A2 Addiction as disorder of volition: Impaired cognitive control functions in nicotine dependence and pathological gambling
Background and aims: Research of the past years has shown that dysfunctional changes in valuation systems and impaired cognitive control networks are two core mechanisms involved in Substance-Related and Addictive Disorders (SRAD). In Study 1, we addressed the important open research question 1) which patterns of decision-making impairments and cognitive control dysfunctions are associated with nicotine dependence (ND) and pathological gambling (PG). To improve our knowledge on the adequate stability of the applied decision-making and cognitive control measures for future longitudinal studies on the aetio-pathological processes in SAD, we further aimed 2) to analyze retest reliabilities of such behavioral measures in SAD and controls. In Study 2 we aimed to find out 3) whether decision-making and cognitive control dysfunctions are general characteristics of ND or specifically prominent in substance-related contexts.
Methods: Study 1: We recruited a convenience sample of three groups: A PG group (n=26), a ND group (n=42), both diagnosed according to DSM-IV, and a healthy control group (n=52). Participants performed two test sessions within 3-4 weeks with six tasks assessing decision-making and cognitive control. Study 2: In a convenience sample of 27 smokers with ND according to DSM-IV and a control group of 33 never smokers we assessed inhibitory control and decision-making. Priming with smoking-related and neutral pictures was applied before each trial within the tasks. Additionally, we tested the effects of valence ratings, nicotine deprivation and craving.
Results: Our findings in Study 1 highlight 1) that ND and PG exhibit lower inhibitory control compared to the control group. Decision-making deficits are more pronounced in PG when compared to ND. 2) Retest reliabilities varied extremely between tasks and parameters with the majority displaying fair to good reliabilities. Importantly, retest reliabilities differed significantly between the SAD groups and the control group. In Study 2, we found that 3) after smoking-related compared to neutral primes, the ND group exhibited increased delay discounting and shorter go reaction times compared to the never-smoker group. The speed-up in go trials after smoking-related compared to neutral cues was significantly related to more pleasant valence ratings, a longer time since last cigarette and increased craving within the ND group.
Conclusions: 1) While ND and PG share deficits in inhibitory control, decision-making is more impaired in PG. Intervention strategies strengthening cognitive control skills might be effective for PG as well as ND whereas strategies enhancing maladaptive valuation of rewards might be specifically effective in PG. 2) Retest reliabilities of decision-making and cognitive control measures are adequate for longitudinal and intervention studies of SRAD, although tasks parameters should be selected carefully. However, group differences in retest reliabilities may result in misleading group and intervention effects. To minimize measurement error, studies investigating longitudinal designs may apply latent variable models. 3) Individuals with ND compared to never-smokers decide more dysfunctional and react faster after smoking-related compared to neutral cues. Faster reactions after smoking-related cues within the ND group, especially in states of increased nicotine deprivation and craving, without more errors could be explained by an increased attentional focus. Cue-induced alterations in decision-making and inhibitory control in ND highly depend on the temporal sequence of cue presentation.
Pls: Prof. Gerhard Bühringer, Prof. Thomas Goschke
Staff: Dipl.-Psych. Anja Kräplin
Funding: DFG
Duration: 04/2011 - 03/2014
Publications
Kräplin, A., Scherbaum, S., Bühringer, G. & Goschke, T. (2019). Decision-making and inhibitory control after smoking-related priming in nicotine dependent smokers and never-smokers. Addictive Behaviors, 88, 114-121. doi:10.1016/j.addbeh.2018.08.020
Kräplin, A., Scherbaum, S., Bühringer, G., & Goschke, T. (2016). Retest reliabilities of decision-making and cognitive control measures in addictive disorders. Sucht, 62(4), 191–202. doi:10.1024/0939-5911/a000430
Kräplin, A., Behrendt, S., Scherbaum, S., Dshemuchadse, M., Bühringer, G., & Goschke, T. (2015). Increased impulsivity in pathological gambling: Considering nicotine dependence. Journal of Clinical and Experimental Neuropsychology, 37(4), 367-378. doi:10.1080/13803395.2015.1018145
Kräplin, A., Bühringer, G., Oosterlaan, J., van den Brink, W., Goschke, T., & Goudriaan, A. E. (2014). Dimensions and disorder specificity of impulsivity in pathological gambling. Addictive Behaviors, 39(11), 1646-1651. doi:10.1016/j.addbeh.2014.05.021
Kräplin, A., Dshemuchadse, M., Behrendt, S., Scherbaum, S., Goschke, T., & Bühringer, G. (2014). Dysfunctional decision-making in pathological gambling: pattern specificity and the role of impulsivity. Psychiatry Research, 215(3), 675–682. doi:10.1016/j.psychres.2013.12.041