Role of aggressivity on reactivity and craving before and after cue exposure in recently detoxified alcoholics: Results from an experimental study

The role of aggressivity and cue exposure in induction of craving were investigated in a clinical setting. Thirty abstinent alcoholic patients were divided into a low and a high aggressive group based on scores on the physical aggression subscale of the Buss-Durkee Hostility Inventory and exposed to alcohol cues. Craving was measured by means of the Alcohol Craving Questionnaire (ACQ) and Visual Analogue Scales (VAS). Important findings are: (1) main effects of aggressivity on `emotionality', `purposefulness' and `expectancy' of ACQ were very significant; (2) on `drinking intention' and `craving for alcohol' of VAS, aggressivity and cue exposure showed a significant interaction; (3) the main effect of cue exposure on heart rate also reached a significance level of 0.007. The results were discussed in the context of the Classical, Operant Conditioning Theory, the Cognitive Craving Theory of Tiffany, Gilbert's STAR Model, and the Self-Medication Hypothesis Copyright (C) 2001 S. Karger AG, Basel

Effects of irritability on craving before and after cue exposure in abstinent alcoholic inpatients: Experimental data on subjective response and heart rate

Objective: Irritability is often linked with problem drinking. The aim of this study is to examine the possible influence of irritability on craving induced by a cue-exposure paradigm. Methods: 30 male abstinent alcoholic inpatients of the Psychiatric Hospital of Munich University, Germany gave answers to a series of personality questionnaires. Results of this study concerning the impact of aggressivity on craving for alcohol has recently been published. In this study, the subjects were subdivided into a low- and a high-irritable group based on their scores on the irritability subscale of the Buss-Durkee Hostility Inventory and were exposed to alcohol cues. Craving was measured by means of the Alcohol Craving Questionnaire (ACQ) and Visual Analogue Scales (VAS). The heart rate was also assessed throughout the whole process. ANCOVA for repeated measurement was employed to evaluate the data - irritability disposition as the between-subject factor and the experimental manipulation (absence vs. presence of alcohol cues) as the within-subject factor. Results: Major findings are: (1) main effects of irritability on `emotionality', `purposefulness', and `expectancy' of the ACQ as well as on `craving for alcohol' of the VAS were significant; (2) cue exposure also exerted a significant main effect on I craving for alcohol' of the VAS and on the heart rate after the presentation of alcohol cues; (3) on `compulsivity' of the ACQ and `intention to alcohol intake' of the VAS; there was a significant interaction between irritability and cue exposure. The high-irritable alcoholics, compared with their statements in the baseline, tended to report a higher control over alcohol intake and a lower intention to alcohol use after cue exposure. However, after confrontation with alcohol stimuli, their low-irritable counterparts reported a much lower control and a slightly higher intention than they did in the baseline. Conclusions: The results of this study indicate that induced craving in hospitalized alcohol addicts probably varies with the magnitude of their irritability; it might make patients more aware of their vulnerability to alcohol, help them develop more differential coping strategies and improve medical therapy against alcohol craving. Copyright (C) 2002 S. Karger AG, Basel

Alcohol consumption in heroin users, methadone-substituted and codeine-substituted patients - Frequency and correlates of use

This retrospective study aims to determine whether there is a difference in the additional consumption of alcohol between addicts treated with methadone or dihydrocodeine (DHC) and untreated addicts injecting heroin. 1,685 patients admitted for opioid withdrawal between 1991 and 1997 were reviewed. Cross-reference tables and multiple logistic regression analyses were carried out. 28% of patients take more than 40 g of alcohol daily (on average 176 g). We found that patients who are treated with methadone or DHC drink alcohol significantly more often daily than the heroin-dependent patients (p<0.01). Using multiple regression analyses, the results were confirmed. Additionally, we found that co-abuse of alcohol was predicted by male gender, longer duration of drug use, additional daily consumption of tetrahydrocannabinol and daily consumption of benzodiazepines. Alcohol consumption by opioid-addicted patients treated with methadone or DHC presents a serious medical problem. Co-abuse of alcohol will receive more attention Copyright (C) 2003 S. Karger AG, Basel

The Utility of Research Domain Criteria in Diagnosis and Management of Dual Disorders: A Mini-Review

The Research Domain Criteria (RDoC) initiative has been considered a comprehensive alternative classification framework for understanding neuropsychiatric ailments, as opposed to the longstanding, traditional DSM framework. Where the DSM categorizes neuropsychiatric disorders as each being distinct and diagnostically defined by the presence of specified symptoms, RDoC provides a multidimensional conceptualization of psychiatric disorders with neurobiological roots. By taking a multidimensional approach, RDoC overcomes two major constraints of the DSM framework: that is, that the DSM is categorical in its approach to psychiatric disorders to the point of understating the intersectionality between concomitant disorders, and that the DSM focuses mainly on clinical features. RDoC seems to better account for the intersection between dual disorders and considers a range of factors, from the more microscopic (e.g., genetics or molecular functions) to the more macroscopic (e.g., environmental influences). The multidimensional approach of RDoC is particularly appealing in the context of dual disorders. Dual disorders refers to a concurrent psychiatric disorder with an addiction disorder. RDoC accounts for the fact that there is often overlap in symptoms across and bidirectional influence between various disorders. However, to date, there is limited research into the clinical utility of RDoC, and less so in the context of the clinical management of dual disorders. In this Mini-Review, we discuss how RDoC differs from the DSM, what outcomes have been reported in utilizing RDoC clinically, the utility of RDoC for the diagnosis, management, and monitoring of psychopathology, and the limitations of RDoC as well as avenues for future research

