Maintenance Of Addictive Behavior Research Articles

Cue-reactivity to distal cues in individuals at risk for gaming disorder

BackgroundGaming disorder (GD) is a disorder due to addictive behaviors (ICD-11). Cue-reactivity and craving are relevant mechanisms in the development and maintenance of addictive behaviors. When confronted with cues showing in-game content (proximal cues) individuals with higher symptom severity show increased cue-reactivity. Based on conditioning and addiction theories on incentive sensitization, cue-reactivity responses may generalize to more distal cues, e.g. when individuals at risk of developing a GD are confronted with a starting page of an online game. In cue-reactivity paradigms so far, only proximal gaming cues have been used. MethodsWe investigated the effect of distal gaming cues compared to gaming-unrelated control cues on cue-reactivity and craving in 88 individuals with non-problematic use of online games (nPGU) and 69 individuals at risk for GD (rGD). The distal cues showed the use of an electronic device (e.g., desktop PC or smartphone) whose screen showed starting pages of either games (target cues), shopping- or pornography sites (control cues) from a first-person perspective. FindingsWe found significantly higher urge and arousal ratings as well as longer viewing times for gaming-related compared to gaming-unrelated control cues in rGD compared to nPGU. Valence ratings did not differ between groups. InterpretationThe results demonstrate that already distal gaming-specific cues lead to cue-reactivity and craving in rGD. This finding indicates that based on conditioning processes, cue-reactivity and craving develop during the course of GD and generalize to cues that are only moderately related to the specific gaming activity.

Not “just for fun”: Gambling, substance use, and the transdiagnostic role of emotion regulation

Models of substance use disorders and more recently pathological gambling underscore stress-relief in maintenance of addictive behaviors. This study examines emotion regulation difficulties as predictors of gambling severity in a community sample with and without substance use disorder symptomatology, hypothesizing that more emotion regulation difficulties, and particularly the reliance on avoidance, would be associated with greater addiction severity both for substances and gambling. Adults regular gamblers were recruited using social media advertising for a survey on emotion regulation, gambling, and substance use. As expected, substance use and gambling showed high co-occurrence. Emotion regulation difficulties predicted severity of gambling but not alcohol use symptoms, although correlations were significant for both disorders. Participants with gambling only and comorbid gambling and substance use showed the greatest reliance on emotional non-acceptance and non-awareness. Poor emotion regulation and avoidance of emotional awareness may contribute to the maintenance of addictions, especially gambling pathology. Improvement of emotional awareness, expression, and acceptance may provide a pathway for reducing such behaviors.

No significant effect of frequent online sexual behaviour on Pavlovian-to-instrumental transfer (PIT): Implications for compulsive sexual behaviour disorder.

Reward based learning is broadly acknowledged to underpin the development and maintenance of addictive behaviour although the mechanism in sexual compulsivity is less understood. Using a Pavlovian-to-Instrumental Transfer (PIT) task we tested whether the motivational aspect of conditioned Pavlovian conditioned stimulus invigorated instrumental responding in relation to specific compatible monetary rewards. Performance on the task was analysed between two groups of males based on Low (N = 38) and High (N = 41) self-report online sexual behaviour (OSB). Psychometric tests including sexual compulsivity scale and behavioural activation/behavioural inhibition (BIS/BAS) were also administered to determine the relationship between OSB and general reward sensitivity. We show clear evidence of acquisition in the Pavlovian and instrumental conditioning phases. Specific transfer effect was greater in the High-OSB group although the difference compared to the Low-OSB group was non-significant. OSB negatively correlated with both BIS and BAS indicative of introversion and low reward sensitivity. OSB positively correlated with sexual compulsivity although it is unclear whether individuals in the High-OSB group considered their behaviour either excessive or problematic. These findings contribute to the ongoing debate regarding the nature of problematic OSB. Fundamental differences in motivational characteristics and mechanism contributing to compulsive behaviour in relation to high-OSB might indicate incompatibility with behavioural addiction models. PIT was not enhanced in high-OSB by appetitive conditioning, although problematic OSB could stem from failure to inhibit actions. Further research should investigate whether aversive conditioning differentially affects responding in high-OSB individuals, potentially explaining perseverant behaviour despite negative consequences.

