACKGROUND AND AIMS

Social-networks-use disorder is discussed as a potential further type of disorders due to addictive behaviors. Theoretical models assume cue-induced craving and disadvantageous decision making to be relevant mechanisms. This study investigates if the presentation of social-networks-related cues interferes with decision making under ambiguity.

METHODS

Craving was induced with a cue-reactivity paradigm and assessed with a visual analogue scale. Participants (N = 146) played a modified Iowa Gambling Task with social-networks-related cues and neutral cues presented on the advantageous and disadvantageous decks respectively, or vice versa. Symptoms of social-networks-use disorder were measured with a modified version of the short Internet Addiction Test.

RESULTS

Overall, participants chose options with neutral cues more often than those with social-networks-related cues, even if it was disadvantageous. There was a significant interaction between decision-making performance and Iowa Gambling Task condition in predicting symptom severity. The results indicate that choosing decks with social-networks-related cues even if it was disadvantageous is associated with higher tendencies towards a social-networks-use disorder. The interaction with cue-induced craving did not explain further variance.

DISCUSSION AND CONCLUSIONS

The results highlight the relevance of cue reactivity, decision making, and their interaction as potential mechanisms explaining tendencies towards a social-networks-use disorder. Decision making was influenced by affective responses, which could result in a higher risk of a potential addictive behavior. This is consistent with the findings from addiction research and with theoretical approaches assuming an imbalance between affective and cognitive processes in addictive behaviors.

Does alcohol-related desire thinking predict in-the-moment drinking behaviours?

Desire thinking (voluntary thinking involving a perseverative focusing on desired target-related memories, images, and information), is an important factor in the experience of drinking urges and cravings. Research has not examined the relationship between desire thinking, behavioural intention and the implementation of that behaviour into action, nor how one's past repeated behaviour in situ (expressed as habit) may moderate these relationships. We employed an ad libitum drinking paradigm to provide indirect measures of in-the-moment drinking behaviours (amount poured [mls] and amount consumed [mls]) in a group of eighty-eight self-defined social drinkers immediately after measuring self-reported drinking habit, drinking-related desire thinking, and general drinking behaviour. Results confirmed the predicted positive relationship between desire thinking and in-the-moment drinking behaviour with the effects increasing as a function of rising drinking habit strength. We also observed a dissociation between desire thinking components (verbal perseveration and imaginal prefiguration) in the moderating effects of habit strength on drinking behaviour. For imaginal prefiguration (thoughts related to construction of mental images of a desired target or of its context for consumption) a direct effect on drinking behaviours was shown. In comparison, the effect for verbal perseveration (repetitive self-talk regarding the need to achieve a desired target) was not shown to independently predict drinking-related behaviour but was significantly moderated by increasing drinking-related habit strength. Future work should formulate the nature of this moderating influence on perseverative goal-directed thinking.

Meat disgust is negatively associated with meat intake - Evidence from a cross-sectional and longitudinal study

Meat consumption is increasingly seen as unsustainable, unhealthy, and unethical. Understanding what factors help people reduce their meat intake is urgently needed. One such factor is meat disgust, a feeling reported by many vegetarians, and which could be a promising basis for meat reduction interventions. However, meat disgust and its impact on meat consumption is poorly understood. We examined meat disgust and its role in vegetarianism and reducing meat intake in a cross-sectional and longitudinal online study. We measured self-reported meat consumption, meat disgust (by self-report and Implicit Association Test), meat liking, self-control, and disgust sensitivity in N = 711 adults (57% omnivores, 28% flexitarians, 15% vegetarians) recruited from a community cohort. Results showed that 73% of vegetarians can be classified as 'meat disgusted', and that meat disgust predicted meat intake better than self-control in omnivores and flexitarians at baseline. Following up a sub-sample of participants (N = 197) after six months revealed that changes in meat intake over time were also associated with changes in meat disgust. This is the first study to quantify the impact of meat disgust on (changes in) meat consumption and its prevalence in the vegetarian and the general population. Our findings advance research into meat disgust and encourage the development of disgust-based interventions to reduce meat intake.

Deficits in executive functions but not in decision making under risk in individuals with problematic social-network use

BACKGROUND

The tendency to strive for immediate gratification by neglecting potential negative long-term outcomes characterizes addictive behaviors, such as substance use or gaming disorder. Problematic social-network use is currently discussed as another potential addictive behavior, which is considered to result from an imbalance between affective and cognitive processes, indicated by traits such as increased impulsivity and/or decreased executive functions and decision-making abilities.

METHODS

This study investigates the respective functions in social-network users by use of the Cards and Lottery Task (CLT) - a decision-making task under risk conditions in which options contain conflicting immediate and long-term outcomes at the same time. A sample of German and Spanish participants (N = 290) performed the CLT as well as the Modified Card Sorting Test (MCST), Barratt Impulsiveness Scale (BIS), the short Internet Addiction Test specified for social-networking (sIAT-SNS), and screeners on other potentially problematic behaviors.

RESULTS

Comparing extreme groups based on sIAT-SNS scores (1SD above/below mean), individuals with problematic social-network use (n = 56), as compared to those with non-problematic social-network use (n = 50), showed increased attentional impulsivity and reduced executive functions. No differences were observed in decision-making performance.

CONCLUSION

The findings indicate that problematic social-network use is related to attentional rather than general decision-making deficits. Furthermore, problematic social-network use is likely to co-occur with other problematic Internet-use behaviors, particularly gaming or shopping.

Physical activity: A promising adjunctive treatment for severe alcohol use disorder

Substance use disorder develops from complex interactions between socio-environmental and neurobiological factors. A neurocognitive model of addiction, the triadic model, proposes that Alcohol Use Disorder (AUD) is the result of an imbalance between the reflective and the impulsive subcomponents along with a disruption of the regulatory subcomponent. Physical activity is considered as an emerging treatment for severe AUD (sAUD). This short review examines the efficacy and mechanisms of action of physical intervention as an adjunctive treatment in severe AUD (sAUD) within the theoretical framework of the triadic model. Physical activity is a feasible, safe, and less stigmatizing approach than classical treatments. It improves sAUD patients' mental and physical comorbidities. The key finding of this short review is that physical activity could contribute to a rebalancing of the triadic model in sAUD patients by 1) improving neuroplasticity and cognitive functioning, 2) reducing impulsivity and urgency, and improving emotional regulation, and 3) reducing craving. This rebalancing could eventually reduce the risk of relapse. However, due to methodological issues, it remains difficult to observe an effect of physical activity on drinking outcomes. At best, a trend towards a reduction in alcohol consumption was noted. The mechanisms that could explain the benefits of physical activity in sAUD patients involve multiple physiological processes such as dopaminergic or glutamatergic transmission and signaling or neuroplasticity. Future randomized controlled trials should include neuropsychological and impulsivity assessments, in more controlled environments. Physical activity could contribute to a personalization of sAUD treatment using each subcomponent of the triadic model as a therapeutic target. Physical exercise could be an adjunctive treatment for sAUD patients, favoring the benefit of more usual treatments such as cognitive behavioral therapies. It could also be a stand-alone intervention in less severe patients.

