1. Study suggests that learning about slot-machine tricks can help new players avoid gambling addiction

    October 20, 2017 by Ashley

    From the University of Waterloo press release:

    Novice gamblers who watched a short video about how slot machines disguise losses as wins have a better chance of avoiding gambling problems, according to new research.

    Slot machines present losses disguised as wins (LDWs) with celebratory music and flashing lights, even though players actually won less money than they bet. People can mistakenly believe that they are winning and continue paying to play.

    Researchers at the University of Waterloo found that showing inexperienced gamblers a brief educational video before they play helps make them more aware and curb false perceptions about the number of times they won.

    “One of the keys to gambling harm prevention is to curtail misperceptions before they become ingrained in the minds of gamblers,” said Michael Dixon, professor and research director in the Gambling Research Lab at Waterloo. “By exposing these outcomes for what they are, our study shows a way in which we can lead slots gamblers to have a more realistic view of their gambling experiences and possibly prevent problems down the road.”

    Earlier research from the University’s Gambling Research Lab found that LDWs can also lead players to gamble for longer even when they are losing money — a symptom of gambling addiction.

    As part of this study, one group of participants watched an educational video on slot machines and how they present LDWs, while a second group watched a different, unrelated video. All participants then played two games, one with few LDWs and one with many LDWs. They then had to estimate the number of times they won more than they wagered on each game.

    “We found that the video was effective in correcting multiple misperceptions. Players not only remembered their actual number of wins more correctly, but they were also more capable of labelling losses disguised as wins during slot machine play,” said Candice Graydon, lead author and a PhD candidate in Waterloo’s Department of Psychology at the time of this study. “We’d like to assess whether shining the light on LDWs will make gamblers stop playing sooner.”

    On the many LDW games, both groups got actual wins on approximately 10 per cent of spins. The group that did not watch the video drastically overestimated their wins — believing won on 23 per cent of spins. The group that watched the educational video, however, gave accurate win estimates. They recalled winning on only 12 per cent of spins. The study suggests that novice players who view the educational video will become more aware of LDWs, which could make them more attentive to other slot features such as the running total counter. Researchers would like to see the animation available to players both online and on casino floors.


  2. Study suggests cocaine use during adolescence is even more harmful than during adulthood

    October 19, 2017 by Ashley

    From the Fundação de Amparo à Pesquisa do Estado de São Paulo press release:

    People who begin using cocaine during adolescence display more significant cognitive deficits than people who begin using the drug in adulthood. That which experts in neuroscience have long suspected has been given an objective confirmation by researchers working at the University of São Paulo’s Medical School (FM-USP), in Brazil.

    When scientists compared the two groups of cocaine users, they observed pronounced differences, mainly in specific neuropsychological functions such as sustained attention (required for performing long tasks, such as completing a questionnaire), working memory (used in specific actions, for example, a waiter remembering the order of each table until the time comes to deliver the orders) and declarative memory (storing and retrieving data after a period of time).

    They also found that among early-onset users, the concurrent consumption of cannabis and alcohol was 50% and 30% more frequent, respectively, compared with late-onset users, defined as those who began using cocaine at or over the age of 18. The complete findings of the research project, which was supported by the São Paulo Research Foundation — FAPESP, were published in the journal Addictive Behaviors.

    Adolescence is considered one of the key stages of brain development when surplus synapses are eliminated and the structures essential to adulthood are selected and refined. Drug use in this stage can impair the brain programming process and lead to the loss of important connections,” said Paulo Jannuzzi Cunha, a professor at FM-USP and principal investigator for the project.

    Differentiated Methodology

    According to Cunha, one of the novel aspects of the research project conducted at the Psychiatry Institute of Hospital das Clínicas, FM-USP’s teaching and general hospital, was the measurement of cognitive functions during controlled abstinence.

    “Many studies of this kind assess outpatients without any possibility of knowing whether they’ll use drugs when they go home,” he said. “In our case, however, all participants were hospital inpatients. We can, therefore, be sure the findings didn’t reflect acute effects of cocaine or other substances.”

