Inhibitory Control and Craving in Dual Disorders and Recurrent Substance Use. Preliminary Findings.

Objective: In Dual Disorders (DD), which involves the co-occurrence of a disorder in substance use and a mental disorder, recurrent struggles with addictive behavior are frequent. Neuropsychological knowledge concerning the profile of inhibitory control and the irresistible urge to use substances (craving) within the DD patient group may contribute to the prevention of this recurrent addictive behavior. Methods: Inhibitory control and craving were assessed in 25 patients with DD and 25 healthy controls (HC). Inhibitory control tasks (Go/No-go task and Stop Signal Task) were performed combined with brain measurements (Event Related Potentials) mapping inhibitory control. Moreover, implicit and explicit measures concerning craving were administered. Statistical DD and HC comparisons, correlational and regression analyses on exploratory base were conducted. Results: DD patients committed more inhibitory control errors than HC when confronted with (alcohol) consumption-related picture stimuli. Furthermore, patients with DD showed higher levels of implicit and explicit craving. The number of inhibitory control errors was positively related to levels of implicit and explicit craving. Moreover, explicit craving and impulsivity (as a dimension of inhibitory control) predicted the severity of addictive behavior. Event Related Potential analyses did not show differences in inhibitory control-associated brain activity between DD patients and HC; both groups showed reduction of P300 amplitudes in response to alcohol pictures. Conclusions: Impulsivity and craving are elevated in DD patients and show predictive value for the severity of addictive behavior. One's level of impulsive action tendency may trigger less effort to control (recurrent) substance use. The findings may contribute to existing DD treatment indications by the promotion of impulse control training via "stop-think-act" methods for DD patients.

Is a Negative Attentional Bias in Individuals with Autism Spectrum Disorder Explained by Comorbid Depression? An Eye-Tracking Study.

Heightened attention towards negative information is characteristic of depression. Evidence is emerging for a negative attentional bias in Autism spectrum disorder (ASD), perhaps driven by the high comorbidity between ASD and depression. We investigated whether ASD is characterised by a negative attentional bias and whether this can be explained by comorbid (sub) clinical depression. Participants (n = 116) with current (CD) or remitted depression (RD) and/or ASD, and 64 controls viewed positively and negatively valenced (non-)social pictures. Groups were compared on three components of visual attention using linear mixed models. Both CD individuals with and without ASD, but not remitted depressed and never-depressed ASD individuals showed a negative bias, suggesting that negative attentional bias might be a depressive state-specific marker for depression in ASD.

The Emergence of Inner Speech and Its Measurement in Atypically Developing Children.

Inner speech (IS), or the act of silently talking to yourself, occurs in humans regardless of their cultural and linguistic background, suggesting its key role in human cognition. The absence of overt articulation leads to methodological challenges to studying IS and its effects on cognitive processing. Investigating IS in children is particularly problematic due to cognitive demands of the behavioral tasks and age restrictions for collecting neurophysiological data [e.g., functional magnetic resonance imaging (fMRI) or electromyography (EMG)]; thus, the developmental aspects of IS remain poorly understood despite the long history of adult research. Studying developmental aspects of IS could shed light on the variability in types and amount of IS in adults. In addition, problems in mastering IS might account for neuropsychological deficits observed in children with neurodevelopmental conditions. For example, deviance in IS development might influence these children's general cognitive processing, including social cognition, executive functioning, and related social-emotional functioning. The aim of the present paper is to look at IS from a developmental perspective, exploring its theory and identifying experimental paradigms appropriate for preschool and early school-aged children in Anglophone and Russian literature. We choose these two languages because the original work carried out by Vygotsky on IS was published in Russian, and Russian scientists have continued to publish on this topic since his death. Since the 1960s, much of the experimental work in this area has been published in Anglophone journals. We discuss different measurements of IS phenomena, their informativeness about subtypes of IS, and their potential for studying atypical language development. Implications for assessing and stimulating IS in clinical populations are discussed.