Blunted prefrontal signature of proactive inhibitory control in cocaine use disorder

BACKGROUND

Impulsivity is an established risk factor for substance use disorder (SUD). Integral to SUD recovery is proactive control (leveraging information about a potential need for behavioral restraint to marshal increased cognitive resources toward inhibition) when cues for drug use are unavoidable. However, proactive control is little studied in SUD, and is merely inferred from post-error performance adjustments.

METHODS

We probed covert neurocircuit signatures of proactive control in persons with SUD, as well as the moderating effects of incentives for successfully exerting proactive control. We administered a Monetary Incentive Stop Task (MIST) during functional magnetic resonance imaging of adults with cocaine use disorder (CUD; n = 21) and healthy controls (n = 21). The MIST blended the reward and loss-anticipatory cues of the Monetary Incentive Delay (MID) Task with a variant of the Stop-Signal Task, in which target color signaled whether or not withholding a response might be necessary.

RESULTS

In controls, but not in CUD participants, targets that signaled a potential need to stop (as a contrast with targets that signaled no need to stop) activated portions of right operculum akin to activation commonly elicited by stop signals, despite no actual stop signal. Across all participants, this proactive control activation did not relate to task behavior or to questionnaire impulsivity. Anticipatory incentive cues did not recruit ventral striatum.

CONCLUSIONS

These data suggest that persons with CUD show blunted covert signatures of attention and proactive control. This potentially accounts in part for the role of poor executive function in relapse vulnerability.

The effect of sensation seeking on alcohol use among middle school students: a latent state-trait analysis

BACKGROUND

Sensation seeking has been implicated as a major risk factor for underage alcohol use, however little research into this personality trait has been conducted among children.

OBJECTIVE

The current study examined if sensation seeking presents as a state or trait in children, and if the state or trait predicted future alcohol use.

METHODS

A latent state-trait (LST) analysis was conducted among 552 individuals (54.3% female; age range 8-13; mean age 9.3) to determine the state or trait-based aspects of sensation seeking, and if this state or trait predicted future alcohol use. Sensation seeking behavior and lifetime alcohol use were assessed at four time points using two previously validated measures.

RESULTS

Between 49.4% and 95.3% of individual differences in sensation seeking could be attributed to a stable underlying sensation seeking trait. Further, logistic regression of the stable trait of sensation seeking predicted future alcohol use. A one unit increase in the latent trait increased the odds a student would try alcohol by 7.83 times (95% CI = 1.49-41.11, p = .015). Standardized regression coefficients revealed that an increase of one standard deviation in the latent trait of sensation seeking increased the odds of experimentation with alcohol by 1.29 times (95% CI = 1.11-1.49, p = .001).

CONCLUSION

Findings suggest sensation seeking presents as a stable trait during childhood, which can cause children to seek out a novel or exciting behaviors such as alcohol use. Future substance use interventions may need to account for the influence of the underlying trait.

Risky drinking decisions: The influence of party music and alcohol abuse in young adult women

Music is a ubiquitous feature of young adults' social drinking environments, yet no studies have assessed whether and how it impacts risky decisions to drink alcohol. Previous research on the influence of music on risky decisions is largely based around decision tasks with monetary incentives.

METHODS

To assess the impact of music listening on risky drinking decisions, the current study used visual alcohol cues paired with hypothetical risky drinking scenarios (e.g., "You do not have a safe ride home" for alcohol). Young adult women with a history of alcohol abuse (N = 34) and casual-drinking control women (N = 29) made hypothetical decisions about whether or not to drink alcohol, or eat food (an appetitive control condition), in risky contexts while personal "party music" (music chosen by participants for "going out") and "home music" (music chosen for "staying in") played in the background. The main dependent measure - likelihood of drinking - was reported on a 4-point scale where 1 corresponded to "very unlikely", and 4 to "very likely".

RESULTS

Listening to party music while making decisions increased the likelihood of making risky decisions, regardless of alcohol abuse history, while other personal music did not. Further, party music specifically increased the likelihood of risky drinking decisions relative to risky eating decisions. As expected, those with a history of alcohol abuse made more risky drinking decisions in general, regardless of the type of music heard.

DISCUSSION

The results suggest that party music is an important feature of the drinking environment associated with increased risky decisions about drinking alcohol in young adult women, regardless of their history of alcohol abuse. The finding that music plays an important role in risky drinking decisions indicates that further investigation into the real-world drinking environments of young adults is crucial, as it will aid in the development of a more complete picture of risky drinking decisions in young adults.

Interactions of impulsivity, general executive functions, and specific inhibitory control explain symptoms of social-networks-use disorder: An experimental study

While the use of social media and online-communication applications has become an integral part of everyday life, some individuals suffer from an excessive, uncontrolled use of social media despite experiencing negative consequences. In accordance with neuropsychological models of addiction, we assume the tendency of a social-networks-use disorder to be related to an interplay of predisposing personality traits (e.g., impulsivity), and reductions in cognitive functions (e.g., executive functions, inhibitory control). The current study makes first strides towards examining this interplay. In addition to a newly developed social-networks-specific auditory Go-NoGo paradigm, other neuropsychological paradigms were used. Impulsivity and social-networks-use-disorder symptoms were assessed by standardized questionnaires. The results show that the symptom severity of a social-networks-use disorder is mainly associated with attentional impulsivity. General executive functions and specific inhibitory control of social-networks-related cues have no direct effect on symptom severity. However, moderated regression analyses emphasize that increased symptom severity is associated with higher attentional impulsivity, especially if there are additionally reductions in executive functions or specific inhibitory control. The results complement previous findings and inform future research on social-networks-use disorder. The findings support the applicability of theoretical models of addictive behaviors to the social-networks-use disorder and point to social-networks-related specificities regarding attention-related facets.

