Behavioral phenotypes of impulsivity related to the ANKK1 gene are independent of an acute stressor

<p>Abstract</p> <p>Background</p> <p>The A1 allele of the <it>ANKK1 Taq</it>IA polymorphism (previously reported as located in the D2 dopamine receptor (DRD2) gene) is associated with reduced DRD2 density in the striatum and with clinical disorders, particularly addiction. It was hypothesized that impulsivity represents an endophenotype underlying these associations with the <it>Taq</it>IA and that environmental stress would moderate the strength of the gene-behavior relationship.</p> <p>Methods</p> <p><it>Taq</it>IA genotyping was conducted on 72 healthy young adults who were randomly allocated to either an acute psychosocial stress or relaxation induction condition. Behavioral phenotypes of impulsivity were measured using a card-sorting index of reinforcement sensitivity and computerized response inhibition and delay discounting tasks.</p> <p>Results</p> <p>Separate analyses of variance revealed associations between the A1 allele and two laboratory measures of impulsivity. The presence of the <it>Taq</it>IA allele (A1+) was associated with slower card-sorting in the presence of small financial reinforcers, but was overcome in a second administration after either a five-minute rest or psychosocial stress induction. A1+ participants also demonstrated significantly poorer response inhibition and faster response times on a computerized stop inhibition task, independent of acute stress exposure.</p> <p>Conclusion</p> <p>These findings indicate the A1 allele is associated with an endophenotype comprising both a "rash impulsive" behavioral style and reinforcement-related learning deficits. These effects are independent of stress.</p

Development and validation of the Cannabis Refusal Self-Efficacy Questionnaire (CRSEQ) in adult cannabis users in treatment

Background: There are few valid clinical assessment instruments for cannabis. Self-efficacy, or the ability of users to resist temptation, is a central feature of social cognitive theory. This study outlines the development and validation of the Cannabis Refusal Self-Efficacy Questionnaire (CRSEQ), which measures the situational confidence to refuse cannabis

Craving mediates the effect of impulsivity on lapse-risk during alcohol use disorder treatment

Rash impulsiveness, the propensity for approach behaviour despite potential negative consequences, is associated with stronger alcohol craving in patients with Alcohol Use Disorder (AUD). This relationship is poorly understood and implications for treatment response are unexamined. This study explored the relationship between rash impulsiveness, craving, and treatment response among 304 outpatients enrolled in a 12-week abstinence-based Cognitive-Behavioural Therapy (CBT) program for AUD. Assessments were completed pre-and-post treatment, with craving and alcohol consumption monitored at each treatment session. Higher rash impulsiveness predicted more frequent craving over treatment (b = 0.95, 95% CI = 0.40, 1.50). Higher craving was associated with greater lapse-risk (b = 0.04, 95% CI = 0.03, 0.05), with the association between craving and lapse-risk increasing as treatment progressed (b = 0.01, 95% CI = 0.01, 0.02). Craving positively mediated the relationship between rash impulsiveness and lapse-risk (µ = 0.38, 95% CI = 0.10, 0.70). Contrary to hypotheses, the risk of lapse in response to craving was not moderated by rash-impulsiveness. These results suggest that AUD patients with a predisposition for rash impulsiveness are more vulnerable to alcohol craving, and subsequently, poorer treatment outcomes

Social cognitive predictors of treatment outcome in cannabis dependence

Background Drug-related outcomes expectancies and refusal self-efficacy are core components of Social Cognitive Theory. Both predict treatment outcome in alcohol use disorders. Few studies have reported expectancies and refusal self-efficacy in cannabis dependence. None have examined both, although both constructs are key targets in Cognitive-Behavioural Therapy (CBT). This study tests the predictive role of expectancies and refusal self-efficacy in treatment outcome for cannabis dependence. Design Outpatients completed a comprehensive assessment when commencing cannabis treatment and predictors of treatment outcome were tested. Setting A university hospital alcohol and drug outpatient clinic. Participants 221 cannabis-dependent patients participated in a 6-week CBT program where the goal was abstinence. Measurements Cannabis Expectancy Questionnaire and Cannabis Refusal Self-Efficacy Questionnaire, cannabis dependence severity [Severity of Dependence Scale], psychological distress [General Health Questionnaire] at baseline; the timeline follow-back procedure at baseline and each session. Findings Patients reporting lower confidence in their ability to resist cannabis during high negative affect (emotional relief refusal self-efficacy) had a lower likelihood of abstinence (p\ua0=\ua00.004), more days of use (p\ua

Measuring adolescent drinking-refusal self-efficacy: development and validation of the Drinking Refusal Self-Efficacy Questionnaire-Shortened Adolescent version (DRSEQ-SRA)

Background: This study aimed to develop and validate a shortened version of the Drinking Refusal Self-Efficacy Questionnaire-Revised Adolescent version (DRSEQ-RA) using a large sample of adolescents

