María Blasa Sánchez-Barrera

Dysregulation of emotional response in current and abstinent heroin users: negative heightening and positive blunting

ObjectiveEvidence suggests that abstinent opioid users have abnormal emotional response to natural reinforcing stimuli, but little is known about the emotional response of subjects currently using heroin. Abnormal emotional experience could underlie poor sensitivity to negative events related to heroin use and reduced ability to consider alternative reinforcers to help overcome addiction. In this paper, we will assess the subjective response of current and abstinent heroin users exposed to emotionally competent positive and negative stimuli.Materials and methodsWe administered the “Clinical Instrument for Emotional Response Evaluation” (including neutral, pleasant, and unpleasant images from the International Affective Picture System) to 22 current opioid users enrolled in a clinical trial using controlled prescribed heroin and 41 abstinent opioid users enrolled in residential treatment. The dependent variable was their subjective response to the images measured with the Self-Assessment Manikin, a scale designed to rate the International Affective Picture System (IAPS) images in the three dimensions of emotion: valence, arousal, and dominance. We compared these ratings with IAPS normative values for healthy participants.ResultsSignificant group × emotional condition interactions were found in the arousal dimension. Post-hoc tests showed that compared to healthy participants, both current and abstinent heroin users had greater emotional response to neutral images and lower response to pleasant images. Furthermore, current opioid users had higher emotional response to unpleasant images when compared to healthy participants and lower response to pleasant images when compared to abstinent users.ConclusionsCurrent opioid users have abnormal emotional experience, characterized by heightened response to unpleasant stimuli and blunted response to pleasant stimuli.

Variables modulating stress and coping that discriminate drug consumers from low or nondrug consumers.

The present study assesses how certain stress and coping variables relate to drug use. A total of 124 subjects (85 men, 39 women) took part. They were divided into two groups: consumers and low or nonconsumers. Results indicate that consumers show significantly lower scores in self-control than low or nonconsumers. This research is of interest because it analyzes the relationship among assertiveness, self-control, self-efficacy, and drug use. We consider it worthwhile to take these variables into account when planning prevention programs.

Tobacco craving and eyeblink startle modulation using 3D immersive environments: a pilot study.

Both the cue reactivity and startle reflex modulation paradigms have been used in addiction research to investigate the motivational mechanism of craving. However, while there is a growing body of literature that indicates the utility of 3D technology in addiction-relevant cue reactivity research, no study has been reported on its utility using the startle reflex modulation paradigm. The aim of the present study was to extend the 3D technology to research on tobacco craving using the startle reflex methodology. Participants were 32 university students who smoked more than 10 cigarettes daily. They participated in a psychophysiological testing to assess the modulation of the startle reflex induced by viewing pleasant, unpleasant, and tobacco-related 3D immersive environment stimuli (3D-IEs). Results confirmed that 3D-IEs were effective in inducing emotional states to modulate the startle response. Pleasant and unpleasant 3D-IEs modulated the startle response, as expected: The reflex was increased while viewing unpleasant stimuli and decreased while viewing pleasant ones. Tobacco-related 3D-IEs were similar to unpleasant stimuli in increasing the startle response. However, they were subjectively evaluated as positive, which suggests that the mechanism underlying craving coactivates both aversive and appetitive motivational tendencies.

Negative mood induction normalizes decision making in male cocaine dependent individuals

RationaleDecision making is thought to play a key role in psychostimulant relapse, but very few studies have addressed the issue of how to counteract decision-making deficits in addicted individuals. According to the somatic marker framework, pervasive decision-making problems in addicted individuals may relate to abnormalities in the processing of emotional signals that work to anticipate the prospective outcomes of potential decisions.ObjectiveThe present study was conducted to test whether the induction of different emotional states (positive, negative, or drug-related) could either normalize or further impair decision-making performance in male cocaine polysubstance-using individuals (CPSI), as indexed by the Iowa gambling task (IGT).MethodsForty-two CPSI and 65 healthy control individuals (all males) were randomly allocated in four affective conditions using a parallel-group design. Participants in the different conditions performed the IGT during exposure to neutral, positive, negative, or drug-related sets of affective images.ResultsThe results showed that the CPSI exposed to the negative affective context showed a preference for the risk-averse safe choices of the IGT and had a net performance indistinguishable from that of controls. On the other hand, CPSI exposed to positive, drug-related, and neutral contexts showed the typical pattern of disadvantageous performance in the IGT and performed significantly poorer than controls. The impact of the negative mood induction could not be explained in terms of baseline differences in decision-making skills, personality traits related to sensitivity to reward/punishment, or trait positive/negative affect.ConclusionsWe conclude that negative mood induction can normalize decision-making performance in male CPSI, which may have important implications for the treatment of cocaine use-related disorders.

