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1.
Qual Life Res ; 28(7): 1813-1823, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30875009

RESUMO

PURPOSE: Besides reducing recidivism, juvenile justice institutions aim to rehabilitate juvenile delinquents, in order for them to reintegrate in society. As such, improving quality of life (QoL), especially post detention, is an important treatment goal. However, research is primarily focused on recidivism as an outcome measure for juvenile detention. The aim of the current study is therefore to describe and predict QoL of detained young offenders up to 1 year after an initial assessment, and to examine whether QoL differs between youth who are still detained versus released. METHODS: A sample of 186 juveniles admitted to juvenile justice institutions in the Netherlands was assessed within the institution (initial assessment/T0), using psychosocial and neurobiological factors as predictors (self-control, treatment motivation, trauma, mental health problems, respiratory sinus arrhythmia). QoL (MANSA), as well as substance use (alcohol, cannabis) and daily activities (education, work) were assessed at first, second, and third follow-up (respectively 2.5 months, 4.5 months, and 12 months after T0). RESULTS: QoL increased from first to third follow-up, and was higher for individuals who were no longer detained. The model that best predicted higher QoL upon follow-up consisted of lower trauma and stronger parasympathetic nervous system reactivity. The effects of the predictors did not differ between the various follow-ups, nor between individuals who were or were not detained. CONCLUSION: Methods incorporating trauma-sensitive focus and relaxation techniques in treatment protocols in juvenile justice institutions may be of added value in improving the general functioning of these individuals.


Assuntos
Delinquência Juvenil/psicologia , Prisioneiros/psicologia , Qualidade de Vida/psicologia , Terapia de Relaxamento/psicologia , Adolescente , Adulto , Feminino , Hospitalização , Humanos , Masculino , Motivação , Países Baixos , Reincidência/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias , Adulto Jovem
2.
Appetite ; 96: 560-571, 2016 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-26482282

RESUMO

Adolescents and children are the targets of much food advertising, the majority of which is for unhealthy snacks. Although the effects of advertising on food preferences and consummatory behavior are well documented, our understanding of the underlying mechanisms is still limited. The present study investigates an associative (ideomotor) mechanism by which exposure to rewarding (snack) outcomes may activate behavior that previously resulted in these rewards. Specifically, we used a computerized task to investigate whether exposing adolescents to food pictures directly, or to Pavlovian cues predictive of those food pictures, would bias their subsequent responses towards the presented/signaled food. Furthermore, we assessed whether this effect was particularly pronounced with palatable, high-calorie snacks (crisps and chocolate) relative to low-calorie snacks (tomatoes and cucumber). In two experiments, adolescents learnt that certain key presses would yield particular food pictures - some high calorie and others low calorie - before learning Pavlovian associations between cues (cartoon monsters) and these same food pictures. Subsequently, in a response-priming test, we examined the extent to which the food pictures and Pavlovian cues spontaneously primed the previously associated response. The results show that we replicated, in adolescents, previous demonstrations of ideomotor response priming in adults: food pictures biased responding towards the response that previously yielded them, and this effect transferred to the Pavlovian cues. Furthermore, the priming effect was significantly stronger for high-calorie rewards than for low-calorie. These findings indicate that the ideomotor mechanism plays an important role in the detrimental effect of our obesogenic environment, with its plethora of unhealthy food reminders, on adolescents' food-related choices.


Assuntos
Comportamento de Escolha , Meio Ambiente , Preferências Alimentares/psicologia , Adolescente , Índice de Massa Corporal , Sinais (Psicologia) , Ingestão de Energia , Comportamento Alimentar/psicologia , Feminino , Humanos , Fome , Masculino , Obesidade Infantil/epidemiologia , Fatores Sexuais , Lanches , Inquéritos e Questionários
3.
Alcohol Alcohol ; 49(1): 118-22, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24226811

RESUMO

In response to our suggestion to define substance use disorders via 'heavy use over time', theoretical and conceptual issues, measurement problems and implications for stigma and clinical practice were raised. With respect to theoretical and conceptual issues, no other criterion has been shown, which would improve the definition. Moreover, heavy use over time is shown to be highly correlated with number of criteria in current DSM-5. Measurement of heavy use over time is simple and while there will be some underestimation or misrepresentation of actual levels in clinical practice, this is not different from the status quo and measurement of current criteria. As regards to stigma, research has shown that a truly dimensional concept can help reduce stigma. In conclusion, 'heavy use over time' as a tangible common denominator should be seriously considered as definition for substance use disorder.