The Effect of Alexithymia on Attentional Bias Toward Emotional Stimuli in Depression: An Eye-Tracking Study.

Alexithymia-reflecting deficits in cognitive emotion processing-is highly prevalent in individuals with depressive disorders. Subsequently, mixed evidence for attentional bias is found in these individuals. Alexithymia may be a potential influencing factor for attentional bias in depression. In the current study, 83 currently depressed (CD) and 76 never-depressed (ND) controls completed an eye-tracker task consisting of valenced (non)-social pictures. Alexithymia scores were also included as a moderator as both a continuous and categorical measure (so high vs. low alexithymia). No group difference or moderating effect of alexithymia was found on attentional bias. Thus, alexithymic symptoms, included both dimensionally and categorically, may not influence biased attentional processing in depression compared to ND individuals. Thus, it is important to explore other potential explaining factors for the equivocal results found on biased attentional processing of emotional information in depression.

Dutch translation and adaptation of the Barkley Deficits in Executive Functioning Scale (BDEFS)

Abstract Background Based on his model of self-regulation and executive functions, Barkley developed a self- and other-report questionnaire (the Barkley Deficits in Executive Functioning Scale - BDEFS). The BDEFS measures deficits in executive functions as expressed in daily life activities like self-management of time, self-organization, self-restraint, self-motivation, and self-regulation of emotion. Objectives This study created and analyzed a Dutch translation and adaptation in conformance with official guidelines. Methods The Dutch and English BDEFS were completed by 25 bilingual Dutch adults to evaluate semantic correspondence. Consequently, 60 Dutch participants completed the Dutch BDEFS, Barratt Impulsiveness Scale-Eleventh edition (BIS-11) and the Dysexecutive Questionnaire (DEX) to evaluate concurrent validity and internal consistency. Results The versions demonstrated sufficient semantic equivalence and Spearman's rho of total scores was high; items mostly showed moderate-to-high correlations. Regression analysis showed no proportional bias. Internal consistency was also high. Correlations between BDEFS, BIS-11 and DEX supported concurrent validity. Discussion We conclude that a successful BDEFS translation and adaptation was created with satisfactory reliability and validity. Further research should assess the utility of the BDEFS in Dutch clinical practice.

Procedural learning across the lifespan: A systematic review with implications for atypical development.

This systematic review aimed to investigate procedural learning across the lifespan in typical and atypical development. Procedural learning is essential for the development of everyday skills, including language and communication skills. Although procedural learning efficiency has been extensively studied, there is no consensus yet on potential procedural learning changes during development and ageing. Currently, three conflicting models regarding this trajectory exist: (1) a model of age invariance; (2a) a model with a peak in young adulthood; and (2b) a model with a plateau in childhood followed by a decline. The aims of this study were (1) to investigate this debate on procedural learning across the lifespan by systematically reviewing evidence for each model from studies using the serial reaction time task; and (2) to review procedural learning in autism spectrum disorder (ASD) and specific language impairment (SLI), two developmental disorders characterized by deficits in communication skills, in the light of these models. Our findings on typical development strongly support a model of age-related changes (Model 2a or 2b) and show that mixed findings regarding the developmental trajectory during childhood can be explained by methodological differences across studies. Applying these conclusions to systematic reviews of studies of ASD and SLI makes it clear that there is a strong need for the inclusion of multiple age groups in these clinical studies to model procedural learning in atypical development. Clinical implications of the findings are discussed. Future research should focus on the role of declarative learning in both typical and atypical development.

Implicit learning seems to come naturally for children with autism, but not for children with specific language impairment: Evidence from behavioral and ERP data.

