Identifying internalizing transdiagnostic profiles through motivational and cognitive control systems: Relations with symptoms, functionality, and quality of life.

BACKGROUND: The diversity of patients' symptomatology among people seeking treatment on community-based mental health services poses significant challenges to traditional models of care. Recent approaches favor identifying transdiagnostic factors that allow a better understanding of patient heterogeneity and designing more effective and quality interventions. This study examines the heterogeneity of patients with internalizing symptoms based on profiles identified with cognitive and motivational control variables. Differences between these profiles on dimensional measures of psychopathology and quality of life are examined. METHODS: 263 patients were selected by non-probabilistic sampling procedures on mental health services in the province of Huelva (Spain). A latent class analysis on the standardized scale scores of The Behavioral Inhibition/Behavioral Activation System Scales and the Effortful Control Scale of the Adult Temperament Questionnaire Short-Form was conducted. Profiles were compared on the scores of the Inventory of Depression and Anxiety Symptoms-II, the WHO Disability Assessment Schedule II, and the Health Assessment Questionnaire SF-36. RESULTS: The four latent profile solution is the one that showed the best fit indicators and substantive interpretability, with a kappa of 0.94 in the cross-validation procedure with 75% of the sample. No sex differences were found between the profiles (χ32 5.17, p = .160). Profiles #1 and #3, both characterized by an imbalance between low activation and high inhibition, had lower well-being, lower functionality, and quality of life. When comparing profile #2 (featuring the highest inhibitory control) lower scores on most internalizing scales are observed, specially claustrophobia, social anxiety, panic mania. Profile #4 (low control, high activation, and high inhibition) showed greater scores on both mania and euphoria and lower scores on emotional role. CONCLUSIONS: We identified four distinctive profiles that had overly increased behavioral inhibition (as expected in internalizing disorders) and differed in the degree of imbalance between inhibition and activation systems, and between motivational systems and top-down cognitive control. The profile characterized by high activation and reduced cognitive (inhibitory) control was the one showing greater mood-related symptoms and lower levels of quality of life. These profiles could be generated by treatment providers to guide clinical management in an evidence-based manner.

Excessive body fat linked to blunted somatosensory cortex response to general reward in adolescents.

BACKGROUND AND AIMS: The brain reward system is key to understanding adolescent obesity in the current obesogenic environment, rich in highly appetising stimuli, to which adolescents are particularly sensitive. We aimed to examine the association between body fat levels and brain reward system responsivity to general (monetary) rewards in male and female adolescents. METHODS: Sixty-eight adolescents (34 females; mean age (s.d.)= 16.56 (1.35)) were measured for body fat levels with bioelectric impedance, and underwent a functional magnetic resonance imaging (fMRI) scan during the Monetary Incentive Delay (MID) task. The MID task reliably elicits brain activations associated with two fundamental aspects of reward processing: anticipation and feedback. We conducted regression analyses to examine the association between body fat and brain reward system responsivity during reward anticipation and feedback, while controlling for sex, age and socioeconomic status. We also analysed the moderating impact of sex on the relationship between fat levels and brain responsivity measures. Brain imaging analyses were corrected for multiple comparisons, with a cluster-defining threshold of P<0.001, and minimum cluster size of 38 contiguous voxels. RESULTS: Higher body fat levels were associated with lower activation of the primary somatosensory cortex (S1) and the supramarginal gyrus during reward feedback after controlling for key sociodemographic variables. Although we did not find significant associations between body fat and brain activations during reward anticipation, S1/supramarginal gyrus activation during feedback was linked to increased negative prediction error, that is, less reward than expected, in illustrative post hoc analyses. Sex did not significantly moderate the association between body fat and brain activation in the MID task. CONCLUSIONS: In adolescents, higher adiposity is linked to hypo-responsivity of somatosensory regions during general (monetary) reward feedback. Findings suggest that adolescents with excess weight have blunted activation in somatosensory regions involved in reward feedback learning.

Brain substrates of unhealthy versus healthy food choices: influence of homeostatic status and body mass index.

