Levels Of Impulsivity Research Articles

Creating Conspiracy Beliefs: How Our Thoughts Are Shaped

Creating Conspiracy Beliefs: How Our Thoughts Are Shaped

"Sensitivity to the disinhibiting effect of alcohol: The role of trait impulsivity and sex differences": Clarification.

Higher trait impulsivity is associated with more impulsive responding on certain behavioral measures of disinhibition. Additionally, behavioral disinhibition is acutely elevated following alcohol consumption. The present study examined the possibility that trait impulsivity may predict individual differences in sensitivity to the disinhibiting effect of alcohol. Specifically, the present study tested the hypothesis that those with elevated trait impulsivity also experience heightened sensitivity to the disinhibiting effect of alcohol, which might further compound their tendency toward impulsive action. To test this hypothesis, data from six studies were aggregated to comprise a sample of 190 young adults. Participants completed the Barratt Impulsiveness Scale-11 (BIS-11), and behavioral disinhibition was assessed using a cued go/no-go task following consumption of 0.65 g/kg alcohol and a placebo. Alcohol increased disinhibition overall, but higher impulsivity did not predict increased sensitivity to alcohol-induced disinhibition. In men, higher levels of trait impulsivity predicted heightened disinhibition in the unintoxicated state following placebo, but this relationship was not present in women. These findings suggest significant sex differences in the relationship between trait impulsivity and disinhibition. This sex difference may explain inconsistent research findings in studies assessing links between trait and behavioral measures of impulsivity. The data also point to trait impulsivity and sensitivity to alcohol-induced disinhibition as independent constructs. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Are Signals Regulating Energy Homeostasis Related to Neuropsychological and Clinical Features of Gambling Disorder? A Case-Control Study.

Gambling disorder (GD) is a modestly prevalent and severe condition for which neurobiology is not yet fully understood. Although alterations in signals involved in energy homeostasis have been studied in substance use disorders, they have yet to be examined in detail in GD. The aims of the present study were to compare different endocrine and neuropsychological factors between individuals with GD and healthy controls (HC) and to explore endocrine interactions with neuropsychological and clinical variables. A case−control design was performed in 297 individuals with GD and 41 individuals without (healthy controls; HCs), assessed through a semi-structured clinical interview and a psychometric battery. For the evaluation of endocrine and anthropometric variables, 38 HCs were added to the 41 HCs initially evaluated. Individuals with GD presented higher fasting plasma ghrelin (p < 0.001) and lower LEAP2 and adiponectin concentrations (p < 0.001) than HCs, after adjusting for body mass index (BMI). The GD group reported higher cognitive impairment regarding cognitive flexibility and decision-making strategies, a worse psychological state, higher impulsivity levels, and a more dysfunctional personality profile. Despite failing to find significant associations between endocrine factors and either neuropsychological or clinical aspects in the GD group, some impaired cognitive dimensions (i.e., WAIS Vocabulary test and WCST Perseverative errors) and lower LEAP2 concentrations statistically predicted GD presence. The findings from the present study suggest that distinctive neuropsychological and endocrine dysfunctions may operate in individuals with GD and predict GD presence. Further exploration of endophenotypic vulnerability pathways in GD appear warranted, especially with respect to etiological and therapeutic potentials.

Effect of Selective Personality-Targeted Alcohol Use Prevention on 7-Year Alcohol-Related Outcomes Among High-risk Adolescents

