The effects of prolonged abstinence on the processing of smoking cues: an ERP study among smokers, ex-smokers and never-smokers

Abstract Processing bias is an important feature of substance abuse. The issue whether processing bias is a more or less permanent feature of nicotine addiction remains to be resolved. The present study addresses the role of smoking status on smoking-related processing bias. We employed Event-Related Brain Potentials (ERPs) as measure of processing bias to investigate this issue. Further, self-report measures of nicotine craving and pleasantness ratings of smoking stimuli were obtained. Three groups, smokers, ex-smokers and never-smokers, were compared on their electrophysiological brain response to smoking-related and neutral pictures. The present study shows that both the P300 and SPW amplitudes in response to smoking-related pictures are significantly more enhanced for smokers than for ex-smokers and never-smokers at frontal and central sites, whereas the magnitude of the P300 and SPW amplitudes in response to neutral pictures does not differ between the three groups. Accordingly, it can be concluded that smokers show more bias for smoking-related pictures than ex-smokers and smokers. Because there is no significant difference between the P300 and SPW amplitudes of ex-smokers and never-smokers, it can also be concluded that ex-smokers display the same (low) level of processing bias as never-smokers. In addition, nicotine-craving ratings and pleasantness ratings of smoking stimuli were higher in smokers compared to ex-smokers. It can be concluded that the smoking-related craving, pleasantness rating, and processing bias decreases after a period of prolonged abstinence

Intentional modulation of the late positive potential in response to smoking cues by cognitive strategies in smokers

Attentional bias is considered an important concept in addiction since it has been found to correlate with subjective craving and is strongly associated with relapse after periods of abstinence. Hence, investigating in ways to regulate attention for drug cues would be of major clinical relevance. The present study examined deliberate, cognitive modulation of motivated attention for smoking cues in smokers. The effects of three different reappraisal strategies on an electrophysiological measure of attentive processing were investigated. Early and late LPP components in response to passively viewed neutral and smoking pictures were compared with LPPs in response to smoking pictures that were reappraised with three different reappraisal strategies. Results show that when smokers actively imagine how pleasant it would be to smoke (pleasant condition), their early LPP in response to smoking cues increases, but when smokers actively focus on an alternative stimulus (distraction condition) or think of a rational, uninvolved interpretation of the situation (rational condition), smoking-related late LPP amplitude decreases to the processing level of neutral stimuli. Present results are the first to indicate that smoking cue-elicited LPP amplitudes can be modulated by cognitive strategies, suggesting that attentive processing of smoking cues can be intentionally regulated by smokers with various levels of dependence. Although cognitive strategies can lead to enhanced processing of smoking cues, it is not completely clear whether cognitive strategies are also successful in reducing smoking-related motivated attention. Although findings do point in this direction, present study is best considered preliminary and a starting point for other research on this topic. A focus on the distraction strategy is proposed, as there are indications that this strategy is more successful than the rational strategy in decreasing LPP amplitude

Psychometric properties of the brief Questionnaire on Smoking Urges (QSU-Brief) in a Dutch smoker population

Abstract We investigated the reliability, validity, and factor structure of the 10-item Questionnaire on Smoking Urges (QSU-Brief) in a Dutch smokers sample (N = 208). The questionnaire displayed good internal consistency (Cronbach’s alphas > 0.83), and scores were strongly correlated with three other rating scales for measuring craving, urge, and desire for cigarettes, and moderately linked to questionnaires that tap related constructs, such as cigarette dependence. As in previous research, a two factor structure was revealed. The first factor was best described by ‘the relief from nicotine withdrawal or negative affect with an urgent and overwhelming desire to smoke’, and appeared to be associated with negative affect, but not with positive affect. The second factor reflected ‘the desire and intention to smoke’, and was neither associated with positive nor negative affect. The factor structure, however, slightly deviates from the original, English version of the QSU-Brief, which might be explained by language differences. Overall, the Dutch translation of the QSU-Brief offers a reliable, valid, and multidimensional assessment of cigarette craving and appears suitable for use in a general population of young, Dutch adults

Changes in the electroencephalographic spectrum in response to smoking cues in smokers and ex-smokers

Aims: To investigate the changes in the electroencephalographic (EEG) spectrum in smokers during exposure to a neutral and a smoking-related cue to determine whether these EEG changes are still present in ex-smokers after prolonged abstinence and to examine the relationship between the power in each spectral bandwidth and subjective craving. Methods: EEG frequencies in response to a smoking-related and a neutral cue were examined in 23 smokers and 21 ex-smokers, who quit smoking for 1.4 years on average. Additionally, self-report measures of cigarette craving and nicotine dependence were obtained. The spectral power of each bandwidth was computed, log-transformed, and analyzed using a within-subject design. Differences between EEG activity under neutral and smoking conditions were correlated with differences between pre- and postexperimental subjective craving. Results: Increases in reward craving (desire and intention to smoke) were associated with reduced theta activity, whereas increases in withdrawal craving (reduction of negative affect and withdrawal symptoms) were correlated with increases in both delta and higher alpha power. Furthermore, in smokers, but not in ex-smokers, a significant beta power increase was observed between the neutral condition and the smoking condition. Conclusion: Since the beta band is associated with arousal, attention, and alertness, it is suggested that the beta increase in response to the smoking cue might reflect an enhanced allocation of resources to smoking-related stimuli, i.e. a processing bias, which is an important feature of substance abuse. Since ex-smokers do not respond to the smoking cue with beta activity enhancement, we preliminarily conclude that smoking cues do not arouse ex-smokers or capture their attention as much as they do in smokers