BACKGROUND/OBJECTIVES: Unhealthy dietary choices are a major contributor to harmful weight gain and obesity. This study interrogated the brain substrates of unhealthy versus healthy food choices in vivo, and evaluated the influence of hunger state and body mass index (BMI) on brain activation and connectivity. SUBJECTS/METHODS: Thirty adults (BMI: 18-38 kg m-2) performed a food-choice task involving preference-based selection between beverage pairs consisting of high-calorie (unhealthy) or low-calorie (healthy) options, concurrent with functional magnetic resonance imaging (fMRI). Selected food stimuli were delivered to participants using an MRI-compatible gustometer. fMRI scans were performed both after 10-h fasting and when sated. Brain activation and hypothalamic functional connectivity were assessed when selecting between unhealthy-healthy beverage pairings, relative to unhealthy-unhealthy and healthy-healthy options. Results were considered significant at cluster-based family-wise error corrected P<0.05. RESULTS: Selecting between unhealthy and healthy foods elicited significant activation in the hypothalamus, the medial and dorsolateral prefrontal cortices, the anterior insula and the posterior cingulate. Hunger was associated with higher activation within the ventromedial and dorsolateral prefrontal cortices, as well as lower connectivity between the hypothalamus and both the ventromedial prefrontal cortex and dorsal striatum. Critically, people with higher BMI showed lower activation of the hypothalamus-regardless of hunger state-and higher activation of the ventromedial prefrontal cortex when hungry. CONCLUSIONS: People who are overweight and obese have weaker activation of brain regions involved in energy regulation and greater activation of reward valuation regions while making choices between unhealthy and healthy foods. These results provide evidence for a shift towards hedonic-based, and away from energy-based, food selection in obesity.

Planning deficits in polysubstance dependent users: Differential associations with severity of drug use and intelligence.

BACKGROUND: Polysubstance use is associated with alterations in different components of executive functioning such as working memory and response inhibition. Nevertheless, less attention has been given to executive planning skills, which are required to benefit of low structured interventions. This study examines the association between severity of use of cocaine, heroin, alcohol, fluid and crystallized intelligence and planning tasks varying on degree of structure. METHODS: Data were collected from 60 polysubstance users and 30 healthy controls. Cognitive assessment consisted of three planning tasks with different structure levels: Stockings of Cambridge, Zoo Map test, and Multiple Errands Test. RESULTS: Polysubstance users had significant planning deficits across the three tasks compared to healthy controls. Hierarchical regression models showed that severity of drug use and fluid and crystallized intelligence significantly explained performance in all the planning tasks. However, these associations were higher for low-structured real world tasks. These low-structured tasks also showed a unique association with crystallized but not fluid intelligence. CONCLUSION: Drug abuse is negatively associated with planning abilities, and intelligence is positively associated with planning performance in real-world tasks.

Impulsive choice predicts short-term relapse in substance-dependent individuals attending an in-patient detoxification programme.

BACKGROUND: Impulsivity is a hallmark characteristic of substance use disorders. Recently, studies have begun to explore whether increased impulsivity in substance-dependent individuals (SDIs) is associated with a greater propensity to relapse following treatment. Despite growing recognition of its multidimensional nature, however, most studies have treated impulsivity unilaterally. Accordingly, it remains unclear whether certain facets of impulsivity are more relevant to relapse than others. The aim of the current study was to examine the relationship between multiple facets of impulsivity and short-term relapse in SDIs. As a secondary aim, we explored the role of treatment retention in this relationship. METHOD: A personality-based impulsivity questionnaire (UPPS) and three neurocognitive tasks of impulsivity [stop-signal task (SST), delay discounting task (DDT) and Iowa gambling task (IGT)] were administered in a heterogeneous sample of 70 SDIs shortly following their entry in an in-patient detoxification programme. Mediation analyses were performed to explore whether the effects of impulsivity on relapse were mediated by treatment retention. RESULTS: Performance on two neurocognitive indices of impulsive choice (i.e. delay discounting and impulsive decision-making) significantly predicted short-term relapse. The effects of delay discounting and impulsive decision-making on relapse propensity were mediated by treatment retention. CONCLUSIONS: Neurocognitive indices of impulsivity may be more sensitive to the prediction of relapse than trait-based self-report questionnaires. Post-treatment relapse in SDIs may be reduced by targeting the processes involved in impulsive choice and by improving treatment retention in SDIs with inflated impulsivity.

Affective, sensory and empathic sharing of another's pain: The Empathy for Pain Scale.