    The sample contained 103 cocaine-dependent patients, 52 of whom were early-onset users who had begun using the drug before they were 18, while 51 were late-onset users who began when they were 18 or older. All individuals were evaluated after at least a week of abstinence. The absence of cocaine metabolites was verified by toxicological urine tests. A third group of 63 people with no history of psychoactive substance use served as the control.

    The participants’ ages ranged from 20 to 35. The proportions of men and women were similar. One of the early-onset users had begun consuming cocaine at age 12.

    “Data in the scientific literature shows that a brain region called the prefrontal cortex continues to develop until age 25. This region relates to what are known as executive functions, such as planning, decision making, inhibitory control, attention, and working memory. We, therefore, decided to investigate whether these functions were more impaired in early-onset users,” said psychologist Bruna Mayara Lopes, first author of the article.

    The evaluation involved a number of tests, including the Frontal Assessment Battery (FAB), Stroop Color Word Test (SCWT), Controlled Oral Word Association Test (COWAT), Wisconsin Card Sorting Test (WCST), Rey Osterrieth Complex Figure Test (ROCFT) and Iowa Gambling Task (IGT). The use of alcohol and other drugs was assessed using the Addiction Severity Index (ASI-6).

    “Basically, we presented the participants with a task they had to complete, such as repeating a sequence of numbers in reverse order or reproducing a figure from memory about 30 minutes after observing it,” Lopes said.

    When they compared late-onset users with the control group and adjusting the results for variables such as age and intelligence quotient (IQ), the only difference the researchers found was in divided attention, which relates to the ability to perform multiple tasks at the same time.

    Going deeper

    In a study under way at USP’s Neuroimaging Laboratory (LIM-21), the researchers are now seeking to correlate the cognitive profile observed in the two groups of cocaine-dependent patients with decision-making and resting-state brain activity, using functional magnetic resonance imaging (fMRI). Studies of brain structure and correlations with levels of a protein known as BDNF (brain-derived neurotrophic factor) will also be performed using these findings.

    “We’re measuring such variables as prefrontal cortex volume and white matter integrity. We’ll be able to disclose some of our findings shortly,” said Priscila Dib Gonçalves, supervisor of the Psychology & Neuropsychology Service at the Psychiatry Institute and co-author of the article.

    White matter, found in the deeper tissues of the brain, contains axons connecting grey matter, which is where all synapses are located.

    According to Gonçalves, a higher probability of cognitive impairment due to early-onset drug use was already observed in a study involving 104 chronic cannabis users. This study, published in 2011 in the British Journal of Psychiatry, was conducted at the Federal University of São Paulo (UNIFESP) by Maria Alice Fontes. It found that people who began smoking marijuana before age 15 underperformed late-onset users in tests that assessed executive functions.

    For Gonçalves, both studies evidence the need to develop more effective prevention strategies and programs targeting adolescents. “We live in a society that associates recreation with the use of psychoactive substances, and this is an important cultural aspect,” she said. “One way to raise awareness of the risks could be to hold workshops with students, who should be called on to play a leading role in this awareness-raising process, rather than being passive recipients of information.”

    For Cunha, the results also show that patients with severe cognitive deficits need intense multidisciplinary treatment, including medication as well as therapy.


  3. Epigenetic study untangles addiction and relapse in the brain

    October 6, 2017 by Ashley

    From the Medical University of South Carolina press release:

    Why do some drug users continue to seek out drugs despite the prospect of losing family, friends, health or livelihood?

    There are notable features — cues — of the early drug-using environment that often develop into persistent and powerful triggers for relapse. Epigenetic factors — enzymes in the brain that alter the packaging and accessibility of genes without changing the genes themselves — influence this process, according to research at the Medical University of South Carolina (MUSC) appearing online on September 27, 2017 in Neuron.

    A major challenge in addiction science is to understand how transient experiences lead to long-lasting risk for relapse in users who try to quit, according to MUSC professor Christopher W. Cowan, Ph.D., William E. Murray SmartState® Endowed Chair in Neuroscience, and senior researcher on the project. “Our goal was to discover the brain mechanisms responsible for the rewarding effects of the drug and the motivation to seek it even after long periods of abstinence,” says Cowan.

