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1.
Alcohol Alcohol ; 59(4)2024 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-38864292

RESUMO

AIMS: The objective of the current study was to describe and analyse associations between childhood emotional abuse, severity of depressive symptoms, and analgesic expectations of drinking in individuals with alcohol use disorder (AUD). METHODS: A total of 240 individuals aged 43.85 ± 11.0 with severe AUD entering an inpatient, abstinence-based, and drug-free treatment program were assessed. The data on AUD severity, depressive symptoms, expectations towards the analgesic effects of alcohol and childhood emotional trauma was collected using questionnaire measures. The PROCESS SPSS macro for serial mediation with bootstrapping was used to test whether current severity of depressive symptoms and expectations towards analgesic effects of alcohol use serially mediated the association between childhood emotional abuse on AUD symptom severity. RESULTS: There was evidence for two simple mediated effects, whereby the severity of depressive symptoms mediated the association between childhood emotional abuse on AUD symptom severity, and expectations towards analgesic effects of alcohol mediated the association between childhood emotional abuse on AUD symptom severity. There was also evidence to support serial mediation whereby both severity of depressive symptoms and expectations towards analgesic effects of alcohol mediated the association between childhood emotional abuse on AUD symptom severity. CONCLUSIONS: It might be clinically relevant to address experiences of childhood emotional trauma, as well as individual expectations of analgesic effects of alcohol, in AUD treatment programs.


Assuntos
Alcoolismo , Depressão , Humanos , Masculino , Feminino , Adulto , Alcoolismo/psicologia , Depressão/psicologia , Depressão/tratamento farmacológico , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Inquéritos e Questionários , Abuso Emocional/psicologia , Experiências Adversas da Infância/psicologia
2.
J Sex Med ; 17(9): 1761-1769, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32690426

RESUMO

BACKGROUNDS: The classification of addictions and impulse control disorders is changing as reflected in the 11th version of International Classification of Disorders (WHO, 2018). However, studies focusing on direct comparison of structural brain differences in behavioral and substance addictions are limited. AIM: Here, we contrast gray matter volumes (GMVs) across groups of individuals with compulsive sexual behavior disorder (CSBD), gambling disorder (GD), and alcohol use disorder (AUD) with those with none of these disorders (healthy controls participants; HCs). METHODS: Voxel-based morphometry was used to study brain structure, and severities of addiction symptoms were assessed with questionnaires. To identify brain regions related to severities of addictions, correlations between questionnaire scores and GMVs were computed. MAIN OUTCOME: We collected magnetic resonance imaging (GMVs) data from 26 patients with CSBD, 26 patients with GD, 21 patients with AUD, and 25 HC participants (all heterosexual males; age: 24-60; mean = 34.5, standard deviation = 6.48). RESULTS: Affected individuals (CSBD, GD, AUD) compared with HC participants showed smaller GMVs in the left frontal pole, specifically in the orbitofrontal cortex. The most pronounced differences were observed in the GD and AUD groups, and the least in the CSBD group. In addition, a negative correlation was found between GMVs and disorder severity in the CSBD group. Higher severity of CSBD symptoms was correlated with decreased GMVs in the right anterior cingulate gyrus. CLINICAL IMPLICATIONS: Our findings suggest similarities between CSBD and addictions. STRENGHS AND LIMITIATIONS: This study is the first showing smaller GMVs in 3 clinical groups of CSBD, GD, and AUD. But the study was limited only to heterosexual men. Longitudinal studies should examine the extent to which ventral prefrontal decrements in volume may represent preexisting vulnerability factors or whether they may develop with disorder progression. CONCLUSIONS: Our research extends prior findings in substance use disorders of lower GMVs in prefrontal cortical volumes among 3 clinical groups of patients with specific impulse control (CSBD) and behavioral (GD) and substance (AUD) addictive disorders. The negative correlation between CSBD symptoms and GMV of right anterior cingulate gyrus suggests a link with clinical symptomatology. Draps M, Sescousse G, Potenza MN, et al. Gray Matter Volume Differences in Impulse Control and Addictive Disorders-An Evidence From a Sample of Heterosexual Males. J Sex Med 2020;17:1761-1769.


