Psilocybin-assisted therapy for severe alcohol use disorder: protocol for a double-blind, randomized, placebo-controlled, 7-month parallel-group phase II superiority trial.

BACKGROUND: A significant number of individuals with alcohol use disorder remain unresponsive to currently available treatments, which calls for the development of new alternatives. In parallel, psilocybin-assisted therapy for alcohol use disorder has recently yielded promising preliminary results. Building on extant findings, the proposed study is set to evaluate the feasibility and preliminary clinical efficacy of psilocybin-assisted therapy when incorporated as an auxiliary intervention during inpatient rehabilitation for severe alcohol use disorder. Moreover, it intends to pinpoint the modifications in the two core neurocognitive systems underscored by dual-process models of addiction. METHODS: In this double-blind, randomized, placebo-controlled, 7-month parallel-group phase II superiority trial, 62 participants aged 21-64 years will be enrolled to undergo psilocybin-assisted therapy as part of a 4-week inpatient rehabilitation for severe alcohol use disorder. The experimental group will receive a high dose of psilocybin (30 mg), whereas the control group will receive an active placebo dose of psilocybin (5 mg), both within the context of a brief standardized psychotherapeutic intervention drawing from key elements of acceptance and commitment therapy. The primary clinical outcome is the between-group difference regarding the change in percentage of heavy drinking days from baseline to four weeks posthospital discharge, while safety and feasibility metrics will also be reported as primary outcomes. Key secondary assessments include between-group differences in terms of changes in (1) drinking behavior parameters up to six months posthospital discharge, (2) symptoms of depression, anxiety, trauma, and global functioning, (3) neuroplasticity and key neurocognitive mechanisms associated with addiction, and (4) psychological processes and alcohol-related parameters. DISCUSSION: The discussion outlines issues that might arise from our design. TRIAL REGISTRATION: EudraCT 2022-002369-14 and NCT06160232.

Narrating: from Evolutionary to Clinical Advantages.

Human beings constantly narrate reality. They narrate themselves, to themselves and to others. They narrate each other and narrate humanity. They narrate the world and nature. They narrate meaning, the meaning of life and things. This article aims to explore this phenomenon of "narrating". Through a narrative review, we will attempt to gather elements of reflection on narrative, considered here as the ability to narrate, it means to represent oneself, to put meaning. Firstly, we will focus on how cognition, interpretation, and culture allow Homo Sapiens to narrate reality to himself. Then, we will explore why they do it and discover the evolutionary advantages of language, of sharing experiences between individuals through the phenomenon of cumulative cultural evolution, and how narrative facilitates the species' access to these advantages. Finally, we will delve into the clinical implications of narrative, discussing therapeutic interviews, therapy, and psychopathology. Narratives and pre-linguistic mental representations appear to have driven the Homo genus to develop cognitive abilities that enable the development of language and the sophistication of narratives as a cultural medium. Through language, Homo sapiens share their narratives and develop a cumulative common culture. Each individual's culture seems to be constructed in dialectic with this shared culture through narratives. This dialectic gives rise to psychopathological processes while also producing therapeutic leverage. Understanding the mechanisms of co-construction of these narratives is essential in clinical research in mental health. Furthermore, placing narratives in the perspective of an essential evolutionary strategy in the Homo genus solidifies the significance of the narrative faculty in the biological functioning of Homo sapiens, and so the importance of narratives in mental health.

Association Between Bipolar Disorder and Parkinson's Disease.