A Mixed Methods Design to Detect Adolescent and Young Adults' Impulsiveness on Decision-Making and Motor Performance

Impulsiveness in adolescents and young adults is an important aspect of psychological research. However, there still is lack of research that relates impulsiveness and motor performance in those. Thus, we aim to detect the levels of impulsiveness related to motor skills, motor laterality, spatial orientation, and individual interaction on the decision-making of adolescents and young adults across three staggered workouts. The study had 71 participants (53 males and 18 females), ranging in age from 17 to 24 years old (Mage = 18.5 years; SD = 1.72) and classified as non-impulsiveness (n = 47), impulsiveness (n = 17), and attention deficit hyperactivity disorder (ADHD) (n = 7). A Mixed Methods research was conducted throughout four research tools (a) The Observational System of Motor Skills (OSMOS) was used to observe and detect the movement sequences patterns; (b) The Spanish version of Impulsive Behavior Scale (UPPS-P) was administered to obtain the impulsiveness profiles; (c) The Precision and Agility Tapping over Hoops (PATHoops) was carried out to observe the decision-making and temporal-spatial over movement effectiveness; (d) Motor Laterality Inventory (MOTORLAT) was applied to obtain the laterality profiles related to motor skills performance. This Mixed Methods approach has obtained useful results for impulsiveness in motor situations as the results from the different tools converge to established three clear profiles of impulsiveness. Participants with ADHD showed lack of interpersonal interaction, non-resolute decision-making, and lesser richness of motor skills patterns than non-impulsiveness and impulsiveness subjects. Additionally, impulsiveness participants also showed rich motor patterns, dyadic interactions, good decision making in spatial orientation tasks, and more versatile laterality in the lower limbs.

Sensation seeking to marijuana use: Exploring the mediating roles of risk appraisal and social norms

While studies have shown a robust association between sensation seeking (SS) and adolescent marijuana use, comparatively little is known about the mechanisms that potentially account for this association. The current study tests a theoretical model linking SS to marijuana use through risk appraisal and normative influences (i.e., perceived behavior and attitudes of others). Utilizing a nationally representative, cross-sectional sample of high school seniors (N = 2117), the current study finds risk appraisal and normative influences mediate the relationship between SS and marijuana use. Furthermore, perceptions of risk appear to be strongly influenced by proximal peer norms. These results indicate risk appraisal and normative processes may be key explanatory mechanisms in the association between SS and adolescent marijuana use. Theoretical and policy implications for this model are discussed.

Effectiveness of a web-based screening and brief intervention with weekly text-message-initiated individualised prompts for reducing risky alcohol use among teenagers: study protocol of a randomised controlled trial within the ProHEAD consortium

BACKGROUND

Early and excessive alcohol use is a significant threat to healthy development. Evidence supports the effectiveness of electronic alcohol interventions for young drinkers. However, effects are typically small and studies targeting under 18-year-olds are scarce. This trial is the first to evaluate the effectiveness of a single-session, brief, motivational, web-based intervention (ProWISE) plus weekly text-message-initiated individualised prompts (TIPs) in reducing alcohol consumption and alcohol-related harm among children and adolescents aged ≥ 12 years. TIPs are designed to decrease risky alcohol use by reaching youth in the contexts of their everyday lives and by providing individualised feedback on drinking intentions, actual drinking and succession in achieving personal goals for low-risk drinking or abstinence.

METHODS/DESIGN

The trial is part of the multicentre consortium ProHEAD testing e-interventions for mental health problems in children and adolescents. Participants in grades 6-13 aged ≥ 12 years will be recruited in schools which participate in ProHEAD (target N = 15,000). Main criterion for inclusion in the ProWISE-TIP trial is a positive screening for at-risk alcohol use in the CRAFFT-d questionnaire (target n = 1076). In a multicentre, four-arm, randomised controlled design the following groups will be compared: (A) web-based intervention plus TIPs for 12 weeks; (B) web-based intervention plus text-message-initiated assessment of alcohol consumption for 12 weeks; (C) web-based intervention only; and (D) alcohol-related psychoeducation. TIPs will be delivered shortly before and after high-risk situations for excessive alcohol use and will be tailored to age, gender, drinking motives and alcohol consumption. Study participants will be followed up at three, six and nine months in the ProWISE-TIP trial and at one and two years in the ProHEAD consortium. Primary outcome is alcohol use in the past 30 days at nine months after enrolment. Secondary outcomes are alcohol-related problems, co-occurring substance use, health service utilisation, mental health problems and quality of life.

DISCUSSION

Trial results will generate important evidence on how to enhance effectiveness of single-session, web-based alcohol interventions for youth. The ProWISE-TIP intervention, if effective, can be used as a stand-alone alcohol intervention or as an add-on to school-based or community-based alcohol prevention programs.

TRIAL REGISTRATION

German Clinical Trials Register, DRKS00014606 Registered on 20 April 2018.

Self-control, implicit alcohol associations, and the (lack of) prediction of consumption in an alcohol taste test with college student heavy episodic drinkers

The high levels of problematic drinking in college students make clear the need for improvement in the prediction of problematic drinking. We conducted a laboratory-based experiment that investigated whether implicit measures of alcohol-related associations, self-control, and their interaction predicted drinking. Although a few studies have evaluated self-control as a moderator of the relationship between implicit measures of alcohol-related associations and drinking, this study extended that work by using a previously-validated manipulation that included a more (vs. less) cognitively demanding task and incentive to restrain drinking and by evaluating multiple validated measures of alcohol-related associations. Experimental condition was expected to moderate the relationship between implicit measures of alcohol-related associations and drinking, with a more positive relationship between alcohol-related associations and drinking among participants who completed the more (vs. less) cognitive demanding task. Secondary aims were to evaluate how individual differences in control factors (implicit theories about willpower and working memory capacity) might further moderate those relationships. One hundred and five U.S. undergraduate heavy episodic drinkers completed baseline measures of: drinking patterns, three Implicit Association Tests (evaluating drinking identity, alcohol excite, alcohol approach associations) and their explicit measure counterparts, implicit theories about willpower, and working memory capacity. Participants were randomized to complete a task that was more (vs. less) cognitively demanding and were given an incentive to restrain their drinking. They then completed an alcohol taste test. Results were not consistent with expectations. Despite using a previously validated manipulation, there was no evidence that one condition was more demanding than the other, and none of the predicted interactions reached statistical significance. The findings raise questions about the relation between self-control, implicit measures of alcohol-related associations, and drinking, as well as the conditions under which implicit measures of alcohol-related associations predict alcohol consumption in the laboratory.