Alcohol consumption is one of the leading preventable causes of burden of disease worldwide. Selective prevention of alcohol use can be effective in delaying the uptake and reducing harmful use of alcohol during the school years; however, little is known about the durability of these effects across the significant transition from early adolescence into late adolescence and early adulthood. To examine the sustained effects of a selective personality-targeted alcohol use prevention program on alcohol outcomes among adolescents who report high levels of 1 of 4 personality traits associated with substance use. A cluster randomized clinical trial was conducted to assess the effectiveness of the selective personality-targeted PreVenture program on reducing the growth of risky alcohol use and related harms from early to late adolescence and early adulthood. Participants included grade 8 students attending 14 secondary schools across New South Wales and Victoria, Australia, in 2012 who screened as having high levels of anxiety sensitivity, negative thinking, impulsivity, and/or sensation seeking. Schools were block randomized to either the PreVenture group (7 schools) or the control group (7 schools). The primary end point of the original trial was 2 years post baseline; the present study extends the follow-up period from July 1, 2017, to December 1, 2019, 7 years post baseline. Data were analyzed from July 22, 2021, to August 2, 2022. The PreVenture program is a 2-session, personality-targeted intervention designed to upskill adolescents to better cope with their emotions and behaviors. Self-reported monthly binge drinking, alcohol-related harms, and hazardous alcohol use measured by the Alcohol Use Disorders Identification Test-Concise consumption screener. Of 438 participants (249 male [56.8%]; mean [SD] age, 13.4 [0.5] years) from 14 schools, 377 (86.2%) provided follow-up data on at least 2 occasions, and among those eligible, 216 (54.0%) participated in the long-term follow-up. Compared with the control condition, the PreVenture intervention was associated with reduced odds of any alcohol-related harm (odds ratio [OR], 0.81 [95% CI, 0.70-0.94]) and a greater mean reduction in the frequency of alcohol-related harms (β = -0.22 [95% CI, -0.44 to -0.003]) at the 7.0-year follow-up. There were no differences in the odds of monthly binge drinking (OR, 0.80 [95% CI, 0.56-1.13]) or hazardous alcohol use (OR, 0.87 [95% CI, 0.59-1.27]) at the 7.0-year follow-up. Exploratory analyses at the 5.5-year follow-up showed that compared with the control condition, the PreVenture intervention was also associated with reduced odds of monthly binge drinking (OR, 0.87, [95% CI, 0.77-0.99]) and hazardous alcohol use (OR, 0.91 [95% CI, 0.84-0.99]), but this was not sustained. This study demonstrated that a brief selective personality-targeted alcohol use prevention intervention delivered in the middle school years can have sustained effects into early adulthood. anzctr.org.au Identifier: ACTRN12612000026820.

Trait-Related Impulsivity, Affective Temperaments and Mood Disorders: Results from a Real-World Multicentric Study.

Trait-related impulsiveness is highly prevalent in patients with mood disorders, being associated with negative outcomes. The predictive role of affective temperaments on trait-related impulsivity is still understudied. The aim of the present study is to investigate the relationship between impulsivity and affective temperaments in a sample of euthymic patients with mood disorders. This is a real-world multicentric observational study, carried out at the outpatient units of seven university sites in Italy. All patients filled in the short version of Munster Temperament Evaluation of the Memphis, Pisa, Paris and San Diego and the Barratt Impulsiveness Scale. The study sample included 653 participants, mainly female (58.2%), with a mean age of 46.9 (±14.1). Regression analyses showed that higher levels of trait-related impulsivity were associated to suicide attempts (p &lt; 0.000), the presence of psychotic symptoms during acute phases (p &lt; 0.05), a seasonal pattern (p &lt; 0.05), a lower age at onset of the disorder (p &lt; 0.05), cyclothymic (p &lt; 0.01) and irritable temperaments (p &lt; 0.01). The results of our study highlight the importance to screen patients with mood disorders for impulsivity and affective temperaments in order to identify patients who are more likely to present a worse outcome and to develop personalized and integrated early pharmacological and psychosocial treatment plans. Novelties of the present paper include the recruitment of patients in a stable phase, which reduced possible bias in patients' self-reports, and the multicentric nature of the study, resulting in the recruitment of a large sample of patients with mood disorders, geographically distributed across Italy, thus improving the generalizability of study results.