Prepared and reactive inhibition in smokers and non-smokers

IntroductionModels of addiction have identified deficits in inhibitory control, or the ability to inhibit inappropriate or unwanted behaviors, as one factor in the development and maintenance of addictive behaviors. Current literature supports disruption of the prefrontal circuits that mediate reactive inhibitory control processes (i.e., inhibition in response to sudden, unplanned changes in environmental demands) in substance use disorders. However, the relationship between disorders of addiction, such as nicotine dependence, and planned inhibitory processes (i.e., inhibition that occurs after advance warning) is unclear. The goal of the present study was to examine the extent to which reactive and planned inhibitory processes are differentially disrupted in nicotine dependent individuals. MethodWe employed an internet-based novel stop signal task wherein participants were instructed to stop a continuous movement at either a predictable or unpredictable time. This task explicitly separated planned and reactive inhibitory processes and assessed group differences in task performance between smokers (N = 281) and non-smokers (N = 164). The smoker group was defined as any participant that identified as a smoker and reported an average daily nicotine consumption of at least 2 mg. The non-smoker group was defined as any participant that identified as a non-smoker and had not been a former smoker that quit within the last year. The smoker group also completed a questionnaire regarding smoking behaviors which included the Fägerstrom Test of Nicotine Dependence (FTND). We used these data to assess the continuous relation between planned stopping, unplanned stopping, and smoking behaviors. ResultsWe found significant differences in stop times for both reactive and planned stopping between groups as well as within the smoker group. Additionally, in the smoker group, dependence as measured by the FTND was associated with longer stop times on planned stop trials. Surprisingly, greater daily average consumption of nicotine was related to faster stopping for both trial types. ConclusionThese results indicate the relevance of measuring both reactive and planned inhibitory processes for elucidating the relationship between nicotine addiction and mechanisms of inhibitory control.

Limitations of cross-lagged panel models in addiction research and alternative models: An empirical example using project MATCH.

Models of addiction often posit bidirectional and dynamic associations between constructs relevant to the etiology and maintenance of addictive behaviors. The cross-lagged panel model (CLPM) is commonly used in addiction research but has been critiqued for not appropriately adjusting for between-person variance. Alternatives to the CLPM have been suggested but remain underutilized. The primary purpose of this article is to highlight interpretational limitations of the CLPM and to provide examples of alternative models. We specified CLPM, Random-Intercept CLPM, and a Latent Curve Model with Structured Residuals using four waves of data from Project MATCH (n = 1,201). We modeled prospective relations among depression symptoms and temptation to drink. Substantive inferences and assumptions across models were compared. The CLPM provided the most evidence of significant cross-lagged paths but the poorest fit to the data compared to other models. Alternative models found little evidence of prospective within-person associations, and more evidence for between-person associations and wave-specific within-person relations between depression symptoms and temptation to drink. This study highlights shortcomings of the CLPM and details alternative models to consider. Addiction researchers should consider alternatives to the CLPM to more optimally delineate relations among constructs across time. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Repetitive negative thinking, metacognitive beliefs, and their interaction as possible predictors for problematic cannabis use

The metacognitive formulation of addictive behaviours considers repetitive negative thinking (RNT) and metacognitive beliefs as two important processes involved in the development and maintenance of addictive behaviours. To date, very limited research has investigated the implication of these processes in problematic cannabis use. The present study was aimed at exploring the association between RNT, metacognitive beliefs, and cannabis use in a sample of 157 problematic cannabis users. Participants were administered measures of cannabis use severity, RNT, metacognitive beliefs, anxiety, and depression. Multiple regression analysis showed that metacognitive beliefs (cognitive confidence, beliefs about the need to control thought, and cognitive self-consciousness) were independent predictors of problematic cannabis use and related problem severity when controlling for RNT and negative affect (anxiety and depression). Furthermore, RNT predicted problematic cannabis use severity only for users with low levels of negative beliefs about thoughts concerning uncontrollability and danger. These data suggest that metacognitive beliefs and RNT may be two relevant cognitive processes for understanding problematic cannabis use. More generally, it enables the consideration of cannabis use from the perspective of self-regulation theories, and more specifically cognitive regulation, thus offering several theoretical and clinical implications.

