The dopamine D2 receptor mediates approach-avoidance tendencies in smokers

Dopamine D2 receptors (DRD2) have been strongly implicated in reward processing of natural stimuli and drugs. By using the Approach-Avoidance Task (AAT), we recently demonstrated that smokers show an increased approach bias toward smoking-related cues but not toward naturally-rewarding stimuli. Here we examined the contribution of the DRD2 Taq1B polymorphism to smokers’ and non-smokers’ responsivity toward smoking versus naturally-rewarding stimuli in the AAT. Smokers carrying the minor B1 allele of the DRD2 Taq1B polymorphism showed reduced approach behavior for food-related pictures compared to non-smokers with the same allele. In the group of smokers, a higher approach-bias toward smoking-related compared to food-related pictures was found in carriers of the B1 allele. This pattern was not evident in smokers homozygous for the B2 allele. Additionally, smokers with the B1 allele reported fewer attempts to quit smoking relative to smokers homozygous for the B2 allele. This is the first study demonstrating that behavioral shifts in response to smoking relative to natural rewards in smokers are mediated by the DRD2 Taq1B polymorphism. Our results indicate a reduced natural-reward brain reactivity in smokers with a genetically determined decrease in dopaminergic activity (i.e., reduction of DRD2 availability). It remains to be determined whether this pattern might be related to a different outcome after psychological cessation interventions, i.e. AAT modification paradigms, in smokers

Automatic action tendencies in smokers

Diese Dissertation untersuchte, ob (a) Raucher eine verzerrte automatische Annäherung an Rauch- versus natürlich verstärkende Reize zeigen, (b) ob verzerrtes Annäherungsverhalten durch Varianten des Dopamin D2 Rezeptorgens (DRD2) moduliert werden und (c) ob eine Annäherungsverzerrung für Rauchreize durch ein Training modifizierbar ist. Studie 1 zeigte eine spezifische Annäherungsverzerrung für Rauchreize bei Rauchern. Nichtraucher zeigten jedoch auch eine ähnliche (wenngleich geringere) Annäherung zu Rauchreizen. Ergebnisse der zweiten Studie deuteten darauf hin, dass Raucher mit dem B1 Allel des DRD2 Taq1B Polymorphismus eine verminderte automatische Annäherung an natürlich verstärkende Reize ausweisen. Studie 3 zeigte, dass ein Nikotinvermeidungstraining eine automatische Annäherungsverzerrung für Rauchreize nicht reduzieren konnte. In der 3-monats Katamnese konnte das Nikotinvermeidungstraining jedoch den Nikotinkonsum stärker reduzieren als ein Placebotraining.This dissertation sought to unravel (a) whether smokers display biased automatic approach behavior in response to smoking versus naturally rewarding cues, (b) whether biased approach behavior is modulated by variants of the DRD2 gene, and (c) whether a smoking-related approach bias is malleable through training. $\textit {Study 1}$ revealed a specific approach bias for smoking cues in smokers. However, non-smokers also exhibited a similar (albeit smaller) approach bias for smoking stimuli. $\textit {Study 2}$ showed that smokers with the B1 allele of the DRD2 Taq1B polymorphism displayed less approach for food pictures as compared to smoking pictures and as compared to their non-smoking counterparts, suggesting an attenuated response to naturally rewarding stimuli. $\textit {Study 3}$ revealed that a nicotine avoidance training was not feasible to reduce an approach bias for smoking cues. However, nicotine avoidance training was superior to sham training in reducing nicotine consumption at a thee-month follow-up

Der Einsatz von Virtueller Realität in der Psychotherapeutischen Praxis: Aktueller Forschungsstand, Chancen, Risiken und Herausforderungen

<jats:title>Zusammenfassung</jats:title><jats:p>In den letzten Jahren sind durch die Fortschritte der Digitalisierung neue psychotherapeutische Behandlungsmöglichkeiten und Unterstützungsangebote entstanden. Während sich bestimmte Innovationen wie die Videotherapie im letzten Jahr stark verbreitet haben, sind andere Formate wie z. B. Psychotherapieanwendungen in der Virtuellen Realität (VR) zwar sehr gut wissenschaftlich untersucht, aber dennoch kaum in die (tägliche) Praxis implementiert worden.</jats:p><jats:p>Der folgende Artikel gibt einen Überblick über den aktuellen Forschungsstand zum Einsatz von VR im Kontext Psychotherapie. Hierbei wird auf zwei wichtige (kognitiv-verhaltenstherapeutische) Interventionsmethoden fokussiert, bei denen VR oft eingesetzt und untersucht wurde: (1) Behaviorale Exposition bei Angsterkrankungen und (2) Modifikation von Informationsverarbeitungsprozessen (Cognitive Bias Modification, CBM). Es werden aktuelle Studien zur Wirksamkeit sowie weitere aktuelle Ergebnisse zur Nutzung und dem Einsatz diskutiert. Weiterhin beschreibt der Artikel die grundsätzliche Nutzung der Virtuellen Realität und definiert wichtige Begriffe und Anwendungen.</jats:p&gt

