Frontal Alpha Asymmetry and Inhibitory Control among Individuals with Cannabis Use Disorders

To better understand the biopsychosocial mechanisms associated with development and maintenance of cannabis use disorder (CUD), we examined frontal alpha asymmetry (FAA) as a measure of approach bias and inhibitory control in cannabis users versus healthy nonusers. We investigated: (1) whether FAA could distinguish cannabis users from healthy controls; (2) whether there are cue-specific FAA effects in cannabis users versus controls; and (3) the time course of cue-specific approach motivation and inhibitory control processes. EEG data were analyzed from forty participants (CUD (n = 20) and controls (n = 20)) who completed a modified visual attention task. Results showed controls exhibited greater relative right hemisphere activation (indicating avoidance/withdrawal motivation) when exposed to cannabis cues during the filtering task. By contrast, cannabis users exhibited greater relative left activation (approach) to all cues (cannabis, positive, negative, and neutral), reflecting a generalized approach motivational tendency, particularly during later stages of inhibitory control processes. The difference between cannabis users and controls in FAA was largest during mid- to late processing stages of all cues, indicating greater approach motivation during later stages of information processing among cannabis users. Findings suggest FAA may distinguish cannabis users from healthy controls and shows promise as a measure of inhibitory control processes in cannabis users

Impact of Cannabis Use on Treatment Outcomes among Adults Receiving Cognitive-Behavioral Treatment for PTSD and Substance Use Disorders

Background: Research has demonstrated a strong link between trauma, posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) in general and cannabis use disorders in particular. Yet, few studies have examined the impact of cannabis use on treatment outcomes for individuals with co-occurring PTSD and SUDs. Methods: Participants were 136 individuals who received cognitive-behavioral therapies for co-occurring PTSD and SUD. Multivariate regressions were utilized to examine the associations between baseline cannabis use and end-of-treatment outcomes. Multilevel linear growth models were fit to the data to examine the cross-lagged associations between weekly cannabis use and weekly PTSD symptom severity and primary substance use during treatment. Results: There were no significant positive nor negative associations between baseline cannabis use and end-of-treatment PTSD symptom severity and days of primary substance use. Cross-lagged models revealed that as cannabis use increased, subsequent primary substance use decreased and vice versa. Moreover, results revealed a crossover lagged effect, whereby higher cannabis use was associated with greater PTSD symptom severity early in treatment, but lower weekly PTSD symptom severity later in treatment. Conclusion: Cannabis use was not associated with adverse outcomes in end-of-treatment PTSD and primary substance use, suggesting independent pathways of change. The theoretical and clinical implications of the reciprocal associations between weekly cannabis use and subsequent PTSD and primary substance use symptoms during treatment are discussed

The Effects of Trauma and Stress on Tobacco Dependence Treatment Outcomes in Lower SES Individuals

A significant proportion of individuals have experienced one or more traumatic event, and trauma exposure has been associated with increased smoking and greater difficulty quitting, yet the relationship between traumatic event exposure and smoking cessation outcomes has not been widely studied. Similarly, while the experience of stressful life events is nearly universal, and research suggests their effects may produce psychopathological outcomes similar to those of traumatic events, research on the relationship between stressful life event exposure and smoking cessation is sparse. The current study sought to investigate the effects of trauma and stress on tobacco dependence treatment outcomes in lower SES individuals, as well as whether trauma or stress moderated the effects of an adapted smoking cessation intervention. There were several notable findings with implications for future research, including a significant positive association between traumatic event exposure and cigarettes smoked at baseline, a significant relationship between stressful life event exposure and nicotine dependence, and a marginally significant association between stressful life event exposure and abstinence at week 15. However, we did not find significant evidence that either traumatic or stressful event exposure was associated with greater smoking, greater nicotine dependence, or worse tobacco cessation outcomes after smoking cessation treatment. Nor did we find that, in general, traumatic or stressful life event exposure significantly moderated the effects of the adapted smoking cessation treatment. The failure to identify a significant relationship between prior traumatic event or stressful life event exposure and treatment outcomes may indicate that the effects were too small to reliably detect or that such stressors do not effect response to smoking cessation treatment. Given the modest power of the current investigation, it is not possible to distinguish between these two possibilities. Findings are consistent with previous research in highlighting associations between trauma/stress and increased smoking behavior and dependence, as well as the potential impact of stress on cessation outcomes. Findings also support the need for further investigation of traumatic and stressful event exposure and their effects on smoking behavior and cessation, as well as reiterating the potential for incorporating stress reduction and stress management techniques into smoking cessation treatments

Frontal Alpha Asymmetry and Inhibitory Control among Individuals with Cannabis Use Disorders

To better understand the biopsychosocial mechanisms associated with development and maintenance of cannabis use disorder (CUD), we examined frontal alpha asymmetry (FAA) as a measure of approach bias and inhibitory control in cannabis users versus healthy nonusers. We investigated: (1) whether FAA could distinguish cannabis users from healthy controls; (2) whether there are cue-specific FAA effects in cannabis users versus controls; and (3) the time course of cue-specific approach motivation and inhibitory control processes. EEG data were analyzed from forty participants (CUD (n = 20) and controls (n = 20)) who completed a modified visual attention task. Results showed controls exhibited greater relative right hemisphere activation (indicating avoidance/withdrawal motivation) when exposed to cannabis cues during the filtering task. By contrast, cannabis users exhibited greater relative left activation (approach) to all cues (cannabis, positive, negative, and neutral), reflecting a generalized approach motivational tendency, particularly during later stages of inhibitory control processes. The difference between cannabis users and controls in FAA was largest during mid- to late processing stages of all cues, indicating greater approach motivation during later stages of information processing among cannabis users. Findings suggest FAA may distinguish cannabis users from healthy controls and shows promise as a measure of inhibitory control processes in cannabis users