Assuntos
Estigma Social , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/psicologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Humanos , Transtornos Relacionados ao Uso de Substâncias/terapia , Fatores de Tempo
4.
Appetite ; 79: 139-48, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24743030

RESUMO

Why do we indulge in food-seeking and eating behaviors at times when we are already fully sated? In the present study we investigated the hypothesis that food-associated cues in the environment can interfere with goal-directed action by eliciting food-seeking that is independent of the current desirability of the outcome. To this end, we used a computerized task in which participants learned to press keys for chocolate and popcorn rewards. Subsequently, we investigated whether satiation on one of these rewards would bias choice toward the other, still desirable, food reward. We found that satiation did indeed selectively reduce responding on the associated key in the absence of food-associated cues. In contrast, in a Pavlovian-instrumental transfer (PIT) test, satiation failed to reduce cue-elicited food-seeking: in line with our hypothesis, cues that had previously been paired with chocolate and popcorn led to increased responding for the signaled food reward, independent of satiation. Furthermore, we show that food-associated cues will not only bias choice toward the signaled food (outcome-specific transfer), but also enhance the vigor of responding generally (general transfer). These findings point to a mechanism that may underlie the powerful control that cues in our obesogenic environment exert over our behavior.


Assuntos
Condicionamento Operante , Sinais (Psicologia) , Comportamento Alimentar/psicologia , Objetivos , Reforço Psicológico , Resposta de Saciedade , Transferência de Experiência , Adolescente , Adulto , Comportamento de Escolha , Meio Ambiente , Extinção Psicológica , Feminino , Humanos , Masculino , Motivação , Recompensa , Lanches , Adulto Jovem
5.
Alcohol Alcohol ; 48(6): 633-40, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23926213

RESUMO

AIMS: The aim of the study was to explore whether the concept of heavy substance use over time can be used as definition of substance use disorder. METHODS: Narrative review. RESULTS: Heavy use over time clearly underlies the neurobiological changes associated with current thinking of substance use disorders. In addition, there is evidence that heavy use over time can explain the majority of social problems and of burden of disease (morbidity and mortality). A definition of substance use disorders via heavy use over time would avoid some of the problems of current conceptualizations, for instance the cultural specificity of concepts such as loss of control. Finally, stressing the continuum of use may avoid the high level of stigmatization currently associated with substance use disorders. CONCLUSION: 'Heavy substance use over time' seems to be a definition of substance use disorders in line with results of basic research and epidemiology. Additionally, it reduces stigmatization. This approach should thus be further explored.


Assuntos
Transtornos Relacionados ao Uso de Substâncias/psicologia , Humanos , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Terminologia como Assunto
6.
Tijdschr Psychiatr ; 55(11): 833-40, 2013.
Artigo em Holandês | MEDLINE | ID: mdl-24242142

RESUMO

BACKGROUND: Motivational processes play an important role in addictive behaviours. Craving is mainly an explicit or conscious process that can motivate individuals to continue alcohol, take drugs or smoke cigarettes. Craving also plays a role in relapse; self-reported craving has often been associated with relapse. However, craving cannot explain all addictive behaviours. In addition to craving, implicit cognitive processes play an important part in motivating individuals to become involved in substance use. AIM: To describe some of these implicit cognitive processes, namely the role of salience, attention bias, automatic memory associations and action tendencies. METHOD: A description is given of recent research results and the implications of these implicit processes for clinical practice. RESULTS: Oversensitive/hypersensitive motivational processes and a lack of control over these processes both play an important role in addiction. This can be expressed by an uncontrollable urge to inject the drug or substance again, in spite of the fact that it is unwise for the person in question to do so. Recent research has shown that there are various very promising methods for dealing with these two problems (oversensitive/hypersensitive motivational processes and a lack of control over these processes), either separately or together. The methods involve behavioural training programmes, medication and neural stimulation. CONCLUSION: The research results are very promising, but more research is needed.