BACKGROUND: Through two studies, we introduce and validate the Empathy for Pain Scale (EPS), which characterizes the phenomenology of empathy for pain, including the vicarious experience of pain when seeing others in pain. METHODS: In study 1, 406 individuals completed the EPS and Interpersonal Reactivity Index (IRI). In the EPS, four painful scenarios (witnessing surgery, patient recovering from surgery, assault and accidental injury) were rated for 12 emotional, empathic and sensory responses. In study 2, 59 participants completed the same questionnaires and then watched and rated videos of sporting injuries. RESULTS: In study 1, we identified three factors of the EPS with principal component analysis, which were validated with confirmatory factor analysis: affective distress; vicarious pain; and empathic concern. The EPS demonstrated good psychometric properties, re-test reliability (n = 105) and concurrent validity. In study 2, we validated the EPS against empathic reactions to the pain of others as displayed in video clips depicting sporting injuries and showed that the scale has unique utility to characterize empathic reactions to pain above general trait empathy measures. Both studies showed that the affective distress and empathic concern subscales of the EPS correlated with measures of cognitive and affective empathy from the IRI, whereas the vicarious pain subscale was only correlated with the personal distress IRI subscale. CONCLUSIONS: The EPS is a psychometrically sound new scale that characterizes empathy for pain and vicarious pain. The EPS offers valuable insight to the phenomenological profile of the affective, empathic and sensory dimensions of empathy for pain.

Comparatively preserved impulse control in late-onset opiate users.

RATIONALE: A substantial literature indicates that in alcohol addiction aspects of impulsive decision-making are typical of individuals with an early onset of addictive behaviour problems. It is not known whether the same applies to opiate addiction, and this insight has important theoretical and clinical implications. OBJECTIVES: This study aims to examine the relationship between age at onset of addictive behaviour problems and decision-making in opiate addiction. METHODS: Ninety-three opiate-dependent, treatment-seeking individuals were divided in three groups, early, late and intermediate onset of problems, and completed impulsivity questionnaires and delay discounting and gambling tasks. RESULTS: Individuals with a late onset of opiate problems (25 years or above) had lower delay discounting rates than individuals with early (18 years or less) or intermediate onset. There were no differences in performance on the gambling tasks. Late-onset individuals were older and had shorter drug histories, but there was no relationship between either age or length of exposure to opiates and delay discounting rates. CONCLUSIONS: In keeping with previous studies in alcohol addiction, these findings support the notion of at least two distinct subgroups of opiate-dependent individuals, characterised by a different onset of problems, different propensity to impulsive behaviour and perhaps distinct mechanisms leading to addiction.

Impulsividad, comorbilidad e impacto de los tratamientos: del desarrollo de instrumentos a la satisfacción del usuario / Impulsiveness, comorbidity and impact of the treatments: from development of instruments to user satisfaction

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Validación de una versión breve de la escala de comportamiento impulsivo UPPS-P / Validation of a short Spanish version of the UPPS-P impulsive behaviour scale

Objetivo. La impulsividad es un constructo multifactorial con un papel central en la psicopatología y en especial en las adicciones. El objetivo de este estudio es desarrollar y validar una versión española de la escala breve de comportamiento impulsivo UPPS-P1, que evalúa cinco rasgos relacionados con el comportamiento impulsivo: urgencia positiva, urgencia negativa, falta de premeditación, falta de perseverancia y búsqueda de sensaciones. Métodos. Participaron 189 sujetos que completaron la versión breve de la escala UPPS-P. Sobre esta muestra, se llevó a cabo un análisis factorial confirmatorio que corroboró la validez de la estructura factorial de cinco dimensiones de la escala original. Resultados. Los resultados indicaron buenos índices de fiabilidad. La validez externa de la escala queda apoyada por su asociación específica con una escala de evaluación de estrategias de regulación emocional. Conclusión. La versión breve en español de la Escala UPPS¿P presenta buenas propiedades psicométricas y puede considerarse un instrumento prometedor para su uso en contextos de investigación y especialmente por su brevedad en contextos clínicos (AU)

