Impulsivity mediates the association between narcissism and substance-related problems beyond the degree of substance use: a longitudinal observational study.

BACKGROUND: Narcissism has been implied as a putative risk factor for substance use disorders (SUDs). However, previous research did not disentangle the degree of substance use from substance-related problems, the symptoms of SUDs. This preregistered study addressed the open question whether grandiose and vulnerable narcissism and their constituent traits convey specific SUD risk, that is, explain substance-related problems beyond the degree of use. Furthermore, we tested whether impulsivity or substance use motives linked to narcissistic self-regulation mediate this association. METHODS: Narcissism, impulsivity, substance use motives, past-year substance use, and substance-related problems were assessed in 139 (poly-)substance users, 121 of whom completed a one-year follow-up. For significant longitudinal associations between narcissism factors and substance-related problems controlled for the degree of use, we tested impulsivity and substance use motives as mediators. RESULTS: Grandiose narcissism (r =.24, p =.007) and its constituent factors antagonistic (r =.27, p =.003) and agentic narcissism (r =.18, p =.050), but not vulnerable narcissism, prospectively predicted substance-related problems beyond the degree of substance use. Associations of grandiose narcissism and antagonistic narcissism with substance-related problems were fully mediated by impulsivity, but not substance use motives. Impulsivity explained roughly one third of the association of both grandiose (P̂M = 0.30) and antagonistic narcissism (P̂M = 0.26) with substance-related problems. DISCUSSION: We demonstrate that grandiose narcissism- particularly antagonistic but also agentic narcissism- is specifically linked to substance-related problems beyond the degree of substance use. The mediating effect of impulsivity but not substance use motives suggests that impulsivity may be a more important mechanism than narcissistic self-regulation in promoting SUD in narcissism. However, future studies may use more targeted measures than substance use motives to further probe the role of self-regulation. Similar result patterns for alcohol compared to all substances together indicate that mechanisms may be alike across substances. In conclusion, narcissistic individuals may not use substances more but have a higher SUD risk, informing prevention and treatment.

Brain activation during social cognition predicts everyday perspective-taking: A combined fMRI and ecological momentary assessment study of the social brain.

Identifying distinct neural networks underlying social affect (empathy, compassion) and social cognition (Theory of Mind) has advanced our understanding of social interactions. However, little is known about the relation of activation in these networks to psychological experience in daily life. This study (N = 122) examined the ecological validity of neural activation patterns induced by a laboratory paradigm of social affect and cognition with respect to social interactions in everyday life. We used the EmpaToM task, a naturalistic video-based paradigm for the assessment of empathy, compassion, and Theory of Mind, and combined it with a subsequent 14-day ecological momentary assessment protocol on social interactions. Everyday social affect was predicted by social affect experienced during the EmpaToM task, but not by related neural activation in regions of interest from the social affect network. In contrast, everyday social cognition was predicted by neural activation differences in the medial prefrontal cortex - a region of interest from the social cognition network - but not by social cognition performance in the EmpaToM task. The relationship between medial prefrontal cortex activation and everyday social cognition was stronger for spontaneous rather than deliberate perspective taking during the EmpaToM task, pointing to a distinction between propensity and capacity in social cognition. Finally, this neural indicator of Theory of Mind explained variance in everyday social cognition to a similar extent as an established self-report scale. Taken together, this study provides evidence for the ecological validity of lab-based social affect and cognition paradigms when considering relevant moderating factors.

Disentangling substance use and related problems: urgency predicts substance-related problems beyond the degree of use.

BACKGROUND: Substance use disorders are reliably associated with high impulsivity and sensation seeking. Importantly, both precede problematic substance use, implicating them as risk factors. Individuals with substance use disorders show variable degrees of substance use (combined quantity and frequency) and substance-related problems and differ in both aspects from healthy controls. Dimensional research has indicated differential associations of impulsivity-related traits as well as sensation seeking with the degree of substance use and substance-related problems. The current study aimed to clarify whether impulsivity-related traits and sensation seeking predict substance-related problems above and beyond the degree of substance use and are thus specifically linked to problems, the dimension that characterizes substance use disorders. METHOD: We assessed impulsivity-related traits and sensation seeking using self-report, as well as delay discounting, a behavioral indicator of impulsivity, in a sample of 258 substance-using adults. RESULTS: Sensation seeking and impulsivity-related traits significantly predicted the degree of substance use, with sensation seeking explaining the largest portion of variance. In contrast, self-reported impulsivity, in particular when experiencing negative emotions (urgency), but not sensation seeking or delay discounting, predicted substance-related problems when controlling for the degree of substance use. CONCLUSIONS: This suggests that urgency, but not sensation seeking, may be specifically linked to substance-related problems and thus especially relevant for substance use disorders. Taken together, this study underlines the necessity to assess and control for the degree of substance use in risk factor research concerning substance-related problems. Thus, it may inform future research improving targeted prevention and therapy.