    The brains of drug users who have progressed to addiction differ markedly from those of early or casual users. Long-lasting associations form between the early use of a drug and different aspects of the early drug-using environment, such as the location in which a drug was first taken or the emotions a user was experiencing at the time. This can cause addicted users who have quit to experience cravings when in a similar setting. Understanding these connections could lead to better treatments for addiction.

    Cowan’s challenge was to determine which genes were activated in the early drug-using environment. Cowan and his fellow researchers had previously found that the epigenetic enzyme histone deacetylase 5 (HDAC5) slows the rodent brain from forming associations between cocaine and simple cues in the environment, such as light and sound. HDAC5 is found in high amounts in neurons in the nucleus accumbens, part of the reward center of the brain that reacts strongly to cocaine, opioids and alcohol — both in rodents and humans. When HDACs are in the nucleus of neurons, they change the way genomic DNA is packaged in the cell nucleus and often block the ability of certain genes to be turned on.

    In the new study, rodents were trained to press a lever to receive a dose of cocaine. Each time they received a dose, a lamp went on above the lever and a brief sound was generated. These served as simple environmental cues for drug use. Next, some rodents were given a form of HDAC5 that traveled straight to the nuclei of neurons. Those rodents still pressed the lever just as many times to receive drug, meaning that HDAC5, on its own, was likely not blocking genes that promoted early drug-seeking behavior.

    Yet the next experiment proved that HDAC5 reduced drug-seeking behavior during abstinence. To simulate withdrawal and abstinence, rodents were given rest without cocaine for one week, followed by a period during which they had access to the lever again. To simulate relapse, the rodents were shown the environmental cues again, this time without having pressed the lever. The presentation of the cues triggered robust lever pressing, indicating drug seeking, in control animals, proving that the associations between drug and environment persisted in their brains. In contrast, animals who had the nuclear form of HDAC5 did not press the lever nearly as often, even after the experimenters gave the animals a small priming dose of cocaine, which often produces strong drug-seeking behaviors.

    HDAC5, the gene suppressor, did not prevent addiction-like behaviors from forming, but it did prevent later drug seeking and relapse during abstinence — at least in rodents.

    The researchers next used a cutting-edge technique that encourages epigenetic enzymes to bind to DNA, allowing them to identify all the genes inhibited by HDAC5. The gene for NPAS4 was a top hit, and significant for an important reason: it is an early-onset gene, meaning that its effects could be exerted on the brain rapidly unless HDAC5 was there to inhibit it — just the molecular event Cowan and his team were seeking.

    In similar experiments, animals with less NPAS4 in the nucleus accumbens took more time to form those early connections between environmental cues and cocaine, but they still sought the drug just as often during later simulated relapse. Apparently, NPAS4 accounts for some addiction-related learning and memory processes in the brain, but not all of them, meaning that HDAC5 must be regulating additional genes that reduce relapse events. Cowan thinks uncovering additional downstream genes could help researchers untangle the details of how the brain transitions from early drug use to addiction, and how new treatments might be developed to reduce relapse in individuals suffering from substance use disorders.

    Animals in the research setting may not mimic the full complexity of human addiction. However, abstinent patients report cravings when given reminders of their drug-associated environment or cues, and animals and humans share similar enzyme pathways and brain structures. Perhaps most exciting for addiction research is that these processes may be similar in the transition to cocaine, alcohol and opioid addictions. “We might have tapped into a mechanism with relevance to multiple substance use disorders,” says Cowan.


  4. Study suggests binge drinking in college may lower chances of landing a job after college

    October 1, 2017 by Ashley

    From the American Friends of Tel Aviv University press release:

    Heavy drinking six times a month reduces the probability that a new college graduate will land a job by 10 percent, according to Tel Aviv University and Cornell University research published in the Journal of Applied Psychology.