Aim. Impulsivity is a multifaceted construct that has a prominent role in psychiatry and especially in addiction. The objective of the current study is to develop and validate a Spanish version of the short UPPS-P impulsive behavior scale1, which assesses five distinct impulsivity traits (positive urgency, negative urgency, lack of premeditation, lack of perseverance, and sensation seeking). Material and methods. One hundred and eighty-nine participants were included in the study. Confirmatory factor analyses supported the five-factor model of the original scale. Results. The results indicated good internal reliability. External validity was supported by specific relationships with a scale assessing emotion regulation strategies. Conclusion. Accordingly, the short Spanish version of the UPPS-P scale presents good psychometric properties and may be considered a promising instrument for both research and clinical practice (AU)

Estudio exploratorio del impacto de las creencias nucleares relacionadas con la adicción en el consumo tras la abstinencia / Exploratory study of the impact of core addiction beliefs on drug consumption during abstinence

Objetivo. El objetivo de este estudio fue conocer si existen diferencias en el grado con el que se identifican los pacientes que se encuentran abstinentes con determinadas creencias inmediatamente antes de que se produzca un episodio de consumo y días posteriores al mismo. Material y método. La muestra la componen 29 personas que presentan dependencia a la cocaína o al alcohol, en el que el 75,9 % de ellos son hombres y el 24,1 % mujeres. Todos ellos siguen tratamiento ambulatorio desde hace al menos dos meses. Se les pidió a los pacientes que contestaran al cuestionario de modo que permitiera llevar a cabo una estrategia para la detección y desarticulación de creencias que influyen, según estos resultados, en la decisión de consumir nuevamente cuando se está abstinente. Resultados. Los resultados muestran que existen diferencias entre en el grado con el que los pacientes se identifican con las creencias evaluadas antes y después del consumo, destacando el impacto tanto de las creencias relacionadas con la adicción como las relacionadas con la renuncia al consumo sobre el deseo de consumir. Conclusiones. Se concluye que la presencia de creencias nucleares relacionada con el consumo de drogas predispone al consumo, destacando particularmente aquellas que guardan relación con la decisión de cese definitivo del consumo de drogas porque no suelen verbalizarse fácilmente a lo largo de la terapia (AU)

Objetive. The aim of this study was to determine whether there are differences in the degree to which substance abusing patients identify themselves with core addiction beliefs immediately before a consumption episode (retrospectively assessed) vs. some days afterwards. Material and method. The sample was composed by 29 individuals diagnosed with alcohol or cocaine dependence (75.9 % males and 24.1 % females) that were following outpatient treatment for at least two months. We asked the patients to answer the questionnaire in a way that allowed them to implement a strategy to detect and inoculate these core beliefs that negatively impact abstinence maintenance. Results. Showed signifi cant differences in the degree to which patients identify themselves with beliefs before vs. after the consumption episode. These results were signifi cant both in regards to beliefs associated with addiction and to beliefs associated with the decision to give-up consumption. Conclusion. We conclude that the existence of core addiction beliefs may predispose to consumption, with particular relevance of the beliefs associated with the decision to give-up consumption, since they are not easily verbalized thru therapy (AU)

El rol de la metodología en el estudio de las adicciones / The role of methodology in the study of addictions

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Trastornos adictivos 2.0 / "Trastornos adictivos" 2.0

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Procesamiento emocional, interocepción y funciones ejecutivas en policonsumidores de drogas en tratamiento / Emotional processing, interocepcion and executive functions in poly-substance users in treatment

Objetivo. El objetivo principal de este estudio es caracterizar el perfil de funcionamiento emocional (reconocimiento y experimentación de emociones e interocepción) y rendimiento neuropsicológico (disfunciones del comportamiento asociadas al sistema cerebral frontal, flexibilidad y toma de decisiones) en policonsumidores de sustancias frente al de control de no consumidores. Material y método. La muestra está compuesta por 60 sujetos: 30 personas policonsumidoras de diversas drogas, actualmente en tratamiento, y 30 individuos sanos que forman el grupo control. Se han administrado cuestionarios para medir el procesamiento emocional, la alexitimia, la amplificación somatosensorial y pruebas para la medición de funciones ejecutivas. Resultados. Los resultados indican que a nivel emocional existen mayores niveles de alexitimia y amplificación somatosensorial en personas consumidoras, así como un peor reconocimiento de las emociones de miedo, tristeza y asco, y una menor activación ante estímulos reforzadores naturales. En cuanto a aspectos neuropsicológicos, se ha encontrado, en este mismo grupo, una menor flexibilidad para el cambio y más déficits ejecutivos que en el grupo control. Cuando se analiza la asociación entre ambos tipos de variables, aparecen correlaciones significativas entre la alexitimia y la amplificación somatosensorial y, a su vez, con disfunciones ejecutivas, toma de decisiones y percepción del miedo y más desinhibición cuando el consumo de cocaína es mayor. Conclusiones. El grupo de personas con policonsumo presentan peor funcionamiento neuropsicológico y emocional que las personas que forman el grupo control (AU)