Predictors of Effective Working Memory Training in Individuals with Alcohol Use Disorders

BACKGROUND

Low working memory (WM) capacity is associated with alcohol use disorders (AUDs). The importance of WM to adaptive functioning has led to a recent influx of studies attempting to improve individual WM capacity using various cognitive training methods. The present study aimed to examine the efficacy of complex WM training for improving WM capacity among individuals with AUD.

METHODS

Individuals were randomized to complete either adaptive WM training or active control training. We applied a methodologically rigorous and structured approach, including a battery of near and moderate transfer measures in those with AUDs and a control group. Additionally, we examined cognitive factors (at baseline) and other predictors of adherence, training task improvement, and transfer.

RESULTS

Results suggest improved WM in individuals with AUDs and controls, as evidenced by improved scores on several transfer measures, after adaptive WM training. However, individuals with AUDs showed poorer adherence and less improvement on the training tasks themselves. Neither IQ, WM, sex, nor condition predicted adherence. Level of training task performance, baseline WM, and IQ predicted transfer task improvement.

CONCLUSIONS

This is the first study to rigorously examine both the efficacy of WM training in those with AUDs, and predictors of successful training program adherence and transfer in a large sample. Among study completers, results suggest that AUD status does not predict training improvement and transfer. However, AUD status did predict lower program adherence. WM training was more effective in those with higher cognitive ability at baseline. This study provides direct translation to the development of cognitive interventions for treating AUD.

Trait and state impulsivity in males with tendency towards Internet-pornography-use disorder

INTRODUCTION

Impulsivity has been identified to be involved in the development and maintenance of specific Internet-use disorders (IUD). It can be differentiated between relatively stable trait impulsivity and state impulsivity which is dependent on environmental and affective factors such as craving. Following the I-PACE (Interaction of Person-Affect-Cognition-Execution) model, both trait and state impulsivity may play an interactive role in IUD. The present study aimed to investigate the relationship between trait and state impulsivity and symptom severity of Internet-pornography-use disorder (IPD) as one form of IUD.

METHODS

Fifty heterosexual males participated in this study. State impulsivity was measured with reaction times in a modified stop-signal task. Each participant conducted two blocks of this task which included neutral and pornographic pictures. Moreover, current subjective craving, trait impulsivity, and symptom severity of IPD were assessed using several questionnaires.

RESULTS

Results indicate that trait impulsivity was associated with higher symptom severity of IPD. Especially those males with higher trait impulsivity and state impulsivity in the pornographic condition of the stop-signal task as well as those with high craving reactions showed severe symptoms of IPD.

CONCLUSION

The results indicate that both trait and state impulsivity play a crucial role in the development of IPD. In accordance with dual-process models of addiction, the results may be indicative of an imbalance between the impulsive and reflective systems which might be triggered by pornographic material. This may result in loss of control over the Internet-pornography use albeit experiencing negative consequences.

Toward a mechanistic understanding of the impact of food insecurity on obesity

Nettle et al. provide a useful but incomplete analysis of the drivers of obesity. In this commentary, we argue that a dual-motives conceptualization of self-control, together with insights from the psychology of (perceived and actual) scarcity, might help advance a more fine-grained mechanistic understanding of the observed association between food insecurity and obesity.

Do daily fluctuations in inhibitory control predict alcohol consumption? An ecological momentary assessment study

RATIONALE

Deficient inhibitory control is predictive of increased alcohol consumption in the laboratory; however, little is known about this relationship in naturalistic, real-world settings.

OBJECTIVES

In the present study, we implemented ecological momentary assessment methods to investigate the relationship between inhibitory control and alcohol consumption in the real world.

METHODS

Heavy drinkers who were motivated to reduce their alcohol consumption (N = 100) were loaned a smartphone which administered a stop signal task twice per day at random intervals between 10 a.m. and 6 p.m. for 2 weeks. Each day, participants also recorded their planned and actual alcohol consumption and their subjective craving and mood. We hypothesised that day-to-day fluctuations in inhibitory control (stop signal reaction time) would predict alcohol consumption, over and above planned consumption and craving.

RESULTS

Multilevel modelling demonstrated that daily alcohol consumption was predicted by planned consumption (β = .816; 95% CI .762-.870) and craving (β = .022; 95% CI .013-.031), but inhibitory control did not predict any additional variance in alcohol consumption. However, secondary analyses demonstrated that the magnitude of deterioration in inhibitory control across the day was a significant predictor of increased alcohol consumption on that day (β = .007; 95% CI .004-.011), after controlling for planned consumption and craving.

CONCLUSIONS

These findings demonstrate that short-term fluctuations in inhibitory control predict alcohol consumption, which suggests that transient fluctuations in inhibition may be a risk factor for heavy drinking episodes.

Impulsivity as a mechanism linking child abuse and neglect with substance use in adolescence and adulthood

Emerging developmental perspectives suggest that adverse rearing environments promote neurocognitive adaptations that heighten impulsivity and increase vulnerability to risky behavior. Although studies document links between harsh rearing environments and impulsive behavior on substance use, the developmental hypothesis that impulsivity acts as mechanism linking adverse rearing environments to downstream substance use remains to be investigated. The present study investigated the role of impulsivity in linking child abuse and neglect with adult substance use using data from (a) a longitudinal sample of youth (Study 1, N = 9,421) and (b) a cross-sectional sample of adults (Study 2, N = 1,011). In Study 1, the links between child abuse and neglect and young adult smoking and marijuana use were mediated by increases in adolescent impulsivity. In Study 2, indirect links between child abuse and neglect and substance use were evidenced via delayed reward discounting and impulsivity traits. Among impulsivity subcomponents, robust indirect effects connecting childhood experiences to cigarette use emerged for negative urgency. Negative urgency, positive urgency, and sensation seeking mediated the effect of child abuse and neglect on cannabis and alcohol use. Results suggest that child abuse and neglect increases risk for substance use in part, due to effects on impulsivity. Individuals with adverse childhood experiences may benefit from substance use preventive intervention programs that target impulsive behaviors.

