Processes In Substance Use Disorders Research Articles

Slower Learning Rates from Negative Outcomes in Substance Use Disorder over a 1-Year Period and Their Potential Predictive Utility.

Computational modelling is a promising approach to parse dysfunctional cognitive processes in substance use disorders (SUDs), but it is unclear how much these processes change during the recovery period. We assessed 1-year follow-up data on a sample of treatment-seeking individuals with one or more SUDs (alcohol, cannabis, sedatives, stimulants, hallucinogens, and/or opioids; N = 83) that were previously assessed at baseline within a prior computational modelling study. Relative to healthy controls (HCs; N = 48), these participants were found at baseline to show altered learning rates and less precise action selection while completing an explore-exploit decision-making task. Here we replicated these analyses when these individuals returned and re-performed the task 1 year later to assess the stability of baseline differences. We also examined whether baseline modelling measures could predict symptoms at follow-up. Bayesian and frequentist analyses indicated that: (a) group differences in learning rates were stable over time (posterior probability = 1); and (b) intra-class correlations (ICCs) between model parameters at baseline and follow-up were significant and ranged from small to moderate (.25 ≤ ICCs ≤ .54). Exploratory analyses also suggested that learning rates and/or information-seeking values at baseline were associated with substance use severity at 1-year follow-up in stimulant and opioid users (.36 ≤ rs ≤ .43). These findings suggest that learning dysfunctions are moderately stable during recovery and could correspond to trait-like vulnerability factors. In addition, computational measures at baseline had some predictive value for changes in substance use severity over time and could be clinically informative.

The roles of implicit approach motivation and explicit reward in excessive and problematic use of social networking sites.

Despite growing concerns about the addictive potential of social networking sites (SNSs), little is known about the precise neural, cognitive, and emotional processes underpinning compulsive SNS behaviours, such as excessive checking of SNSs. Recent evidence points to the important role of reward in SNS behaviours and one avenue to examine reward processes related to SNSs is the use of behavioural paradigms that allow for the measurement of implicit motivational responses, such as the approach avoidance task (AAT). The AAT has been successfully utilised to capture changes in unconscious reward processes in substance use disorders and other behavioural addictions, with faster approach reactions to addiction-related stimuli reflecting increased wanting/urges to have/consume the reward. In the present study 411 young adults completed an online Visual Approach/Avoidance by the Self Task (VAAST) with social media and control logos as well as other subjective (explicit) measures of reward experience related to SNSs. Our results showed that across participants SNS logos elicited strong approach reactions (compared to control stimuli) and that stronger SNS approach tendencies predicted more frequent SNS checking. Importantly, increased approach motivation was not associated with more problematic use. However, both checking frequency and problematic use were related to alterations of explicit reward processing, including the subjective experience of SNS urges or wanting. We conclude that changes in automatic approach motivation towards SNS stimuli are common in most SNS users, which suggests that implicit imbuement of social media with reward has become pervasive among young adults. Problematic SNS use however may be more reliably indicated by changes in explicit reward processing, such as subjective wanting.

Symptom networks in patients with substance use disorders

BackgroundReciprocity between symptoms of psychiatric disorders is increasingly recognized to contribute to their chronicity. In substance use disorders (SUD) little is known on reciprocal interactions between symptoms. We applied network analyses to study these interactions. MethodsWe analyzed 11 DSM-IV / DSM-5 criteria for SUD for the most prevalent substances in addiction care (alcohol, cannabis, cocaine, stimulants, and opioids) in a sample of 10,832 SUD patients in treatment. First, we estimated an overall symptom network. Second, we compared symptom networks between the different substances. Finally, we tested differences in symptom networks between DSM-IV and DSM-5. ResultsIn the overall symptom network for SUD patients the most central symptom was: “spending substantial amount of the day obtaining, using, or recovering from substance use”. The symptoms "giving up or cutting back on important activities because of use" and "repeated usage causes or contributes to an inability to meet important obligations", were the symptoms that influenced each other the most. Networks differed between substances both in global strength and structure, especially regarding the position of “use despite health or interpersonal problems”. Networks based on DSM-5 criteria differed moderately from DSM-IV, mainly because “craving” was more central in the DSM-5 network than “legal problems” in DSM-IV. ConclusionsNetwork analyses can identify core symptoms of SUD that could maintain the disease processes in SUD. Future studies should address whether targeting these core symptoms with precedence, might help to break through the addictive process.