Dissociating the Link of Neural Correlates of Inhibition to the Degree of Substance Use and Substance-Related Problems: A Preregistered, Multimodal, Combined Cross-sectional and Longitudinal Study.

BACKGROUND: Frontal hypoactivation during inhibition is a promising phenotype for substance use disorders (SUDs), but studies comparing individuals with SUDs with unaffected individuals have reported inconsistent results. This may result from distinctive associations of neural correlates of inhibition with the degree of substance use and the severity of substance-related problems-two correlated but distinct facets of SUDs-reflecting a potentially disregarded confounding effect. This preregistered study tested whether frontal hypoactivation during inhibition is specifically linked to substance-related problems in SUDs beyond the degree of substance use. METHODS: A stop signal task during functional magnetic resonance imaging, trait self-control, substance use, and substance-related problems in the past 12 months were assessed in 121 (poly)substance users. One hundred seven participants completed a 1-year follow-up. We examined the association between multimodal indicators of inhibition (neural activation in regions of interest, inhibitory performance, trait self-control) and substance-related problems while controlling for the degree of substance use. RESULTS: Right inferior frontal gyrus hypoactivation explained variance in substance-related problems beyond the degree of substance use, while hyperactivation in the same region explained variance in the degree of substance use beyond the effects of substance-related problems, both cross-sectionally (problems: Bonferroni-Holm-corrected p = .048; use: p < .01) and prospectively (problems at trend level: p = .096; use: p = .01). Trait and behavioral inhibition were unrelated to problems beyond the effects of substance use (ps > .05). CONCLUSIONS: We demonstrated that frontal hypoactivation during inhibition specifically relates to substance-related problems. Interestingly, increased activity may even represent a resilience factor in substance use without SUDs. Future studies should distinguish between processes linked to the degree of substance use and substance-related problems to advance understanding of why some substance users develop SUDs and others do not.

Neural correlates of inhibitory control in relation to the degree of substance use and substance-related problems - A systematic review and perspective.

Inhibitory control deficits are associated with substance use disorders (SUDs) and considered a risk factor. Most studies compare SUD groups with unaffected individuals, although the degree of substance use might relate to inhibitory control deficits and explain group differences. This raises the question to which extent these deficits are specifically linked to substance-related problems. We review studies reporting associations of inhibition-related neural activation (stop signal and go/nogo task) with continuous measures of the degree of substance use and substance-related problems, and with substance-related problems controlling for the degree of substance use. Results suggest negative associations between inhibition-related neural activation and the degree of substance use, but are inconclusive on the association with substance-related problems. Nonetheless, two studies reported significant associations of inhibition-related neural activation with substance-related problems controlling for the degree of substance use. Despite numerous studies showing alterations in inhibition-related neural activation in SUDs, the role of the degree of substance use needs further investigation and studies using dimensional approaches are necessary to uncover specific links to substance-related problems.

"We Dance and Find Each Other"1: Effects of Dance/Movement Therapy on Negative Symptoms in Autism Spectrum Disorder.

The treatment of deficits in social interaction, a shared symptom cluster in persons with schizophrenia (negative symptoms) and autism spectrum disorder (DSM-5 A-criterion), has so far remained widely unsuccessful in common approaches of psychotherapy. The alternative approach of embodiment brings to focus body-oriented intervention methods based on a theoretic framework that explains the disorders on a more basic level than common theory of mind approaches. The randomized controlled trial at hand investigated the effects of a 10-week manualized dance and movement therapy intervention on negative symptoms in participants with autism spectrum disorder. Although the observed effects failed to reach significance at the conventional 0.05 threshold, possibly due to an undersized sample, an encouraging trend towards stronger symptom reduction in the treatment group for overall negative symptoms and for almost all subtypes was found at the 0.10-level. Effect sizes were small but clinically meaningful, and the resulting patterns were in accordance with theoretical expectations. The study at hand contributes to finding an effective treatment approach for autism spectrum disorder in accordance with the notion of embodiment.