Assuntos
Comportamento Aditivo , Substância Cinzenta , Adulto , Comportamento Aditivo/diagnóstico por imagem , Córtex Cerebral , Substância Cinzenta/diagnóstico por imagem , Heterossexualidade , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Adulto Jovem
3.
J Sex Med ; 14(1): 125-133, 2017 01.
Artigo em Inglês | MEDLINE | ID: mdl-27989490

RESUMO

INTRODUCTION: Rape and pedophilic child molestation are the most commonly convicted sexual offenses in Poland. Recent studies have suggested a possible genetic contribution toward pathologic sexual interests and behaviors. AIM: To analyze and compare functional polymorphisms of genes associated with the activity of the serotonin and dopamine systems in a group of paraphilic sexual offenders and control subjects. METHODS: The study sample (n = 97) consisted of two groups: paraphilic sexual offenders (65 pedophilic child molesters and 32 rapists) and controls (n = 76). Genetic polymorphisms previously associated with behavioral control, addictive behaviors, and sexual functions were chosen for analyses. Specifically, functional polymorphisms in dopamine receptors genes (DRD1, DRD2, DRD4), catechol-O-methyltransferase gene (COMT), dopamine transporter gene (DAT), serotonin transporter gene (SLC6A4), serotonin type 2A receptor gene (5HTR2A), tryptophan hydroxylase 2 gene (TPH2), monoamine oxidase A gene (MAOA), and brain-derived neurotrophic factor gene (BDNF) were analyzed. MAIN OUTCOME MEASURES: An association between a history of sexual offense and the distribution of genotypes and alleles in the analyzed polymorphisms. RESULTS: Our results found no association between a history of sexual offense and the distribution of genotypes or alleles in the analyzed polymorphisms. CONCLUSION: Although these results are limited by the small sample and are exploratory, they highlight a novel approach to sample selection in a population that is difficult to access and study. Future research should include larger samples and other relevant polymorphisms to advance this field of study.


Assuntos
Criminosos , Dopamina/metabolismo , Pedofilia/genética , Serotonina/metabolismo , Adulto , Alelos , Estudos de Casos e Controles , Catecol O-Metiltransferase/genética , Criança , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Polônia , Polimorfismo Genético , Delitos Sexuais
4.
Subst Use Misuse ; 51(10): 1307-17, 2016 08 23.
Artigo em Inglês | MEDLINE | ID: mdl-27223091

RESUMO

BACKGROUND: Individuals with alcohol use disorders have been shown to be at increased risk for suicidal behaviors and chronic pain. OBJECTIVES: The aim of this study was to conduct initial analyses of the association between current physical pain and the likelihood of suicidal behavior history in alcohol-dependent patients entering treatment in Poland. METHODS: A sample of 366 (73.5% men and 26.5% women) participants were recruited from alcohol treatment centers in Warsaw, Poland. Information was obtained about a history of lifetime suicidal behavior, past 4-week pain level, demographics, social functioning, childhood abuse, depressive symptoms, severity of alcohol and sleep problems. RESULTS: A total of 118 individuals (32.2%) reported at least one suicidal behavior during their lifetime. In unadjusted analyses, there was a significant association between a history of lifetime suicidal behavior and a moderate or greater experience of physical pain during the last four weeks. Other variables that were significantly associated with suicidal behaviors were: younger age, history of childhood abuse, depressive symptoms, sleep problems, consequences of drinking, and lower social support. In the multivariate logistic regression analysis, only experience of moderate or greater pain, age, and depressive symptoms remained significantly associated with a history of suicidal behavior. CONCLUSIONS: The experience of physical pain is significantly associated with a lifetime history of suicidal behavior in alcohol-dependent patients. Clinicians should be aware of these associations when conducting assessments and treating alcohol use disorders.