Effects of Mindfulness-Based Interventions on Gray Matter Volume in Patients with Opioid Dependence

Introduction: Recently, several mindfulness-based programs showed promising clinical effects in the treatment of psychiatric disorders including substance use disorders. However, very little is known about the effects of mindfulness-based interventions (MBIs) on brain structure in such patients. Methods: This study aimed to detect changes in gray matter volume (GMV) in opioid-dependent patients receiving MBI during their first month of treatment. Thirty patients were assigned to either 3 weeks of MBI (n = 16) or treatment as usual (TAU, n = 14) and were investigated using structural magnetic resonance imaging before and after treatment. Longitudinal pipeline of the Computational Anatomy Toolbox for SPM (CAT12) was used to detect significant treatment-related changes over time. The identified GMV changes following treatment were related to clinically relevant measures such as impulsivity, distress tolerance, and mindfulness. Results: After treatment, increased mindfulness scores were found in individuals receiving MBI compared to TAU. In the MBI group, there were also significant differences with respect to distress tolerance and impulsivity. Effects on mindfulness, distress tolerance, and impulsivity were also found in the TAU group. Longitudinal within-group analysis revealed increased left anterior insula GMV in individuals receiving MBI. Anterior insula volume increase was associated with decreased impulsivity levels. In the TAU group, significant GMV changes were found in the right lingual gyrus and right entorhinal cortex. Discussion/Conclusion: MBI can yield significant clinical effects during early abstinence from opioid dependence. MBI is particularly associated with increased insula GMV, supporting an important role of this region in the context of MBI-induced neural changes.

Feasibility analysis of solar thermal propulsion system with thermal energy storage

Possessing relatively high specific impulse and moderate thrust levels, solar thermal propulsion (STP) is a promising candidate in spacecraft propulsion system. However, the traditional solar thermal propulsion system suffers from thrust failure in the shadow area, which seriously affects its applicability. In this paper, we investigate feasibility of regenerative solar thermal propulsion system (RSTP) incorporating thermal energy storage, which can effectively overcome unmatched synchronous working time and illumination time. A numerical model for RSTP considering the whole energy transfer process from light concentrating, heat storage, to thrust generation is built, which is verified by experiment measurements with relative errors less than 15 %. The result shows that the maximum time to complete heat storage is about 4000 s, which is within the illumination time for low Earth orbit. In the solar eclipse region, the thrust (Ft) and the specific impulse (Isp) of the system increase with the propellant flow rate, which can reach about 2 N and 690 s, respectively. What’s more, the system can operate for around 100 s continuously at the maximum thrust in the shadow area. This work provides alternative approaches for microsatellite propulsion with high specific impulse, high thrust, and continuous operation despite presence of solar eclipse.

The interplay of daily affect and impulsivity measured by mobile surveys in bipolar disorder

BackgroundImpulsivity is a prominent feature of bipolar disorder associated with various negative sequelae; moreover, it may be a precursor to shifts in affect or mood, but little is known about its association with affect on a day-to-day timescale. Ecological momentary assessments (a method that captures moment-to-moment ratings of psychological states by repeatedly sampling the same individual) of impulsivity and affect using mobile surveys allow for more nuanced examination of mechanisms of mood and behavior dysregulation. However, few existing studies have validated an ecological momentary assessment of impulsivity in bipolar disorder and examined its time-lagged associations with positive and negative affect. 70 participants with bipolar disorder and 102 healthy comparisons participated in an intensive longitudinal study: they underwent 14 days of ecological momentary assessment data collection annually for 1–4 years. Multiple measures of impulsivity and affect were collected using self-report, behavioral, and ecological momentary assessment modalities; these measures were compared, and levels of impulsivity were compared between bipolar disorder and healthy comparison groups. Time-lagged analyses using daily means explored the next-day predictive relationship of impulsivity on positive/negative affect, and vice versa.ResultsThe ecological momentary measure of impulsivity was moderately correlated with the self-report but not behavioral impulsivity measure. Bipolar disorder participants evinced higher self-report, behavioral, and daily impulsivity than healthy comparison participants. Time-lagged analyses revealed a bi-directional association between high impulsivity and high next-day negative (but not positive) affect. Post hoc analyses showed that impulsivity specifically predicted next-day anger and anxiety.ConclusionsOur multimodal assessment of impulsivity allowed for an examination of the day-to-day course of impulsivity and affect, crucial steps toward understanding the mechanisms of mood symptom and episode onset in bipolar disorder.

