Cognitive impairment and response inhibition deficits in alcohol use disorders: impact on relapse and neural processing

  • The present dissertation focused on cognitive control processes and impulsivity in the context of AUDs with an emphasis on response inhibition towards alcohol-related and neutral stimuli. Overall, different paradigms, methods and samples have been used in three studies including behavioural tasks, questionnaire data and fMRI recordings. For the assessment of specific response inhibition processes a go/no-go paradigm with pictures of the preferred alcoholic drinks and neutral stimuli has been further developed for this work to combine the aspects of behavioural inhibition and salience of drug-associated cues. Study 1 investigated the association between binge drinking, trait impulsivity and behavioural impulse control. The results revealed that only binge drinkers showed an alcohol-specific impairment of response inhibition and that the number of commission errors towards alcohol related stimuli was the only significant predictor for binge drinking. However, binge drinkers did not significantly differ from non-binge drinkers in regardThe present dissertation focused on cognitive control processes and impulsivity in the context of AUDs with an emphasis on response inhibition towards alcohol-related and neutral stimuli. Overall, different paradigms, methods and samples have been used in three studies including behavioural tasks, questionnaire data and fMRI recordings. For the assessment of specific response inhibition processes a go/no-go paradigm with pictures of the preferred alcoholic drinks and neutral stimuli has been further developed for this work to combine the aspects of behavioural inhibition and salience of drug-associated cues. Study 1 investigated the association between binge drinking, trait impulsivity and behavioural impulse control. The results revealed that only binge drinkers showed an alcohol-specific impairment of response inhibition and that the number of commission errors towards alcohol related stimuli was the only significant predictor for binge drinking. However, binge drinkers did not significantly differ from non-binge drinkers in regard to self-reported impulsivity and overall response inhibition performance. In study 2, a large sample of recently detoxified ADP and HC were compared with respect to their performance on five different behavioural tasks assessing different aspects of cognitive control processes and the association between cognitive control deficits in ADP and relapse behaviour in a six-month follow-up period has been investigated. Compared to HC, ADP showed an impairment in response inhibition, response initiation, complex sustained attention and executive functions. Both groups made more commission errors when they had to inhibit their reactions towards alcohol pictures compared to geometrical stimuli. This suggests a specific response inhibition deficit for alcoholic cues, however not specifically for the group of ADP. The strongest predictor for relapse has been the interaction between the number of previous detoxifications and response inhibition deficits, revealing that ADP with a higher number of detoxifications and a pronounced impairment in response inhibition had the highest relapse risk. Study 3 focused on neuronal activity patterns, assessed with fMRI, in ADP and HC during a response inhibition task. During successful inhibition towards all stimuli, ADP showed enhanced neural activity compared to HC in brain areas linked to cognitive control, including the anterior cingulate gyrus, medial frontal gyrus and medial orbitofrontal cortex. These results are interpreted as an additional demand for neural resources, respectively a compensation due to a deficit in cognitive control processes in ADP. In summary, it can be stated that ADP show a pronounced impairment in several cognitive control processes and that especially a deficit in response inhibition combined with many detoxifications in the past, is related to an enhanced relapse risk. Regarding the impact of alcoholic cues on response inhibition, the results suggest that alcohol-related stimuli interfere with response inhibition performance and are associated with more errors. Interventions for people with AUDs, including binge drinkers, should take those factors in account and clinicians should be particularly aware of patients with many detoxifications and poor response inhibition, as those factors comprise the high risk relapse group.show moreshow less
  • Kognitive Kontrollprozesse ermöglichen eine zielgerichtete und adäquate Steuerung von Verhaltensreaktionen. Ausgehend von der Literatur zu kognitiver Kontrolle (oder Impulsivität) bei Abhängigkeitserkrankungen (de Wit, 2009; Crews & Boettiger, 2009) wird kognitive Kontrolle als ein multi-dimensionales Konstrukt betrachtet, das u.a. Prozesse der Aufmerksamkeitssteuerung, des Entscheidungsverhaltens und der Inhibition von Verhaltensreaktionen umfasst. Dabei wird postuliert, dass es sich um separate kognitive Prozesse handelt. Bisherige Studien untersuchten meist nur ein bis drei verschiedene kognitive Prozesse bei Alkoholabhängigkeit und auch wurde der Zusammenhang zwischen Beeinträchtigungen kognitiver Kontrollprozesse und der Wiederaufnahme des Alkoholkonsums nach einer Abstinenzphase zuvor nicht untersucht. Vor diesem Hintergrund, war der Fokus dieser Dissertation die umfassende Untersuchung verschiedener kognitiver Kontrollprozesse, insbesondere der Impulskontrolle, in Bezug auf Alkoholabhängigkeit sowie Rauschtrinken sowie dieKognitive Kontrollprozesse ermöglichen eine zielgerichtete und adäquate Steuerung von Verhaltensreaktionen. Ausgehend von der Literatur zu kognitiver Kontrolle (oder Impulsivität) bei Abhängigkeitserkrankungen (de Wit, 2009; Crews & Boettiger, 2009) wird kognitive Kontrolle als ein multi-dimensionales Konstrukt betrachtet, das u.a. Prozesse der Aufmerksamkeitssteuerung, des Entscheidungsverhaltens und der Inhibition von Verhaltensreaktionen umfasst. Dabei wird postuliert, dass es sich um separate kognitive Prozesse handelt. Bisherige Studien untersuchten meist nur ein bis drei verschiedene kognitive Prozesse bei Alkoholabhängigkeit und auch wurde der Zusammenhang zwischen Beeinträchtigungen kognitiver Kontrollprozesse und der Wiederaufnahme des Alkoholkonsums nach einer Abstinenzphase zuvor nicht untersucht. Vor diesem Hintergrund, war der Fokus dieser Dissertation die umfassende Untersuchung verschiedener kognitiver Kontrollprozesse, insbesondere der Impulskontrolle, in Bezug auf Alkoholabhängigkeit sowie Rauschtrinken sowie die Bedeutung dieser kognitiven Prozesse für das Rückfallrisiko (Rückfallprädiktion). Ferner sollte die Bedeutung einer möglicherweise spezifischen Beeinträchtigung der Inhibition bei Präsentation alkohol-assoziierter Reize untersucht werden sowie unterschiedliche neuronale Aktivitätsmuster während einer erfolgreichen Inhibitionsreaktion untersucht werden.show moreshow less

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Metadaten
Institutes:Fakultät Humanwissenschaften / Fakultät Humanwissenschaften: Abschlussarbeiten
Author:Marta Czapla
Advisor:Sabine Löber
Place of publication:Bamberg
Publisher:opus
Year of publication:2017
Pages / Size:169 Seiten : Illustrationen, Diagramme
Remarks:Kumulative Dissertation, Otto-Friedrich-Universität Bamberg, 2016
Year of first publication:2016
SWD-Keyword:Alkoholismus ; Rezidiv ; Achtsamkeitsbasierte Kognitive Therapie; Suchtkranker ; Rezidiv ; Kognitive Psychotherapie
Keywords:alcohol dependence; binge drinking; fMRI; impulsivity; response inhibition
DDC-Classification:1 Philosophie und Psychologie / 15 Psychologie / 150 Psychologie
RVK-Classification:YH 2800; CW 6940
URN:urn:nbn:de:bvb:473-opus4-488541
Document Type:Dissertation
Language:English
Publishing Institution:Otto-Friedrich-Universität Bamberg
Release Date:2017/03/22
Licence (German):License LogoDeutsches Urheberrecht