Charles Kornreich

Impaired emotional facial expression recognition in alcoholics, opiate dependence subjects, methadone maintained subjects and mixed alcohol-opiate antecedents subjects compared with normal controls.

The present study aims to explore whether an impairment in emotional facial expressions (EFE) decoding is specific to alcoholism compared with opiate dependence. An EFE decoding test consisting of 16 photographs of EFE portraying happiness, anger, sadness and disgust was administered to five different groups of 30 subjects each: recently detoxified alcoholics (RA); opiate addicts under methadone maintenance treatment (OM); detoxified opiate addicts (OA); detoxified subjects with both alcohol and opiate dependence antecedents (DAO); and normal controls (NC). Repeated measures analysis of variance using a multivariate approach was conducted on EFE decoding accuracy scores with group as the between-subjects factor. Accuracy scores were significantly lower in RA and DAO than in OM and OA, which had significantly lower scores than NC. Low accuracy scores in RA and DAO confirm previous results indicating that alcoholism is associated with impaired EFE recognition. Results in OM and OA indicate that opiate dependence is also associated with an impaired EFE decoding but less than in alcoholism. Alcohol and opiate chronic consumption could both exercise a deleterious effect on EFE-decoding brain function, alcohol having the most severe impact. Alternatively, EFE-decoding problems could be present before the development of alcohol and opiate dependence, with an additional effect of chronic alcohol consumption on EFE decoding. In this context, EFE-decoding impairment could reflect a more general emotional intelligence deficit in addicted populations.

Impaired emotional facial expression recognition in alcoholism compared with obsessive-compulsive disorder and normal controls.

Emotional facial expression (EFE) decoding skills have been shown to be impaired in recovering alcoholics (RA). The aim of the present study is to replicate these results and to explore whether these abnormalities are specific to alcoholism using two control groups: non-patient controls (NC) and patients with obsessive-compulsive disorder (OC). Twenty-two alcoholic patients at the end of their detoxification process (RA) were compared to 22 OC and 22 NC matched for age, sex and education level. They were presented with 12 photographs of facial expressions portraying different emotions: happiness; anger; and fear. Each emotion was displayed with mild (30%) and moderate (70%) intensity levels. Each EFE was judged on 8 scales labeled happiness, sadness, fear, anger, disgust, surprise, shame and contempt. For each scale, subjects rated the estimated intensity level. RA were less accurate in EFE decoding than OC and NC, particularly for anger and happiness expressions. RA overestimated the emotional intensity for mild intensity level expressions compared with both OC and NC while no significant differences emerged for moderate intensity level expressions. Deficits in EFE decoding skills seem to be specific to RA when compared with OC. Comparison with other psychopathological groups is still needed. Possible consequences of EFE decoding deficits in RA include distorted interpersonal relationships.

Is the P300 deficit in alcoholism associated with early visual impairments (P100, N170)? An oddball paradigm

OBJECTIVE Studies exploring chronic alcoholism with event-related potentials (ERPs) have shown delayed latency and reduced amplitude of the P300, a long-lasting positive potential reflecting decisional processing. This P300 deficit in alcoholism is generally interpreted as a disturbance in central nervous system inhibition or in memory/attention. The present study aimed at identifying if this electrophysiological deficit is already present on earlier components, and advances a new hypothesis concerning the interpretation of the P300 alteration. METHODS Patients suffering from alcoholism and matched healthy controls had to detect, in an oddball paradigm, emotional faces among a succession of neutral faces. Behavioral performance and ERP data (recorded from 32 electrodes) were analyzed. RESULTS In line with previous studies, data showed that alcoholism led to a P300 deficit. Moreover, we observed for the first time that this deficit begins at earlier visual (P100) and face-processing (N170) stages, and we found high positive correlations between P100, N170 and P300 for amplitude and latency values, suggesting cumulative deficits on the cognitive continuum. CONCLUSIONS We suggest that the P300 deficit observed in chronic alcoholism could be linked to earlier visuo-spatial deficits rather than being an impairment of the specific processes linked to the P300. SIGNIFICANCE These results call for reconsidering the interpretation of P300 impairments at a fundamental and clinical level, and shows that earlier ERP components must be taken into account in future studies.

