Addiction: Brain and Cognitive Stimulation for Better Cognitive Control and Far Beyond

Addiction behaviors are characterized by conditioned responses responsible for craving and automatic actions as well as disturbances within the supervisory network, one of the key elements of which is the inhibition of prepotent response. Interventions such as brain stimulation and cognitive training targeting this imbalanced system can potentially be a positive adjunct to treatment as usual. The relevance of several invasive and noninvasive brain stimulation techniques in the context of addiction as well as several cognitive training protocols is reviewed. By reducing cue-induced craving and modifying the pattern of action, memory associations, and attention biases, these interventions produced significant but still limited clinical effects. A new refined definition of response inhibition, including automatic inhibition of response and a more consistent approach to cue exposure capitalizing on the phase of reconsolidation of pre-activated emotional memories, all associated with brain and cognitive stimulation, opens new avenues for clinical research

Neurological soft signs in obsessive-compulsive disorder: two empirical studies and meta-analysis

Neurological soft signs (NSS) have been inconsistently reported in obsessive-compulsive disorder (OCD) but may make an impact on treatment response. Method: The current study examined the presence of NSS in two independent European samples of OCD patients (combined 85 patients and 88 matched healthy controls) using a standardized instrument and conducted a meta-analysis of all published studies identified in the literature with the aim to provide a more definitive answer to the question of whether OCD patients are characterized by increased NSS. Results Both empirical studies found elevated NSS scores in patients compared with matched controls. The results of the meta-analysis, which included 15 studies (combined 498 patients and 520 controls) showed large effect sizes (Hedges' g=1.27, 95% confidence interval 0.80-1.75), indicating that OCD patients have significantly higher rates of NSS than matched controls on both sides of the body and in multiple domains (motor coordination, sensory integration and primitive reflexes). The results were robust and remained largely unchanged in our reliability analyses, which controlled for possible outliers. Meta-regression was employed to examine the role of potential variables of interest including sociodemographic variables, symptom severity, medication effects and the use of different instruments, but none of these variables was clearly associated with NSS. Conclusions: As a group, OCD patients are characterized by increased rates of NSS, compared with healthy controls. However, their origins and potential clinical importance remain to be clarified. Future directions for research are discussed

Effects of evaluative conditioning on implicit evaluation of alcohol and drinking behaviors: A direct replication

Background. Recent research suggests that evaluative conditioning can change implicit evaluation of alcohol and reduce drinking behaviors among college students (Houben, Havermans et al., 2010). This study has been conceptually replicated in two previous studies. To date, however, there is no direct and independent replication of the original study. In this paper, we report a high-powered direct replication of Houben, Havermans et al.’s (2010) study. Method. One hundred and sixty-eight French college students took part in this preregistered study. Drinking behavior was assessed before the intervention and two weeks after. The intervention consisted of 120 trials of words related to alcoholic beverages or to soft drink, paired with neutral, positive, or negative pictures. The two conditions were factually equivalent and only differed by the contingency between alcohol-related words and negative pictures. In the evaluative conditioning condition, but not in the control condition, alcohol-related words were systematically paired with negative pictures. Results. Evaluative conditioning did not change implicit evaluation of alcohol and drinking behaviors. However, evaluative conditioning reduced drinking behaviors specifically among hazardous drinkers. Conclusion. This high-powered pre-registered direct replication of Houben, Havermans et al. (2010) suggests that the original effects are more fragile than initially thought. The effect of evaluative conditioning on drinking behaviors may be restricted to heavy drinkers, and we found no evidence that this effect is mediated by a change in implicit attitudes. Further studies are needed to test the original effects in clinical populations

Preliminary Evidence That the Short Allele of 5-HTTLPR Moderates the Association of Psychiatric Symptom Severity on Suicide Attempt: The Example in Obsessive-Compulsive Disorder