    Previous studies were unable to determine the precise effect of alcohol consumption on first-time employment. But according to the new study, each individual episode of student binge-drinking during a month-long period lowers the odds of attaining full-time employment upon graduation by 1.4 percent.

    “The manner in which students drink appears to be more influential than how much they drink when it comes to predicting the likelihood of getting a job upon graduation,” says Prof. Peter Bamberger of TAU’s Coller School of Business Management and Cornell University, who co-authored the study with Prof. Samuel Bacharach of Cornell University; Prof. Mary Larimer and Prof. Irene Geisner, both of the University of Washington; Jacklyn Koopmann of Auburn University; Prof. Inbal Nahum-Shani of the University of Michigan; and Prof. Mo Wang of the University of Florida.

    “Binge-drinking” is defined as ingesting four or more alcoholic drinks within two hours by a woman and five or more alcoholic drinks within two hours by a man, according to the National Institute on Alcohol Abuse and Alcoholism.

    How often, not how much

    The research found that a non-binge pattern of drinking does not adversely impact job search results unless and until their drinking reaches binge levels.

    Data for the study was provided by 827 individuals who graduated in 2014, 2015, and 2016 from Cornell, the University of Washington, the University of Florida, and the University of Michigan.

    “A student who binge-drinks four times a month has a 6 percent lower probability of finding a job than a student who does not engage in similar drinking habits. Those students who drank heavily six times a month increased their unemployment probability to 10 percent,” says Prof. Bamberger.

    Funded by a $2.2 million grant from the National Institute on Alcoholism and Alcohol Abuse, the research is the first installment of a longitudinal study on how alcohol misuse affects the college-to-work transition. More than 16,000 individuals have been contacted as part of the five-year study.

    “This paper is consistent with the recent emphasis on the impact of drinking behavior on career transition from Cornell’s Smithers Institute,” said Prof. Bacharach. “It is in concert with the previous work we’ve done on retirement, and on-boarding [the entry and socialization of newcomers into an organization]. Most importantly, it is also consistent with the Smithers Institute’s continued programmatic interest in substance abuse not only in the workplace, but in the college community as well.”


  5. Managing negative emotions can help pregnant smokers quit

    September 28, 2017 by Ashley

    From the University at Buffalo press release:

    A new study by scientists in the University at Buffalo’s Research Institute on Addictions has shown that pregnant smokers are more likely to quit if they can learn to manage negative emotions that lead to smoking.

    Smoking during pregnancy is a matter of serious concern, says Clara Bradizza, PhD, senior research scientist at RIA.

    “It’s well-documented that smoking cigarettes while pregnant leads to a range of negative health effects on fetuses, including increased risk of low birth weight and preterm delivery, and greater rates of asthma and learning disabilities,” she says.

    The research involved 70 pregnant women who wanted to quit smoking and reported smoking in response to stress, anger and anxiety. “These women use smoking as a way to manage their negative feelings,” Bradizza says. “Many experience poverty, insecure housing and unemployment, along with the stress of pregnancy, which increases negative emotions. All these factors make it more difficult to quit.”

    Half of the women took part in a smoking cessation program consisting of emotion regulation treatment (ERT) combined with standard cognitive-behavioral therapy (CBT), while the others received CBT and a control treatment consisting of health and lifestyle education.

    “ERT is an exposure-based therapy where counselors help participants imagine stressful situations that elicit strong urges or cravings to smoke, and then allow them to experience these feelings in session, without smoking. The women were also taught mindfulness skills and effective ways to cope with urges to smoke,” Bradizza says.

    The women who took part in the ERT program showed significantly higher rates of smoking cessation, with 23 percent remaining smoke-free two months after beginning ERT treatment, compared to none in the control group. They also reported feeling more confident they could remain abstinent from smoking. In addition, the women in the ERT program who did not quit smoking showed improvement, as they smoked less than half the number of cigarettes daily as those in the control group.

    Because smoking cessation medications such as Chantix (varenicline) are not recommended for use in pregnancy, there is a greater reliance on behavioral treatments to help pregnant smokers quit. Bradizza plans a larger trial of the ERT program to help further develop a new approach that is critically needed to help pregnant women quit.