Major depression is associated with impaired processing of emotion in music as well as in facial and vocal stimuli

BACKGROUND The processing of emotional stimuli is thought to be negatively biased in major depression. This study investigates this issue using musical, vocal and facial affective stimuli. METHODS 23 depressed in-patients and 23 matched healthy controls were recruited. Affective information processing was assessed through musical, vocal and facial emotion recognition tasks. Depression, anxiety level and attention capacity were controlled. RESULTS The depressed participants demonstrated less accurate identification of emotions than the control group in all three sorts of emotion-recognition tasks. The depressed group also gave higher intensity ratings than the controls when scoring negative emotions, and they were more likely to attribute negative emotions to neutral voices and faces. LIMITATIONS Our in-patient group might differ from the more general population of depressed adults. They were all taking anti-depressant medication, which may have had an influence on their emotional information processing. CONCLUSIONS Major depression is associated with a general negative bias in the processing of emotional stimuli. Emotional processing impairment in depression is not confined to interpersonal stimuli (faces and voices), being also present in the ability to feel music accurately.

Alcohol-Related Context Modulates Performance of Social Drinkers in a Visual Go/No-Go Task: A Preliminary Assessment of Event-Related Potentials

Background Increased alcohol cue-reactivity and altered inhibitory processing have been reported in heavy social drinkers and alcohol-dependent patients, and are associated with relapse. In social drinkers, these two processes have been usually studied separately by recording event-related potentials (ERPs) during rapid picture presentation. The aim of our study was to confront social drinkers to a task triggering high alcohol cue-reactivity, to verify whether it specifically altered inhibitory performance, by using long-lasting background picture presentation. Methods ERP were recorded during visual Go/No-Go tasks performed by social drinkers, in which a frequent Go signal (letter “M”), and a rare No-Go signal (letter “W”) were superimposed on three different types of background pictures: neutral (black background), alcohol-related and non alcohol-related. Results Our data suggested that heavy social drinkers made more commission errors than light drinkers, but only in the alcohol-related context. Neurophysiologically, this was reflected by a delayed No-Go P3 component. Conclusions Elevated alcohol cue-reactivity may lead to poorer inhibitory performance in heavy social drinkers, and may be considered as an important vulnerability factor in developing alcohol misuse. Prevention programs should be designed to decrease the high arousal of alcohol stimuli and strengthen cognitive control in young, at-risk individuals.

Binge Drinking in Adolescents: A Review of Neurophysiological and Neuroimaging Research

AIMS While the relationship between chronic exposure to alcohol and neurobiological damage is well established, deleterious brain effects of binge drinking in youths have only recently been studied. METHODS Narrative review of studies of brain disturbances associated with binge drinking as assessed by neuroimaging (EEG and IRMf techniques in particular) in adolescent drinkers. RESULTS Some major points still deserved to be investigated; directions for future research are suggested. CONCLUSIONS Information and prevention programs should emphasize that binge drinking is not just inoffensive social fun, but if carried on, may contribute to the onset of cerebral disturbances possibly leading to alcohol dependence later in life.

Decision making under ambiguity but not under risk is related to problem gambling severity

The aim of the present study was to examine the relationship between problem gambling severity and decision-making situations that vary in two degrees of uncertainty (probability of outcome is known: decision-making under risk; probability of outcome is unknown: decision-making under ambiguity). For this purpose, we recruited 65 gamblers differing in problem gambling severity and 35 normal controls. Decision-making under ambiguity was assessed with the Iowa Gambling Task (IGT) and the Card Playing Task (CPT). Decision-making under risk was assessed with the Coin Flipping Task (CFT) and the Cups Task. In addition, we included an examination of two working memory components (verbal storage and dual tasking). Results show that problem gamblers performed worse than normal controls on both ambiguous and risky decision-making. Higher problem gambling severity scores were associated with poorer performance on ambiguous decision-making tasks (IGT and CPT) but not decision-making under risk. Additionally, we found that dual task performance correlated positively with decision-making under risk (CFT and Cups tasks) but not with decision-making under ambiguity (IGT and CPT). These results suggest that impairments in decision-making under uncertain conditions of problem gamblers may represent an important neurocognitive mechanism in the maintenance of their problem gambling.

Impaired decision-making under risk in individuals with alcohol dependence.