Structural hyperconnectivity of the subthalamic area with limbic cortices underpins anxiety and impulsivity in Tourette syndrome.

Tourette syndrome (TS) is a neurodevelopmental disorder characterized by motor and vocal tics, which is often associated with psychiatric comorbidities. Dysfunction of basal ganglia pathways might account for the wide spectrum of symptoms in TS patients. Although psychiatric symptoms may be related to limbic networks, the specific contribution of different limbic structures remains unclear. We used tractography to investigate cortical connectivity with the striatal area (caudate, putamen, core and shell of the nucleus accumbens), the subthalamic nucleus (STN), and the adjacent medial subthalamic region (MSR) in 58 TS patients and 35 healthy volunteers. 82% of TS patients showed psychiatric comorbidities, with significantly higher levels of anxiety and impulsivity compared to controls. Tractography analysis revealed significantly increased limbic cortical connectivity of the left MSR with the entorhinal (BA34), insular (BA48), and temporal (BA38) cortices in TS patients compared to controls. Furthermore, we found that left insular-STN connectivity was positively correlated with impulsivity scores for all subjects and with anxiety scores for all subjects, particularly for TS. Our study highlights a heterogenous modification of limbic structure connectivity in TS, with specific abnormalities found for the subthalamic area. Abnormal connectivity with the insular cortex might underpin the higher level of impulsivity and anxiety observed in TS.

Investigating a role of orexin and ‘cocaine- and amphetamine-regulated transcript’ in the nucleus accumbens shell in binge eating of male rats and the relationship with impulsivity

Binge eating disorder (BED) is the most prevalent eating disorder in the adult population. It is characterized by recurrent episodes of uncontrollable overconsumption of palatable food (PF). BED is connected to several comorbidities such as obesity, major depression, and substance use disorder, and was linked to heightened levels of impulsivity. The neurobiological basis of BED is however still vaguely known. Binge eating (BE) occurs without homeostatic needs, and therefore, relates to hedonic consumption of PF. A major brain structure in the control of hedonic feeding, and part of the network regulating impulsive action, is the nucleus accumbens shell (NAcSh). The present study in rats assessed the influence of trait impulsivity on the development of BE-like feeding and the role of the orexigenic neuropeptide orexin (OX) and the anorexigenic neuropeptide cocaine- and amphetamine-regulated transcript (CART) within the NAcSh in a BE-model. The rats were initially ranked for their trait impulsivity based on a screening in the 5-choice serial reaction time task. They were subsequently introduced into a limited access-model to establish BE-like feeding with pure vegetable fat to examine a correlation between trait impulsivity and the development of BE-like feeding. The effect of bilateral infusions of the OX 1-receptor (OX1R) antagonist SB-334867 (SB) and CART-antibodies (CART-ABs) into the NAcSh was examined in relation to trait impulsivity. Further, accumbal OX1R density was evaluated by immunohistochemical staining in rats with normal and BE-like feeding behavior. We found that all animals developed stable BE-like PF intake, independent of trait impulsivity and without differences in the dynamics. The blockade of accumbal OX1Rs effectively reduced PF intake only in the control group that had daily access to PF, with impulsivity trait as a decisive factor, pointing towards alterations in orexinergic transmission in the NAcSh of rats bingeing on pure fat. This was corroborated by a lower density of OX1Rs in the NAcSh of rats with BE-like feeding behavior, precisely, in low-impulsive bingeing rats. Regardless of impulsivity trait, antagonizing CART in the NAcSh did not affect PF intake of control or bingeing animals. This suggests that endogenous accumbal CART does not influence consummatory behavior in ad libitum-fed rats with access to fat, under both normal and BE-like feeding patterns.