Bipolar disorder and Parkinson's disease are two distinct neurological conditions that share common features related to dopaminergic dysfunction. This article presents a comprehensive review of the existing literature to investigate the association between bipolar disorder and Parkinson's disease, focusing on the dopaminergic hypothesis and potential therapeutic options. The dopaminergic hypothesis suggests that both bipolar disorder and Parkinson's disease involve impairments in the nigrostriatal or mesolimbic dopaminergic pathways. Studies have demonstrated alterations in dopamine regulation during manic and depressive phases of bipolar disorder. Similarly, Parkinson's disease is characterized by the loss of dopaminergic neurons in the substantia nigra, resulting in motor symptoms. Recent analyses have highlighted a predisposition to Parkinson's disease in individuals with bipolar disorder. Longitudinal studies and meta-analyses have demonstrated an increased risk of developing Parkinson's disease in patients with bipolar disorder. However, differentiating idiopathic Parkinson's disease from parkinsonism induced by medications used in bipolar disorder can be challenging. Dopamine transporter (DAT) scans can aid in making a differential diagnosis. Treatment options for patients with both bipolar disorder and Parkinson's disease are limited. Neuroleptics, commonly used to manage psychotic symptoms in Parkinson's disease, may worsen motor symptoms and have limitations in bipolar disorder patients. Clozapine has shown efficacy in treating psychosis without worsening motor symptoms. Pimavanserin, an inverse agonist of the 5-HT2A receptor can offer new opportunities. However, its efficacy in bipolar disorder patients with Parkinson's disease remains unexplored. In conclusion, the association between bipolar disorder and Parkinson's disease is supported by the involvement of the dopaminergic system in both conditions. The identification of shared mechanisms opens new avenues for potential therapeutic interventions. Further research is needed to investigate the efficacy of pimavanserin and explore other treatment options for individuals with both bipolar disorder and Parkinson's disease.

Dissociative Identity Disorder: Between History and Culture.

The Dissociative Identity Disorder has undergone significant transformations over the years. Once regarded as a rare condition, it gained popularity in the 1980s in the United States following the publication of a book on the subject, only to subsequently wane due to extensive controversies. Presently, we are witnessing a resurgence of adolescents who believe they may be afflicted by this disorder. This article delves into the changes that have occurred since the initial surge in 1980, with a particular focus on the role of social media in the dissemination of Dissociative Identity Disorder. The concepts of Mass Social Media-Induced Illness and Munchausen's by Internet are explored to elucidate this phenomenon. Additionally, we examine the criteria essential for distinguishing imitative Dissociative Identity Disorder from genuine cases, with the aim of aiding accurate diagnosis by psychiatrists. Mental health professionals may encounter new challenges when assessing young adults whose presentations are influenced by social media, necessitating awareness of the impact of social media on the dissemination of certain disorders.

Tobacco Use Cessation in Three Patients Suffering from Psychotic Disorders: The Impact of the COVID-19 Pandemic.

BACKGROUND: Tobacco use is one of the major causes of morbidity and mortality amoung patients suffering from psychotic disorders. The association between severe COVID-19 and tobacco use is still debated. The aim of this paper is to enhance the importance of providing up to date informations about nicotine and tobacco use in connection with the SARS-CoV-2-related conditions. METHODS: We present 3 cases of sudden tobacco use cessation in 3 long-term heavy smokers receiving mental health care for chronic psychotic disorders. Fear of severe form of COVID-19 was their principal motivation. Nicotine replacement therapy and quitline counseling were provided and no major withdrawal symptoms were declared. RESULTS: As mass media later wrongly presented tobacco use as a protective factor regarding COVID-19, all three patients resumed smoking. Rigorous counseling took advantage of psychotic symptoms to correct false informations and finally promote tobacco use cessation. CONCLUSIONS: The COVID-19 pandemic might paradoxically represent a great motivational factor to quit smoking, espacially when considering patients suffering from severe mental health disorders. Beyond the terrible suffering it causes, we illustrate with a case serie that this opportunity must be exploited by mental health professionals to improve quality and life expectancy of their patients.

Gastric Bypass and Alcohol Use: A Literature Review.