Assuntos
Ideação Suicida , Alcoolismo , Criança , Maus-Tratos Infantis , Feminino , Humanos , Masculino , Dor , Polônia , Fatores de Risco , Tentativa de Suicídio
5.
Neuropsychobiology ; 72(2): 126-31, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26630184

RESUMO

OBJECTIVES: Dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis leads to impaired stress response. FK506-binding protein 51 (FKBP5), which influences HPA axis activity via glucocorticoid receptors, is supposed to play an important role in the regulation of negative feedback and glucocorticoid resistance. Since ineffective stress response mechanisms are considered as a biological background of suicide behavior, we aimed to analyze a possible association between FKBP5 functional polymorphisms and completed suicide. METHODS: The selected FKBP5 polymorphisms rs1360780 and rs3800373 were genotyped in a sample of 563 suicide victims and 475 controls. RESULTS: A significant association between the high-induction rs3800373 C allele and completed suicide was detected (OR = 1.36, p = 0.007). In this polymorphism, genotype distribution supported a codominant model of inheritance. The analyzed SNPs were in strong linkage disequilibrium (D' = 0.916 and r2 = 0.826) with the rs1360780 (T)-rs3800373 (C) haplotype apparently responsible for the observed association (OR = 1.34, p = 0.010). CONCLUSION: The results of the present study indicate that genetic alterations in FKBP5 may influence vulnerability to suicide.


Assuntos
Polimorfismo de Nucleotídeo Único , Suicídio , Proteínas de Ligação a Tacrolimo/genética , Adulto , Feminino , Predisposição Genética para Doença , Genótipo , Técnicas de Genotipagem , Humanos , Desequilíbrio de Ligação , Masculino , Modelos Genéticos
6.
Alcohol Alcohol ; 50(2): 173-9, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25543129

RESUMO

AIMS: Growing data reveals deficits in perception, understanding and regulation of emotions in alcohol dependence (AD). The study objective was to explore the relationships between emotional processing, drinking history and relapse in a clinical sample of alcohol-dependent patients. METHODS: A group of 80 inpatients entering an alcohol treatment program in Warsaw, Poland was recruited and assessed at baseline and follow-up after 12 months. Baseline information about demographics, psychopathological symptoms, personality and severity of alcohol problems was obtained. The Schutte Self-Report Emotional Intelligence (EI) Test and Toronto Alexithymia Scale (TAS) were utilized for emotional processing assessment. Follow-up information contained data on drinking alcohol during the last month. RESULTS: At baseline assessment, the duration of alcohol drinking was associated with lower ability to utilize emotions. Patients reporting more difficulties with describing feelings drank more during their last episode of heavy drinking, and had a longer duration of intensive alcohol use. A longer duration of the last episode of heavy drinking was associated with more problems identifying and regulating emotions. Poor utilization of emotions and high severity of depressive symptoms contributed to higher rates of drinking at follow-up. CONCLUSIONS: These results underline the importance of systematic identification of discrete emotional problems and dynamics related to AD. This knowledge has implications for treatment. Psychotherapeutic interventions to improve emotional skills could be utilized in treatment of alcohol-dependent patients.


Assuntos
Sintomas Afetivos/psicologia , Alcoolismo/psicologia , Depressão/psicologia , Inteligência Emocional , Emoções , Adulto , Transtornos Relacionados ao Uso de Álcool/psicologia , Transtornos Relacionados ao Uso de Álcool/terapia , Alcoolismo/terapia , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Polônia , Recidiva , Índice de Gravidade de Doença , Fatores de Tempo
7.
Community Ment Health J ; 51(5): 628-34, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25535045

RESUMO

The study investigated explicit and implicit attitudes towards people with mental illness among medical students (non-professionals) with no previous contact with mentally ill patients and psychiatrists and psychotherapists (professionals) who had at least 2 years of professional contact with mentally ill patients. Explicit attitudes where assessed by self-report. Implicit attitudes were measured with the Go/No-Go Association Task, a variant of the Implicit Association Test that does not require the use of a comparison category. Compared to non-professionals, mental health professionals reported significantly higher approach emotions than non-professionals towards people with mental illness, showed a lesser tendency to discriminate against them, and held less restrictive attitudes. Both groups reported negative implicit attitudes towards mentally ill. Results suggest that both non-professionals and professionals display ambivalent attitudes towards people with mental illness and that professional, long-term contact with people with mental illness does not necessarily modify negative implicit attitudes.


