Dopamine-modulated aversive emotion processing fails in alcohol-dependent patients.

Negative mood states after alcohol detoxification may enhance the relapse risk. As recently shown in healthy volunteers, dopamine storage capacity (V d) in the left amygdala was positively correlated with functional activation in the left amygdala and anterior cingulate cortex (ACC) during an emotional task; high functional connectivity between the amygdala and the ACC, a region important for emotion regulation, was associated with low trait anxiety. Based on these findings, we now tested whether detoxified alcohol-dependent patients have a disrupted modulation of the anterior cingulate cortex activation in response to aversive stimuli by amygdala dopamine. Furthermore, we asked whether disrupted functional coupling between amygdala and ACC during aversive processing is related to trait anxiety.We used combined 6-[18F]-fluoro-l-DOPA positron emission tomography (PET), functional magnetic resonance imaging (fMRI) and Spielberger's state-trait anxiety questionnaire (STAI) in 11 male detoxified alcohol-dependent patients compared to 13 matched healthy controls.Unlike healthy controls, patients showed no significant correlation between our PET metric for dopamine storage capacity (FDOPA V d), in left amygdala and activation in left ACC. Moreover, the functional connectivity between amygdala and ACC during processing of aversive emotional stimuli was reduced in patients. Voxel-based morphometry did not reveal any discernible group differences in amygdala volume.These results suggest that dopamine-modulated corticolimbic circuit function is important for responding to emotional information such that apparent functional deficits in this neuromodulatory circuitry may contribute to trait anxiety in alcohol-dependent patients.

Development and factorial validation of a short version of the narcissism inventory (NI-20).

BACKGROUND: Narcissism is seen as a normal but heterogeneously formed personality variable, ranging from 'grandiosity-exhibitionism' to 'vulnerability-sensitivity'. This article reports the development and factorial validation of a short version of a narcissism inventory. SAMPLING AND METHODS: The sample includes data of 4,509 consecutive psychosomatic inpatients. The overall sample was divided in 2 equally sized randomized subsamples. One sample (n = 2,262) was used for exploratory factor analysis (principal component analysis). The other sample (n = 2,265) was used for confirmatory tests of the model fit of the newly built NI-20 version, and to analyze the model fit separately for men and women using structural equation modeling with AMOS software. RESULTS: The short version (NI-20) consists of 20 items, with items representing almost all of the original 18 subscales and 4 second-order dimensions. The NI-20 possesses properties similar to the NI-90, with a considerable gain in test economy. The 4-factor structure of the NI-20 was confirmed, and reaches good fit indices. CONCLUSIONS: The NI-20 is an economical instrument with acceptable psychometric characteristics that reflects the heterogeneous aspects of narcissism. A methodological limitation is that the interactions between sociodemographic variables were not included as potential predictors.

[Evidence-based psychotherapy: addiction and personality disorders as comorbidities]. / Evidenzbasierte Psychotherapie: Sucht und Persönlichkeitsstörung als Komorbidität.

A large number of studies have shown that various psychotherapeutic methods have a positive effect on the course of addiction and personality disorders when they are treated separately. Co-morbid occurrence of both disorders is common but a chronologically separated treatment often leads to renewed occurrence of the symptoms of the initially treated disorder. Failures of abstinence motivation, severe drug craving and the activation of dysfunctional behavior patterns frequently lead to renewed consumption of addictive substances and thus endanger the further course of treatment. So far, evidence of effectiveness exists only for dialectic behavior therapy and dual focus schema therapy. This article summarizes the current state of knowledge and introduces both methods by highlighting the core therapeutic strategies.