Autism spectrum disorder (ASD) and specific language impairment (SLI) are two neurodevelopmental disorders characterized by deficits in verbal and nonverbal communication skills. These skills are thought to develop largely through implicit-or automatic-learning mechanisms. The aim of the current paper was to investigate the role of implicit learning abilities in the atypical development of communication skills in ASD and SLI. In the current study, we investigated Response Times (RTs) and Event Related Potentials (ERPs) during implicit learning on a Serial Reaction Time (SRT) task in a group of typically developing (TD) children (n = 17), a group of autistic children (n = 16), and a group of children with SLI (n = 13). Findings suggest that learning in both ASD and SLI are similar to that in TD. However, electrophysiological findings suggest that autistic children seem to rely mainly on more automatic processes (as reflected by an N2b component), whereas the children with SLI seem to rely on more controlled processes (as reflected by a P3 component). The TD children appear to use a combination of both learning mechanisms. These findings suggest that clinical interventions should aim at compensating for an implicit learning deficit in children with SLI, but not in children with ASD. Future research should focus on developmental differences in implicit learning and related neural correlates in TD, ASD, and SLI. Autism Res 2018, 11: 1050-1061. © 2018 The Authors Autism Research published by International Society for Autism Research and Wiley Periodicals, Inc. LAY SUMMARY: Autism and Specific Language Impairment (SLI) are two disorders characterized by problems in social communication and language. Social communication and language are believed to be learned in an automatic way. This is called "implicit learning." We have found that implicit learning is intact in autism. However, in SLI there seems different brain activity during implicit learning. Maybe children with SLI learn differently, and maybe this different learning makes it more difficult for them to learn language.

The Association Between Sequence Learning on the Serial Reaction Time Task and Social Impairments in Autism.

It is assumed that learning on the Serial Reaction Time (SRT) task is related to learning involved in social skill development affected in autism, but this assumption has hardly been investigated. We have therefore examined associations between SRT task learning and social impairment measured by the Social Responsiveness Scale in 72 autistic and non-autistic adults. Results revealed a positive correlation between deterministic sequence learning, putatively involving explicit learning, and social impairment in autistic adults but not in non-autistic adults. No correlations with probabilistic learning were found. These results suggest that the type of learning that helps autistic adults during a deterministic SRT task hinders them during social development, and call for further investigating the ecological validity of the SRT task.

Autism: Too eager to learn? Event related potential findings of increased dependency on intentional learning in a serial reaction time task.

It has been suggested that people with autism spectrum disorder (ASD) have an increased tendency to use explicit (or intentional) learning strategies. This altered learning may play a role in the development of the social communication difficulties characterizing ASD. In the current study, we investigated incidental and intentional sequence learning using a Serial Reaction Time (SRT) task in an adult ASD population. Response times and event related potentials (ERP) components (N2b and P3) were assessed as indicators of learning and knowledge. Findings showed that behaviorally, sequence learning and ensuing explicit knowledge were similar in ASD and typically developing (TD) controls. However, ERP findings showed that learning in the TD group was characterized by an enhanced N2b, while learning in the ASD group was characterized by an enhanced P3. These findings suggest that learning in the TD group might be more incidental in nature, whereas learning in the ASD group is more intentional or effortful. Increased intentional learning might serve as a strategy for individuals with ASD to control an overwhelming environment. Although this led to similar behavioral performances on the SRT task, it is very plausible that this intentional learning has adverse effects in more complex social situations, and hence contributes to the social impairments found in ASD. Autism Res 2017, 10: 1533-1543. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

Unraveling Executive Functioning in Dual Diagnosis.