  6. Immune system linked to alcohol drinking behavior

    by Ashley

    From the University of Adelaide press release:

    Researchers from the University of Adelaide have found a new link between the brain’s immune system and the desire to drink alcohol in the evening.

    In laboratory studies using mice, researchers have been able to switch off the impulse to drink alcohol by giving mice a drug that blocks a specific response from the immune system in the brain.

    Now published in the journal Brain, Behavior and Immunity, this research is one of the first of its kind to show a link between the brain’s immunity and the motivation to drink alcohol at night.

    “Alcohol is the world’s most commonly consumed drug, and there is a greater need than ever to understand the biological mechanisms that drive our need to drink alcohol,” says lead author Jon Jacobsen, PhD student in the University of Adelaide’s Discipline of Pharmacology.

    “Our body’s circadian rhythms affect the ‘reward’ signals we receive in the brain from drug-related behavior, and the peak time for this reward typically occurs during the evening, or dark phase. We wanted to test what the role of the brain’s immune system might have on that reward, and whether or not we could switch it off.”

    The researchers focused their attention on the immune receptor Toll-like receptor 4 (TLR4). They administered the drug (+)-Naltrexone (pronounced: PLUS-NAL-TREX-OWN), which is known to block TLR4, to mice.

    “Our studies showed a significant reduction in alcohol drinking behavior by mice that had been given (+)-Naltrexone, specifically at night time when the reward for drug-related behavior is usually at its greatest,” Mr Jacobsen says.

    “We concluded that blocking a specific part of the brain’s immune system did in fact substantially decrease the motivation of mice to drink alcohol in the evening.”

    Senior author Professor Mark Hutchinson, Director of the ARC Centre of Excellence for Nanoscale BioPhotonics at the University of Adelaide and leader of the Neuroimmunopharmacology lab in which this work was conducted, says these findings point to the need for further research to understand the implications for drinking behavior in humans.

    “Our study is part of an emerging field which highlights the importance of the brain’s immune system in the desire to drink alcohol. Given the drinking culture that exists in many nations around the world, including Australia, with associated addiction to alcohol and related health and societal issues, we hope our findings will lead to further studies.”

    This research has been funded by the Australian Research Council (ARC), the US National Institute on Drug Abuse (NIDA) and the National Institute of Alcohol Abuse and Alcoholism.


  7. Study looks at neurological aspects of quitting cocaine addiction

    September 25, 2017 by Ashley

    From the Mount Sinai Hospital / Mount Sinai School of Medicine press release:

    Cocaine-addicted individuals say they find the drug much less enjoyable after years of use, but they have great difficulty quitting. A new brain imaging study led by researchers at the Icahn School of Medicine at Mount Sinai reveals why this might be so, as well as why a common psychological therapy may not work in addicted cocaine users.

    Their study, published September 5 in Addiction Biology, finds that chronic users have a “global impairment” in the ventromedial prefrontal cortex (VMPFC), an area of the brain that is linked to impulse and self-control, and is responsible for the kind of learning that assigns value to objects and behaviors.

    The Mount Sinai study investigated a specific type of learning called extinction — the process by which a new, affectively neutral, association replaces an old, affectively arousing association — to identify the neurobiological mechanism that underlies the persistence of drug seeking in addiction despite negative consequences and a reduction in the drug’s rewarding affects.

    To investigate these questions, the research team collected functional magnetic resonance imaging (fMRI) data on a three-phase classical conditioning paradigm in individuals with a history of chronic cocaine use and healthy control individuals without the drug habit. They found that in drug-addicted individuals, there was a VMPFC-mediated impairment in forming and maintaining new associations for stimuli that were previously, although no longer, predictive of both drug and non-drug related outcomes.

    “Our study data suggests that it will be hard for longtime cocaine users to unlearn what once was a positive experience if this ‘unlearning’ or new learning relies on this brain region to be effective,” says the study’s lead investigator, Anna Konova, PhD, who worked on the study while at the Icahn School of Medicine, but who is now a postdoctoral fellow at the Center for Neural Science at New York University.