Assuntos
Atitude do Pessoal de Saúde , Pessoal de Saúde/psicologia , Transtornos Mentais/psicologia , Estereotipagem , Estudantes de Medicina/psicologia , Adulto , Emoções , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polônia , Psiquiatria , Testes Psicológicos , Psicoterapia , Faculdades de Medicina , Estigma Social , Adulto Jovem
8.
Front Psychiatry ; 14: 1175664, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37252141

RESUMO

Background: Previous research suggests that low distress tolerance may be associated with poor emotion regulation, contribute to drinking to cope motives, and predict alcohol-related problems in non-clinical populations. However, little is known about the ability to tolerate distress among individuals with alcohol use disorder (AUD) and its association with emotional dysregulation. The aim of this study was to examine the link between emotional dysregulation and a behavioral measure of distress tolerance among individuals with AUD. Methods: The sample consisted of 227 individuals with AUD enrolled in an 8-week abstinence-based inpatient treatment program. Behavioral distress tolerance was assessed using a test of ischemic pain tolerance and the Difficulties in Emotion Regulation Scale (DERS) was used to assess emotion dysregulation. Results: Distress tolerance was significantly associated with emotional dysregulation even when accounting for alexithymia, depressive symptomatology, age, and biological sex. Conclusion: The current study provides preliminary support for an association between low distress tolerance and emotion dysregulation in a clinical group of patients with AUD.

9.
Front Psychiatry ; 14: 1229985, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37810600

RESUMO

Background: Interoception (i.e., the ability to recognize bodily signals), alexithymia (i.e., the inability to recognize emotional states) and negative affect (i.e., unpleasant feelings such as anxiety) have been associated with alcohol use disorder (AUD). Previous research suggests that interoception may underlie alexithymia, which in turn may be associated with negative affectivity. However, this remains to be empirically tested. This study investigates whether alexithymia mediates the association between interoception and anxiety and whether this association differs across individuals with AUD and a healthy control (HC) comparison group. Methods: The AUD group consisted of 99 participants enrolled in an 8-week abstinence-based inpatient treatment program. The HC group included 103 healthy individuals. The heartbeat counting task (HCT) was used to assess interoception (cardiac interoceptive accuracy). The Toronto Alexithymia Scale (TAS-20) was used to assess alexithymia. The Brief Symptom Inventory (BSI) was used to assess anxiety. Results: The moderated mediation model with interoception as the predictor, alexithymia as the mediator, and negative affect (i.e., state anxiety) as the dependent variable was tested. The analysis showed that the conditional indirect effect of interoception on anxiety via alexithymia was significant for individuals with AUD [ab = -0.300, bootstrap 95% CI = (-0.618, -0.088)], as well as for HCs [ab = -0.088, bootstrap 95% CI = (-0.195, -0.014)]; however, the conditional indirect effect significantly differed across HCs and individuals with AUD. Namely, the mediated effect was greater among individuals with AUD compared to the HC group. Conclusion: The results suggests that interoceptive impairment contributes to greater negative affect (i.e., state anxiety) via alexithymia especially for individuals with AUD. Improving emotion recognition via therapeutic methods focused on strengthening interoceptive abilities could improve outcomes for individuals receiving treatment for AUD.