In mental health, the term dual-diagnosis is used for the co-occurrence of Substance Use Disorder (SUD) with another mental disorder. These co-occurring disorders can have a shared cause, and can cause/intensify each other's expression. Forming a threat to health and society, dual-diagnosis is associated with relapses in addiction-related behavior and a destructive lifestyle. This is due to a persistent failure to control impulses and the maintaining of inadequate self-regulatory behavior in daily life. Thus, several aspects of executive functioning like inhibitory, shifting and updating processes seem impaired in dual-diagnosis. Executive (dys-)function is currently even seen as a shared underlying key component of most mental disorders. However, the number of studies on diverse aspects of executive functioning in dual-diagnosis is limited. In the present review, a systematic overview of various aspects of executive functioning in dual-diagnosis is presented, striving for a prototypical profile of patients with dual-diagnosis. Looking at empirical results, inhibitory and shifting processes appear to be impaired for SUD combined with schizophrenia, bipolar disorder or cluster B personality disorders. Studies involving updating process tasks for dual-diagnosis were limited. More research that zooms in to the full diversity of these executive functions is needed in order to strengthen these findings. Detailed insight in the profile of strengths and weaknesses that underlies one's behavior and is related to diagnostic classifications, can lead to tailor-made assessment and indications for treatment, pointing out which aspects need attention and/or training in one's self-regulative abilities.

How stimulus and task complexity affect monitoring in high-functioning adults with autism spectrum disorder.

The present study examined whether individuals with autism spectrum disorder (ASD) are able to update and monitor working memory representations of visual input, and whether performance is influenced by stimulus and task complexity. 15 high-functioning adults with ASD and 15 controls were asked to allocate either elements of abstract figures or semantically meaningful pictures to the correct category, according to a certain set of rules. In general, the groups did not differ on measures of intelligence, working memory, attention, fluency and memory. For the monitoring of allocation of abstract figures, a similar pattern of reaction times was found for ASD and control participants. For the monitoring of allocation of semantically meaningful pictures, a different response pattern was found, with a stronger increase in response times for the ASD than for the control group when the number of categories increased. This suggests that participants with ASD are able to monitor working memory representations, but suffer under more complex circumstances.

Can monitoring in language comprehension in Autism Spectrum Disorder be modulated? Evidence from event-related potentials.

The present study examined language comprehension in Autism Spectrum Disorder (ASD) in light of monitoring. It was studied whether individuals with ASD monitor their language perception, and whether monitoring during language perception could be modulated with instructions. We presented higher-level (semantic) linguistic violations and lower-level (orthographic) linguistic violations in a free reading condition and in an instructed condition, recording event-related potentials. For control participants, a monitoring response as tapped by the P600 effect was found to semantically and orthographically incorrect input in both conditions. For participants with ASD, however, a monitoring response to semantically implausible input, tapped by the P600, was found only in the instructed condition. For orthographic errors monitoring was observed both in the free reading and in the instructed condition. This suggests that people with ASD are less inclined than typical individuals to monitor their perception of higher-level linguistic input, but that this can be enhanced with instructions.

The interplay between mood and language comprehension: evidence from P600 to semantic reversal anomalies.

Little is known about the relationship between language and emotion. Vissers et al. (2010) investigated the effects of mood on the processing of syntactic violations, as indexed by P600. An interaction was observed between mood and syntactic correctness for which three explanations were offered: one in terms of syntactic processing, one in terms of heuristic processing, and one in terms of more general factors like attention and/or motivation. In this experiment, we further determined the locus of the effects of emotional state on language comprehension by investigating the effects of mood on the processing of semantic reversal anomalies (e.g., "the cat that fled from the mice"), in which heuristics play a key role. The main findings were as follows. The mood induction was effective: participants were happier after watching happy film clips and sadder after watching sad film clips compared to baseline. For P600, a mood by semantic plausibility interaction was obtained reflecting a broadly distributed P600 effect for the happy mood vs. absence of a P600 for the sad mood condition. Correlation analyses confirmed that changes in P600 in happy mood were accompanied by changes in emotional state. Given that semantic reversal anomalies are syntactically unambiguous, the P600 modulation by mood cannot be explained by syntactic factors. The semantic plausibility by mood interaction can be accounted for in terms of (1) heuristic processing (stronger reliance on a good enough representation of the input in happy mood than sad mood), and/or (2) more general factors like attention (e.g., more attention to semantic reversals in happy mood than sad mood).