Assuntos
Comportamento Aditivo/psicologia , Cognição , Motivação , Transtornos Relacionados ao Uso de Substâncias/psicologia , Sistema Nervoso Autônomo/fisiopatologia , Comportamento Aditivo/fisiopatologia , Condicionamento Clássico , Humanos , Modelos Psicológicos , Recidiva , Síndrome de Abstinência a Substâncias/fisiopatologia , Síndrome de Abstinência a Substâncias/psicologia
7.
Int J Obes (Lond) ; 36(10): 1334-9, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21986703

RESUMO

OBJECTIVE: Starting from a model of impaired response inhibition and salience attribution for addictive behaviour we investigated whether obese participants show a greater impairment of inhibitory control in response to food-associated cues compared with neutral stimuli and whether this is seen in normal-weight control subjects. In addition, we questioned whether an attentional bias towards food-associated cues can be observed in an early stage of information processing. DESIGN: Control-group study including the administration of behavioural tasks (that is, go/no-go task with food-associated and neutral words, visual dot probe task with food-associated and neutral pictures) and self-reported measures of eating behaviour and impulsivity. RESULTS: Although self-reported measures indicated disinhibition of eating behaviour of obese patients, we found that food-associated stimuli induced an impairment of inhibitory control in both obese participants as well as normal-weight controls. Results from the visual dot-probe task indicated that food-associated cues did not modulate attention allocation in a very early stage of information processing, which suggests that the incentive salience of food-associated stimuli might be lower than that of drug-associated cues. CONCLUSION: These findings are not in line with hypotheses derived from models of addictive behaviour and call into question that an impairment of inhibitory control in response to food-associated cues and salience attribution might be at the core of obesity. Future studies using larger sample sizes and refined experimental procedures are warranted to further investigate mechanisms controlling food intake in obesity.


Assuntos
Atenção , Ingestão de Alimentos/psicologia , Potenciais Evocados , Comportamento Alimentar/psicologia , Comportamento Impulsivo/psicologia , Obesidade/psicologia , Adolescente , Adulto , Idoso , Viés , Sinais (Psicologia) , Feminino , Humanos , Fome , Comportamento Impulsivo/fisiopatologia , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Obesidade/fisiopatologia , Recompensa , Inquéritos e Questionários , Adulto Jovem
8.
Behav Res Ther ; 156: 104157, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35863242

RESUMO

The study investigated the role of parental anxiety symptoms in treatment outcomes for children with a primary social anxiety disorder compared to children with other primary anxiety disorders. Participants were 152 children between 7 and 18 years and their parents (146 mothers, 123 fathers). Anxiety was assessed pretreatment, posttreatment, and at three months and one year follow ups. There were no baseline differences in parental anxiety symptoms between the two groups. In both groups parental anxiety symptoms decreased from pretreatment to posttreatment, and only mothers' anxiety symptoms decreased further from posttreatment to the one year follow up. Parental anxiety symptoms before the treatment were not related to the being free of all anxiety diagnoses in the children at posttreatment. However, some indications were found for greater improvements during treatment when parents had higher anxiety symptoms before treatment. Changes in parental anxiety symptoms were found to be related to changes in child anxiety symptoms. This was not found for the total clinical severity of all inclusion anxiety disorders. This relation was visible independently in fathers or mothers, or in groups of children with a primary social anxiety disorder or with another primary anxiety disorder. In conclusion, we did not find clear indications that parental anxiety symptoms explain the differences in treatment outcomes for children with a primary social anxiety disorder compared to children with other primary anxiety disorders. More research with larger samples is needed to draw stronger conclusions.