BACKGROUND Alcohol dependence is associated with poor decision-making under ambiguity, that is, when decisions are to be made in the absence of known probabilities of reward and loss. However, little is known regarding decisions made by individuals with alcohol dependence in the context of known probabilities (decision under risk). In this study, we investigated the relative contribution of these distinct aspects of decision-making to alcohol dependence. METHODS Thirty recently detoxified and sober asymptomatic alcohol-dependent individuals and 30 healthy control participants were tested for decision-making under ambiguity (using the Iowa Gambling Task[IGT]) and decision-making under risk (using the Cups Task and Coin Flipping Task). We also tested their capacities for working memory storage (digit span forward) and dual tasking (operation span task). RESULTS Compared to healthy control participants, alcohol-dependent individuals made disadvantageous decisions on the IGT, reflecting poor decisions under ambiguity. They also made more risky choices on the Cups and Coin Flipping Tasks reflecting poor decision-making under risk. In addition, alcohol-dependent participants showed some working memory impairments, as measured by the dual tasking, and the degree of this impairment correlated with high-risk decision-making, thus suggesting a relationship between processes subserving working memory and risky decisions. CONCLUSIONS These results suggest that alcohol-dependent individuals are impaired in their ability to decide optimally in multiple facets of uncertainty (i.e., both risk and ambiguity) and that at least some aspects of these deficits are linked to poor working memory processes.

Early attentional modulation by alcohol-related cues in young binge drinkers : an event-related potentials study

OBJECTIVE Episodic excessive alcohol consumption (i.e., binge drinking) is now considered to be a major concern in our society. Previous studies have shown that alcohol cues can capture attentional resources in chronic alcoholic populations and that the phenomenon is associated with the development and maintenance of alcoholism. Using event-related potentials (ERPs), we investigated the responses of binge drinkers to alcohol-related pictures. METHODS Two groups of college students (n=18 in each group) were recruited for the study. One group was composed of binge drinkers and the other of controls. Each student completed a simple visual oddball paradigm in which alcohol-related and non-alcohol-related pictures (positive, neutral or negative) were presented. ERPs were recorded to explore the electrophysiological activity associated with the processing of each cue during the different cognitive steps. RESULTS Although there were no behavioural differences between the two groups after detection of alcohol- and non-alcohol-related cues, the ERP data indicated that processing of alcohol-related stimuli was modulated by binge drinking: in the binge drinkers, the P100 amplitudes elicited by the alcohol-related pictures were significantly larger than those elicited by the non-alcohol pictures. CONCLUSIONS The present study provides evidence for an early processing enhancement, indexed by increased P100 amplitude, in binge drinkers when confronted with alcohol cues. SIGNIFICANCE These findings suggest that higher reactivity to alcohol cues is not a phenomenon limited to adult alcoholics, but that young binge drinkers exhibit signs of prioritizing processing related to alcohol. Prevention intervention for alcohol misuse in young people should consider approaches that address this automatic cue reactivity.

Time course of attentional bias for gambling information in problem gambling.

There is a wealth of evidence showing enhanced attention toward drug-related information (i.e., attentional bias) in substance abusers. However, little is known about attentional bias in deregulated behaviors without substance use such as abnormal gambling. This study examined whether problem gamblers (PrG, as assessed through self-reported gambling-related craving and gambling dependence severity) exhibit attentional bias for gambling-related cues. Forty PrG and 35 control participants performed a change detection task using the flicker paradigm, in which two images differing in only one aspect are repeatedly flashed on the screen until the participant is able to report the changing item. In our study, the changing item was either neutral or related to gambling. Eye movements were recorded, which made it possible to measure both initial orienting of attention as well as its maintenance on gambling information. Direct (eye-movements) and indirect (change in detection latency) measures of attention in individuals with problematic gambling behaviors suggested the occurrence of both engagement and of maintenance attentional biases toward gambling-related visual cues. Compared to nonproblematic gamblers, PrG exhibited (a) faster reaction times to gambling-cues as compared to neutral cues, (b) higher percentage of initial saccades directed toward gambling pictures, and (c) an increased fixation duration and fixation count on gambling pictures. In the PrG group, measures of gambling-related attentional bias were not associated with craving for gambling and gambling dependence severity. Theoretical and clinical implications of these results are discussed.