Motivation to quit smoking and startle modulation in female smokers: context specificity of smoking cue reactivity

RationaleCue reactivity and startle reflex modulation paradigms have been used in addiction research to determine the affective motivational state of craving induced by viewing drug-related cues. However, recent studies suggest that cue reactivity and startle reflex modulation in people with addictions can be suppressed, or even reversed, depending on context.ObjectiveThe present study looked at the contextual specificity of smoking cue startle modulation by examining individuals with low and high motivation to quit smoking.Materials and methodsEmotional modulation of the startle reflex was examined in 32 female smokers exposed to affective stimuli and tobacco cues. The sample was divided into high and low motivation to quit smoking groups using the Processes of Change Questionnaire.ResultsThe tobacco cues produced a greater startle magnitude in the group with high motivation to quit smoking than the group with low motivation, which was independent of craving level.ConclusionMotivation to be abstinent is a relevant contextual factor accounting for variance in cue reactivity in individual smokers.

Symptom validity testing and its underlying psychophysiological response pattern: a preliminary study.

Very little is known about the autonomic psychophysiological responses while individuals are executing a Symptom Validity Test. Therefore, the aim of this study is to analyze the peripheral psychophysiological correlates (electrodermal conductance and heart rate) during the performance of the Victoria Symptom Validity Test (VSVT). The sample of this study was composed of 30 participants who underwent the VSVT under two conditions: Exaggeration of cognitive deficits (ECD) and normal effort. Our results showed differences on skin conductance between correct answers and errors limited to the decision-making phase of the ECD condition. Those differences found in the maximum conductance value when participants decide to simulate their deficits could be related to emotional activation. No differences were found on the variable heart rate between the two conditions of the study. Implications of these results are discussed.

Coocurrencia de trastornos de personalidad en pacientes con trastornos de ansiedad

La coocurrencia entre los trastornos de personalidad y los trastornos de ansiedad puede tener implicaciones importantes. Los diagnosticos multiples nos pueden dar idea de la gravedad de la alteracion, el deterioro del funcionamiento y el pronostico. El objetivo de este estudio fue doble, analizar la coocurrencia entre trastornos de personalidad y trastornos de ansiedad, e identificar perfiles de trastornos de personalidad en los diferentes trastornos de ansiedad. En este estudio participaron 31 pacientes con trastornos de ansiedad, distribuidos en cuatro grupos: fobia especifica, fobia social, ansiedad generalizada y panico, con y sin presencia de agorafobia. Los instrumentos de evaluacion utilizados fueron El Inventario Clinico Multiaxial de Millon II y la Entrevista para los Trastornos de Ansiedad segun el Manual diagnostico y estadistico de los trastornos mentales IV. El grupo de fobia especifica presenta puntuaciones mas bajas en las distintas escalas y menor frecuencia de trastornos de personalidad. Por el contrario, el grupo de ansiedad generalizada presenta mayor tasa de diagnosticos multiples de trastornos de personalidad. Las puntuaciones mas altas se observan en las escalas esquizoide, dependiente, autodestructiva, evitativa y compulsiva. Cada trastorno de ansiedad presenta un perfil de trastornos de personalidad. Tener en cuenta la coocurrencia entre trastornos puede ayudar a comprender el exito o no de un tratamiento, por lo que la evaluacion sistematica de la personalidad patologica en el ambito clinico es recomendable.