11.
Drug Alcohol Depend ; 236: 109500, 2022 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-35623159

RESUMO

BACKGROUND: Adolescent electronic cigarette use (e-cigarette) is a public health concern and factors associated with vaping remain to be understood. Childhood emotional abuse/neglect is a risk factor for e-cigarettes. Yet, pathways by which trauma impacts use remain unclear. Alexithymia (i.e., difficulties identifying and describing feelings) is one possible link. Indeed, emotional abuse/neglect leads to difficulties identifying and verbalizing emotions. This impairment may lead to distress and promote e-cigarette use as a coping strategy. METHODS: Using parallel mediation, this study examined the degree to which alexithymia, assessed using the Toronto Alexithymia Scale, mediates the link between emotional abuse/neglect, assessed using the Child and Adolescent Trauma Screen, and e-cigarette use. The sample (n = 166) consisted of adolescents from a larger multi-wave study. RESULTS: Emotional abuse/neglect predicted difficulty describing feelings (effect = 0.23, p = 0.001), which in turn predicted e-cigarette use (effect = 0.30, p = 0.004). Moreover, difficulty describing feelings mediated the link between emotional abuse/neglect and e-cigarette use (sum of indirect 95% CI [1.68, 16.48]). Difficulty identifying feelings was not a significant mediator and the externally-oriented thinking subscale was excluded due to low reliability. CONCLUSIONS: As e-cigarettes are often used in social contexts, teens who experience difficulty describing feelings may vape as a means of connecting emotionally with others. Moreover, nicotine, found in most e-cigarettes, releases dopamine and noradrenaline in the brain modulating action, learning, and memory processes; plausibly, improving verbalization of emotions. Programming which identifies nuances in alexithymia among adolescents with emotional abuse/neglect could mitigate e-cigarette use or delay initiation.


Assuntos
Experiências Adversas da Infância , Sistemas Eletrônicos de Liberação de Nicotina , Vaping , Adolescente , Sintomas Afetivos/psicologia , Criança , Emoções , Humanos , Reprodutibilidade dos Testes
12.
Artigo em Inglês | MEDLINE | ID: mdl-35270392

RESUMO

Alcohol craving is associated with insomnia symptoms, and insomnia is often reported as a reason for alcohol relapse. The current study examined associations between emotional regulation, anxiety, and insomnia among a group of 338 patients with alcohol use disorder (AUD). Because insomnia most often develops after stressful experiences, it was expected that anxiety symptoms would mediate the association between emotional dysregulation and insomnia severity. It was also expected that an insomnia diagnosis would moderate the association between emotional dysregulation and anxiety symptoms, namely that higher anxiety levels would be found in individuals with insomnia than in those without insomnia. Insomnia severity was assessed with a total score based on the Athens Insomnia Scale (AIS). Additionally, an eight-point cut-off score on the AIS was used to classify participants as with (n = 107) or without (n = 231) an insomnia diagnosis. Moreover, participants completed the Emotion Regulation Scale (DERS; total score) and the Brief Symptoms Inventory (BSI; anxiety). Individuals with insomnia did not differ from those without insomnia in age (p = 0.86), duration of problematic alcohol use (p < 0.34), mean days of abstinence (p = 0.17), nor years of education (p = 0.41). Yet, individuals with insomnia endorsed higher anxiety (p < 0.001) and higher emotional dysregulation (p < 0.001). Anxiety symptoms fully mediated the association between emotional dysregulation and insomnia severity (p < 0.001). Furthermore, insomnia diagnosis positively moderated the association between emotional dysregulation and anxiety (p < 0.001). Our results suggest that emotional dysregulation can lead to insomnia via anxiety symptoms. Treating anxiety symptoms and emotional dysregulation could help to prevent or alleviate symptoms of insomnia in people with AUD. Moreover, treating insomnia in people with AUD may also have a positive effect on anxiety symptoms.


Assuntos
Alcoolismo , Distúrbios do Início e da Manutenção do Sono , Consumo de Bebidas Alcoólicas , Alcoolismo/complicações , Alcoolismo/epidemiologia , Ansiedade/epidemiologia , Ansiedade/psicologia , Transtornos de Ansiedade , Humanos , Distúrbios do Início e da Manutenção do Sono/epidemiologia
13.
J Psychiatr Res ; 151: 131-135, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35477077