Cognitive training as a potential treatment for overweight and obesity: A critical review of the evidence

The aim of this review is to critically evaluate the effectiveness and candidate mechanisms of action of psychological interventions which aim to either (a) improve the capacity for self-regulatory, reflective processes or (b) reduce the impact of automatic appetitive processes, in an attempt to influence food intake and associated weight-gain. Our aim was to examine three important issues regarding each type of intervention: i) whether the intervention influenced behaviour in the laboratory, ii) whether the intervention influenced behaviour and/or body mass index in the real world, and iii) whether the proposed mechanism of action was supported by evidence. We systematically searched three commonly used databases and identified 32 articles which were relevant to at least one of these issues. The majority of studies attempted to manipulate food intake in the laboratory using associative learning paradigms, in normal-weight female participants. Most of the laboratory studies demonstrated the predicted effects of interventions on behaviour in the laboratory, but studies that attempted to translate these interventions outside of the laboratory yielded more mixed findings. The hypothesised mechanisms of action received inconsistent support across studies. We identified several limitations which may complicate interpretation of findings in this area, including heterogeneity of study methods, small sample sizes, and absence of adequate control groups. We provide recommendations for future studies that aim to develop and evaluate these promising interventions for the reduction of overweight and obesity.

Meta-analysis of the relationship between impulsivity and substance-related cognitive biases

BACKGROUND

Evidence indicates that substance-related cognitive biases (attentional, memory, and approach bias) contribute to the maintenance and development of substance misuse. Impulsivity has been suggested to influence how cognitive biases contribute to substance misuse, possibly by biasing incentive salience attribution processes. However, the strength and moderators of the relationship between impulsivity and substance-related cognitive biases has yet to be empirically examined.

METHODS

A meta-analysis using random-effects models was completed assessing 19 studies that reported a quantitative relationship between an impulsivity measure and a substance-related cognitive bias. Two-component conceptualisation of impulsivity, impulsivity measurement type, gender, and age were assessed as moderators.

RESULTS

A small, significant positive relationship (r=0.10) was observed between impulsivity and substance-related attentional, memory, and approach biases. No moderators examined had a significant influence on this relationship.

CONCLUSIONS

Results are consistent with incentive sensitisation theories of addiction and suggests a weak synergistic relationship between impulsivity and substance-related cognitive biases. This relationship holds across different measures and components of impulsivity. Results provide some support for the viability of impulsivity and cognitive bias interaction models which may warrant further investigation of these factors in relation to predicting addiction treatment outcomes.

Effectiveness of a brief school-based intervention on depression, anxiety, hyperactivity, and delinquency: a cluster randomized controlled trial

Problematic substance use and mental health problems often co-occur in adolescents. Effective school-based interventions that are brief and target multiple problems are promising in the field of health promotion. Preventure is a brief, school-based, selective preventive intervention, tailored to four personality profiles. Preventure has already proved effective on alcohol outcomes. Previous trials also reveal effects on several mental health outcomes, yet the evidence for these outcomes is limited. This study presents the results of the Dutch Preventure Trial, on a range of mental health outcomes. In a cluster RCT, including 699 high risk students (mean age 14 years), the intervention effects on mental health problems at 2, 6, and 12 months post intervention were tested in the total high risk population and in four specific personality groups. No significant intervention effects were found on 22 from the 24 tests. A positive intervention effect on anxiety was found in the anxiety sensitivity personality group at 12-month follow-up, and a negative intervention effect on depression was found at 12-month follow-up in the negative thinking group. In post hoc growth curve analyses these effects were not found. This study found no convincing evidence for the effectiveness of Preventure in The Netherlands on mental health problems. This finding is not in line with the results of an earlier effectiveness study in the UK. This highlights the need for more research into the knowledge transfer model of interventions, to ensure that interventions are effective in a variety of circumstances.

Altered subjective reward valuation among drug-deprived heavy marijuana users: Aversion to uncertainty

Marijuana is the most commonly used illicit drug in the United States and its use is rising. Nonetheless, scientific efforts to clarify the risk for addiction and other harm associated with marijuana use have been lacking. Maladaptive decision-making is a cardinal feature of addiction that is likely to emerge in heavy users. In particular, distorted subjective reward valuation related to homeostatic or allostatic processes has been implicated for many drugs of abuse. Selective changes in responses to uncertainty have been observed in response to intoxication and deprivation from various drugs of abuse. To assess for these potential neuroadaptive changes in reward valuation associated with marijuana deprivation, we examined the subjective value of uncertain and certain rewards among deprived and nondeprived heavy marijuana users in a behavioral economics decision-making task. Deprived users displayed reduced valuation of uncertain rewards, particularly when these rewards were more objectively valuable. This uncertainty aversion increased with increasing quantity of marijuana use. These results suggest comparable decision-making vulnerability from marijuana use as other drugs of abuse, and highlights targets for intervention.

The Prospective Joint Effects of Self-Regulation and Impulsive Processes on Early Adolescence Alcohol Use

OBJECTIVE

Dual-process models propose that behavior is influenced by the interactive effect of impulsive (automatic) and self-regulatory (controlled) processes. Elaborations of this model posit that the effect of impulsive processes on alcohol use is influenced by capacity and motivation to self-regulate. The interactive effect of these three processes on drinking has not previously been tested. The goal of this study was to provide a developmental extension of this model to early adolescent alcohol use and to test the three-way interaction between impulsive processes (implicit alcohol cognition), self-regulatory capacity (inhibitory and activation control), and self-regulatory motivation (negative alcohol outcome expectancies [AOE]) in a 1-year prospective prediction of adolescent alcohol use.

METHOD

Adolescents (N = 325; 54% girls, mean age = 13.6 years at baseline) completed the Single Category Implicit Association Test and self-reports of alcohol expectancies and use. Inhibitory and activation control were based on parental report.