Background The severity of symptoms represents an important source of distress in patients with a psychiatric disease. However, the extent to which this endogenous stress factor interacts with genetic vulnerability factors for predicting suicide risks remains unclear. Methods We evaluated whether the severity of symptoms interacts with a genetic vulnerability factor (the serotonin transporter gene-linked promoter region variation) in predicting the frequency of lifetime suicide attempts in patients with a psychiatric disease. Symptom severity and 5-HTTLPR polymorphism were collected from a sample of 95 patients with obsessive-compulsive disorder (OCD). Lifetime suicide attempt was the primary outcome, and antecedent of multiple suicide attempts was the secondary outcome. Results The gene-by-symptoms interaction was associated with an excess risk of suicide attempts (OR = 4.39, 95CI[1.44, 13.38], p < 0.009) and of multiple suicide attempts (OR = 4.18, 95CI[1.04, 16.77], p = 0.043). Symptom severity (moderate, severe, or extreme) was associated with an approximately five-fold increase in the odds of a lifetime suicide attempt in patients carrying one or two copies of the short allele of 5-HTTLPR. No such relationship was found for patients carrying the long allele. Conclusion This study provides preliminary evidence for the gene-by-stress interaction on suicide attempt when stress is operationalized as symptom severity. Progress in suicide research may come from efforts to investigate the gene-by-symptoms interaction hypothesis in a variety of diseases

Preprint

Research suggests that implicit identification with death/suicide can accurately predict suicide attempt several months in advance (Nock et al., 2010). We report here the first direct and independent replication of this promising finding. Participants were 165 patients seeking treatment at an emergency psychiatric department of a hospital in France. At baseline, patients completed the Suicide-Implicit Association Test (S-IAT), a semi-structured interview, and a self-report measure of suicide ideation. Six months later, we contacted patients by phone and examined their hospital medical records to determine if they made a new suicide attempt. Results showed that the S-IAT did not discriminate patients who presented for suicide attempts (vs. other reasons). As in the original study, however, the S-IAT predicted suicide attempts within the 6-month follow-up period over and beyond well-known predictors. The test correctly classified 85% of patients, confirming its diagnostic value for identifying who will make a future suicide attempt

Suicidal Ideation in Elite Schools: A Test of the Interpersonal Theory and the Escape Theory of Suicide

International audienceObjective: The present study compared the ability of two contemporary theories of suicidal behavior—the interpersonal and escape theories of suicide—to predict suicidal ideation. The interpersonal theory proposes that the interaction of perceived burdensomeness and thwarted belongingness predicts suicidal ideation. The escape theory proposes that feelings of failure predict suicidal ideation and that escape motivation mediates this relationship. The present study intended to determine which of the two theories more successfully explains suicidal ideation. Method: A sample of 306 students from elite schools in Morocco (193 women, Mage = 21.21 years, predominantly Muslims) completed a questionnaire assessing feelings of failure and escape motivation, perceived burdensomeness and thwarted belongingness, suicide ideation, and control variables. Results: In line with previous research, separate tests revealed support for the two theories. Interestingly, when entered simultaneously in a multiple regression analysis, the two frameworks explained a unique and cumulative part of the variance in suicidal ideation. Moreover, the effects remained significant after controlling for past suicide attempts, depression, hopelessness, and stress. Conclusions: The findings suggest that combining the interpersonal and escape theories of suicide could help better explain the emergence of suicidal ideation among college students

Treating refractory obsessive–compulsive disorder with transcranial direct current stimulation: An open label study

International audienc

Validity of the Good Practice Guidelines: The example of type 2 diabetes

International audienc

Mummy, Daddy, and Addiction: Implicit Insecure Attachment is Associated with Substance Use in College Students

Indirect measures of cognition have become an important tool in research on addiction. To date, however, no research has examined whether indirect measures of parent attachment relate to substance use. To examine this issue, a sample of college students (N = 121) was asked to complete two measures of explicit attachment (the Relationship Questionnaire; Bartholomew & Horowitz, 1991, and the Adult Attachment Styles; Collins & Read, 1990), and a measure of implicit attachment (the Single Category Implicit Association Test, Karpinski & Steinman, 2006). The indirect attachment measure assessed the strength of automatic mental association between the concepts parents and secure. Participants also completed different measures of tobacco, cannabis, and alcohol use. Results showed that, for most of the participants, the parents were considered a source of security at both the explicit and implicit levels. Direct and indirect attachment measures were not related to each other. Overall, explicit attachment was not related to substance use. However, implicit attachment was significantly associated with the use of licit (tobacco) and illicit (cannabis) drugs. We also found some evidence that polydrug use is especially common among students with an insecure implicit attachment. This is the first study to examine how implicit attachment processes relate to addictive behaviors. The results suggest that implicit attachment, thought to reflect unconscious traces of past experiences, is a better predictor of substance use in college students than direct, self-reported measures of attachment. Further studies should examine whether implicit attachment is associated with severe substance use disorders in clinical populations