Blunted autonomic responses to emotional stimuli in alcoholism: relevance of impulsivity. / Respuestas autonómicas reducidas ante estímulos emocionales en el alcoholismo: la relevancia de la impulsividad.

Alcohol dependence is associated with abnormalities in the processing of emotional signals and impulsive alcohol-seeking behaviours, and these alterations compromise the effectiveness of treatment approaches. However, there is a lack of studies linking the experience of emotions to everyday motivationally relevant stimuli in alcohol-dependent individuals using both autonomic and self-report measures. We analysed heart rate (HR), skin conductance (SC) and subjective emotional reactivity to everyday affective stimuli in alcohol-dependent individuals, and their associations with impulsivity and degree of alcohol consumption. SC and HR were continuously monitored in 28 alcohol-dependent individuals and in 31 non-alcohol healthy controls during passive viewing of pleasant, unpleasant, and neutral emotional pictures. Participants assessed the pictures for valence, arousal, and dominance and completed the Barratt Impulsiveness Scale. Alcohol-dependent individuals showed reduced HR and SC reactivity to both positive and negative emotional stimuli. In the case of SC, this blunted response was associated with impulsivity. Furthermore, alcohol-dependents displayed decoupled physiological and subjective responses, with blunted autonomic responses and normal subjective reports regarding emotional stimuli. Our findings indicate that alcohol-dependent individuals failed to use emotional autonomic feedback in response to natural, emotionally relevant stimuli, and provide initial evidence of the contribution of impulsivity to emotional processing deficits in this population. These results are in keeping with the proposed key role played by emotional experience and impulsivity in substance abuse.

La dependencia al alcohol está asociada con anormalidades en el procesamiento de las emociones y comportamientos impulsivos en la búsqueda de alcohol. Sin embargo, pocos estudios han analizado las respuestas emocionales hacia estímulos motivacionalmente relevantes en personas dependientes al alcohol usando medidas tanto autonómicas como subjetivas. En este estudio se analizó la tasa cardiaca (TC), la conductancia de la piel (CP) y las respuestas subjetivas a estímulos emocionales cotidianos en individuos dependientes al alcohol, y su asociación con la impulsividad y el consumo de alcohol. La TC y la CP fueron registradas en 28 participantes dependientes al alcohol y en 31 participantes sanos durante la visualización pasiva de imágenes emocionales placenteras, desagradables y neutras. Posteriormente, los participantes evaluaron valencia, activación y dominancia de las imágenes y completaron la Escala de Impulsividad de Barratt. Los participantes dependientes mostraron respuestas reducidas en TC y CP, tanto hacia las imágenes emocionales positivas como negativas. En el caso de la CP, estas respuestas se asociaron a la impulsividad. Los participantes dependientes al alcohol mostraron una disociación entre las respuestas fisiológicas y subjetivas, con unas respuestas autonómicas disminuidas y unas respuestas subjetivas normales. Estos resultados sugieren que los individuos dependientes al alcohol tienen problemas en utilizar el feedback fisiológico emocional al responder a estímulos emocionales relevantes, y proporcionan una evidencia inicial de la contribución de la impulsividad a los déficits de procesamiento emocional en esta población. Estos resultados son congruentes con el papel clave que juega la experiencia emocional y la impulsividad en el abuso de sustancias.

Impaired decoding of fear and disgust predicts utilitarian moral judgment in alcohol-dependent individuals.

BACKGROUND: Recent studies of moral reasoning in patients with alcohol use disorders have indicated a "utilitarian" bias, whereby patients are more likely to endorse emotionally aversive actions in favor of aggregate welfare (e.g., throwing a dying person into the sea to keep a lifeboat of survivors afloat). Here, we investigate the underlying psychological and neuropsychological processes. METHODS: Alcohol-dependent individuals (n = 31) and healthy comparison participants (n = 34) completed a validated moral judgment task, as well as measures of impulsivity, mood symptoms (anxiety and depression), and emotional face recognition. RESULTS: Alcohol-dependent individuals were more likely to endorse utilitarian choices in personal moral dilemmas compared with controls and rated these choices as less difficult to make. Hierarchical regression models showed that poorer decoding of fear and disgust significantly predicted utilitarian biases in personal moral dilemmas, over and above alcohol consumption. Impulsivity and mood symptoms did not predict moral decisions. CONCLUSIONS: These findings suggest that impaired fear and disgust decoding contributes to utilitarian moral decision-making in alcohol-dependent individuals.

Are batterers different from other criminals? An fMRI study.