    Extinction forms the basis for exposure therapy, which is often used to treat anxiety disorders like phobias.

    “There is a strong impetus for extinction-based therapy in addiction, but our findings highlight potential limitations of these existing therapies in their reliance on the VMPFC to achieve therapeutic benefits,” says the study’s senior investigator, Rita Z. Goldstein, PhD, who directs Mount Sinai’s Neuropsychoimaging of Addiction and Related Conditions research group.

    Dr. Goldstein is an international expert in the use of functional neuroimaging methods to examine the neurobiological basis of impaired cognitive and emotional functioning in human drug addiction and other disorders of self-control. Dr. Konova was a graduate student in Dr. Goldstein’s lab.

    A well-known example of the kind of learning that Dr. Konova and the research team studied in this study is the famous “Pavlov’s dog” experiment in which dogs learned to associate a food treat with the sound of a bell. Dogs soon started salivating when the bell rang. But if the bell rang enough times without being followed by the treat the salivation response of the dogs was reduced or extinguished.

    “The idea behind extinction learning as a therapeutic intervention is that a user can learn to substitute a relaxing thought — such as taking a nature stroll — for the thought of procuring cocaine when walking by their neighborhood park where they might have previously purchased or consumed the drug. By relying on these new associations, an addicted individual may be able to control their habit,” says Dr. Konova.

    Fear-based extinction learning is now widely used to treat anxiety, such as in phobias and post-traumatic stress disorder (PTSD). In this technique, a person is exposed to the thing that makes them afraid until the fear response to that thing (which is no longer associated with any real harm) is reduced and eventually extinguished, perhaps by forming a new, neutral or positive, association with their originally feared object or situation.

    While previous experiments have suggested VMPFC impairment in addicted individuals who have long used stimulants such as cocaine — a consistent finding is that the gray matter (a marker of neuronal morphological integrity) is altered in that brain area in these individuals — this is the first experiment to examine if these changes have implications for extinction learning in drug users and non-users using functional magnetic resonance imaging (fMRI) brain scans.

    The study participants — 18 chronic cocaine users and 15 control individuals from the same community — completed three rounds of learning over two days. The cocaine-using individuals had an average lifetime history of 17 years of cocaine use and currently used cocaine about twice a week. None were seeking treatment to stop.

    On the first day, while in the fMRI scanner, participants were shown, say, a colored square (a neutral cue) followed by a picture of a pleasant stimulus (such as a puppy), a different colored square this time followed by a drug-related picture (such as a crack pipe), and a third one followed by a picture of a household item. Like Pavlov’s dogs, the control individuals learned to anticipate the corresponding picture once they saw the specific square (anticipating the puppy, the drug item, or the household item). Their VMPFC also responded accordingly. They had learned the first association.

    Next, the groups were shown just the cues (squares) repeatedly and depending on the picture that had been linked to them before, their brain responses again responded accordingly: VMPFC responses now were not as high to the cues that predicted the picture of the puppy (a pleasant stimulus) and not as low as to the cues that predicted the crack pipe (an unpleasant stimulus). This was the first extinction phase, when extinction learning should occur. That is, new learning was taking place that the affectively charged pictures no longer followed the cues.

    Participants stayed overnight, and the next morning, they were shown the cues again. The extinction response was even more pronounced this time due to retention of some of the extinction association from the previous day.

    However, VMPFC signals in the cocaine-using group did not resemble that of the control group. Their data revealed that extinction learning did not engage the VMPFC to the same degree, which could result in failures in extinction learning, Dr. Konova says.

    “It may be possible to train other areas of the brain, such as the striatum, which we found did have normal responses in the drug users, to update the strong and well-established drug associations,” she says. “Or there could be ways to increase VMPFC function through cognitive retraining or pharmacologically. But our findings suggest that neither extinction learning for positive outcomes — anticipating seeing a cute puppy when this is no longer likely — or drug-related outcomes — anticipating seeing a crack pipe when this too is no longer likely — using that critical brain area will help longtime cocaine users quit.”