On the relationship between autistic traits and executive functioning in a non-clinical Dutch student population.

We examined the association between autistic traits and different aspects of executive functioning (EF), using non-clinical Social Science and Science students as participants. Autistic traits, and associated personality traits, were measured using the Autism Quotient (AQ) and the Temperament and Character Inventory (TCI), respectively. EF was examined by means of a random number generation test and a phonemic fluency test. Using appropriate dependent measures, the following EF components were examined: 1) inhibition of prepotent responding, 2) simple output inhibition, 3) working memory monitoring and updating, and 4) switching. No significant relationship was found between the AQ and each of the four components of EF. However, two TCI subscales were reliably correlated with either the working memory or the shifting component. These results were discussed in view of the concept of an autism spectrum with respect to executive abilities.

The interplay between attentional strategies and language processing in high-functioning adults with autism spectrum disorder.

This study examined the hypothesis of an atypical interaction between attention and language in ASD. A dual-task experiment with three conditions was designed, in which sentences were presented that contained errors requiring attentional focus either at (a) low level, or (b) high level, or (c) both levels of language. Speed and accuracy for error detection were measured from 16 high-functioning adults with ASD, and 16 matched controls. For controls, there was an attentional cost of dual level processing for low level performance but not for high level performance. For participants with ASD, there was an attentional cost both for low level and for high level performance. These results suggest a compensatory strategic use of attention during language processing in ASD.

Diagnosing autism spectrum disorders in elderly people.

BACKGROUND: As autism spectrum disorders (ASD) have largely been neglected in old-age psychiatry, the objective of the present paper is to describe the diagnostic process in elderly patients. METHODS: A systematic review of the literature on ASD in older age was undertaken and illustrated by a case series of three elderly patients first diagnosed with ASD in later life by a tertiary mental health clinic. RESULTS: The search of the literature only yielded three papers on late-life ASD, while the review of the available diagnostic procedures among adults suggests some relevance for screening instruments (Autism Questionnaire), diagnostic instruments (Module 4, Autism Diagnostic Observation Schedule), and neuropsychological examination to profile impairments. Nonetheless, the case reports clearly showed that taking a thorough history with the patient, corroborated and supplemented by a close relative or caregiver who has known the patient for at least ten years, still remains the most important diagnostic tool. CONCLUSION: The three case studies show that in clinical practice ASD can easily be missed in elderly individuals presenting with comorbid psychiatric disorders, potentially causing iatrogenic damage. Although further research on phenotyping and diagnosing ASD in older people is warranted, the most important step at this point is to create a greater awareness of the possibility of ASD in old age among health-care professionals working with people in this age group.

Attentional set shifting in autism spectrum disorder: differentiating between the role of perseveration, learned irrelevance, and novelty processing.

Autism spectrum disorders (ASD) are associated with impaired attentional set shifting, which may reflect enhanced perseverative responding, enhanced learned irrelevance, and/or reduced novelty processing. We assessed the contribution of these potential error sources in ASD adults. A total of 17 ASD and 19 matched comparison individuals first solved a discrimination learning task. Thereafter, the participants faced three types of attentional shift, specifically designed to isolate the effect of the three possible error sources. ASD participants made more errors than comparison individuals in a shift implying a choice between a novel relevant stimulus attribute and a familiar attribute that was previously relevant but now irrelevant. However, they made fewer errors in a shift involving a choice between a novel irrelevant attribute and a familiar, previously irrelevant but now relevant attribute. The results in combination suggest that the performance difference, at least in the present shift task, is caused by reduced novelty processing in ASD participants.

The relationship of language and emotion: N400 support for an embodied view of language comprehension.