Objetive. The main aim of this study is to characterize the profile of emotional functioning (emotion recognition and experience and interoception) and neuropsychological performance (frontal-executive related behavioural dysfunction, flexibility and decision-making) in polysubstance users vs. controls. Material and method. The sample is composed by 60 subjects: 30 polysubstance abusers currently in treatment and 30 healthy individuals that formed the control group. Questionnaire measures were used to assess interoception and alexythimia, and performance tests were used for assessment of emotion recognition and experience and executive functions. Results. Polysubstance abusers showed increased levels of alexithymia and somatosensory amplification, poorer recognition of fear, sadness and disgust, and a flattened arousal response towards natural reinforcing stimuli. With regard to neuropsychological performance, polysubstance abusers had poorer switching and greater behavioural problems related to frontal striatal systems than the control group. We found significant correlations between alexithymia and somatosensory amplification, both dimensions correlated with executive dysfunctions, and between decision making and perception of fear. Conclusions. Polysubstance abusers have combined interrelated deficits in neurocognitive and emotional functions (AU)

Inteligencia emocional en individuos dependientes de cocaína / Emotional intelligence in cocaine dependent individuals

Objetivo. La dependencia de cocaína afecta de manera drástica al funcionamiento social del paciente adicto, lo que podría ser el reflejo de una deficitaria inteligencia emocional (IE). A pesar de su relevancia, la mayoría de los estudios realizados en dependientes de cocaína se han centrado en estudiar el reconocimiento de expresiones faciales emocionales, pero sin profundizar en el estudio de este constructo. El objetivo principal de este estudio es explorar el constructo de IE en consumidores de cocaína y examinar la relación entre dicho constructo y las habilidades más básicas de reconocimiento de expresiones faciales emocionales. Material y métodos. Treinta y un pacientes dependientes de cocaína (PDC) y 53 controles sanos fueron evaluados con el Inventario de pensamiento constructivo (para IE) y el Test de reconocimiento de expresiones faciales de Ekman (para reconocimiento). Resultados. Los PDC obtuvieron puntuaciones más bajas en IE y en las dimensiones emotividad, eficacia y rigidez. Los PDC tenían peor reconocimiento emocional global y peor reconocimiento del asco. La IE se correlaciona con la capacidad de reconocer emociones, corroborando el vínculo entre ambas destrezas. Conclusiones. Los PDC presentan déficits en IE y en la habilidad específica de reconocimiento de expresiones faciales emocionales. Estas carencias se relacionan con una estructura de pensamiento inflexible, falta de decisión sobre la conducta ante situaciones percibidas como descontro lables y, como consecuencia, dificultades en el establecimiento de relaciones personales y sociales gratificantes. Estos déficits podrían poner en peligro la continuidad y el éxito de los programas de rehabilitación dirigidos a estos individuos (AU)

Aim. Cocaine dependence drastically affects the social functioning of cocaine users, which could reflect an impairment of emotional intelligence. Despite its importance, most studies in cocaine users have focused only on the recognition of facial emotional expressions. The main aim of this study is to explore emotional intelligence in cocaine users and to examine its relation with emotional recognition. Material and methods. Thirty-one cocaine dependent individuals (CDI) and 53 healthy control individuals were assessed using The Constructive Thinking Inventory (for emotional intelligence) and The Ekman Faces Test (for emotional recognition). Results. CDI scored lower in emotional intelligence and on the subscales: emotional coping, behavioral coping and categorical thinking. CDI had significantly poorer global emotional recognition and poorer recognition for facial expressions of disgust. Emotional intelligence correlates with the ability to recognize facial emotional expressions, showing the link between both skills. Conclusions. CDI show impairments on emotional intelligence and on the ability to recognize facial emotional expressions. These impairments are related with an inflexible structure of thought, lack of decision on unpredictable situations and therefore difficulties in establishing rewarding social relationships. These impairments may affect the success of cocaine rehabilitation programs (AU)

Effectiveness of holistic neuropsychological rehabilitation for Spanish population with acquired brain injury measured using Rasch analysis.