BACKGROUND: Obesity is public health issue; bariatric surgery is considered as the most efficient treatment. However, the risk of developing an alcohol use disorder could increase after Roux-en-Y bypass. The purpose of this review is to emphasize the further research needed in this area. METHODS: Pubmed and Sciencedirect databases were searched. Articles written in another language than French or English as well as abstracts, conference presentations, editorials and expert opinions were excluded. RESULTS: Most of studies included in this review show an increased risk of developing an AUD (alcohol use disorder) after gastric bypass surgery. Male sex, younger age, smoking, regular alcohol consumption, AUD, recreational drug use, lower sense of belonging and undergoing a RYGB (Roux-en-Y gastric bypass) were identified as risk factors. There is an alteration of alcohol metabolism after gastric bypass. Gut hormones could also play a role in the development of AUD. The hypothesis of an addiction transfer is still controversial. CONCLUSIONS: The risk of developing an AUD seems to increase after surgery. Long term follow-up, after the second post-surgery year, is needed. Further researches are needed to understand the mechanisms that underlie the development of AUD.

The Relationship between Typus Melancholicus and Unipolar Depression: A Literature Review.

BACKGROUND: The Typus Melancholicus (TM) is the premorbid personality of endogenous depression defined by Tellenbach and Kraus and characterized by orderliness, conscientiousness, norm orientation and intolerance of ambiguity. Tellenbach's hypothesis was to find around 50% of TM in the sample of patients with an Unipolar Depression (UD). The present paper aims to make a literature review on the relationship between the Typus Melancholicus (TM) and Unipolar Depression (UD). METHODS: Nineteen references were selected through searches on PubMed, Google Scholar and Sciences-Direct with the following MeSH terms in the title: Typus Melancholicus AND Depressive or Depression or Dépression or Depressione. Nine of them were selected for our review. RESULTS: Eight of the nine reviewed articles confirm Tellenbach's hypothesis. The literature review also shows that, in a population of UD, TM is always constant regardless of age or sex, has no relationship to clinical characteristics and could contribute to the chronicity of depression. The TM with depression have increased levels of "lack of vital drive" and "feelings of guilt" and low scores in irritability and dysphoria compared to Non-Typus Melancholicus (NTM). Due to its characteristics, TM could also be involved in some pathologies such as burnout or postpartum depression. TM does not seem to be linked to a particular Personality Disorder or maladaptive personality, but the two may coexist in certain circumstances. It has been suggested that specific psychotherapeutic methods can be used to treat TM with UD. CONCLUSIONS: The TM could be very useful in our clinical practice. Better practical knowledge of TM could lead to more efficient psychiatric care as well as heightened capacity to predict new episodes.

Changes in Pro-Inflammatory Markers in Detoxifying Chronic Alcohol Abusers, Divided by Lesch Typology, Reflect Cognitive Dysfunction.

AIM: To investigate pro-inflammatory markers in the blood and associate with cognitive impairment. METHODS: Il-6 and ferritin were assayed in the blood of 27 patients, divided according to Lesch typology, at the commencement and after 21 days of detoxification, together with a battery of cognitive tests. RESULTS: A significantly higher mean level of IL-6 was present in the blood of patients with Lesch typology 1 compared to the other typologies 2 and 3 on admission to the Detoxification Ward which did not alter significantly after detoxification. The mean level of IL-6 was initially elevated in Lesch typology 2 alcohol abusers and declined to the reference range after detoxification. Lesch typology 3 alcohol abusers showed normal levels of IL-6 at both time points. Only in Lesch typology 1 were the levels of ferritin and IL-10 significantly elevated at the start of the detoxification process. Cognitive impairment, as ascertained by Stroop test and Brown-Peterson procedure was greater in Lesch typology 1 than the other 2 patient groups. CONCLUSION: Such data might indicate a greater degree of neuroinflammation in Lesch typology 1 alcoholic patients. SHORT SUMMARY: Dividing a heterogeneous group of alcoholic subjects into homogenous groups according to Lesch typology, identifies a greater pro-inflammatory profile in Lesch typology 1 patients who also showed greater cognitive impairment.