RESUMO

Studies within the last decade have reported neural and behavioral differences in cognitive control between men with the pedophilic disorder who commit (CSO+) and do not commit (CSO-) child sexual abuse. Prior studies reported a higher number of errors in Go/Nogo task and lower activity of the prefrontal cortex in NoGo trials, in CSO+ compared with CSO-. Moreover, negative mood was reported as a risk factor for child sexual abuse in pedophilic men. We aimed to examine differences in brain function and behavior between CSO+ and CSO- patients regarding emotional interference on cognitive processes and inhibition. We recruited CSO+ (n = 11) and CSO- (n = 14) patients as well as matched healthy controls (HC) (n = 17). Participants performed the affective Go/NoGo task in a block-design functional magnetic resonance imaging experiment. The task comprised the following four conditions: Negative Go, including only Go stimuli and negatively valenced pictures; Negative NoGo, including 50% of Go and 50% of NoGo trials as well as negatively valenced pictures; and two corresponding conditions with neutral pictures. Brain analysis was restricted to the dorsolateral prefrontal (DLPFC), orbitofrontal, and anterior cingulate cortices. The HC and CSO- groups, but not the CSO+ group, showed significantly slower reactions in negative blocks compared with neutral blocks. Brain analysis revealed increased activation in the right DLPFC during emotional interference contrast (Negative > Neutral) in the HC and CSO- groups; however, there was decreased activation in the CSO+ group. In the CSO+ group, negative distractors did not increase cognitive control processes, which was observed in the CSO- and HC groups at the behavioral and neural levels. These results support previous reports indicating offender status is associated with cognitive and emotional impairments.


Assuntos
Abuso Sexual na Infância , Criminosos , Criança , Abuso Sexual na Infância/psicologia , Cognição/fisiologia , Córtex Pré-Frontal Dorsolateral , Emoções/fisiologia , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Córtex Pré-Frontal/diagnóstico por imagem
14.
Drug Alcohol Depend ; 225: 108809, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-34175785

RESUMO

INTRODUCTION: One of the core symptoms of alcohol use disorder (AUD) is impulsivity. The recently published study on the Impulsivity Scale 12 (IS-12) offers a promising tool to use in clinics working with clients with AUD due to its simplicity. IS-12 includes subscales related tocognitive impulsivity and behavioral impulsivity, which are related to different aspects of AUD symptomatology. The aim of the study was to adapt IS-12 to polish and test its utility in a sample of patients diagnosed with AUD. METHODS: Using a Confirmatory Factor Analysis, we compared the two-factor model of the Polish adaptation of the BIS-11 and the IS-12 on a sample of 615 patients diagnosed with AUD. Additionally, we explored the association between the IS-12's cognitive impulsivity and behavioral impulsivity subscales and depressive symptoms, AUD severity, and suicidal ideation using Structural Equation Modeling on a subsample of 450 patients with AUD. RESULTS: The IS-12 demonstrated a better model fit and good reliability compared to the BIS-11. Moreover, cognitive impulsivity predicted suicidal ideation, but not AUD severity, while behavioral impulsivity predicted AUD severity, but not suicidal ideation. Both subscales of IS-12 predicted depressive symptoms. CONCLUSION: Consistent with prior work, findings indicate that the second-order factor model of the BIS-11 had reliability issues and evidenced poor model fit. In contrast, the IS-12 demonstrated a satisfactory model fit and was predictive of clinical symptomatology. Thus, utilizing an easy tool, such as IS-12, might be beneficial for researchers and clinicians working with patients with AUD.


Assuntos
Alcoolismo , Alcoolismo/diagnóstico , Análise Fatorial , Humanos , Comportamento Impulsivo , Reprodutibilidade dos Testes , Ideação Suicida
15.
Psychiatr Pol ; 55(6): 1433-1448, 2021 Dec 31.
Artigo em Inglês, Polonês | MEDLINE | ID: mdl-35472237

RESUMO

A review of the literature on emotion regulation in binge eating disorder (BED) published both in English and Polish between 1990 and 2020. BED might be considered as an impulsive and compulsive disorder associated with altered reward sensitivity and food-related attentional bias. The growing body of research indicated that there were corticostriatal circuitry alterations in BED, comparable to those observed in substance abuse, including altered function of orbitofrontal, prefrontal and insular cortices with the striatum included. Negative emotions and deficits in their regulation play a significant role in BED. Processing of anger, anxiety and sadness appear to be particularly important in this disorder. Research results identified an increase in negative emotions preceding episodes of binge eating. However, there is still inconsistency when it comes to whether these episodes alleviate negative affect. Individuals with BED more often use non-adaptive emotion regulation strategies, such as rumination and suppression of negative sensations. Whereas adaptive ones, for instance, cognitive reappraisal, are used less often. Clinical implications, besides pharmacology, highlight the high effectiveness of enhanced cognitive behavioral therapy (CBT-E), dialectic-behavioral therapy (DBT) and psychodynamic therapy in the treatment of emotional dysregulation in BED. Further studies, including ecological momentary assessment (EMA), should focus on emotional changes related to the binge cycle and the identification of reinforcing factors of BED.