    “This really highlights the importance of neuroscience-informed treatment development for addiction, as this study and others like it can help speak to why some current approaches might fail or discover new, more effective ways to intervene,” says Dr. Goldstein.


  8. What makes alcoholics drink? Research shows it’s more complex than supposed

    September 20, 2017 by Ashley

    From the European College of Neuropsychopharmacology press release:

    What makes alcoholics drink? New research has found that in both men and women with alcohol dependence, the major factor predicting the amount of drinking seems to be a question of immediate mood. They found that suffering from long-term mental health problems did not affect alcohol consumption, with one important exception: men with a history of depression had a different drinking pattern than men without a history of depression; surprisingly those men were drinking less often than men who were not depressed.

    “This work once again shows that alcoholism is not a one-size-fits-all condition,” said lead researcher, Victor Karpyak (Mayo Clinic, MN, USA). “So the answer to the question of why alcoholics drink is probably that there is no single answer; this will probably have implications for how we diagnose and treat alcoholism.”

    The work, presented at the ECNP congress by researchers from the Mayo Clinic*, determined the alcohol consumption of 287 males and 156 females with alcohol dependence over the previous 90 days, using the accepted Time Line Follow Back method and standardized diagnostic assessment for life time presence of psychiatric disorders (PRISM); they were then able to associate this with whether the drinking coincided with a positive or negative emotional state (feeling “up” or “down”), and whether the individual had a history of anxiety, depression (MDD) or substance abuse.

    The results showed that alcohol dependent men tended to drink more alcohol per day than alcohol dependent women. As expected, alcohol consumption in both men and women was associated with feeling either up or down on a particular day, with no significant association with anxiety or substance use disorders. However, men with a history of major depressive disorder had fewer drinking days (p=0.0084), and fewer heavy drinking days (p=0.0214) than men who never a major depressive disorder.

    Victor Karpyak continued: “Research indicates that many people drink to enhance pleasant feelings, while other people drink to suppress negative moods, such as depression or anxiety. However, previous studies did not differentiate between state-dependent mood changes and the presence of clinically diagnosed anxiety or depressive disorders. The lack of such differentiation was likely among the reasons for controversial findings about the usefulness of antidepressants in treatment of alcoholics with comorbid depression.

    This work will need to be replicated and confirmed, but from what we see here, it means that the reasons why alcoholics drink depend on their background as well as the immediate circumstances. There is no single reason. And this means that there is probably no single treatment, so we will have to refine our diagnostic methods and tailor treatment to the individual. It also means that our treatment approach may differ depending on targeting different aspects of alcoholism (craving or consumption) and the alcoholic patient (i.e. man or a woman) with or without depression or anxiety history to allow really effective treatment.”

    Commenting, Professor Wim van den Brink (Professor of Psychiatry and Addiction at the Academic Medical Centre, University of Amsterdam) said:

    “This is indeed a very important issue. Patients with an alcohol use disorder often show a history of other disorders, including mood and anxiety disorders, they also often present with alcohol induced anxiety and mood disorders and finally the may report mood symptoms that do not meet criteria for a mood or anxiety disorder (due to a failure to meet the minimal number of criteria or a duration of less than two weeks). All these different conditions may influence current levels or patterns of drinking.

    The current study seems to show that the current presence of mood/anxiety symptoms is associated with more drinking in both male and female alcoholics, whereas a clinical history of major depression in male alcoholics is associated with lower current dinking levels. Although, the study does not provide a clear reason for this difference, it may have consequences for treatment. For example, antidepressant treatment of males with a history major depression may have no effect on drinking levels. However, these findings may also result from residual confounding, e.g. patients with a history of major depression might also be patients with a late age of onset of their alcohol use disorder and this type of alcohol use disorder is associated with a different pattern of drinking with more daily drinking and less heavy drinking days and less binging. More prospective studies are needed to resolve this important but complex clinical issue.”