RESULTS

Negative AOE and inhibitory/activation control were supported as moderators of the effect of implicit alcohol cognition on 1-year prospective alcohol use. As expected, weak implicit negative alcohol cognition was associated with elevated alcohol use when both negative AOE and inhibitory control were low. Contrary to hypothesis, when activation control was high, weak implicit negative alcohol cognition was unrelated to alcohol use if negative AOE were high (p = .72) (vs. low, p <.01). Activation control may reflect the ability to plan ahead and act pro-socially.

CONCLUSIONS

Our study supports current theory suggesting alcohol use is influenced by a complex interplay of impulsive and self-regulatory processes.

Impulsive choice predicts short-term relapse in substance-dependent individuals attending an in-patient detoxification programme

BACKGROUND

Impulsivity is a hallmark characteristic of substance use disorders. Recently, studies have begun to explore whether increased impulsivity in substance-dependent individuals (SDIs) is associated with a greater propensity to relapse following treatment. Despite growing recognition of its multidimensional nature, however, most studies have treated impulsivity unilaterally. Accordingly, it remains unclear whether certain facets of impulsivity are more relevant to relapse than others. The aim of the current study was to examine the relationship between multiple facets of impulsivity and short-term relapse in SDIs. As a secondary aim, we explored the role of treatment retention in this relationship.

METHOD

A personality-based impulsivity questionnaire (UPPS) and three neurocognitive tasks of impulsivity [stop-signal task (SST), delay discounting task (DDT) and Iowa gambling task (IGT)] were administered in a heterogeneous sample of 70 SDIs shortly following their entry in an in-patient detoxification programme. Mediation analyses were performed to explore whether the effects of impulsivity on relapse were mediated by treatment retention.

RESULTS

Performance on two neurocognitive indices of impulsive choice (i.e. delay discounting and impulsive decision-making) significantly predicted short-term relapse. The effects of delay discounting and impulsive decision-making on relapse propensity were mediated by treatment retention.

CONCLUSIONS

Neurocognitive indices of impulsivity may be more sensitive to the prediction of relapse than trait-based self-report questionnaires. Post-treatment relapse in SDIs may be reduced by targeting the processes involved in impulsive choice and by improving treatment retention in SDIs with inflated impulsivity.

Implicit attitudes towards smoking predict long-term relapse in abstinent smokers

RATIONALE

It has previously been argued that implicit attitudes toward substance-related cues drive addictive behavior. Nevertheless, it remains an open question whether behavioral markers of implicit attitude activation can be used to predict long-term relapse.

OBJECTIVES

The main objective of this study was to examine the relationship between implicit attitudes toward smoking-related cues and long-term relapse in abstaining smokers.

METHODS

Implicit attitudes toward smoking-related cues were assessed by means of the Implicit Association Test (IAT) and the evaluative priming task (EPT). Both measures were completed by a group of smokers who volunteered to quit smoking (patient group) and a group of nonsmokers (control group). Participants in the patient group completed these measures twice: once prior to smoking cessation and once after smoking cessation. Relapse was assessed by means of short telephone survey, 6 months after completion of the second test session.

RESULTS

EPT scores obtained prior to smoking cessation were related to long-term relapse and correlated with self-reported nicotine dependence as well as daily cigarette consumption. In contrast, none of the behavioral outcome measures were found to correlate with the IAT scores.

CONCLUSIONS

These findings corroborate the idea that implicit attitudes toward substance-related cues are critically involved in long-term relapse. A potential explanation for the divergent findings obtained with the IAT and EPT is provided.

Neural mechanisms of high-risk decisions-to-drink in alcohol-dependent women

A hallmark of alcohol dependence (AD) is continually drinking despite the risk of negative consequences. Currently, it is not known if the pattern of disordered activation in AD is more compatible with an over-sensitive reward system, a deficit in control systems or a combination of both to produce the high risk-taking behavior observed in alcohol dependents (ADs). Here, alcohol cues were used in an ecological decisions-to-drink task that involved high- and low-risk scenarios where the chance of serious negative imagined consequences was varied. Non-alcohol cues were included as control stimuli. Functional magnetic resonance imaging (fMRI) was used to measure blood oxygen level-dependent (BOLD) signal change in 15 alcohol-dependent and 16 control women. This design allowed us to address two major questions concerning AD: first, is there a specific pattern of disordered activation that drives the heightened endorsement of high-risk decisions-to-drink in ADs? And, second, is that pattern specific to decisions-to-drink or does it generalize to other appetitive and/or neutral cues? The results showed that, during high-risk decisions-to-drink, alcohol-dependent women activated reward circuits, cognitive control circuits and regions of the default-mode network (DMN), while control women deactivated approach circuits and showed enhanced activation in regions of the DMN. Group differences were found only for decisions-to-drink, suggesting that they are specific to alcohol cues. Simultaneous activation of reward networks, cognitive control networks and the DMN in alcohol-dependent women suggests that over-endorsement of high-risk drinking decisions by alcohol-dependent women may be due to a problem with switching between different neural networks.

Applying a dual process model of self-regulation: The association between executive working memory capacity, negative urgency, and negative mood induction on pre-potent response inhibition

This study tested a dual-process model of self-control where the combination of high impulsivity (negative urgency - NU), weak reflective / control processes (low executive working memory capacity - E-WMC), and a cognitive load is associated with increased failures to inhibit pre-potent responses on a cued go/no-go task. Using a within-subjects design, a cognitive load with and without negative emotional load was implemented to consider situational factors. Results suggested that: (1) high NU was associated with low E-WMC; (2) low E-WMC significantly predicted more inhibitory control failures across tasks; and (3) there was a significant interaction of E-WMC and NU, revealing those with low E-WMC and high NU had the highest rates of inhibitory control failures on all conditions of the task. In conclusion, results suggest that while E-WMC is a strong independent predictor of inhibitory control, NU provides additional information for vulnerability to problems associated with self-regulation.