Approach bias retraining through virtual reality in smokers willing to quit smoking: A randomized-controlled study

Automatic approach biases toward smoking-related cues have been implicated in the development and maintenance of addictive behaviors. Studies aiming at modifying such biases have shown promise in changing maladaptive approach tendencies for smoking cues and reducing smoking behavior. However, training effects tend to be small and partly inconsistent. The present randomized-controlled trial incorporated virtual reality (VR) technology into Approach Bias Modification (ABM) to improve efficacy. One-hundred-eight smokers attended behavioral counseling for smoking cessation and were thereafter randomized to receive VR-ABM or VR-control training. During VR-ABM, participants trained to implicitly avoid smoking-related objects and to approach alternative objects, while no such contingency existed in the VR-control condition. Trainings were administered in six sessions within a two-week period. Assessments were conducted at baseline, post-intervention (three weeks after baseline), and at follow-up (seven weeks after baseline). VR-ABM did not change approach biases, nor other cognitive biases, but it was superior in reducing daily smoking. However, this effect was limited to the two-week training period. Both groups improved in other smoking- and health-related variables across time. Future work should continue to investigate working mechanisms of ABM, in particular crucial training ingredients. VR could prove valuable for public health as the potential of VR-based treatments is large and not fully explored.

Contribution of Fatty Acid Amide Hydrolase to Alcohol Use Disorder: A Systematic Review.

Purpose: Recent research has suggested that chronic alcohol exposure induces changes in the endocannabinoid system within the central nervous system and therefore could be an attractive target for better understanding and treating alcohol use disorder (AUD). Much of this research has centered around the CB1 receptor and its endogenous partial agonist, the endocannabinoid anandamide, as the CB1 receptor is densely expressed in brain regions involved in development and maintenance of addictive behaviors. In addition, recent evidence has suggested that chronic alcohol exposure induces changes in the modulation of endocannabinoid concentration and suggests that these changes may contribute to the motivation to abuse alcohol. Therefore, we performed a systematic literature review to evaluate how fatty acid amide hydrolase (FAAH), an enzyme that degrades anandamide, relates to the characteristics and biology of AUD, as well as how modulating FAAH through pharmacologic inhibition or genetic manipulation affects outcomes related to alcohol use and consumption. Method: A search strategy was developed using the terms "endocannabinoids" or "drug delivery systems" and "alcohol dependence" or "alcohol use disorder" or "alcoholism" and "Fatty Acid Amide Hydrolase" and "FAAH" as text words and Medical Subject Headings (i.e., MeSH and EMTREE). We then used this search strategy on the electronic databases PubMed, Embase, and Web of Science. Results: We found 224 records; after removing repeated records (37%), articles that did not fit the topic question (47%), or were not primary research (4%), we included 26 for qualitative synthesis (12%). Discussion: The literature clearly suggests that FAAH has a role in the biology and characteristics of AUD. FAAH inhibition seems especially promising as a target for alcohol withdrawal as it may lead to a reduction in symptoms, including anxiety and a reduction of alcohol intake reinstatement. However, decreased FAAH may also lead to reduced sensitivity to alcohol along with increased preference and intake. Conclusions: Modulation of FAAH is promising for therapeutic intervention of AUD, but requires more research. Pre-clinical studies have indicated that FAAH inhibition may reduce withdrawal characteristics, but may also exacerbate other characteristics of AUD outside of that period.

Internet addiction in times of COVID-19: Review of the situation

IntroductionCovid-19 pandemic represents a sanitary crisis with social, economic and political negative impacts. Studies had well established the link between stress and the display or maintenance of addictive behaviour. Measures like social distancing and confinement imposed by governments during this pandemic, could explain an outbreak of internet addiction cases.ObjectivesAssess the prevalence of internet addiction in times of the covid-19 pandemic and to study its relationship with personal and family factors but also with the psychiatric comorbidities.MethodsWe conducted a cross sectional analytical study during the period of the covid-19 pandemic, using an internet survey exploring socio-demographic and clinical data: through Hamilton depression and anxiety rating scale and the Rosenberg self esteem scale. The assessment of internet addiction was carried out using Young’s Internet Addiction test.ResultsOur study included 150 users, the average age was 36 years, mainly made up of women, married, having children, with a good socioeconomic level and of university education. The prevalence of depressive and anxious symptoms were respectively 7.3% and 18.7%. The prevalence of internet addiction in our study was 9.4% including 0.7% having severe repercussions. Being married (p<10-3) and having children (p=0.006) were considered as protective factors against internet addiction. People having an internet addiction were at bigger risk of having low self esteem (p=0.023), depressive (p=0.04) and anxious symptoms (p<10-3).ConclusionsInternet addiction is a new concept, though it’s impact on the well being is well established and it’s likely to worsen in times of pandemic. Therefore, it’s necessary to take preventive measures to deal with it.DisclosureNo significant relationships.