Assuntos
Transtornos do Comportamento Infantil , Fobia Social , Ansiedade/terapia , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/terapia , Criança , Feminino , Humanos , Mães , Pais , Fobia Social/terapia
9.
Psychol Med ; 40(8): 1325-36, 2010 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-19917142

RESUMO

BACKGROUND: Cannabis use is common in patients with recent-onset schizophrenia and this is associated with poor disease outcome. More insight in the cognitive-motivational processes related to cannabis use in schizophrenia may inform treatment strategies. The present study is the first known to compare implicit and explicit cannabis associations in individuals with and without psychotic disorder. METHOD: Participants consisted of 70 patients with recent-onset psychotic disorder and 61 healthy controls with various levels of cannabis use. Three Single-Category Implicit Association Tests (SC-IAT) were used to assess 'relaxed', 'active' and 'negative' implicit associations towards cannabis use. Explicit expectancies of cannabis use were assessed with a questionnaire using the same words as the SC-IAT. RESULTS: There were no differences in implicit associations between patients and controls; however, patients scored significantly higher on explicit negative affect expectancies than controls. Both groups demonstrated strong negative implicit associations towards cannabis use. Explicit relaxed expectancies were the strongest predictors of cannabis use and craving. There was a trend for implicit active associations to predict craving. CONCLUSIONS: The findings indicate that patients suffering from schizophrenia have associations towards cannabis similar to controls, but they have stronger negative explicit cannabis associations. The strong negative implicit associations towards cannabis could imply that users of cannabis engage in a behaviour they do not implicitly like. Explicit relaxing expectancies of cannabis might be an important mediator in the continuation of cannabis use in patients and controls.


Assuntos
Afeto , Associação , Abuso de Maconha/psicologia , Transtornos Psicóticos/diagnóstico , Esquizofrenia/diagnóstico , Psicologia do Esquizofrênico , Adolescente , Adulto , Nível de Alerta , Canabinoides/efeitos adversos , Estudos de Casos e Controles , Comorbidade , Humanos , Masculino , Abuso de Maconha/epidemiologia , Motivação , Medição da Dor , Transtornos Psicóticos/epidemiologia , Transtornos Psicóticos/psicologia , Valores de Referência , Esquizofrenia/epidemiologia , Enquadramento Psicológico , Síndrome de Abstinência a Substâncias/diagnóstico , Síndrome de Abstinência a Substâncias/epidemiologia , Síndrome de Abstinência a Substâncias/psicologia , Adulto Jovem
10.
Eur Addict Res ; 16(1): 9-16, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-19887804

RESUMO

BACKGROUND: Several experimental laboratory studies have shown that subjective craving for alcohol increases as a result of low-to-moderate levels of alcohol consumption. Less is known about alcohol prime effects on relatively automatic appetitive motivational processes such as attentional bias (AB). Also, it is not known whether the effects from laboratory studies can be generalized to real-life drinking environments, and whether effects change after higher alcohol doses than those that have been administered in lab studies. METHOD: In two pubs, we investigated alcohol prime dose effects in self-reported craving and AB, measured by a modified Flicker Paradigm. We included an opportunistic sample of 72 social drinkers who had been drinking various amounts of alcohol. RESULTS: Self-reported craving was positively predicted by dose of alcohol consumed, from one up to 16 drinks. In contrast, AB was negatively predicted by dose consumed in participants who had been binge drinking. CONCLUSION: This field study validates earlier experimental research on alcohol prime effects in a real drinking situation. Further, it demonstrates prime effects up to much higher alcohol doses than in previous lab studies.


Assuntos
Consumo de Bebidas Alcoólicas/psicologia , Bebidas Alcoólicas , Atenção , Comportamento Aditivo/psicologia , Sinais (Psicologia) , Restaurantes , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Atenção/fisiologia , Comportamento Aditivo/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Motivação/fisiologia , Países Baixos/epidemiologia , Estimulação Luminosa/métodos , Adulto Jovem
11.
Health Educ Res ; 25(6): 1008-20, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20864604

RESUMO

No definitive picture of the factors determining smoking relapse exists, and many smoking relapse prevention programmes have only modest behavioural effects. This study aims to identify the level of consensus among and compare the opinions of two groups of experts (researchers and coaches who provide smoking cessation courses) regarding factors already studied in relation to smoking relapse, factors that have not yet been addressed and ideas on how to improve prevention programmes. A three-round Delphi method was employed. In the first round, 15 researchers completed an electronic questionnaire on factors associated with relapse. The results were used to develop a structured questionnaire for the second round, which was completed by 47 researchers and 61 coaches. The second-round results were then presented to the same experts in the third round, enabling them to re-rate their answers. Results revealed high consensus on some factors already identified as predicting relapse (e.g. self-efficacy), new factors (e.g. action planning) and several methods to improve prevention programmes. Generally speaking, the researchers and coaches provided similar suggestions. The results paint a picture of the current state of knowledge on relapse-related factors and point the way to areas for further research.