Assuntos
Transtorno da Compulsão Alimentar , Bulimia , Terapia Cognitivo-Comportamental , Regulação Emocional , Transtorno da Compulsão Alimentar/psicologia , Transtorno da Compulsão Alimentar/terapia , Emoções , Humanos , Comportamento Impulsivo
16.
J Clin Med ; 10(6)2021 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-33806849

RESUMO

Previous work suggests that the association between pain and emotional processes among individuals with alcohol use disorder (AUD) may differ from healthy controls. This study investigates whether pain sensitivity mediates the association between negative affect and emotional dysregulation and whether this association differs across AUD status using moderated mediation. The sample included 165 individuals diagnosed with AUD and 110 healthy controls. Of interest was pain sensitivity, as assessed with the Pain Sensitivity Questionnaire, negative affect, as assessed with the Beck Depression Inventory, and emotional dysregulation, as assessed with the Difficulties in Emotional regulation Scale. Age, biological sex, and current pain severity were included as covariates. The results support a moderated partial mediation model that explained 44% of the variance in emotional dysregulation. The findings indicate that negative affect is related to higher pain sensitivity across groups. Moreover, pain sensitivity partially mediated the association between negative affect and emotional dysregulation, but in opposite directions depending on AUD status. Among healthy controls, greater pain sensitivity was related to better emotional regulation, while greater pain sensitivity led to greater emotional dysregulation among individuals with AUD. The potential parallels in the underlying neurobiological mechanisms of emotionality, pain, and AUD suggest that interventions targeting pain may improve adaptive affect regulation skills, which in turn could reduce negative affect and its effect on pain sensitivity among individuals with AUD.

17.
Artigo em Inglês | MEDLINE | ID: mdl-34224795

RESUMO

Interoception, defined as the ability to perceive and interpret body signals, may play an important role in alcohol use disorder (AUD). Earlier studies suggested an association between interoception impairment and known risk factors for AUD (e.g., alexithymia, emotion dysregulation, impulsivity, pain). Neurobiological studies show that the neurotoxicity of alcohol affects various elements of the interoceptive system (especially the insula) at structural and functional levels, with differential short/long term impacts. Conversely, primary interoceptive impairments may promote alcohol consumption and foster the evolution towards addiction. Despite convincing evidence demonstrating that interoception impairment may be an important contributor to the development and course of AUD, only a few studies directly evaluated interoceptive abilities in AUD. The research shows that interoceptive accuracy, the objective component of interoception, is lower in AUD individuals, and is correlated with craving and emotion dysregulation. Interoceptive sensibility is in turn higher in AUD individuals compared to healthy controls. Moreover, there is evidence that therapy focused on improving the ability to sense signals from the body in addiction treatment is effective. However, important methodological limitations in interoceptive measures persist, and it is therefore necessary to further investigate the associations between interoception and AUD.


Assuntos
Alcoolismo , Conscientização/fisiologia , Fissura , Interocepção/fisiologia , Sintomas Afetivos/psicologia , Atenção , Comportamento Aditivo/psicologia , Humanos , Comportamento Impulsivo
18.
Addiction ; 116(1): 18-31, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32533728