Reward sensitivity, attentional bias, and executive control in early adolescent alcohol use

This study examined whether attentional bias for alcohol stimuli was associated with alcohol use in young adolescents, and whether the frequently demonstrated relationship between reward sensitivity and adolescent alcohol use would be partly mediated by attentional bias for alcohol cues. In addition, this study investigated the potential moderating role of executive control (EC), and tested whether the relationship between alcohol-related attentional bias and alcohol use was especially present in young adolescents with weak EC. Participants were 86 adolescents (mean age=14.86), who completed a Visual Probe Task (VPT) as an index of attentional bias, a flanker-task based Attention Network Task (ANT) as an index of EC, the sensitivity of punishment and sensitivity of reward questionnaire (SPSRQ) as an index of reward sensitivity, and an alcohol use questionnaire. High reward sensitivity, high alcohol-related attentional bias, and weak EC were all related to alcohol use. The relationship between reward sensitivity and alcohol use was not mediated by alcohol-related attentional bias. As hypothesized, attentional bias was only associated with alcohol use in participants with weak EC. Together, the present findings are consistent with the view that high reward sensitivity and low EC may be considered as risk factors for adolescent alcohol use. The independent contribution of reward sensitivity and attentional bias might suggest that adolescents who are highly reward sensitive and display an attentional bias for alcohol cues are at even higher risk for excessive alcohol use and developing alcohol abuse problems. Future research using a longitudinal approach would allow an examination of these risk factors on subsequent alcohol use. Treatment implications are discussed, including the importance of strengthening EC and reducing the rewarding value of alcohol use.

Psychometrically improved, abbreviated versions of three classic measures of impulsivity and self-control

Self-reported impulsivity confers risk factor for substance abuse. However, the psychometric properties of many self-report impulsivity measures have been questioned, thereby undermining the interpretability of study findings using these measures. To better understand these measurement limitations and to suggest a path to assessing self-reported impulsivity with greater psychometric stability, we conducted a comprehensive psychometric evaluation of the Barratt Impulsiveness Scale-11 (BIS-11), the Behavioral Inhibition and Activation Scales (BIS/BAS), and the Brief Self-Control Scale (BSCS) using data from 1,449 individuals who participated in substance use research. For each measure, we evaluated (a) latent factor structure, (b) measurement invariance, (c) test-criterion relationships between the measures, and (d) test-criterion relations with drinking and smoking outcomes. Notably, we could not replicate the originally published latent structure for the BIS, BIS/BAS, or BSCS or any previously published alternative factor structure (English language). Using exploratory and confirmatory factor analysis, we identified psychometrically improved, abbreviated versions of each measure: 8-item, 2-factor BIS-11 (root-mean-square error of approximation [RMSEA] = .06, comparative fit index [CFI] = .95); 13-item, 4-factor BIS/BAS (RMSEA = .04, CFI = .96); and 7-item, 2-factor BSCS (RMSEA = .05, CFI = .96). These versions evidenced (a) stable, replicable factor structures, (b) scalar measurement invariance, ensuring our ability to make statistically interpretable comparisons across subgroups of interest (e.g., sex, race, drinking/smoking status), and (c) test-criterion relationships with each other and with drinking/smoking. This study provides strong support for using these psychometrically improved impulsivity measures, which improve data quality directly through better scale properties and indirectly through reducing response burden.

Impulsive and reflective processes related to alcohol use in young adolescents

BACKGROUND

Dual process models suggest that the development of addictive behaviors is the result of interplay between impulsive and reflective processes, modulated by boundary conditions such as individual or situational factors. Empirical support for this model has been repeatedly demonstrated in adult samples [for a meta-analysis, see Ref. (1)]. The purpose of this study was to test these processes as they relate to emerging alcohol use in adolescents. Specifically, the interactive effects of several measures of impulsive and reflective processes and working memory capacity (WMC) are examined as predictors of changes in alcohol use among adolescents. It was expected that measures of reflective processes would better predict changes in alcohol use than measures of impulsive processes. Moreover, it was anticipated that WMC would moderate the relation between alcohol-specific impulsive and reflective processes and changes in adolescent alcohol use.

METHODS

The sample consisted of 427 adolescents (47.7% male) between 12 and 16 years of age (M = 13.96, SD = 0.78) who reported drinking alcohol at least once. Four measures of impulsive processes were included. Attentional bias for alcohol was assessed with a Visual Probe Test; approach bias toward alcohol was assessed with a Stimulus Response Compatibility (SRC) Test; and memory associations with alcohol were assessed with an Implicit Association Test (IAT) and a Word Association Test. Two measures of reflective measures were included: positive and negative expectancies. WMC was measured using a Self-Ordered Pointing Task.

RESULTS

RESULTS showed that positive expectancies predicted changes in alcohol use, but this effect was qualified by an interaction with IAT scores. Moreover, SRC scores predicted changes in alcohol use only when negative expectancies were low. Attentional bias and word association scores did not predict changes in alcohol use. The relations between alcohol-specific processes or reflective processes and alcohol use were not moderated by WMC.

CONCLUSION

Although there is empirical evidence for the validity of the model in predicting heavier alcohol use in adolescents, or alcohol abuse and dependence in adults, these observations do not generalize to a sample of normative, early adolescents. More specifically, results indicated that reflective processes are more important predictors of changes in alcohol use than impulsive process during adolescence.

An information processing/associative learning account of behavioral disinhibition in externalizing psychopathology

Externalizing psychopathology (EXT) is associated with low executive working memory (EWM) capacity and problems with inhibitory control and decision-making; however, the specific cognitive processes underlying these problems are not well known. This study used a linear ballistic accumulator computational model of go/no-go associative-incentive learning conducted with and without a working memory (WM) load to investigate these cognitive processes in 510 young adults varying in EXT (lifetime problems with substance use, conduct disorder, ADHD, adult antisocial behavior). High scores on an EXT factor were associated with low EWM capacity and higher scores on a latent variable reflecting the cognitive processes underlying disinhibited decision-making (more false alarms, faster evidence accumulation rates for false alarms [vFA], and lower scores on a Response Precision Index [RPI] measure of information processing efficiency). The WM load increased disinhibited decision-making, decisional uncertainty, and response caution for all subjects. Higher EWM capacity was associated with lower scores on the latent disinhibited decision-making variable (lower false alarms, lower vFAs and RPI scores) in both WM load conditions. EWM capacity partially mediated the association between EXT and disinhibited decision-making under no-WM load, and completely mediated this association under WM load. The results underline the role that EWM has in associative-incentive go/no-go learning and indicate that common to numerous types of EXT are impairments in the cognitive processes associated with the evidence accumulation-evaluation-decision process.