The impulsiveness level influences the salivary cortisol response and social stress sensitivity in suicidal patients

IntroductionSuicide attempters (SA) are more vulnerable to social stress and show disturbed cortisol response in stressful conditions compared with psychiatric and healthy controls. Recent data suggest that this dysregulation might be related to impulsivity traits. However, little is known about the emotional consequences of social stress in SA exposed to stress. ObjectivesThe aim of our study was to evaluate the cortisol and emotional responses to social stress in patients with depression with and without suicide attempt, by taking into account impulsivity traits and depression severity. Methods67 adult women (41 SA and 26 affective controls (AC,i.e. without suicide attempt history)) with lifetime history of major depressive episode were included. Patients performed the Trier Social Stress Test (TSST), a well-validated social stress task. Patients provided seven saliva samples, to measure the cortisol response, and filled in questionnaires to assess psychological pain, positive and negative mood, and anxiety at different time points (from 10 min before to 120 min after the TSST). Moderated regression models were used including suicide attempt history, depression severity, and impulsivity as independent variables and their interactions. ResultsIn patients with low depression and high impulsivity, salivary cortisol response during the TSST was higher in SA than in AC (p < .001). Psychological pain, negative mood, and anxiety were increased in all patients just after the TSST, followed by a decrease at 120 min. Positive mood recovery was slower in SA, and in patients with high impulsivity and low depression level (p < .001). ConclusionsImpulsivity traits have an important role in suicidal vulnerability in stress conditions. Impulsivity traits might help to differentiate patients at risk of suicide who are highly sensitive to stress when depression level is low. Higher impulsiveness may increase the sensitivity to emotional distress that translates into inadequate physiological responses.

`Association study of dehydroepiandrosterone sulfate, impulsivity personality traits and moderate alcohol consumption in men

This study focused on inspecting the relationship between impulsivity traits, salivary dehydroepiandrosterone sulfate (DHEA-S) concentrations, and moderate alcohol consumption in healthy subjects. In previous studies, impulsivity has been related to alcohol consumption and androgens. Limited research has focused on the sulfated form of DHEA-S and alcohol consumption or impulsivity. Moderate alcohol consumption can increase DHEA-S levels. Effects of alcohol, impulsivity and androgens levels may depend on age and gender. The participants were 120 healthy men (Mage = 44.39; SD = 12.88). The results showed positive correlations between DHEA-S and alcohol consumption (r = 0.22; p < .01) and an impulsivity factor (r = 0.22; p < .01) controlling for age. Regression analysis showed a significant relationship between DHEA-S (p < .001), impulsivity factor and AUDIT (p < .05). Analyzing the two extreme impulsivity groups, an association is observed between DHEA-S with AUDIT scores (R2 = 0.12; p < .05) in the high impulsivity group, but not in the low impulsivity one. It is therefore concluded that the effect of moderate alcohol consumption is cumulative and slightly associated with levels of impulsiveness and DHEA-S.

Impulsivity in Bipolar Disorder: State or Trait?

Impulsive behaviour is a key characteristic of mania in bipolar disorder (BD). However, there is mixed evidence as to whether impulsivity is a trait feature of the disorder, present in the euthymic state in the absence of mania. The aim of this systematic review and meta-analysis was to examine whether impulsivity is elevated in euthymic BD in comparison to controls. Electronic databases were searched for papers published until April 2022 reporting data on a self-report or behavioural measure of impulsivity in a euthymic BD group and a healthy control group. In total, 46 studies were identified. Euthymic BD showed significantly higher levels of self-reported impulsivity compared to controls (large effect size). Euthymic BD also showed significantly higher levels of impulsivity on response inhibition and inattention tasks, with moderate and large effect sizes, respectively. Only two studies measured delay of gratification, finding no significant differences between groups. Our results suggest impulsivity may be a trait feature of BD, however longitudinal cohort studies are required to confirm whether elevated impulsivity is present before illness onset. Future research should establish whether cognitive interventions are beneficial in improving impulsivity in BD.