Окрема думка судді в кримінальному процесі

З’ясовується змістове наповнення правових засад, на підставі яких суддя може викласти окрему думку. Досліджується поняття «окремої думки судді» в різних країнах та правових системах. Висвітлюється механізм реалізації окремої думки судді в порівнянні з правом зарубіжних держав та вносить пропозиції щодо запозичення та ведення аналогічних механізмів реалізації окремої думки судді в Україні.Раскрывается содержание правовых принципов, на основании которых судья может изложить особое мнение. Исследуется понятие «особого мнения судьи » в разных странах и правовых системах. Освещается механизм реализации особого мнения судьи в сравнении с правом зарубежных государств и вносит предложение относительно заимствования и ведения аналогичных механизмов реализации особого мнения судьи в Украине.This article investigated the legal principles on which the judge may express the separate opinion; the existence of the notion of «the separate opinion of judge» in different countries and legal systems is conducted. The author analyzed the mechanism of realization of the separate opinion of judge in comparison with the law of foreign countries and made proposals for borrowing and introduction of the similar mechanisms for realization the dissenting the separate opinion of judge in Ukraine

Barriers and facilitators for shared decision making in older patients with multiple chronic conditions: A systematic review

Background The aim of this study was to describe barriers and facilitators for shared decision making (SDM) as experienced by older patients with multiple chronic conditions (MCCs), informal caregivers and health professionals. Methods A structured literature search was conducted with 5 databases. Two reviewers independently assessed studies for eligibility and performed a quality assessment. The results from the included studies were summarized using a predefined taxonomy. Results Our search yielded 3838 articles. Twenty-eight studies, listing 149 perceived barriers and 67 perceived facilitators for SDM, were included. Due to poor health and cognitive and/or physical impairments, older patients with MCCs participate less in SDM. Poor interpersonal skills of health professionals are perceived as hampering SDM, as do organizational barriers, such as pressure for time and high turnover of patients. However, among older patients with MCCs, SDM could be facilitated when patients share information about personal values, priorities and preferences, as well as information about quality of life and functional status. Informal caregivers may facilitate SDM by assisting patients with decision support, although informal caregivers can also complicate the SDM process, for example, when they have different views on treatment or the patient’s capability to be involved. Coordination of care when multiple health professionals are involved is perceived as important. Conclusions Although poor health is perceived as a barrier to participate in SDM, the personal experience of living with MCCs is considered valuable input in SDM. An explicit invitation to participate in SDM is important to older adults. Health professionals need a supporting organizational context and good communication skills to devise an individualized approach for patient care

Speed Matters: Relationship between Speed of Eye Movements and Modification of Aversive Autobiographical Memories

Eye movement desensitization and reprocessing (EMDR) is an efficacious treatment for post-traumatic stress disorder. In EMDR, patients recall a distressing memory and simultaneously make eye movements (EM). Both tasks are considered to require limited working memory (WM) resources. Because this leaves fewer resources available for memory retrieval, the memory should become less vivid and less emotional during future recall. In EMDR analogue studies, a standardized procedure has been used, in which participants receive the same dual task manipulation of 1 EM cycle per second (1 Hz). From a WM perspective, the WM taxation of the dual task might be titrated to the WM taxation of the memory image. We hypothesized that highly vivid images are more affected by high WM taxation and less vivid images are more affected by low WM taxation. In study 1, 34 participants performed a reaction time task, and rated image vividness, and difficulty of retrieving an image, during five speeds of EM and no EM. Both a high WM taxing frequency (fast EM; 1.2 Hz) and a low WM taxing frequency (slow EM; 0.8 Hz) were selected. In study 2, 72 participants recalled three highly vivid aversive autobiographical memory images (n = 36) or three less vivid images (n = 36) under each of three conditions: recall + fast EM, recall + slow EM, or recall only. Multi-level modeling revealed a consistent pattern for all outcome measures: recall + fast EM led to less emotional, less vivid and more difficult to retrieve images than recall + slow EM and recall only, and the effects of recall + slow EM felt consistently in between the effects of recall + fast EM and recall only, but only differed significantly from recall + fast EM. Crucially, image vividness did not interact with condition on the decrease of emotionality over time, which was inconsistent with the prediction. Implications for understanding the mechanisms of action in memory modification and directions for future research are discussed