Assuntos
Internacionalidade , Prevenção do Hábito de Fumar , Técnica Delphi , Feminino , Humanos , Masculino , Países Baixos , Fatores de Risco , Prevenção Secundária , Inquéritos e Questionários
12.
J Behav Ther Exp Psychiatry ; 68: 101545, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32171997

RESUMO

BACKGROUND AND OBJECTIVES: Attentional Bias Modification (ABM) paradigms targeting anxiety aim to reduce attentional biases for threatening stimuli and thereby reduce anxiety. Based on cognitive theories of performance and learning, elevated levels of arousal during ABM might enhance its effectiveness by making training more engaging and activating fear schemas. This study investigated whether elevated levels of arousal during ABM would increase its effectiveness in reducing attentional bias, stress reactivity, and post-event processing. METHOD: We randomly assigned 79 high socially anxious students to a session of ABM or control training preceded by either a social stress or control induction to manipulate arousal. Training outcomes were attentional bias, stress reactivity, and post-event processing. Subjective arousal was assessed before, during, and after training. RESULTS: Results indicated that ABM was not successful in reducing attentional bias, stress reactivity or post-event processing, and that the effects of ABM were not moderated by subjective arousal. There was a trend towards ABM being more effective than control training in reducing attentional bias directly after training when participants were more aroused. However, this effect was not maintained one day after the training. LIMITATIONS: The arousal manipulation did not result in significant between-group differences in subjective arousal. CONCLUSIONS: This study did not provide support for the moderating role of arousal in ABM training effects. Replications with more effective mood induction procedures and more power are needed as a trend finding was observed suggesting that higher levels of arousal improved the direct ABM effects on attentional bias.


Assuntos
Ansiedade/psicologia , Ansiedade/terapia , Viés de Atenção , Terapia Cognitivo-Comportamental , Fobia Social/psicologia , Fobia Social/terapia , Estudantes/psicologia , Feminino , Humanos , Masculino , Adulto Jovem
13.
Drug Alcohol Depend ; 187: 186-194, 2018 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-29679913

RESUMO

BACKGROUND: Neuroimaging studies have demonstrated gray matter (GM) volume abnormalities in substance users. While the majority of substance users are polysubstance users, very little is known about the relation between GM volume abnormalities and polysubstance use. METHODS: In this study we assessed the relation between GM volume, and the use of alcohol, tobacco, cocaine and cannabis as well as the total number of substances used, in a sample of 169 males: 15 non-substance users, 89 moderate drinkers, 27 moderate drinkers who also smoke tobacco, 13 moderate drinkers who also smoke tobacco and use cocaine, 10 heavy drinkers who smoke tobacco and use cocaine and 15 heavy drinkers who smoke tobacco, cannabis and use cocaine. RESULTS: Regression analyses showed that there was a negative relation between the number of substances used and volume of the dorsal medial prefrontal cortex (mPFC) and the ventral mPFC. Without controlling for the use of other substances, the volume of the dorsal mPFC was negatively associated with the use of alcohol, tobacco, and cocaine. After controlling for the use of other substances, a negative relation was found between tobacco and cocaine and volume of the thalami and ventrolateral PFC, respectively. CONCLUSION: These findings indicate that mPFC alterations may not be substance-specific, but rather related to the number of substances used, whereas, thalamic and ventrolateral PFC pathology is specifically associated with tobacco and cocaine use, respectively. These findings are important, as the differential alterations in GM volume may underlie different cognitive deficits associated with substance use disorders.