INTRODUCTION: The Rasch model is increasingly used in the field of rehabilitation because it improves the accuracy of measurements of patient status and their changes after therapy. OBJECTIVE: To determine the long-term effectiveness of a holistic neuropsychological rehabilitation program for Spanish outpatients with acquired brain injury (ABI) using Rasch analysis. METHODS: Eighteen patients (ten with long evolution - patients who started the program > 6 months after ABI- and eight with short evolution) and their relatives attended the program for 6 months. Patients' and relatives' answers to the European Brain Injury Questionnaire and the Frontal Systems Behavior Scale at 3 time points (pre-intervention. post-intervention and 12 month follow-up) were transformed into linear measures called logits. RESULTS: The linear measures revealed significant improvements with large effects at the follow-up assessment on cognitive and executive functioning, social and emotional self-regulation, apathy and mood. At follow-up, the short evolution group achieved greater improvements in mood and cognitive functioning than the long evolution patients. CONCLUSIONS: The program showed long-term effectiveness for most of the variables, and it was more effective for mood and cognitive functioning when patients were treated early. Relatives played a key role in the effectiveness of the rehabilitation program.

Self-regulation and treatment retention in cocaine dependent individuals: a longitudinal study.

BACKGROUND: We aimed to explore the association between baseline executive functioning and treatment outcome in Therapeutic Communities (TCs). METHODS: We used a longitudinal descriptive design: a baseline neuropsychological assessment was performed within the first 30 days of treatment in TCs. Once participants finished or abandoned treatment, the information about time of stay in treatment was computed for each individual. The study was conducted across six TCs located in the region of Andalusia (Spain): Cartaya, Almonte, Mijas, Los Palacios, La Línea, and Tarifa. Participants were 131 patients with cocaine dependence who initiated and finished treatment in TCs between January 2009 and December 2010 (2 years). Cognitive assessment was composed of general measures of executive functioning: Letter Number Sequencing (working memory) and Similarities (reasoning), and executive tasks sensitive to ventromedial prefrontal cortex dysfunction, including the Delis-Kaplan Stroop test (inhibition/cognitive switching), the Revised-Strategy Application Test (strategy application/multitasking), and the Iowa Gambling Task (decision-making). The outcome measure was retention, defined as time in TC treatment (number of days). RESULTS: Poor executive functioning significantly predicted shorter treatment retention in cocaine dependent individuals on TC residential treatment (14% of explained variance). Reduced performance on the R-SAT, a multitasking test taxing the ability to develop and apply the best strategy to organize multiple sub-routine tasks in order to achieve a long-term goal, was the most powerful predictor of treatment retention. CONCLUSIONS: Self-regulation deficits predict the capacity to remain in residential treatment among cocaine dependents.

Preliminary study for the validation of the Spanish version of the Personality Belief Questionnaire

Introduction. Dysfunctional beliefs are defined as cognitive schemas that drive an abnormal perception and interpretation of reality, being present in all personality disorders. Beck and Beck developed the Personality Belief Questionnaire (PBQ) in order to measure the degree to which individuals endorse basic beliefs associated with personality disorders, providing unique information about the intensity of the dysfunctional beliefs that must be addressed during treatment. Objective. The aims of this study are, first, to develop a Spanish version of the PBQ and to evaluate its psychometric properties in a sample from the normal population, and second, to examine if PBQ's indexed intensity of dysfunctional beliefs may discriminate between subgroups of individuals within the extreme tails of their corresponding personality traits (measured by a gold standard, the MCMI-III). Methods. We administered the PBQ and the MCMI-III to a sample of 63 undergraduate students of Spanish nationality. Results. Results showed that the Spanish adaptation of the PBQ have sound psychometric properties. Furthermore, we showed that there is a good fit between the personality traits measured with the gold standard and the intensity of dysfunctional beliefs measured with the PBQ, since this questionnaire was able to discriminate between individuals with high vs. low levels of the corresponding personality traits. Conclusions. We conclude that the Spanish adaptation of the PBQ presents adequate psychometric properties (in terms of reliability and construct validity) and holds an important potential for application to clinical populations, in which it may assist the treatment process (AU)