Ecstasykonsumenten: Neurokognitive und funktionelle Problemkonstellationen und Ansätze zu spezifischen Frühinterventionen

Hintergrund: In den letzten Jahren ist zunehmend deutlich geworden, dass Konsumenten von Ecstasy sich hinsichtlich Gebrauchsmuster und -kontext wie auch Spontanverlauf, Risiken und Konsequenzen von Konsumenten anderer legaler und illegaler Substanzen unterscheiden und möglicherweise eine recht eigenständige Gruppe darstellen. Diese eigenständige Gruppe wird im angelsächsischen Raum zum Teil auch als club drug user bezeichnet. Alarmierend waren die Vermutungen aus Voruntersuchungen, dass club drug-Konsumenten auch nach dem Konsum geringer Mengen von Ecstasy bemerkenswerte und möglicherweise überdauernde neurobiologische Veränderungen mit assoziierten kognitiven Beeinträchtigungen und Störungen aufzeigen. Dies stellt an sich eine mögliche Gefährdung der Konsumenten dar, zusätzlich wiederum können kognitive Veränderungen auch Einfluss nehmen auf den Verlauf des weiteren Suchtmittelkonsums und den Erfolg von Interventionen. Ziel: In der MAYA-Studie (Munich Assessment of Young Adults) werden an einer epidemiologischen Bevölkerungsstichprobe junger Erwachsener (Stichprobe A) sowie an einer klinischen Stichprobe von Ecstasy-Konsumenten (Stichprobe B) die Art und das Ausmaß kognitiver Störungen und Defizite in Abhängigkeit von Gebrauchsmustern und anderen Einflussfaktoren untersucht. Bei der Stichprobe A handelt es sich um ein Subsample der EDSPStudie. Zusätzlich zu den bereits erhobenen Charakterisierungen werden spezifische neurokognitive Maße (vor allem Aufmerksamkeit, Gedächtnis und exekutive Funktionen) und Fragebögen (Impulsivität, BDI, STAI etc.) erhoben. Die Probanden erhalten weiterhin ein Screening mit dem neu eingeführten Instrument WHO ASSIST (Alcohol, Smoking and Substance Involvement Screening Test). Wenn indiziert, wird eine Intervention im Sinne eines Motivational Enhancement durchgeführt. Initiale Auswirkungen werden in einem Telefoninterview sechs Wochen später überprüft. Ergebnisse: Die vorläufigen Ergebnisse beruhen auf einer Teilstichprobe. Insgesamt handelte es sich eher um Konsumenten mit geringgradigem bis moderaten Konsum. Dennoch ließen sich Unterschiede zwischen den Konsumentengruppen (Ecstasy, Cannabis, Alkohol) und den Nichtkonsumenten erkennen. Die Konsumenten von Ecstasy unterschieden sich am ausgeprägtesten von den Kontrollen. Die sich bisher abzeichnenden Unterschiede bei Aufmerksamkeit, Gedächtnis und exekutiven Funktionen scheinen bei der Gedächtnis- und Merkfähigkeit am ausgeprägtesten zu sein. Bei diesen vorläufigen Ergebnissen sind die Untersuchungsgruppen noch sehr heterogen und enthalten z.B. Probanden, die ihren Ecstasykonsum bereits wieder aufgegeben haben.Introduction: In recent years it has become increasingly evident that ecstasy users represent a group distinct from users of other drugs. This is based on consumption patterns, context of use, development of use patterns and other factors. This group of users might be considered "club drug users", given the overlap, similarity of use patterns and consumptions within the class of club drugs. In recent neurobiological research, alarming results have been reported, indicating that persistent neurotoxic effects with concomitant cognitive problems may be induced by ecstasy consumption. Methods: In the Munich Assessment of Young Adults Study (MAYA) two samples of ecstasy users are investigated. Sample A is a sample of users drawn from an ongoing epidemiological longitudinal study of young adults in Munich. Sample B is an additional clinical sample. Both samples are characterized extensively and are neuropsychologically tested for attention, memory and executive functioning. A screening for harmful use is conducted with the German version of the WHO ASSIST (Alcohol, Smoking and Substance Involvement Screening Test). A Motivational Enhancement Intervention is applied when harmful use is detected. With a telephone interview the intervention's initial effect is assessed. Results: Initial results are based on a small sample. Use within the tested population is low to moderate. Still significant differences in attention, memory, and executive functioning could be detected with the current testing. Ecstasy users almost consistently showed the lowest cognitive functioning. The one difference is that ecstasy users were significantly faster in finger tapping and reaction. Note that the results are preliminary. The sample is heterogeneous, including both current and former users. Firmer results will be reported with the full sample size, allowing to further elucidate subgroups and interactions