Measuring impulse insertion loss of hearing protection device using high-level impulse noise

The American National Standard, ANSI S12.42-2010, specifies the impulse peak insertion loss (IPIL) for a hearing protection device (HPD) using an acoustic test fixture (ATF) over a range of impulse levels nominally at 132, 150, and 168 dB peak sound pressure level (dB pSPL). The GRAS 45CB ATFs have ear simulators fitted with GRAS 40BP microphones (6.35 mm diameter) that have amplitude limits of about 169 dB SPL (172 dB pSPL). The open ear transfer function measured at the 168-dB level can cause the peak amplitude to exceed the design specification of the microphone. Accordingly, the standard directs the user to measure the 150-dB transfer function between the field microphone and unoccluded ear (HFF,TM) and apply it to the field microphone measurement at 168 dB. We have measured the HFF,TM with GRAS 45CB ATF and with the GRAS 45CB-S2 ATF equipped with GRAS 40BH microphones (193 dB/196 dB pSPL). Impulse peak insertion loss measured with both ATFs will be reported and compared.

Overvoltage Response at the Terminal for Impulse Current Injection to 10 kV Distribution Line

This paper presents the three-phase impulse overvoltage measured at the terminal of a 10 kV distribution line when the impulse current was injected into the phase conductor of the distribution line. The overvoltage observation station was installed at the terminal of the line to record the three-phase overvoltage waveforms. It is shown that the struck phase overvoltage consists of three components including the negative pulse, the stage of residual voltage maintenance and the overshoot oscillation part. The observed negative peak values of the struck phase overvoltage range from −85.4 kV to −96.0 kV in three different injected impulse levels at 90,120,150 kV charging voltage. The duration of residual voltage depends on the duration time of injected current. Furthermore, there is a strong positive relationship between the oscillation amplitude of the struck phase overvoltage and the injected current amplitude. The peak amplitudes of three-phase overvoltage always have the following magnitude relationship: struck phase C > induced phase B > induced phase A. The voltage coupling coefficients of induced phases will not exceed 0.4. The test method proposed in this paper will be helpful to the research on the lightning overvoltage response characteristics of the distribution line and the protection analysis of arresters.

The Influence of Shopee Pay Later on the Impulsive Buying of E-commerce Shopee Users: A Study from Indonesia Utilitarian and Hedonic Attributes in Online Purchase Intentions

The purpose of this study is to show the influence of Shopee Pay later on impulsive buying through utilitarian attributes, hedonic attributes, affective attitude, and cognitive attitude variables. The researcher disseminates an online questionnaire via Google form to 232 respondents to conduct this study. The analysis of this study uses the method of Structural Equation Modelling (SEM) using the Smart PLS (Partial Least Square) software. The result of this study is that the utilitarian attributes, hedonic attributes, affective attitude, and cognitive attitude have a positive and significant relation to the impulsive buying variable. So, there are the higher value of the utilitarian attributes and hedonic attributes, the higher level of affective attitude and cognitive attitude, and then, there are the higher value of affective attitude and cognitive attitude, the greater level of consumer impulsiveness in shopping using the Shopee Pay later feature.

Multi-disciplinary optimization of the low-thrust orbit raising for the hydroterra Earth Explorer mission

Hydroterra was selected in September 2018 as one of the three candidates for the ESA's Earth Explorer-10 mission. Hydroterra aims at observing and improving the understanding of fundamental processes of daily water cycle, enhancing prediction capability of extreme rainfall and related flooding. To achieve this goal, the mission concept envisages placing a satellite embarking a synthetic aperture radar instrument in geosynchronous orbit. The satellite is designed to be launched with VEGA-C into low Earth orbit and to be transferred to the operational orbit by means of electric propulsion. In this paper, the multidisciplinary optimization process carried out to obtain the baseline electric orbit raising transfer for Hydroterra will be presented. The computed trajectory will meet the mission requirements, including targeting to the operational orbit, the launcher performance model, and the target on-station mass. Additionally, system-level constraints related to the satellite design that have an influence on the ideally optimized trajectory will be derived and considered in the optimization. In particular, the impact of the solar cell degradation on the thrust and specific impulse levels of the thruster due to the passage through the Van-Allen belts, the need to re-charge the batteries before entering the next eclipse, and the agility requirements will be accounted for. The obtained results show that a feasible electric orbit raising trajectory can be successfully obtained for the Hydroterra mission.