Future Thinking Priming Especially Effective at Modifying Delay Discounting Rates among Cigarette Smokers

Background: Tobacco use remains one of the world’s greatest preventable causes of death and disease. While most smokers want to quit, few are successful, highlighting a need for novel therapeutic approaches to support cessation efforts. Lower delay discounting (DD) rates are associated with increased smoking cessation success. Future thinking priming (FTP) reliably reduces DD rates in large populations. Smokers consistently discount more than nonsmokers, and evidence suggests that changes in DD rates are rate dependent. This study examined whether smoking status moderated the effect of FTP on DD rates and, if so, if the moderation effect could be attributed to differences in baseline rates of DD. Methods: Moderation analysis was conducted to determine whether the effect of FTP, versus neutral priming (NP), on DD differed among smokers and nonsmokers. Results: Smoking status moderated the effect of condition (FTP vs. NP) on post-intervention DD scores (b = −0.2919, p = 0.0124) and DD change scores (b = −0.2975, p = 0.0130). There was no evidence of rate dependence effects in the current sample. Conclusions: FTP had a greater effect on decreasing DD rates among smokers than nonsmokers. FTP is effective and simple to administer, which makes it a promising therapeutic approach for aiding smoking cessation

Threat Appraisals, Neuroticism, and Intrusive Memories: A Robust Mediational Approach with Replication

Background: The appraisal of a stressor influences how we adapt to it. We used an experimental paradigm to test and replicate the effects of threat appraisals on subsequent intrusive memories, as well as their moderation by neuroticism. Method: In three studies (total N = 562; 77.6% female; mean age = 18.45), we randomly assigned participants to an aversive or control video, assessed threat appraisals of the video, and assessed intrusive memories of the video at one, three, five, and seven days. Results: Using a robust causal mediational framework, we found that threat appraisals fully mediated the effect of the video on intrusive memories (studies 1 – 3), and for people higher in neuroticism, the causal mediational pathway was stronger (study 1 and 2). Conclusions: These findings indicate threat appraisals have causal effects on subsequent intrusive memories and neuroticism enhances this effect, lending empirical support to appraisal theories of posttraumatic stress disorder

Increasing Physical Activity among Breast Cancer Survivors by Modulating Temporal Orientation with rTMS: Feasibility and Potential Efficacy

Maintaining adequate amounts of physical activity is a critical component of survivorship care for women with breast cancer. Increased physical activity is associated with increases in well-being, quality of life, and longevity, but women with cancer face unique, cancer-related factors that might affect physical activity. Consistent with the Competing Neurobehavioral Decision Systems model of decision making, we proposed to decrease delay discounting and increase physical activity by stimulating the executive function system via high-frequency repetitive transcranial magnetic stimulation (HF rTMS) of the left dorsolateral prefrontal cortex (LDLPFC). This randomized, sham-controlled, double-blinded trial examined the feasibility and potential efficacy of this approach to increase physical activity in breast cancer survivors. We hypothesized that active rTMS would significantly increase the mean number of steps per day and decrease delay discounting. Participants (n = 30) were primarily middle-aged (M = 53.7, SD = 7.9) and white with a mean BMI and body mass indices below 40. Indicators of feasibility and limited efficacy testing were positive. Although repeated-measures ANOVA revealed no significant changes in delay discounting, generalized estimating equations (GEE) found that participants in the active condition increased their mean daily steps by 400 steps per day, while those in the sham condition decreased this by nearly 600 steps per day. These findings indicate that the continued investigation of HF rTMS for increasing physical activity among women with breast cancer is justified

Impact of Cannabis Use on Treatment Outcomes among Adults Receiving Cognitive-Behavioral Treatment for PTSD and Substance Use Disorders

Background: Background: Research has demonstrated a strong link between trauma, posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) in general and cannabis use disorders in particular. Yet, few studies have examined the impact of cannabis use on treatment outcomes for individuals with co-occurring PTSD and SUDs. Methods: Participants were 136 individuals who received cognitive-behavioral therapies for co-occurring PTSD and SUD. Multivariate regressions were utilized to examine the associations between baseline cannabis use and end-of-treatment outcomes. Multilevel linear growth models were fit to the data to examine the cross-lagged associations between weekly cannabis use and weekly PTSD symptom severity and primary substance use during treatment. Results: There were no significant positive nor negative associations between baseline cannabis use and end-of-treatment PTSD symptom severity and days of primary substance use. Cross-lagged models revealed that as cannabis use increased, subsequent primary substance use decreased and vice versa. Moreover, results revealed a crossover lagged effect, whereby higher cannabis use was associated with greater PTSD symptom severity early in treatment, but lower weekly PTSD symptom severity later in treatment. Conclusion: Cannabis use was not associated with adverse outcomes in end-of-treatment PTSD and primary substance use, suggesting independent pathways of change. The theoretical and clinical implications of the reciprocal associations between weekly cannabis use and subsequent PTSD and primary substance use symptoms during treatment are discussed