Assuntos
Alcoolismo/diagnóstico por imagem , Transtornos Relacionados ao Uso de Cocaína/diagnóstico por imagem , Substância Cinzenta/diagnóstico por imagem , Abuso de Maconha/diagnóstico por imagem , Autorrelato , Tabagismo/diagnóstico por imagem , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/tendências , Alcoolismo/epidemiologia , Cannabis/efeitos adversos , Cocaína/administração & dosagem , Cocaína/efeitos adversos , Transtornos Relacionados ao Uso de Cocaína/epidemiologia , Usuários de Drogas , Etanol/administração & dosagem , Etanol/efeitos adversos , Substância Cinzenta/efeitos dos fármacos , Humanos , Imageamento por Ressonância Magnética/tendências , Masculino , Abuso de Maconha/epidemiologia , Pessoa de Meia-Idade , Neuroimagem/tendências , Tamanho do Órgão , Transtornos Relacionados ao Uso de Substâncias/diagnóstico por imagem , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Nicotiana/efeitos adversos , Uso de Tabaco/epidemiologia , Uso de Tabaco/tendências , Tabagismo/epidemiologia , Adulto Jovem
14.
Pharmacol Biochem Behav ; 86(2): 368-76, 2007 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-16928395

RESUMO

This study investigated the effectiveness of a targeted intervention program aimed at at-risk adolescents in a randomized clinical trial design (N=107). This program combined intervention methods which have been proven effective in reducing drinking in young adults, such as an expectancy challenge, cognitive behavioral skill training and brief motivational feedback. Additionally, this intervention contained the new element of discussing biological, cognitive and social risk factors for developing alcohol problems. We investigated whether this seven session program was successful in changing cognitive determinants of drinking behavior and consequently in moderating alcohol use and the development of alcohol-related problems in at-risk adolescents. The intervention was effective in changing several of the targeted cognitive determinants. However, despite the changes in these cognitive determinants of drinking, the experimental group did not show a significant difference in decrease of drinking at posttest compared with the control group. The results did not yield support for any differential long term effects of the intervention. We concluded that although the present intervention successfully changed important cognitive determinants of drinking more is needed to change subsequent drinking behavior in at-risk adolescents.


Assuntos
Consumo de Bebidas Alcoólicas/terapia , Alcoolismo/terapia , Terapia Cognitivo-Comportamental , Adolescente , Consumo de Bebidas Alcoólicas/psicologia , Alcoolismo/psicologia , Depressores do Sistema Nervoso Central/farmacologia , Etanol/farmacologia , Feminino , Humanos , Masculino , Fatores de Risco , Inquéritos e Questionários
15.
Behav Res Ther ; 92: 57-67, 2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-28257982

RESUMO

Anxiety and depression, which are highly prevalent in adolescence, are both characterized by a negative attentional bias. As Attentional Bias Modification (ABM) can reduce such a bias, and might also affect emotional reactivity, it could be a promising early intervention. However, a growing number of studies also report comparable improvements in both active and placebo groups. The current study investigated the effects of eight online sessions of visual search (VS) ABM compared to both a VS placebo-training and a no-training control group in adolescents with heightened symptoms of anxiety and/or depression (n = 108). Attention bias, interpretation bias, and stress-reactivity were assessed pre- and post-training. Primary outcomes of anxiety and depressive symptoms, and secondary measures of emotional resilience were assessed pre- and post-training and at three and six months follow-up. Results revealed that VS training reduced attentional bias compared to both control groups, with stronger effects for participants who completed more training sessions. Irrespective of training condition, an overall reduction in symptoms of anxiety and depression and an increase in emotional resilience were observed up to six months later. The training was evaluated relatively negatively. Results suggest that online ABM as employed in the current study has no added value as an early intervention in adolescents with heightened symptoms.