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Consumo de cannabis, juventud y género / Cannabis use, youth and gender

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Efectos neuropsicológicos del consumo de cannabis / Neuropsychological effects of cannabis use

El abuso de cannabis está asociado con alteraciones de la motivación y la cognición, así como con un mayor riesgo de desarrollar diversas psicopatologías, como la adicción o la esquizofrenia. En esta revisión discutimos hallazgos neurocientíficos sobre los efectos neuroadaptativos del uso de cannabis, sus repercusiones sobre los mecanismos de aprendizaje, memoria y pensamiento y los vínculos entre las alteraciones de estos mecanismos y la emergencia de síntomas psicopatológicos. Los efectos agudos del cannabis sobre el funcionamiento cerebral generan una hiperactivación de regiones hipocampales durante la codificación de información y una degradación de la activación del estriado durante la recuperación de información. Los estudios de neuroimagen en consumidores crónicos han detectado reducciones volumétricas del hipocampo y disfunciones del metabolismo de la corteza prefrontal medial y lateral. Estas neuroadaptaciones están asociadas con déficits neuropsicológicos de aprendizaje y memoria, control cognitivo y toma de decisiones y con la intensidad de los síntomas psicóticos subclínicos experimentados por los consumidores. La relación funcional entre las distintas regiones cerebrales y las funciones neuropsicológicas afectadas por el consumo de cannabis sugieren la existencia de una desregulación de los circuitos que conectan la corteza prefrontal, el hipocampo y el núcleo estriado, deteriorando la capacidad de contextualizar la información que alimenta los sistemas de pensamiento y predicción (AU)

Cannabis abuse is associated with motivational and cognitive deficits, as well as with a higher risk to develop psychopathologies, including addiction and schizophrenia. In this review we discuss current neuroscientific findings on the neuroadaptive effects of cannabis use, its impact on learning and judgment processes, and the links between deficits in these core basic processes and complex psychopathological symptoms. The acute effects of cannabis on brain functioning induce hyperactivation of hippocampal regions during memory encoding and alterations in the striatal gradient of activation during memory recollection. Neuroimaging studies in chronic users of cannabis have observed volumetric reductions in the hippocampus, and metabolic hypoactivations in medial and lateral prefrontal cortices. These neuroadaptations are associated with neuropsychological deficits in learning, memory, cognitive control and decision-making, and correlate with the intensity of the psychotic symptoms experienced by users. The functional links between the brain regions and neuropsychological mechanisms impacted by cannabis use point to a dysregulation of the prefrontal-hippocampal-striatal systems controlling the cognitive input of judgment and forecasting processes (AU)

Impulsivity and cognitive distortions in pathological gamblers attending the UK National Problem Gambling Clinic: a preliminary report.

BACKGROUND: Pathological gambling (PG) is a form of behavioural addiction that has been associated with elevated impulsivity and also cognitive distortions in the processing of chance, probability and skill. We sought to assess the relationship between the level of cognitive distortions and state and trait measures of impulsivity in treatment-seeking pathological gamblers. METHOD: Thirty pathological gamblers attending the National Problem Gambling Clinic, the first National Health Service clinic for gambling problems in the UK, were compared with 30 healthy controls in a case-control design. Cognitive distortions were assessed using the Gambling-Related Cognitions Scale (GRCS). Trait impulsivity was assessed using the UPPS-P, which includes scales of urgency, the tendency to be impulsive in positive or negative mood states. Delay discounting rates were taken as a state measure of impulsive choice. RESULTS: Pathological gamblers had elevated impulsivity on several UPPS-P subscales but effect sizes were largest (Cohen's d>1.4) for positive and negative urgency. The pathological gamblers also displayed higher levels of gambling distortions, and elevated preference for immediate rewards, compared to controls. Within the pathological gamblers, there was a strong relationship between the preference for immediate rewards and the level of cognitive distortions (R2=0.41). CONCLUSIONS: Impulsive choice in the gamblers was correlated with the level of gambling distortions, and we hypothesize that an impulsive decision-making style may increase the acceptance of erroneous beliefs during gambling play.