Quantification of phosphatidylethanol 16:0/18:1, 18:1/18:1, and 16:0/16:0 in venous blood and venous and capillary dried blood spots from patients in alcohol withdrawal and control volunteers.

Phosphatidylethanol species (PEths) are promising biomarkers of alcohol consumption. Here, we report on the set-up, validation, and application of a novel UHPLC-ESI-MS/MS method for the quantification of PEth 16:0/18:1, PEth 18:1/18:1, and PEth 16:0/16:0 in whole blood (30 µL) and in venous (V, 30 µL) or capillary (C, 3 punches (3 mm)) dried blood spots (DBS). The methods were linear from 10 (LLOQ) to 2000 ng/mL for PEth 16:0/18:1, from 10 (LLOQ) to 1940 ng/mL for PEth 18:1/18:1, and from 19 (LLOQ) to 3872 ng/mL for PEth 16:0/16:0. Extraction efficiencies were higher than 55% (RSD < 18%) and matrix effects compensated for by IS were between 77 and 125% (RSD < 10%). Accuracy, repeatability, and intermediate precision fulfilled acceptance criteria (bias and RSD below 13%). Validity of the procedure for determination of PEth 16:0/18:1 in blood was demonstrated by the successful participation in a proficiency test. The quantification of PEths in C-DBS was not significantly influenced by the hematocrit, punch localization, or spot volume. The stability of PEths in V-DBS stored at room temperature was demonstrated up to 6 months. The method was applied to authentic samples (whole blood, V-DBS, and C-DBS) from 50 inpatients in alcohol withdrawal and 50 control volunteers. Applying a cut-off value to detect inpatients at 221 ng/mL for PEth 16:0/18:1 provided no false positive results and a good sensitivity (86%). Comparison of quantitative results (Bland-Altman plot, Passing-Bablok regression, and Wilcoxon signed rank test) revealed that V-DBS and C-DBS were valid alternatives to venous blood for the detection of alcohol consumption.

A Comparative Event-Related Potentials Study between Alcohol Use Disorder, Gambling Disorder and Healthy Control Subjects through a Contextual Go/NoGo Task.

(1) Background: Inhibitory and rewarding processes that mediate attentional biases to addiction-related cues may slightly differ between patients suffering from alcohol use (AUD) or gambling (GD) disorder. (2) Methods: 23 AUD inpatients, 19 GD patients, and 22 healthy controls performed four separate Go/NoGo tasks, in, respectively, an alcohol, gambling, food, and neutral long-lasting cueing context during the recording of event-related potentials (ERPs). (3) Results: AUD patients showed a poorer inhibitory performance than controls (slower response latencies, lower N2d, and delayed P3d components). In addition, AUD patients showed a preserved inhibitory performance in the alcohol-related context (but a more disrupted one in the food-related context), while GD patients showed a specific inhibitory deficit in the game-related context, both indexed by N2d amplitude modulations. (4) Conclusions: Despite sharing common addiction-related mechanisms, AUD and GD patients showed different patterns of response to (non-)rewarding cues that should be taken into account in the therapeutic context.

Dissociation between affective and cognitive empathy in alcoholism: a specific deficit for the emotional dimension.