Impulsivity as a vulnerability factor for poor addiction treatment outcomes: a review of neurocognitive findings among individuals with substance use disorders

With the current review, we explore the hypothesis that individual differences in neurocognitive aspects of impulsivity (i.e., cognitive and motor disinhibition, delay discounting and impulsive decision-making) among individuals with a substance use disorder are linked to unfavorable addiction treatment outcomes, including high drop-out rates and difficulties in achieving and maintaining abstinence. A systematic review of the literature was carried out using PubMed, PsycINFO and Web of Knowledge searches. Twenty-five unique empirical papers were identified and findings were considered in relation to the different impulsivity dimensions. Although conceptual/methodological heterogeneity and lack of replication are key limitations of studies in this area, findings speak for a prominent role of cognitive disinhibition, delay discounting and impulsive decision-making in the ability to successfully achieve and maintain abstinence during and following addiction treatment. In contrast, indices of motor disinhibition appear to be unrelated to abstinence levels. Whereas the relationship between impulsivity and treatment retention needs to be examined more extensively, preliminary evidence suggests that impulsive/risky decision-making is unrelated to premature treatment drop-out among individuals with a substance use disorder. The reviewed findings are discussed in terms of their clinical implications.

Dysfunctions of decision-making and cognitive control as transdiagnostic mechanisms of mental disorders: advances, gaps, and needs in current research

Disadvantageous decision-making and impaired volitional control over actions, thoughts, and emotions are characteristics of a wide range of mental disorders such as addiction, eating disorders, depression, and anxiety disorders and may reflect transdiagnostic core mechanisms and possibly vulnerability factors. Elucidating the underlying neurocognitive mechanisms is a precondition for moving from symptom-based to mechanism-based disorder classifications and ultimately mechanism-targeted interventions. However, despite substantial advances in basic research on decision-making and cognitive control, there are still profound gaps in our current understanding of dysfunctions of these processes in mental disorders. Central unresolved questions are: (i) to which degree such dysfunctions reflect transdiagnostic mechanisms or disorder-specific patterns of impairment; (ii) how phenotypical features of mental disorders relate to dysfunctional control parameter settings and aberrant interactions between large-scale brain systems involved in habit and reward-based learning, performance monitoring, emotion regulation, and cognitive control; (iii) whether cognitive control impairments are consequences or antecedent vulnerability factors of mental disorders; (iv) whether they reflect generalized competence impairments or context-specific performance failures; (v) whether not only impaired but also chronic over-control contributes to mental disorders. In the light of these gaps, needs for future research are: (i) an increased focus on basic cognitive-affective mechanisms underlying decision and control dysfunctions across disorders; (ii) longitudinal-prospective studies systematically incorporating theory-driven behavioural tasks and neuroimaging protocols to assess decision-making and control dysfunctions and aberrant interactions between underlying large-scale brain systems; (iii) use of latent-variable models of cognitive control rather than single tasks; (iv) increased focus on the interplay of implicit and explicit cognitive-affective processes; (v) stronger focus on computational models specifying neurocognitive mechanisms underlying phenotypical expressions of mental disorders.

A triadic neurocognitive approach to addiction for clinical interventions

According to the triadic neurocognitive model of addiction to drugs (e.g., cocaine) and non-drugs (e.g., gambling), weakened "willpower" associated with these behaviors is the product of an abnormal functioning in one or more of three key neural and cognitive systems: (1) an amygdala-striatum dependent system mediating automatic, habitual, and salient behaviors; (2) a prefrontal cortex dependent system important for self-regulation and forecasting the future consequences of a behavior; and (3) an insula dependent system for the reception of interoceptive signals and their translation into feeling states (such as urge and craving), which in turn plays a strong influential role in decision-making and impulse control processes related to uncertainty, risk, and reward. The described three-systems account for poor decision-making (i.e., prioritizing short-term consequences of a decisional option) and stimulus-driven actions, thus leading to a more elevated risk for relapse. Finally, this article elaborates on the need for "personalized" clinical model-based interventions targeting interactions between implicit processes, interoceptive signaling, and supervisory function aimed at helping individuals become less governed by immediate situations and automatic pre-potent responses, and more influenced by systems involved in the pursuit of future valued goals.

Coping with complexity: Developmental systems and multilevel analyses in developmental psychopathology

Developmental psychopathology is not characterized by adherence to one specific theory but instead serves as an organizational framework in which research is driven by a number of key assumptions. In the developmental psychopathology approach, two primary assumptions emphasize the importance of systems thinking and the utility of multilevel analyses. As will be illustrated here, these emphases are inextricably linked: a systems approach necessitates a multilevel approach, such that a level of organization must bring coherence to a level of mechanisms. Given this assumption, coming to an integrative understanding of the relation between levels is of central importance. One broad framework for this endeavor is relational developmental systems, which has been proposed by certain theorists as a new paradigm for developmental science. The implications of embracing this framework include the potential to connect developmental psychopathology with other approaches that emphasize systems thinking and that take an integrative perspective on the problem of levels of analysis.

Effects of working memory load, a history of conduct disorder, and sex on decision making in substance dependent individuals

BACKGROUND

Substance dependence and antisocial psychopathology, such as a history of childhood conduct disorder (HCCD), are associated with impulsive or disadvantageous decision making and reduced working memory capacity (WMC). Reducing WMC via a working memory load increases disadvantageous decision making in healthy adults, but no previous studies have examined this effect in young adults with substance dependence and HCCD.

METHOD

Young adults with substance dependence (SubDep; n=158, 71 female), substance dependence and HCCD (SubDep+HCCD; n=72, 24 female), and control participants (n=152, 84 female) completed a test of decision making (the Iowa Gambling Task; IGT) with or without a concurrent working memory load intended to tax WMC. Outcomes were (i) net advantageous decisions on the IGT, and (ii) preferences for infrequent- versus frequent-punishment decks.

RESULTS

SubDep+HCCD men made fewer advantageous decisions on the IGT than control men without a load, but there were no group differences among women in that condition. Load was associated with fewer advantageous decisions for SubDep+HCCD women and control men, but not for men or women in the other groups. Participants showed greater preference for infrequent-punishment, advantageous decks under load as well.

CONCLUSIONS

There are gender differences in the effects of substance dependence, HCCD, and working memory load on decision making on the IGT. Decision making by control men and SubDep+HCCD women suffered the most under load. Load increases preferences for less-frequent punishments, similar to a delay discounting effect. Future research should clarify the cognitive and neural mechanisms underlying these effects.