  9. Trauma-informed, mindfulness-based intervention significantly improves parenting

    August 12, 2017 by Ashley

    From the Thomas Jefferson University press release:

    Researchers at Jefferson’s Maternal Addiction Treatment Education & Research (MATER) program found significant improvement in the quality of parenting among mothers who participated in a trauma-informed, mindfulness-based parenting intervention while also in medication-assisted treatment for opioid use disorder. Results of the study, the first to scientifically test a mindfulness-based parenting intervention with this population, were published July 27 in the Journal of Addiction Medicine.

    “Our results validate a powerful intervention when it is needed most,” said senior author Diane Abatemarco, Ph.D., MSW, principal investigator, Director of MATER and Associate Professor of OB/GYN and Pediatrics in the Sidney Kimmel Medical College at Thomas Jefferson University. “By improving parenting through mindfulness, we may be able to change the intergenerational trajectory of trauma and improve children’s and families’ lives.”

    A total of 160 women participated in a 12-week mindful parenting intervention at Jefferson’s Family Center, an outpatient and intensive outpatient treatment center that cares for women who are pregnant, parenting or working toward reuniting with their child. The mindfulness-based program included mother/baby education and practice, education on the impact of trauma, and mindfulness meditation. Themes included non-judgment, full attention and compassion.

    “We designed the mindfulness-based parenting program to give women the resources and tools to be great parents. Our program supports moms, building their self-efficacy and self-confidence,” said Abatemarco.

    The research team conducted pre- and post-tests with the women using three validated instruments to measure observed parenting quality, the mother’s childhood trauma exposure and self-reported mindful parenting. Women who participated in the mindfulness-based parenting program experienced a clinically significant increase in parenting quality, from “low” at baseline to “moderate” at completion.

    “We also found that attendance matters,” said Meghan Gannon, Ph.D., MSPH, first author and research project manager at MATER. “For women who experienced high levels of childhood trauma, attendance was key to improving parenting.”


  10. Why does prenatal alcohol exposure increase the likelihood of addiction?

    July 21, 2017 by Ashley

    From the University at Buffalo press release:

    One of the many negative consequences when fetuses are exposed to alcohol in the womb is an increased risk for drug addiction later in life. Neuroscientists in the University at Buffalo Research Institute on Addictions are discovering why.

    Through a research grant from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) of the National Institutes of Health (NIH), Senior Research Scientist Roh-Yu Shen, PhD, is studying how prenatal alcohol exposure alters the reward system in the brain and how this change continues through adulthood.

    The key appears to lie with endocannibinoids, cannabis-like chemicals that are produced by the brain itself.

    “By understanding the role endocannibinoids play in increasing the brain’s susceptibility to addiction, we can start developing drug therapies or other interventions to combat that effect and, perhaps, other negative consequences of prenatal alcohol exposure,” Shen says.

    Prenatal alcohol exposure is the leading preventable cause of birth defects and neurodevelopmental abnormalities in the United States. Fetal Alcohol Spectrum Disorders (FASD) cause cognitive and behavioral problems. In addition to increased vulnerability of alcohol and other substance use disorders, FASD can lead to other mental health issues including Attention Deficit Hyperactivity Disorder (ADHD), depression, anxiety and problems with impulse control.

    After the prenatal brain is exposed to alcohol, the endocannibinoids have a different effect on certain dopamine neurons which are involved in addicted behaviors than when brain is not exposed to alcohol,” Shen says. “The end result is that the dopamine neurons in the brain become more sensitive to a drug of abuse’s effect. So, later in life, a person needs much less drug use to become addicted.”

    Specifically, in the ventral tegmental area (VTA) of the brain, endocannibinoids play a significant role in weakening the excitatory synapses onto dopamine neurons. The VTA is the part of the brain implicated in addiction, attention and reward processes. However, in a brain prenatally exposed to alcohol, the effect of the endocannabinoids is reduced due to a decreased function of endocannabinoid receptors. As a result, the excitatory synapses lose the ability to be weakened and continue to strengthen, which Shen believes is a critical brain mechanism for increased addiction risk.