BACKGROUND: Emotional impairments constitute a crucial and widely described dimension of alcoholism, but several affective abilities are still to be thoroughly explored among alcohol-dependent patients. This is particularly true for empathy, which constitutes an essential emotional competence for interpersonal relations and has been shown to be highly impaired in various psychiatric states. The present study aimed at exploring empathic abilities in alcoholism, and notably the hypothesis of a differential deficit between emotional and cognitive empathy. METHODS: Empathy abilities were evaluated among 30 recently detoxified inpatients diagnosed with alcohol dependence and 30 paired healthy controls, using highly validated questionnaires (Interpersonal Reactivity Index [J Pers Soc Psychol44:113] and Empathy Quotient [J Autism Dev Disord34:163]). Correlational analyses were performed to evaluate the links between empathy scores and psychopathological measures (i.e., depression, anxiety, interpersonal problems, and alexithymia). RESULTS: When psychiatric comorbities are controlled for, alcoholism is not associated with a general empathy deficit, but rather with a dissociated pattern combining impaired emotional empathy and preserved cognitive one. Moreover, this emotional empathy deficit is not associated with depression or anxiety scores, but is negatively correlated with alexithymia and the severity of interpersonal problems. CONCLUSIONS: At the theoretical level, this first observation of a specific deficit for emotional empathy in alcoholism, combined with the exact inverse pattern observed in other psychiatric populations, leads to a double-dissociation, which supports the notion that emotional and cognitive empathy are 2 distinct abilities. At the clinical level, this deficit calls for considering emotional empathy rehabilitation as a crucial concern in psychotherapy.

The "Reading the Mind in the Eyes" test as a new way to explore complex emotions decoding in alcohol dependence.

It has been repeatedly shown that alcohol dependence is associated with emotional impairments, particularly for emotional facial expression decoding. Nevertheless, most earlier studies focused on basic emotions and did not explore more subtle affective states. In order to obtain a more accurate evaluation, and in view of earlier results showing impaired performance for this task among high-risk children of alcohol-dependent participants, the "Reading the Mind in the Eyes" test was used here to explore emotional recognition in alcohol dependence. We showed that the deficit described earlier for basic negative emotions is (1) generalizable to complex and positive emotions; and (2) specific for emotional features. This strengthens the proposition of a general face recognition impairment in alcohol dependence.

Neurocognitive determinants of novelty and sensation-seeking in individuals with alcoholism.

AIM: Sober alcoholic abusers exhibit personality traits such as novelty-seeking (NS) and sensation-seeking, which overlap to a limited extent. In parallel, they also show impaired executive and decision-making processes. However, little is known about the specific and common cognitive processes associated with NS and sensation-seeking personality traits in detoxified sober alcoholic abusers. METHODS: In these present studies, we have investigated the relationships between executive functioning/central executive of working memory (pre-potent response inhibition, manipulation stored in working memory), and decision-making under uncertainty and NS/sensation-seeking traits in such alcoholics. RESULTS: Compared with healthy controls (n = 30, mean age = 40.2), and in agreement with previous studies, alcoholics (n = 30, mean age = 40.4) showed higher levels of both NS and sensation-seeking traits. Alcoholics were also disadvantaged with respect to (a) gambling tasks, as reported previously, and (b) a poor ability to manipulate information stored in working memory and inhibit pre-potent responses. Most importantly, regression analyses and mediation analyses measures showed that poor response inhibition and decision-making were associated with high NS behaviour. In addition, impaired decision-making and manipulation of stored information in working memory were associated with a high sensation-seeking trait. CONCLUSIONS: Overall, these results support the existence of specific links between cognitive executive functioning, decision-making under uncertainty and NS/sensation-seeking personality traits in individuals with alcoholism.

Transcranial direct current stimulation combined with alcohol cue inhibitory control training reduces the risk of early alcohol relapse: A randomized placebo-controlled clinical trial.