Substance Dependence Among Bipolar, Unipolar Depression and Psychotic Homeless: A Canadian National Study

Introduction: Homeless individuals are often mischaracterized as members of a homogeneous population that suffers from a wide mental health and addiction issues, with little consideration of potentially important differences within or between samples. The aim of the present study was to investigate the comorbidy of alcohol and/or substance dependence (ASD) and major psychiatric diagnoses (bipolar disorder, unipolar depression, and psychotic disorder) in a large Canadian sample of homeless individuals, and to examine potential sources of variability including location and ethnicity.Materials and Methods: A sample of 1,585 homeless individuals were assessed for alcohol and/or substance dependence and bipolar disorder, unipolar depression and psychotic disorder with the Mini-International Neuropsychiatric Interview (version 6.0). Regional and ethnic differences in major psychiatric diagnoses between homeless with and without ASD were examined using univariate (i.e., chi-square) and multivariate (i.e., logistic regression) statistics.Results: Members of the sample with ASD were found to be younger, Aboriginal, less well-educated, and born in the Americas. They were more significantly more prevalent in Western Canada and less prevalent in Central and Eastern Canada. The odds of having ASD were higher among people affected by bipolar disorder and (to a less extent) unipolar depression.Limitations: Data collected were self-reported and no urinalyses were performed. We considered diagnosis of ASD according to the previous 12 months only.Conclusions: Homeless people with major mental illness are at high risk for concurrent ASD, however the prevalence of ASD varies significantly between cities, and based on ethnicity and specific psychiatric diagnosis (with greater prevalence in individuals affected by bipolar disorder and, to a less extent, unipolar depression). Clinicians, administrators and policy makers should develop and deliver services based on careful assessment of the local population

Activity theory, complexity and sports coaching: An epistemology for a discipline

The aim of this article is two-fold. Firstly, it is to advance the case for Activity Theory (AT) as a credible and alternative lens to view and research sports coaching. Secondly, it is to position this assertion within the wider debate about the epistemology of coaching. Following a framing introduction, a more comprehensive review of the development and current conceptualisation of AT is given. Here, AT’s evolution through three distinct phases and related theorists, namely Vygotsky, Leont’ev and Engeström, is initially traced. This gives way to a more detailed explanation of AT’s principal conceptual components, including ‘object’, ‘subject’, ‘tools’ (mediating artefacts), ‘rules’, a ‘community’ and a ‘division of labour’. An example is then presented from empirical work illustrating how AT can be used as a means to research sports coaching. The penultimate section locates such thinking within coaching’s current ‘epistemological debate; arguing that the coaching ‘self’ is not an autonomous individual, but a relative part of social and cultural arrangements. Finally, a conclusion summarises the main points made, particularly in terms in presenting the grounding constructivist epistemology of AT as a potential way forward for sports coaching

Distribution Analysis of Hydrogenases in Surface Waters of Marine and Freshwater Environments

Background Surface waters of aquatic environments have been shown to both evolve and consume hydrogen and the ocean is estimated to be the principal natural source. In some marine habitats, H2 evolution and uptake are clearly due to biological activity, while contributions of abiotic sources must be considered in others. Until now the only known biological process involved in H2 metabolism in marine environments is nitrogen fixation. Principal Findings We analyzed marine and freshwater environments for the presence and distribution of genes of all known hydrogenases, the enzymes involved in biological hydrogen turnover. The total genomes and the available marine metagenome datasets were searched for hydrogenase sequences. Furthermore, we isolated DNA from samples from the North Atlantic, Mediterranean Sea, North Sea, Baltic Sea, and two fresh water lakes and amplified and sequenced part of the gene encoding the bidirectional NAD(P)-linked hydrogenase. In 21% of all marine heterotrophic bacterial genomes from surface waters, one or several hydrogenase genes were found, with the membrane-bound H2 uptake hydrogenase being the most widespread. A clear bias of hydrogenases to environments with terrestrial influence was found. This is exemplified by the cyanobacterial bidirectional NAD(P)-linked hydrogenase that was found in freshwater and coastal areas but not in the open ocean. Significance This study shows that hydrogenases are surprisingly abundant in marine environments. Due to its ecological distribution the primary function of the bidirectional NAD(P)-linked hydrogenase seems to be fermentative hydrogen evolution. Moreover, our data suggests that marine surface waters could be an interesting source of oxygen-resistant uptake hydrogenases. The respective genes occur in coastal as well as open ocean habitats and we presume that they are used as additional energy scavenging devices in otherwise nutrient limited environments. The membrane-bound H2-evolving hydrogenases might be useful as marker for bacteria living inside of marine snow particles