According to embodied theories, the symbols used by language are meaningful because they are grounded in perception, action, and emotion. In contrast, according to abstract symbol theories, meaning arises from the syntactic combination of abstract, amodal symbols. If language is grounded in internal bodily states, then one would predict that emotion affects language. Consistent with this, advocates of embodied theories propose a strong link between emotion and language [Havas, D., Glenberg, A. M., & Rinck, M. Emotion simulation during language comprehension. Psychonomic Bulletin & Review, 14, 436-441, 2007; Niedenthal, P. M. Embodying emotion. Science, 316, 1002-1005, 2007]. The goal of this study was to test abstract symbol vs. embodied views of language by investigating whether mood affects semantic processing. To this aim, we induced different emotional states (happy vs. sad) by presenting film clips that displayed fragments from a happy movie or a sad movie. The clips were presented before and during blocks of sentences in which the cloze probability of mid-sentence critical words varied (high vs. low). Participants read sentences while ERPs were recorded. The mood induction procedure was successful: Participants watching the happy film clips scored higher on a mood scale than those watching the sad clips. For N400, mood by cloze probability interactions were obtained. The N400 cloze effect was strongly reduced in the sad mood compared with the happy mood condition. Furthermore, a difference in late positivity was only present for the sad mood condition. The mood by semantic processing interaction observed for N400 supports embodied theories of meaning and challenges abstract symbol theories that assume that processing of word meaning reflects a modular process.

The influence of mood on the processing of syntactic anomalies: evidence from P600.

In several domains of psychology it has been shown that mood influences the way in which we process information. So far, little is known about the relation between mood and processes of language comprehension. In the present study we explore, whether, and if so how, mood affects the processing of syntactic anomalies in real time by recording event-related potentials (ERPs). To this aim we compared the P600 effect to subject-verb agreement errors relative to correct sentences while ERPs were recorded and mood was manipulated by presenting happy or sad film clips. The prediction was that if emotional state affects processes of language comprehension this should be reflected by an interaction between mood and P600. The results were as follows: first, the mood induction procedure was effective: participants were happier after watching happy film clips and sadder after watching sad film clips compared to baseline. Second, for P600 a mood by syntactic correctness interaction was obtained for the midline and lateral electrodes. The interaction reflected a broadly distributed P600 effect for the happy mood condition and a strong reduction in P600 effect for the sad mood condition. Correlation analyses confirmed that the observed changes in P600 effect were accompanied by reliable changes in emotional state. The present ERP findings demonstrate that mood interacts with processes of language comprehension. Three possible explanations for the mood by syntactic correctness interaction are discussed; one in terms of syntactic processing, one in terms of heuristic processing, and one in terms of more general factors like attention and/or motivation.

Monitoring in language perception: mild and strong conflicts elicit different ERP patterns.

In the language domain, most studies of error monitoring have been devoted to language production. However, in language perception, errors are made as well and we are able to detect them. According to the monitoring theory of language perception, a strong conflict between what is expected and what is observed triggers reanalysis to check for possible perceptual errors, a process reflected by the P600. This is at variance with the dominant view that the P600 reflects syntactic reanalysis or repair, after syntactic violations or ambiguity. In the present study, the prediction of the monitoring theory of language perception was tested, that only a strong conflict between expectancies triggers reanalysis to check for possible perceptual errors, reflected by the P600. Therefore, we manipulated plausibility, and hypothesized that when a critical noun is mildly implausible in the given sentence (e.g., "The eye consisting of among other things a pupil, iris, and eyebrow ..."), a mild conflict arises between the expected and unexpected event; integration difficulties arise due to the unexpectedness but they are resolved successfully, thereby eliciting an N400 effect. When the noun is deeply implausible however (e.g., "The eye consisting of among other things a pupil, iris, and sticker ..."), a strong conflict arises; integration fails and reanalysis is triggered, eliciting a P600 effect. Our hypothesis was confirmed; only when the conflict between the expected and unexpected event is strong enough, reanalysis is triggered.