BACKGROUND: Approximately half of all people with alcohol use disorder (AUD) relapse into alcohol reuse in the next few weeks after a withdrawal treatment. Brain stimulation and cognitive training represent recent forms of complementary interventions in the context of AUD. OBJECTIVE: To evaluate the clinical efficacy of five sessions of 2 mA bilateral transcranial direct current stimulation (tDCS) for 20 min over the dorsolateral prefrontal cortex (DLPFC) (left cathodal/right anodal) combined with alcohol cue inhibitory control training (ICT) as part of rehabilitation. The secondary outcomes were executive functioning (e.g. response inhibition) and craving intensity, two mechanisms strongly related to abstinence. METHODS: A randomized clinical trial with patients (n = 125) with severe AUD at a withdrawal treatment unit. Each patient was randomly assigned to one of four conditions, in a 2 [verum vs. sham tDCS] x 2 [alcohol cue vs. neutral ICT] factorial design. The main outcome of treatment was the abstinence rate after two weeks or more (up to one year). RESULTS: Verum tDCS improved the abstinence rate at the 2-week follow-up compared to the sham condition, independently of the training condition (79.7% [95% CI = 69.8-89.6] vs. 60.7% [95% CI = 48.3-73.1]; p = .02). A priori contrasts analyses revealed higher abstinence rates for the verum tDCS associated with alcohol cue ICT (86.1% [31/36; 95% CI = 74.6-97.6]) than for the other three conditions (64% [57/89; 95% CI = 54-74]). These positive clinical effects on abstinence did not persist beyond two weeks after the intervention. Neither the reduction of craving nor the improvement in executive control resulted specifically from prefrontal-tDCS and ICT. CONCLUSIONS: AUD patients who received tDCS applied to DLPFC showed a significantly higher abstinence rate during the weeks following rehabilitation. When combined with alcohol specific ICT, brain stimulation may provide better clinical outcomes. TRIAL REGISTRATION: ClinicalTrials.gov number NCT03447054 https://clinicaltrials.gov/ct2/show/NCT03447054.

Neurophysiological markers of cue reactivity and inhibition subtend a three-month period of complete alcohol abstinence.

OBJECTIVE: Finding new tools for conventional management of alcohol disorders is a challenge for psychiatrists. Brain indications related to cognitive functioning could represent such an add-on tool. METHODS: Forty alcohol-dependent inpatients undertook two cognitive event-related potential (ERP) tasks at the beginning and at the end of a 4-week detoxification program. These comprised a visual oddball task investigating cue reactivity and a Go/No-go task tagging inhibition using oddball P3d and No-go P3d ERP components. Three months after discharge, the patient group (N = 40) was split into two subgroups: patients who remained abstinent during this post-treatment period (90 days; n = 15), and patients who relapsed (mean time: 28.5 ± 26.2 days; n = 25). Pattern changes of both ERP markers (oddball P3d and No-go P3d) during the detoxification were compared to differentiate these populations. RESULTS: Abstinent patients exhibited similar P3d responses devoted to alcohol cues in Sessions 1 and 2, but an increased No-go P3d devoted to No-go trials in alcohol-related contexts in Session 2 compared to Session 1. CONCLUSIONS: Specific cue-reactivity and inhibitory neurophysiological markers subtend a further three-months of complete abstinence. SIGNIFICANCE: Monitoring these ERP changes during detoxification may provide important clues regarding patients' future abstinence vs. relapse.

Alcohol cues increase cognitive impulsivity in individuals with alcoholism.

BACKGROUND: Individuals with alcoholism are characterized by both attentional bias for alcohol cues and prepotent response inhibition deficit. We tested the hypothesis that alcoholics exhibit greater cognitive disinhibition when the response to be suppressed is associated with alcohol-related information. METHODS: Forty recently detoxified individuals with alcoholism were compared with 40 healthy non-substance abusers on the "Alcohol-Shifting Task", a variant of the go/no-go paradigm requiring a motor response to targets and no response to distracters. The aim was to test the ability of alcoholics to discriminate between alcohol-related and neutral words. Sometimes, the alcohol-related words were the targets for the "go" response, with neutral words as distracters, sometimes the reverse. Several shifts in target type occurred during the task. RESULTS: Alcoholics made significantly more commission errors (i.e., press a key when a distracter displayed) and more omission errors (i.e., not press a key when a target displayed) than controls. Moreover, the number of commission errors was greater in alcoholics when alcohol-related stimuli had to be detected. CONCLUSIONS: These results demonstrate that alcoholics exhibit a basic prepotent response inhibition deficit, which is enhanced when the response to be suppressed is related to alcohol. We discuss clinical and theoretical implications of these findings.