Sharing for relief: associations of trauma-focused interviews and well-being among war-affected displaced populations in the Middle East

ABSTRACT Nonmaleficence is a key ethical value of research among vulnerable populations. Trauma-focused research typically includes detailed interviews about traumatic life events and post-traumatic symptoms. This raises concerns about causing distress and harm for the affected individuals. We aimed to determine the immediate effects of trauma-focused interviews on participants’ wellbeing. We developed the brief Distress and Harm Scale (DH7) for the assessment of current symptoms of distress and urge to harm oneself or others. Using data from 332 Iraqi and Syrian children and both of their parents (N = 996), we assessed these symptoms before and after participating in trauma-focused interviews. Results showed that the mean levels of self-reported distress and harm impulses were significantly decreased among adults and children rather than increased immediately after the interviews. Once measures to safeguard cases at risk are carefully implemented in research, the potential benefits of participating in trauma-focused interviews outweigh the risk for individuals. Potential implications of the results for ethical review boards evaluating trauma-focused studies are discussed.

Impact of Impulsivity, Hyperactivity, and Inattention on Discontinuation Rate among Opioid-Dependent Patients Treated with Extended-Release Naltrexone.

Previous studies have indicated elevated levels of impulsivity, hyperactivity, and inattention (IHI) among opioid-dependent patients seeking outpatient treatment with extended-release naltrexone (XR-NTX). This led us to hypothesize that IHI may be associated with a higher discontinuation rate for XR-NTX treatment. In a group of 162 patients with opioid dependence, discontinuation prior to the full 24 weeks of the study period (six injections and attending the study visit at 24 weeks) occurred in 49% of the patients, primarily in the early stage of treatment. IHI above the clinical cut-off on the adult ADHD self-report scale (ASRS) was not associated with a risk of premature discontinuation. This finding was not altered when controlling for socio-demographics, substance, use and mental health severity. Conclusively, high levels of IHI per se is not contradictive for XR-NTX treatment in regard to concern for premature discontinuation.

Cognitive Behavioral Therapy Plus a Serious Game as a Complementary Tool for a Patient With Parkinson Disease and Impulse Control Disorder: Case Report.

BackgroundImpulse control disorders (ICDs) are commonly developed among patients who take dopamine agonist drugs as a treatment for Parkinson disease (PD). Gambling disorder and hypersexuality are more frequent in male patients with PD, with a prevalence over 4% in dopamine agonists users. Although impulsive-compulsive behaviors are related to antiparkinsonian medication, and even though ICD symptomatology, such as hypersexuality, often subsides when the dopaminergic dose is reduced, sometimes ICD persists in spite of drug adjustment. Consequently, a multidisciplinary approach should be considered to address these comorbidities and to explore new forms of complementary interventions, such as serious games or therapies adapted to PD.ObjectiveThe aim of this study is to present the case of a patient with ICD (ie, hypersexuality) triggered by dopaminergic medication for PD. A combined intervention was carried out using cognitive behavioral therapy (CBT) for ICD adapted to PD, plus an intervention using a serious game—e-Estesia—whose objective is to improve emotion regulation and impulsivity. The aim of the combination of these interventions was to reduce the harm of the disease.MethodsAfter 20 CBT sessions, the patient received the e-Estesia intervention over 15 sessions. Repeated measures, before and after the combined intervention, were administered to assess emotion regulation, general psychopathology, and emotional distress and impulsivity.ResultsAfter the intervention with CBT techniques and e-Estesia, the patient presented fewer difficulties to regulate emotion, less emotional distress, and lower levels of impulsivity in comparison to before the treatment. Moreover, the frequency and severity of the relapses also decreased.ConclusionsThe combined intervention—CBT and a serious game—showed positive results in terms of treatment outcomes.