What can we learn from PWS and SNORD116 genes about the pathophysiology of addictive disorders?

Addictive disorders have been much investigated and many studies have underlined the role of environmental factors such as social interaction in the vulnerability to and maintenance of addictive behaviors. Research on addiction pathophysiology now suggests that certain behavioral disorders are addictive, one example being food addiction. Yet, despite the growing body of knowledge on addiction, it is still unknown why only some of the individuals exposed to a drug become addicted to it. This observation has prompted the consideration of genetic heritage, neurodevelopmental trajectories, and gene-environment interactions in addiction vulnerability. Prader-Willi syndrome (PWS) is a rare neurodevelopmental disorder in which children become addicted to food and show early social impairment. PWS is caused by the deficiency of imprinted genes located on the 15q11-q13 chromosome. Among them, the SNORD116 gene was identified as the minimal gene responsible for the PWS phenotype. Several studies have also indicated the role of the Snord116 gene in animal and cellular models to explain PWS pathophysiology and phenotype (including social impairment and food addiction). We thus present here the evidence suggesting the potential involvement of the SNORD116 gene in addictive disorders.

Electrophysiological Evidence of Event-Related Potential Changes Induced by 12 h Abstinence in Young Smokers Based on the Flanker Study.

The cognitive control processes may be disrupted by abstinence in smokers, which may be helpful in the development and maintenance of addictive behavior. The purpose of this study was to measure the performance of cognitive task after 12 h of smoking abstinence by using event-related potentials (ERPs), including the error-related negativity (ERN) and the error positivity (Pe). In Eriksen flanker task, electroencephalography (EEG) signals of 24 smokers were recorded in two conditions: satiety and 12 h abstinence. In the behavioral data, both conditions exhibited more errors and more time on the incongruent trials than congruence. Meantime, the Minnesota Nicotine Withdrawal Scale (MNWS) score was increased during abstinence. Smokers showed reduced ERN and Pe after 12 h of abstinence, compared with satiety condition. The results indicate that the diminished error processing in young smokers after 12 h of abstinence. It may be related to increased withdrawal symptoms. In conclusion, the disrupted neurophysiological indexes in the general behavior monitoring system may be caused by abstinence. The results of this study may provide us with new ideas about the effects of short-term abstinence on brain cognitive neuroscience and be helpful for the solution of relapse.

Oxytocin attenuates neural response to emotional faces in social drinkers: an fMRI study

IntroductionOxytocin is a key mediator of emotional and social behavior that seems to be of relevance for the development and maintenance of addictive behaviors. We thus investigated the effect of oxytocin on neural response and behavior during a face-matching task in a sample of social drinkers.MethodsThirteen social drinkers underwent a randomized double-blind placebo-controlled cross-over functional magnetic resonance imaging face-matching task with and without prior intranasal application of 24 international units oxytocin. Effects of oxytocin and task condition (faces, shapes) on brain activation and individual task performance were assessed.ResultsFace-matching compared to shape-matching trials resulted in higher brain activation in the bilateral amygdala, hippocampus and parts of the occipital gyri. Oxytocin application vs. placebo reduced activation in bilateral amygdala, parts of the frontal gyri, and the parietal lobe. Region of interest analyses indicated that the oxytocin-induced attenuation of amygdala response was specific to face-stimuli and associated with lower subjective alcohol craving, and a lower percentage of heavy-drinking days (defined as ≥ 5 standard drinks/day).ConclusionFor the first time, we could show that a larger oxytocin-induced attenuation of amygdala response to fearful faces is associated with lower subjective craving for alcohol and percentage of heavy drinking days in social drinkers. Modulation of amygdala activation, induced by emotional stimuli, might represent a neurobiological substrate of oxytocin’s protective effects on drug seeking behavior.

Parenting styles and metacognitions as predictors of cannabis use

Metacognitions, the beliefs held about internal mental processes and the strategies aimed at controlling such processes, are known to play a significant role in the development and maintenance of addictive behaviours. Specifically, lack of cognitive confidence and beliefs about the need to control thoughts have been implicated across addictive behaviours. No research to date, though, has explored the role of metacognitions in cannabis use. Research has also shown that an authoritarian parenting style (where a parent uncompromisingly enforces their own ideas regardless of the will of the child) may be correlated with addictive behaviours. However very limited research has investigated the role of parenting styles in cannabis use. In the current study we aimed to investigate the relative contribution of parenting styles and metacognitions to cannabis use. A sample of 85 participants completed a series of online questionnaires, measuring negative affect, parenting styles, metacognitions and cannabis use. Spearman correlations indicated that cannabis use was positively correlated with each of the metacognitions and both permissive and authoritarian parenting styles. Regression analyses demonstrated that a combination of the physically coercive aspects of the authoritarian parental style and lack of cognitive confidence predicted cannabis use when controlling for negative affect. The implications of the current findings are discussed.