RESUMO

BACKGROUND AND AIMS: Binge eating disorder (BED) is correlated with substance use. This study aimed to estimate the life-time prevalence of alcohol use disorder (AUD) among individuals with non-compensatory binge eating and determine whether their life-time prevalence of AUD is higher than in non-bingeing controls. DESIGN: A systematic search of databases (PubMed, Embase and Web of Science) for studies of adults diagnosed with BED or a related behavior that also reported the life-time prevalence of AUD was conducted. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol was followed. The protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO). SETTING: Studies originating in Canada, Sweden, the United Kingdom and the United States. PARTICIPANTS: Eighteen studies meeting the inclusion criteria were found, representing 69 233 individuals. MEASUREMENTS: Life-time prevalence of AUD among individuals with binge eating disorder and their life-time relative risk of AUD compared with individuals without this disorder. RESULTS: The pooled life-time prevalence of AUD in individuals with binge eating disorder was 19.9% [95% confidence interval (CI) = 13.7-27.9]. The risk of life-time AUD incidence among individuals with binge eating disorder was more than 1.5 times higher than controls (relative risk = 1.59, 95% CI = 1.41-1.79). Life-time AUD prevalence was higher in community samples than in clinical samples (27.45 versus 14.45%, P = 0.041) and in studies with a lower proportion of women (ß = -2.2773, P = 0.044). CONCLUSIONS: Life-time alcohol use disorder appears to be more prevalent with binge eating disorder than among those without.


Assuntos
Alcoolismo/epidemiologia , Transtorno da Compulsão Alimentar/complicações , Adulto , Canadá/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prevalência , Risco , Suécia/epidemiologia , Reino Unido/epidemiologia , Estados Unidos/epidemiologia
19.
J Clin Med ; 10(5)2021 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-33652883

RESUMO

BACKGROUND: Associations between personality traits and problematic smartphone use (PSU) among individuals with substance use disorder (SUD) have not been widely investigated. The current study aims to assess whether SUD status moderates the association between personality traits and PSU. METHODS: The study group included 151 individuals with SUD and a normative sample (NS) comprised of 554 non-SUD students. The following self-report questionnaires were used: the Mobile Phone Problem Use Scale (MPPUS-10) to assess problematic smartphone use (PSU), the Internet Addiction Test (IAT) to assess intensity of internet use, and the NEO Five-Factor Inventory (NEO-FFI) to assess Personality traits. RESULTS: SUD status moderated the association between neuroticism and openness to new experiences on PSU. That is, greater neuroticism and openness were significantly associated with more excessive PSU among the NS. In the SUD group, greater openness was a significant protective factor against PSU. Moderation results were similar when using the IAT (which was significantly correlated with MPPUS) as an outcome. CONCLUSIONS: The presence of SUD may influence how personality traits are associated with problematic mobile phone/internet use. Given that this is among one of the first studies examining this topic, findings should be replicated with additional studies.

20.
Addict Behav ; 112: 106607, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32827968

RESUMO

BACKGROUND: Interoceptive accuracy and pain sensitivity are both risk factors in the development of alcohol use disorder (AUD). However, the synergistic association between these two factors has not been investigated in an AUD sample. Therefore, the aim of the current study was to investigate whether the association between interoceptive accuracy and sensitivity to pain differed across AUD status. METHODS: The study group included 165 individuals diagnosed with AUD (88.1% men) and 110 healthy controls (HCs; 74.5% men). Interoceptive accuracy was assessed with the Schandry Task. The Pain Sensitivity Questionnaire was utilized to measure sensitivity to pain. Anxiety, biological sex, and age were included as covariates in a model examining the role of AUD status as a moderator in the association between interoceptive accuracy and pain sensitivity. RESULTS: A significant interaction was found between interoceptive accuracy and AUD status (b = -4.580, 95% CI = [-8.137, -1.022], p = 0.012, ΔR2 = 0.032). Findings indicate that interoceptive accuracy was negatively associated with pain sensitivity among individuals with AUD, while there was a trend for an opposite association among healthy controls. CONCLUSION: We hypothesize that persistent alcohol drinking may contribute to disruption of the normative association between interoception and pain. Future studies should be conducted to develop knowledge on this association and to investigate its possible therapeutic significance and implications.


Assuntos
Alcoolismo , Interocepção , Ansiedade , Transtornos de Ansiedade , Feminino , Humanos , Masculino , Limiar da Dor
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