Assuntos
Ansiedade/terapia , Viés de Atenção , Depressão/terapia , Psicoterapia , Adolescente , Criança , Feminino , Humanos , Masculino , Resiliência Psicológica , Terapia Assistida por Computador , Resultado do Tratamento , Adulto Jovem
16.
PLoS One ; 12(7): e0181147, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28715495

RESUMO

INTRODUCTION: Anxiety and depression are highly prevalent during adolescence and characterized by negative interpretation biases. Cognitive bias modification of interpretations (CBM-I) may reduce such biases and improve emotional functioning. However, as findings have been mixed and the traditional scenario training is experienced as relatively boring, a picture-based type of training might be more engaging and effective. METHODS: The current study investigated short- and long-term effects (up to 6 months) and users' experience of two types of CBM-I procedure in adolescents with heightened symptoms of anxiety or depression (N = 119, aged 12-18 year). Participants were randomized to eight online sessions of text-based scenario training, picture-word imagery training, or neutral control training. RESULTS: No significant group differences were observed on primary or secondary emotional outcomes. A decrease in anxiety and depressive symptoms, and improvements in emotional resilience were observed, irrespective of condition. Scenario training marginally reduced negative interpretation bias on a closely matched assessment task, while no such effects were found on a different task, nor for the picture-word or control group. Subjective evaluations of all training paradigms were relatively negative and the imagery component appeared particularly difficult for adolescents with higher symptom levels. CONCLUSIONS: The current results question the preventive efficacy and feasibility of both CBM-I procedures as implemented here in adolescents.


Assuntos
Ansiedade/patologia , Depressão/patologia , Imagens, Psicoterapia/métodos , Adolescente , Afeto , Ansiedade/psicologia , Criança , Cognição , Depressão/psicologia , Emoções , Feminino , Humanos , Internet , Masculino , Autoimagem , Inquéritos e Questionários , Resultado do Tratamento
17.
J Psychopharmacol ; 31(10): 1377-1379, 2017 10.
Artigo em Inglês | MEDLINE | ID: mdl-28922968

RESUMO

Using data form a 14-day double-blind trial with 48 smokers randomized to either N-acetylcysteine (2400 mg) or placebo, we tested the effect of N-acetylcysteine on glutamate and gamma-aminobutyric acid concentrations in the dorsal anterior cingulate cortex and on smoking cessation. Smoking related behaviors and neurotransmitter concentrations in the dorsal anterior cingulate cortex were assessed before and after treatment. Forty-seven non-smoking males served as baseline controls. Smokers showed higher baseline glutamate but similar gamma-aminobutyric acid concentrations than non-smokers. There were no treatment effects on dorsal anterior cingulate cortex neurotransmitter concentrations, smoking cessation, craving, or withdrawal symptoms. These results confirm glutamate disbalance in smokers, but not efficacy of N-acetylcysteine.


Assuntos
Acetilcisteína/uso terapêutico , Ácido Glutâmico/metabolismo , Giro do Cíngulo/efeitos dos fármacos , Síndrome de Abstinência a Substâncias/tratamento farmacológico , Síndrome de Abstinência a Substâncias/metabolismo , Tabagismo/tratamento farmacológico , Ácido gama-Aminobutírico/metabolismo , Adulto , Fissura/efeitos dos fármacos , Método Duplo-Cego , Giro do Cíngulo/metabolismo , Humanos , Masculino , Abandono do Hábito de Fumar/métodos , Tabagismo/metabolismo
18.
J Psychopharmacol ; 31(8): 1027-1034, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28741422

RESUMO

BACKGROUND: Cannabis exposure, particularly heavy cannabis use, has been associated with neuroanatomical alterations in regions rich with cannabinoid receptors such as the hippocampus in some but not in other (mainly cross-sectional) studies. However, it remains unclear whether continued heavy cannabis use alters hippocampal volume, and whether an earlier age of onset and/or a higher dosage exacerbate these changes. METHODS: Twenty heavy cannabis users (mean age 21 years, range 18-24 years) and 23 matched non-cannabis using healthy controls were submitted to a comprehensive psychological assessment and magnetic resonance imaging scan at baseline and at follow-up (average of 39 months post-baseline; standard deviation=2.4). Cannabis users started smoking around 16 years and smoked on average five days per week. A novel aspect of the current study is that hippocampal volume estimates were obtained from manual tracing the hippocampus on T1-weighted anatomical magnetic resonance imaging scans, using a previously validated protocol. RESULTS: Compared to controls, cannabis users did not show hippocampal volume alterations at either baseline or follow-up. Hippocampal volumes increased over time in both cannabis users and controls, following similar trajectories of increase. Cannabis dose and age of onset of cannabis use did not affect hippocampal volumes. CONCLUSIONS: Continued heavy cannabis use did not affect hippocampal neuroanatomical changes in early adulthood. This contrasts with prior evidence on alterations in this region in samples of older adult cannabis users. In young adults using cannabis at this level, cannabis use may not be heavy enough to affect hippocampal neuroanatomy.