物质相关线索对成瘾者反应抑制的影响

<p id="C2">Loss of control in substance seeking and use of addicts is closely related to response inhibition. Many studies have explored this relationship in context of substance-related cues. Substance cues can be automatically captured by attention and also induce non-automatic approach-motivated state. As a consequence, these cues may consume limited cognitive resources through a stimulus-driven and a state-dependent manner in order to influence addicts' response inhibition. And these effects also play important roles in the development and maintenance of addictive behaviors. Further research should be carried out to reveal the neural mechanisms of both manners, clarify how motivations and attitudes towards substance use modulate these effects, conduct research in real situations, and discover more effective interventions.

Relationship of sensation seeking with the neural correlates of appetitive conditioning.

Previous research has linked sensation seeking with a heightened risk for drug abuse and other risk-taking behavior. As appetitive conditioning presents a model for the etiology and maintenance of addictive behavior, investigating sensation seeking in a classical conditioning paradigm might elucidate possible pathways toward addiction within this model. Furthermore, the theoretical concept underlying sensation seeking proposes a negative relationship between reward processing and sensation seeking in only moderately arousing situations, which has been neglected by previous research.This study aimed to investigate this inverse relationship in moderately stimulating situations entailing reward processing using functional magnetic resonance imaging. Subjects (N = 38) participated in a classical conditioning paradigm in which a neutral stimulus (CS+) was repeatedly paired with a monetary reward, while another neutral stimulus (CS−) was not.Imaging results revealed a negative relationship between sensation seeking and neural responses in the insula, amygdala and nucleus accumbens during the early phase and in the dorsal anterior cingulate cortex during the late phase of conditioning. These findings suggest reduced reward learning and consequently diminished processing of outcome expectancy in appetitive conditioning in subjects with high sensation seeking scores. The results are discussed with respect to clinical implications.

Persistence of value-modulated attentional capture is associated with risky alcohol use

BackgroundThis study examined how risky patterns of alcohol use might be related to the persistence of learned attentional capture during reversal of stimulus–reward contingencies. MethodsParticipants were 122 healthy adults (mean age 21 years, 66% female) who completed an assessment including a visual search task to measure value-modulated attentional capture, with a reversal phase following a period of initial training. The assessment also included questions about alcohol use. ResultsOverall, attentional capture was greater for distractors associated with high reward than for those associated with low reward, replicating previous findings of value-modulated attentional capture. When stimulus–reward contingencies were reversed, a higher persistence of learned attentional capture was associated with risky patterns of alcohol use. ConclusionThis result highlights how value-modulated attentional capture may persist and is associated with risky alcohol use in a non-clinical sample. Future research (potentially with clinical samples of heavy drinkers) aimed towards understanding the mechanisms that drive these reversal deficits, and their relation to other compulsive behaviours, may provide important insights into the development and maintenance of addictive behaviours.

Bad Choices Make Good Stories: The Impaired Decision-Making Process and Skin Conductance Response in Subjects With Smartphone Addiction.

Introduction: Smartphone Addiction (SA) has caused negative consequences and functional impairments in college students, such as reduction of academic performance and impairment in sleep quality. Studies have shown that individuals with chemical and behavioral dependencies have a bias in decision-making process, which leads to short-term advantageous choices even if they cause long-term harm. This bias in decision-making process is accompanied by a change in somatic markers and is associated with the development and maintenance of addictive behavior. The decision-making process and the measurement of physiological parameters have not yet been analyzed in SA. The neuropsychological and physiological characterization of the SA can contribute to its approach with the other dependency syndromes and to its recognition as a disease.Objective: we aimed to evaluate the decision-making process under risk and under ambiguity in individuals with SA and to measure the physiological parameters that accompany this process.Method: We compared the performance in the Iowa Gambling Task (IGT), Game of Dice Task (GDT) and skin conductance response (SCR) between 50 individuals with SA and 50 controls.Results: Smartphone dependents presented a profile of impairment in decision-making under ambiguity, without impairment in decision-making under risk. They demonstrated lower SCR before disadvantageous choices, higher SCR after rewards and lower SCR after punishments during decision-making, which suggests difficulty in recognizing disadvantageous alternatives, high sensitivity to rewards, and low sensitivity to punishments.Conclusion: The impairment in the decision-making process in smartphone dependents is similar to that found in other chemical and behavioral addictions, such as alcohol addiction, gambling disorders and pathological buy. The impairment in decision under ambiguity with preservation of decision under risk may reflect dysfunction of implicit emotional processes without dysfunction of explicit cognitive process. This profile can contribute to the recognition of SA as a behavioral dependence and to guide specific preventive and therapeutic strategies.