Nicotine-related interpretation biases in cigarette smoking individuals

Abstract Addictive behaviors are characterized by information processing biases, including substance-related interpretation biases. In the field of cigarette smoking, such biases have not been investigated yet. The present study thus adopted an open-ended scenario approach to measure smoking-related interpretation biases. Individuals who smoke, those who ceased smoking, and those without a smoking history (total sample N = 177) were instructed to generate spontaneous continuations for ambiguous, open-ended scenarios that described either a smoking-related or neutral context. Overall, people who smoke generated more smoking-related continuations in response to smoking-relevant situations than non-smoking individuals or people who had stopped smoking, providing evidence for a smoking-related interpretation bias. When differentiating for situation type within smoking-relevant scenarios, smoking individuals produced more smoking-related continuations for positive/social and habit/addictive situations compared to negative/affective ones. Additionally, the tendency to interpret habit/addictive situations in a smoking-related manner was positively associated with cigarette consumption and levels of nicotine dependence. Exploratory analyses indicated that other substance-related continuations were correlated with their respective behavioral counterparts (e.g., the level of self-reported alcohol or caffeine consumption). The present study is the first to demonstrate smoking-related interpretation biases in relation to current cigarette smoking. Future studies should investigate the causal role of such biases in the initiation and/or maintainance of nicotine addiction and the merit of Interpretation-Bias-Modification training to support smoking cessation

Self-guided digital treatment with virtual reality for panic disorder and agoraphobia

Finanziert im Rahmen der DEAL-Verträge durch die Universitätsbibliothek SiegenBackground Cognitive behavioral therapy is the first-line treatment for patients with panic disorder (PD) and agoraphobia (AG). Yet, many patients remain untreated due to limited treatment resources. Digital self-guided short-term treatment applications may help to overcome this issue. While some therapeutic applications are already supported by health insurance companies, data on their efficacy is limited. The current study investigates the effect of self-guided digital treatment comprising psychoeducation and virtual reality exposure therapy (VRET). Methods Thirty patients diagnosed with PD, AG, or panic disorder with agoraphobia (PDA) will be randomly assigned to either the experimental group (EG) or the control group (CG). Participants of both groups will undergo baseline diagnostics in the first two sessions. The subsequent treatment for the EG consists of a self-guided 6-week phase of application-based psychoeducation, one therapy session preparing for the VRET, and 4 weeks of application-based self-guided VRET. To control for the potential effects of the therapy session with the therapist, the CG will receive relaxation and stress-reduction training instead. All patients will then undergo a closing session which terminates with the post-assessment (~ 10 weeks after baseline assessment) and a follow-up assessment 6 weeks following the closing session. Symptom severity (primary outcome) will be assessed at baseline, interim, post-treatment, and follow-up. Additionally, remission status (secondary outcome) will be obtained at follow-up. Both measures will be compared between the groups. Discussion The current study aims at providing insights into the efficacy of short-term treatment applications including psychoeducation and self-guided VRET. If successful, this approach might be a feasible and promising way to ease the burden of PD, AG, and PDA on the public health system and contribute to a faster access to treatment

Self-guided virtual reality therapy for social anxiety disorder

Finanziert im Rahmen der DEAL-Verträge durch die Universitätsbibliothek SiegenBackground Social anxiety disorder (SAD) is a highly prevalent mental disorder associated with enormous stress and suffering. Cognitive behavior therapy (CBT) is the first-line treatment for SAD, yet its accessibility is often constrained with long waiting times. Digital therapeutic applications, including psychoeducation and self-guided behavioral experiments in virtual reality (VR), could facilitate access and reduce waiting times. The study aims to investigate if ultra-short-time therapy involving self-guided digital therapeutic applications with VR components can reduce the severity of SAD. Methods Forty SAD patients will participate in this randomized controlled trial. Half will get access to a self-guided, digital therapeutic application with exposure-based behavioral experiments in VR, while the other half will receive a control treatment. Both treatments include four therapeutic appointments. Changes in the severity of SAD will be measured after each appointment and on a 6-week follow-up assessment and will be compared between groups, with the change in SAD measured at baseline- and post-assessment as primary outcome. Discussion Self-guided digital therapeutic applications including ultra-short-time therapy combined with VR could help reduce the waiting time for patients and relieve the health system. The results of this study may inform psychotherapists regarding the potential of self-guided digital therapeutic applications including exposure-based behavioral experiments in VR for SAD and will provide important insight for future research on VR therapy

Mean sample characteristics and performance in the AAT.

<p><i>Note</i>. N = number of participants; FTND-Score = Score in Fagerström Test for Nicotine Dependence; standard deviations are given in parentheses; variables were analyzed with one-way-ANONA, (<i>F</i>1,137); all p values are two-tailed.</p><p>Mean sample characteristics and performance in the AAT.</p

Mean AAT-bias scores for nicotine-related images, images of toothbrushes, food images and neutral images, in smokers and non-smokers.

<p>A positive score indicates an approach tendency, a negative an avoidance tendency. Error bars correspond +/− 1 standard error. *p < .05; **p < .01; ***p < .001.</p

Mean AAT-bias-scores for smokers and non-smokers per image type.

<p><i>Note</i>. M = mean; SD = standard deviation; SE = standard error; a positive AAT-score indicates an approach bias, a negative AAT-score an avoidance bias.</p><p>Mean AAT-bias-scores for smokers and non-smokers per image type.</p

Schematic demonstration of the trials used in the AAT for nicotine-related pictures.

<p>Pulling the joystick increases the picture size, while pushing the joystick decreases the picture size.</p