Assuntos
Hipocampo/patologia , Fumar Maconha/patologia , Adolescente , Estudos de Casos e Controles , Feminino , Hipocampo/diagnóstico por imagem , Humanos , Estudos Longitudinais , Imageamento por Ressonância Magnética , Masculino , Neuroimagem , Adulto Jovem
19.
J Psychopharmacol ; 30(2): 152-8, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26645206

RESUMO

Cannabis is the most frequently used illicit drug worldwide, but little is known about the mechanisms underlying continued cannabis use. Cue-reactivity (the physical, psychological, behavioural and neural reaction to substance-related cues) might be related to continued cannabis use. In this 3-year prospective neuroimaging study we investigated whether cannabis cue-induced brain activity predicted continued cannabis use and associated problem severity 3 years later. In addition, baseline brain activations were compared between dependent and non-dependent cannabis users at follow-up. Analyses were focussed on brain areas known to be important in cannabis cue-reactivity: anterior cingulate cortex, orbitofrontal cortex, ventral tegmental area, amygdala and striatum. At baseline, 31 treatment-naive frequent cannabis users performed a cue-reactivity functional magnetic resonance imaging task. Of these participants, 23 completed the 3-year follow-up. None of the cue-induced region of interest activations predicted the amount of cannabis use at follow-up. However, cue-induced activation in the left striatum (putamen) significantly and independently predicted problem severity at follow-up (p < 0.001) as assessed with the Cannabis Use Disorder Identification Test. Also, clinically dependent cannabis users at follow-up showed higher baseline activation at trend level in the left striatum compared with non-dependent users. This indicates that neural cue-reactivity in the dorsal striatum is an independent predictor of cannabis use-related problems. Given the relatively small sample size, these results are preliminary and should be replicated in larger samples of cannabis users.


Assuntos
Corpo Estriado/metabolismo , Sinais (Psicologia) , Abuso de Maconha/epidemiologia , Fumar Maconha/epidemiologia , Adulto , Encéfalo/metabolismo , Feminino , Seguimentos , Humanos , Imageamento por Ressonância Magnética , Masculino , Fumar Maconha/psicologia , Estudos Prospectivos , Índice de Gravidade de Doença , Adulto Jovem
20.
Behav Res Ther ; 87: 11-22, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-27585484

RESUMO

Based on information processing models of anxiety and depression, we investigated the efficacy of multiple sessions of online attentional bias modification training to reduce attentional bias and symptoms of anxiety and depression, and to increase emotional resilience in youth. Unselected adolescents (N = 340, age: 11-18 years) were randomly allocated to eight sessions of a dot-probe, or a visual search-based attentional training, or one of two corresponding placebo control conditions. Cognitive and emotional measures were assessed pre- and post-training; emotional outcome measures also at three, six and twelve months follow-up. Only visual search training enhanced attention for positive information, and this effect was stronger for participants who completed more training sessions. Symptoms of anxiety and depression reduced, whereas emotional resilience improved. However, these effects were not especially pronounced in the active conditions. Thus, this large-scale randomized controlled study provided no support for the efficacy of the current online attentional bias modification training as a preventive intervention to reduce symptoms of anxiety or depression or to increase emotional resilience in unselected adolescents. However, the absence of biased attention related to symptomatology at baseline, and the large drop-out rates at follow-up preclude strong conclusions.


Assuntos
Ansiedade/terapia , Viés de Atenção , Depressão/terapia , Adolescente , Comportamento do Adolescente , Criança , Cognição , Emoções , Feminino , Humanos , Internet , Masculino , Resiliência Psicológica , Ensino
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