Response inhibition deficit is involved in poor decision making under risk in nonamnesic individuals with alcoholism.

Individuals with alcoholism exhibit poor decision making as reflected by their continued alcohol use despite encountering problems and by low performance in laboratory tasks of decision making. Here, the authors investigated the relative contribution of several distinct processes of executive functions in performance on the Iowa Gambling Task (IGT; A. Bechara, A. R. Damasio, H. Damasio, & S. W. Anderson, 1994) in recently detoxified individuals with alcoholism. Compared to matched healthy participants, individuals with alcoholism showed below-normal scores in the last 20 trials of the IGT as well as on other tasks of executive functions, specifically those assessing the capacity to manipulate information stored in working memory, detect abstract rules, or inhibit prepotent responses. Prepotent response inhibition best predicted performance in the late trials of the IGT, that is, when participants have likely acquired knowledge about the reward/punishment contingencies of the task. These results underline the important role that response inhibition plays in decision making, especially in risky situations, when knowledge of the probability of a given outcome becomes available (i.e. decisions under risk).

Impaired emotional facial expression recognition in alcoholics: are these deficits specific to emotional cues?

Previous studies have repeatedly linked alcoholism is to impairment in emotional facial expression decoding. The present study aimed at extending previous findings while controlling for exposure times of stimuli. Further, a control task was added on the decoding of non-emotional facial features. Twenty-five alcoholic participants were compared to 26 control participants matched for age, sex and educational level. Participants performed two computer tasks consisting of presentation of photographs of faces for either 250 or 1000 ms. The first task required "yes" or "no" responses as rapidly as possible to questions regarding non-emotional features of the face (gender, age range and cultural identity). The second task involved a different set of photographs implicating emotional facial expression decoding, with the same exposure times. Again, rapid "yes" or "no" responses to trials combining 32 emotional facial expressions by eight emotional labels (happiness, sadness, fear, anger, disgust, surprise, shame, and contempt) were required from participants. Reaction times were recorded for both tasks. Alcoholic and control participants showed similar results in both tasks in terms of response accuracy. Yet, in the emotional facial expression task, alcoholic participants' responses matched more negative emotional labels, especially sadness. Further, alcoholics were slower than control participants specifically to answer emotional questions on emotional facial expression. No differences appeared on reaction times in the control task. Contrary to expectations, no interaction of stimulus time exposure and group was observed. Overall, these findings replicate and extend previous results on emotional facial expression decoding ability: Alcoholics are specifically impaired on emotional non-verbal behavior information processing: They are slower to correctly identify an emotion.

On the automaticity of response inhibition in individuals with alcoholism.

BACKGROUND AND OBJECTIVES: Response inhibition is usually considered a hallmark of executive control. However, recent work indicates that stop performance can become associatively mediated ('automatic') over practice. This study investigated automatic response inhibition in sober and recently detoxified individuals with alcoholism.. METHODS: We administered to forty recently detoxified alcoholics and forty healthy participants a modified stop-signal task that consisted of a training phase in which a subset of the stimuli was consistently associated with stopping or going, and a test phase in which this mapping was reversed. RESULTS: In the training phase, stop performance improved for the consistent stop stimuli, compared with control stimuli that were not associated with going or stopping. In the test phase, go performance tended to be impaired for old stop stimuli. Combined, these findings support the automatic inhibition hypothesis. Importantly, performance was similar in both groups, which indicates that automatic inhibitory control develops normally in individuals with alcoholism.. LIMITATIONS: This finding is specific to individuals with alcoholism without other psychiatric disorders, which is rather atypical and prevents generalization. Personalized stimuli with a stronger affective content should be used in future studies. CONCLUSIONS: These results advance our understanding of behavioral inhibition in individuals with alcoholism. Furthermore, intact automatic inhibitory control may be an important element of successful cognitive remediation of addictive behaviors..