Intimate partner violence (IPV) is a complex and global phenomenon that requires a multi-perspective analysis. Nevertheless, the number of neuroscientific studies conducted on this issue is scarce as compared with studies of other types of violence, and no neuroimaging studies comparing batterers to other criminals have been conducted. Thus, the main aim of this study was to compare the brain functioning of batterers to that of other criminals when they are exposed to IPV or general violence pictures. An fMRI study was conducted in 21 batterers and 20 other criminals while they observed IPV images (IPVI), general violence images (GVI) and neutral images (NI). Results demonstrated that batterers, compared with other criminals, exhibited a higher activation in the anterior and posterior cingulate cortex and in the middle prefrontal cortex and a decreased activation in the superior prefrontal cortex to IPVI compared to NI. The paired t-test comparison between IPVI and GVI for each group showed engagement of the medial prefrontal cortex, the posterior cingulate and the left angular cortices to IPVI in the batterer group only. These results could have important implications for a better understanding of the IPV phenomenon.

Brief Moral Decision-Making Questionnaire: A Rasch-derived short form of the Greene dilemmas.

In this study, we developed the Brief Moral Decision-Making Questionnaire (BrMoD) as a standardized brief form of the dilemmas compiled by Greene and colleagues (Greene, Sommerville, Nystrom, Darley, & Cohen, 2001). An initial Rasch analysis was conducted over responses to 60 dilemmas to retain the most appropriate items. The psychometric properties of the 32-item brief instrument were determined in a community sample of 133 individuals using analyses from both the Rasch model and the classical test theory. The BrMoD scores showed appropriate reliability and construct validity. Differences between dilemma categories proposed by Greene et al. were observed in the BrMoD by measuring the difficulty of decisions and response times of the participants. In addition, there was no differential item functioning by the demographic variables. Therefore, the BrMoD is a good tool for assessing moral decision making in research or professional fields.

Valence of emotions and moral decision-making: increased pleasantness to pleasant images and decreased unpleasantness to unpleasant images are associated with utilitarian choices in healthy adults.

Moral decision-making is a key asset for humans' integration in social contexts, and the way we decide about moral issues seems to be strongly influenced by emotions. For example, individuals with deficits in emotional processing tend to deliver more utilitarian choices (accepting an emotionally aversive action in favor of communitarian well-being). However, little is known about the association between emotional experience and moral-related patterns of choice. We investigated whether subjective reactivity to emotional stimuli, in terms of valence, arousal, and dominance, is associated with moral decision-making in 95 healthy adults. They answered to a set of moral and non-moral dilemmas and assessed emotional experience in valence, arousal and dominance dimensions in response to neutral, pleasant, unpleasant non-moral, and unpleasant moral pictures. Results showed significant correlations between less unpleasantness to negative stimuli, more pleasantness to positive stimuli and higher proportion of utilitarian choices. We also found a positive association between higher arousal ratings to negative moral laden pictures and more utilitarian choices. Low dominance was associated with greater perceived difficulty over moral judgment. These behavioral results are in fitting with the proposed role of emotional experience in moral choice.

Heart rate correlates of utilitarian moral decision-making in alcoholism.

BACKGROUND: Recent studies of moral reasoning in patients with alcohol use disorders have indicated a 'utilitarian' bias, whereby patients are more likely to endorse emotionally aversive actions in favor of aggregate welfare (e.g., to kill a person in order to save a group of people). The aim of the present study was to examine psychophysiological correlates of this tendency indexed by heart rate. METHODS: The sample was composed by 31 alcohol-dependent individuals and 34 healthy controls without alcohol use disorders. Electrocardiogram was recorded at rest and during execution of a validated moral judgment task, including non-moral scenarios, and moral dilemmas that were either high in emotional salience ("personal scenarios") or low in emotional salience ("impersonal scenarios"). RESULTS: Alcohol-dependent individuals showed a blunted response to moral dilemmas. Furthermore, healthy controls displayed decreased heart rate to the personal vs. impersonal or non-moral scenarios, while alcohol-dependent individuals failed to differentiate dilemmas in terms of heart rate both prior decision-making and its post appraisal. These deficits were not related to baseline differences in Heart Rate. CONCLUSION: Our findings indicate that alcohol-dependent individuals failed to engage emotional aversive reactions to personal moral violations in terms of heart rate response.

Moral decision-making in polysubstance dependent individuals.

BACKGROUND: Moral judgments depend on the integration of complex cognitive and emotional processes. Addiction is associated with core deficits in both cognitive and emotional processing, which may jointly lead to utilitarian biases in moral decision-making. METHODS: We assessed 32 polysubstance dependent males and 32 non-drug using controls using a previously validated moral judgment task, including non-moral scenarios, and moral dilemmas that were either high in emotional salience ("personal scenarios") or low in emotional salience ("impersonal scenarios"). RESULTS: Polysubstance dependent individuals endorsed more utilitarian choices for personal dilemmas (e.g., smothering a baby to save a group of hidden people during wartime). These choices were also perceived as less difficult. Severity of alcohol use correlated with the proportion of utilitarian judgments. CONCLUSION: Polysubstance dependent individuals show a more utilitarian pattern of moral decision-making for personal moral scenarios.