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

The Habit Hypothesis of Compulsive Behaviors

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Programme self-help: Un nouvel outil pour faciliter l'accès au traitement des joueurs excessifs

Shame, fear of stigmatization, denial, accessibility to and the cost of treatment program may explain why only a small proportion of problem gamblers sought clinical treatment. In the hope to overcome these barriers, the Gambling Clinic and Other Behavioral Addictions of C.H.U. Brugmann (Brussels) has developed its own self-help program for excessive gamblers. Our goals were to foster readiness to change gambling behaviors and when appropriate to facilitate the transition from self-help program to classical face-to-face clinical intervention. In a sample of 172 problem gamblers who participated, 40 % had never sought help (e.g. clinical treatment) and/or never attempted quit gambling. Interestingly, for some, internet-based self-help treatment preceded their determination for seeking a traditional face-to-face therapeutic setting. Those results led us to discuss this program as a valid clinical tool within a broader health care setting in excessive gamblers.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Dissociative Tendencies and Alcohol Use Disorder

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Dissociative Tendencies and Alcohol Use Disorder

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A Comparative Event-Related Potentials Study between Alcohol Use Disorder, Gambling Disorder and Healthy Control Subjects through a Contextual Go/NoGo Task.

(1) Background: Inhibitory and rewarding processes that mediate attentional biases to addiction-related cues may slightly differ between patients suffering from alcohol use (AUD) or gambling (GD) disorder. (2) Methods: 23 AUD inpatients, 19 GD patients, and 22 healthy controls performed four separate Go/NoGo tasks, in, respectively, an alcohol, gambling, food, and neutral long-lasting cueing context during the recording of event-related potentials (ERPs). (3) Results: AUD patients showed a poorer inhibitory performance than controls (slower response latencies, lower N2d, and delayed P3d components). In addition, AUD patients showed a preserved inhibitory performance in the alcohol-related context (but a more disrupted one in the food-related context), while GD patients showed a specific inhibitory deficit in the game-related context, both indexed by N2d amplitude modulations. (4) Conclusions: Despite sharing common addiction-related mechanisms, AUD and GD patients showed different patterns of response to (non-)rewarding cues that should be taken into account in the therapeutic context.info:eu-repo/semantics/publishe

Reduced calibration between subjective and objective measures of episodic future thinking in alcohol use disorder

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On the processes underlying the relationship between alexithymia and gambling severity

A great number of individuals with persistent problematic gambling behavior exhibit alexithymic tendencies, greater impulsivity, impaired working memory and poor mood. However, the relationship between these cognitive, affective and personality factors in problem gambling remains poorly understood. Our aim was to investigate multiple pathways of the alexithymia and problem gambling relationship. One hundred and six male subjects with different levels of gambling problem severity were recruited. Alexithymia, impulsivity and verbal working memory were evaluated, and their relationships to disordered gambling was examined by means of a path analysis. Results indicate that alexithymia is related to an increase in the severity of gambling indirectly, i.e. through distress severity. In addition, a rise of alexithymic tendencies was also associated with problem gambling severity through enhanced impulsivity that directly increased distress. Working memory capacity failed to significantly impact our path model. Overall, our findings contribute a new finding to the literature by highlighting the importance of alexithymia, in addition to impulsivity, in the understanding of gambling problem severity and its clinical course.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Habitual Routines and Automatic Tendencies Differential Roles in Alcohol Misuse Among Undergraduates.

There is a debate over whether actions that resist devaluation (i.e. compulsive alcohol consumption) are primarily habit- or goal-directed. The incentive habit account of compulsive actions has received support from behavioral paradigms and brain imaging. In addition, the self-reported Creature of Habit Scale (COHS) has been proposed to capture inter-individual differences in habitual tendencies. It is subdivided into two dimensions: routine and automaticity. We first considered a French version of this questionnaire for validation, based on a sample of 386 undergraduates. The relationship between two dimensions of habit and the risk of substance use disorder and impulsive personality traits was also investigated. COHS has good psychometric properties with both features of habits positively associated with an Obsessive-Compulsive Inventory score. Besides, the propensity to rely more on routines was associated with lower levels of alcohol abuse and nicotine use, suggesting that some degree of routine might act as a protective factor against substance use. In contrast, a high automaticity score was associated with an increased risk of harmful alcohol use. These results demonstrate that the COHS is a valid measure of habitual tendencies and represents a useful tool for capturing inter-individual variations in drug use problems in undergraduates.info:eu-repo/semantics/publishe

Impaired non-verbal emotion processing in Pathological Gamblers.

Impaired perception of emotion in others has been described and confirmed in addictions with substances, but no such data exists regarding addictions without substances. As it has been hypothesized that toxic effect of substances on the brain was responsible for the impairments described, studying addictions without substances could be of interest to confirm this hypothesis. Twenty-two male pathological gamblers were compared to 22 male healthy controls matched for age and education level on non-verbal emotion perception tasks including faces, voices, and musical excerpts. Depression and anxiety levels were controlled for. Pathological gamblers significantly underestimated the intensity of peacefulness in music, and overall they were less accurate when reading emotion in voices and faces. They also overestimated emotional intensity in neutral voices and faces. Although anxiety levels did account for accuracy problems when detecting fear in voices and for overestimating emotions in neutral faces, anxiety levels did not explain the range of deficits observed. This is the first study showing non-verbal perception deficits in a purely behavioural addiction. These findings show that deficits in decoding non-verbal signals are associated with addictive behaviours per se, and are not due solely to toxic effects of substances on the brain