The role of the dark tetrad and impulsivity in social media addiction: Findings from Malaysia

The use of social media platforms is now the cornerstone of communication. Nevertheless, seemingly innocuous habitual social media use may be a signal of behavioural addiction. This study examined the relationships among the Dark Tetrad personality traits (psychopathy, narcissism, Machiavellianism, sadism), impulsivity, and social media addiction. One hundred and twenty-eight Malaysian university students completed the GoStop Impulsivity Paradigm task, a laboratory behavioural measure of impulsivity. Participants also completed the Bergen Social Media Addiction Scale, the Short Dark Triad, and the Assessment of Sadistic Personality. Data on participants' average daily time spent on social media and the number of applications they had were retrieved from their smartphones. Correlation analyses showed that average daily screen-time and psychopathy were positively associated with social media addiction. Regression analyses revealed that being a female, having spent more time on social media, and scoring higher on the psychopathy scale were related to greater levels of addiction. Apart from having a positive correlation with the number of social media applications users had, impulsivity was not associated with any of the variables of interest. This study highlights the importance of a multi-measurement approach to assessing the psycho-socio-demographic variables implicated in the initiation, development, and maintenance of addictive behaviours.

The psychological and genetic factors of the addictive behaviors (PGA) study.

Most of the addiction studies focus on very specific aspects of addictions, often with contradictory results, and integrated studies are quite rare. Experimental studies comparing underlying mechanisms of addictions and analyzing data from an integrative psychological and genetic perspective are almost nonexistent. The aim of the present paper is to describe the research protocol of the Psychological and Genetic Factors of Addictive Behaviors (PGA) study, which applies an integrative approach to understanding the acquisition, development, and maintenance of addictive behaviors. A wide-spectrum national study was carried out. Data were collected from 3,003 adolescents. Addictions to both psychoactive substances and behaviors were thoroughly assessed via psychometrically robust scales, which also included assessment related to a wide range of related psychological dimensions. Additionally, a DNA sample was also collected from participants. The paper presents the detailed methodology of the PGA study. Data collection procedures, instrumentation, and the analytical approach used to attain the research objectives are described. Future plans, along with potential contributions of the PGA study, are also discussed. It is envisaged that the study will provide a unique opportunity to test possible mechanisms and causal pathways mediating the associations of genetic factors, psychological characteristics, and addictions.

Mind reading abilities in opiate-dependent patients: An exploratory study

ObjectivesImpairments in social cognition have been described as playing a major role in the maintenance of addictive behavior in substance abusers. This study aimed to investigate the Theory of Mind (ToM) ability of opiate-dependent (OD) patients and to explore whether TOM ability was correlated with length of substance abuse, age at onset of substance abuse and length of abstinence. MethodsOD patients (N = 29) and non-dependent individuals (NDI) (N = 29) were submitted to the Theory of Mind Assessment Scale (Th.o.m.a.s.), a semi-structured interview, and to the Versailles-Lecture Intentionnelle en Situation (V-LIS), a movie paradigm in which participants have to infer the characters' intentions. ResultsThe results confirmed a deficit in ToM ability in OD patients, with OD patients demonstrating poorer performance than NDI on both the V-LIS and the Th.o.m.a.s. The combination of perspective taking and reflecting on others' mental states was particularly difficult for OD patients. Furthermore, impairments in ToM abilities were not correlated with the age at onset of substance abuse or to the duration of substance abuse or abstinence. ConclusionsThe results suggest OD patients may have impaired social cognition, demonstrating deficits in even basic social interaction skills, which may constitute a risk factor for addiction. These findings underline the importance of developing interventions to improve social cognition ability during the rehabilitation of OD patients.