Demand for fentanyl becomes inelastic following extended access to fentanyl vapor self-administration

Opioid use disorder imposes great societal harm in the United States and in countries worldwide. Animal models that accurately capture motivational changes that occur in opioid dependence are critical to studying this disorder. The present study used a model of opioid vapor self-administration combined with a behavioral economics approach to determine whether rats would be more motivated to “work” to defend their baseline intake of fentanyl (i.e., more inelastic demand) following sufficiently frequent, intense, and chronic exposure to self-administered vaporized fentanyl. Male rats were allowed to respond for deliveries of 1.5-s of vaporized 10 mg/ml fentanyl solution. Following 15 sessions of short access (ShA; 1 h) vs. long access (LgA; 12 h) to self-administration, we conducted a between-sessions demand curve procedure, and observed significantly more inelastic demand for fentanyl (Essential Value; EV), and increased maximal response output (Omax) in LgA compared with ShA rats. In a subsequent phase, the unit-dose was doubled to 3 s of fentanyl vaporization. After seven ShA vs. LgA sessions, we assessed demand again and found that LgA rats, contrasted to ShA rats, demonstrated significantly higher baseline intake or “hedonic setpoint” (Q0), in addition to significantly increased EV and Omax. These results demonstrate that extended access to self-administration of a vaporized opioid causes changes in behavioral economic metrics consistent with development of an addiction-like state in rats. The combination of the vapor model with a translationally relevant behavioral economics framework opens new avenues to study dysregulated motivational processes in substance use disorders.

The effect of significant other involvement in treatment for substance use disorders: A meta-analysis.

Substantial research has accrued in support of a key role for social processes in substance use disorders (SUD). Researchers have developed a range of interventions that capitalize on these social processes to bolster treatment outcomes by involving significant others (e.g., romantic partners, family, friends) in SUD treatment. Yet dissemination of these treatments to many contexts has been slow, and information on their broad efficacy is lacking. This meta-analysis aims to quantify the effect of significant other involvement in SUD treatments above and beyond individually-based therapies. A total of 4,901 records were screened for randomized controlled trials examining the effect of Significant Other Involved SUD Treatments (SOIT) versus individually-based active comparator treatments. Our search yielded 77 effect sizes based on data from 2,115 individuals enrolled in 16 independent trials. Findings indicated a significant effect of SOIT above and beyond individually-based active comparator treatments for reducing substance use and substance-related problems, d = 0.242, 95% CI [0.148, 0.336], I² = 10.596, Q(15) = 16.778. This effect was consistent across SOIT treatment types and endured 12-18 months after the end of treatment. Analyses of raw mean differences indicated that this effect translates to a 5.7% reduction in substance use frequency-the equivalent of approximately 3 fewer weeks a year of drinking/drug use. Findings indicate a significant advantage for SOIT in SUD treatment, and hold interesting conceptual implications for theories of SUD maintenance. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Explicating the role of empathic processes in substance use disorders: A conceptual framework and research agenda.

Elucidating the role of empathic processes in developmental pathways to substance use disorders could have important implications for prevention. We searched the biomedical and social sciences literature to determine what is known about empathy and psychopathological manifestations of severe lack of empathy in the initiation, development and maintenance of psychoactive substance use. Thirty-seven empirical studies were identified and formally reviewed. Adults with alcohol and stimulant use disorders exhibited detectable impairments in both cognitive and affective empathy, measured behaviourally, neuroanatomically and by self-report, relative to controls. There were no developmental studies specifically designed to test the role of empathy in substance use pathways, but several studies that included measures of empathy suggest that empathy may be protective. Studies on severe empathic deficits were mixed regarding a unique role of empathy in substance use trajectories, independent of interpersonal style, impulsivity and social deviance. Implications and Conclusions. In the context of findings and methodological limitations of this review, we recommend more rigorous examination of empathy across the spectrum of substance use behaviour. Future work should utilise the following: (i) prospective assessment of empathic capacity in substance abusers during and following treatment; (ii) large, developmentally based prospective designs beginning prior to substance initiation incorporating multiple measures of empathy; (iii) assessment of the moderating role of gender, race and ethnicity; and (iv) prospective study of empathy in children at elevated risk for substance use disorders. [Massey SH, Newmark RL, Wakschlag LS. Explicating the role of empathic processes in substance use disorders: A conceptual framework and research agenda.