Treatment seeking in cannabis dependence: the role of social cognition

Background and aims Relatively few cannabis dependent individuals seek treatment and little is known about the determinants of treatment seeking. Social Cognitive Theory (SCT) provides a useful framework for examining human behaviour and motivation which may be helpful in explaining treatment seeking. This study examined the differences in cannabis outcome expectancies and cannabis refusal self-efficacy between treatment seekers and non-treatment seekers with cannabis dependence. Design Non-treatment seekers were referred to an illicit drug diversion program. Treatment seekers commenced an outpatient cannabis treatment program and completed a comprehensive assessment that included measures of cannabis outcome expectancies and refusal self-efficacy. Setting A public hospital alcohol and drug outpatient clinic. Participants 269 non-treatment seekers and 195 individuals commencing cannabis dependence treatment. Measurements The Cannabis Expectancy Questionnaire (CEQ), Cannabis Refusal Self-Efficacy Questionnaire (CRSEQ), Severity of Dependence Scale – Cannabis (SDS-C), General Health Questionnaire (GHQ-28) and Readiness to Change Questionnaire (RTC) were completed. Findings Treatment seekers had significantly higher levels of negative cannabis outcome expectancies and significantly lower levels of emotional relief refusal self-efficacy (belief in ability to resist using cannabis when experiencing negative affect) (ps < 0.001). Treatment seekers had significantly higher levels of psychological distress and self-perceived cannabis dependence compared to non-treatment seekers (ps < 0.001). Conclusions High negative cannabis outcome expectancies and low emotional relief refusal self-efficacy may play a key role in motivation to seek treatment

Testing the biosocial cognitive model of substance use in cannabis users referred to treatment

The bioSocial Cognitive Theory (bSCT) hypothesizes two pathways linking dimensions of impulsivity to substance use. The first predicts that the association between reward sensitivity and substance use is mediated by positive outcome expectancies. The second predicts that the relationship between rash impulsiveness and substance use is mediated by refusal self-efficacy. This model has received empirical support in studies of alcohol use. The present research provides the first application of bSCT to a cannabis treatment population and aims to extend its utility to understanding cannabis use and severity of dependence.273 patients referred for cannabis treatment completed a clinical assessment that contained measures of interest.A public hospital alcohol and drug clinic.The Sensitivity to Reward Scale, Dysfunctional Impulsivity Scale, Cannabis Expectancy Questionnaire, Cannabis Refusal Self-Efficacy Questionnaire and Severity of Dependence Scale-Cannabis were completed, along with measures of cannabis consumption.The bSCT model provided a good fit to the data for cannabis use and severity of dependence outcomes. The association between reward sensitivity and each cannabis outcome was fully mediated by positive cannabis expectancies and cannabis refusal self-efficacy. The relationship between rash impulsiveness and each cannabis outcome was fully mediated by cannabis refusal self-efficacy.Findings support the application of the bSCT model to cannabis use and dependence severity and highlight the important role of social cognitive mechanisms in understanding the association between impulsivity traits and these outcomes. The differential association of impulsivity traits to social cognition may assist targeted treatment efforts

Alcohol-related expectancies are associated with the D2 dopamine receptor and GABAa receptor B3 subunit genes

Molecular genetic research has identified promising markers of alcohol dependence, including alleles of the D2 dopamine receptor (DRD2) and the GABAA receptor ￢3 subunit (GABRB3) genes. Whether such genetic risk manifests itself in stronger alcohol-related outcome expectancies, or in difficulty resisting alcohol, is unknown. In the present study, A1+ (A1A1 and A1A2 genotypes) and A1- (A2A2 genotype) alleles of the DRD2 and G1+ (G1G1 and G1 non-G1 genotypes) and G1- (non-G1 non-G1 genotype) alleles of the GABRB3 were determined in a group of 56 medically-ill patients diagnosed with alcohol dependence. Mood-related Alcohol Expectancy (AE) and Drinking Refusal Self-Efficacy (DRSE) were assessed using the Drinking Expectancy Profile (Young and Oei, 1996). Patients with the DRD2 A1+ allele, compared to those with the DRD2 A1- allele, reported lower DRSE in situations of social pressure (p=. 009). Similarly, lower DRSE was reported under social pressure by patients with the GABRB3 G1+ allele when compared to those with the GABRB3 G1- allele (p=.027). Patients with the GABRB3 G1+ allele also revealed reduced DRSE in situations characterized by negative affect than patients with the GABRB3 G1- alleles (p=. 037). Patients carrying the GABRB3 G1+ allele showed stronger AE relating to negative affective change (for example, increased depression) than their GABRB3 G1- counterparts (p=. 006). Biological influence in the development of some classes of cognitions is hypothesized. The clinical implications, particularly with regard to patient-treatment matching and the development of an integrated psychological and pharmacogenetic approach are discussed