Pierre Maurage

Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research

Background Behavioral addiction research has been particularly flourishing over the last two decades. However, recent publications have suggested that nearly all daily life activities might lead to a genuine addiction. Methods and aim In this article, we discuss how the use of atheoretical and confirmatory research approaches may result in the identification of an unlimited list of “new” behavioral addictions. Results Both methodological and theoretical shortcomings of these studies were discussed. Conclusions We suggested that studies overpathologizing daily life activities are likely to prompt a dismissive appraisal of behavioral addiction research. Consequently, we proposed several roadmaps for future research in the field, centrally highlighting the need for longer tenable behavioral addiction research that shifts from a mere criteria-based approach toward an approach focusing on the psychological processes involved.

Can disordered mobile phone use be considered a behavioral addiction? An update on current evidence and a comprehensive model for future research

Despite the many positive outcomes, excessive mobile phone use is now often associated with potentially harmful and/or disturbing behaviors (e.g., symptoms of deregulated use, negative impact on various aspects of daily life such as relationship problems, and work intrusion). Problematic mobile phone use (PMPU) has generally been considered as a behavioral addiction that shares many features with more established drug addictions. In light of the most recent data, the current paper reviews the validity of the behavioral addiction model when applied to PMPU. On the whole, it is argued that the evidence supporting PMPU as an addictive behavior is scarce. In particular, it lacks studies that definitively show behavioral and neurobiological similarities between mobile phone addiction and other types of legitimate addictive behaviors. Given this context, an integrative pathway model is proposed that aims to provide a theoretical framework to guide future research in the field of PMPU. This model highlights that PMPU is a heterogeneous and multi-faceted condition.

Alexithymia and the processing of emotional facial expressions (EFEs) : systematic review, unanswered questions and further perspectives

Alexithymia is characterized by difficulties in identifying, differentiating and describing feelings. A high prevalence of alexithymia has often been observed in clinical disorders characterized by low social functioning. This review aims to assess the association between alexithymia and the ability to decode emotional facial expressions (EFEs) within clinical and healthy populations. More precisely, this review has four main objectives: (1) to assess if alexithymia is a better predictor of the ability to decode EFEs than the diagnosis of clinical disorder; (2) to assess the influence of comorbid factors (depression and anxiety disorder) on the ability to decode EFE; (3) to investigate if deficits in decoding EFEs are specific to some levels of processing or task types; (4) to investigate if the deficits are specific to particular EFEs. Twenty four studies (behavioural and neuroimaging) were identified through a computerized literature search of Psycinfo, PubMed, and Web of Science databases from 1990 to 2010. Data on methodology, clinical characteristics, and possible confounds were analyzed. The review revealed that: (1) alexithymia is associated with deficits in labelling EFEs among clinical disorders, (2) the level of depression and anxiety partially account for the decoding deficits, (3) alexithymia is associated with reduced perceptual abilities, and is likely to be associated with impaired semantic representations of emotional concepts, and (4) alexithymia is associated with neither specific EFEs nor a specific valence. These studies are discussed with respect to processes involved in the recognition of EFEs. Future directions for research on emotion perception are also discussed.

Human gender differences in an emotional visual oddball task: an event-related potentials study.

Pictures from the Ekman and Friesen series were used in an event-related potentials study to define the timing of occurrence of gender differences in the processing of positive (happy) and negative (fear) facial expressions. Ten male and 10 female volunteers were confronted with a visual oddball design, in which they had to detect, as quickly as possible, deviant happy or fearful faces amongst a train of standard stimuli (neutral faces). Behavioral results suggest that men and women detected fearful faces more quickly than happy ones. The main result is that the N2b component, functionally considered as an attentional orienting mechanism, was delayed in men for happy stimuli as compared with fearful ones. Gender differences observed in the processing of emotional stimuli could then originate at the attentional level of the information processing system.

When audition alters vision: an event-related potential study of the cross-modal interactions between faces and voices.

Ten healthy volunteers took part in this event-related potential (ERP) study aimed at examining the electrophysiological correlates of the cross-modal audio-visual interactions in an identification task. Participants were confronted either to the simultaneous presentation of previously learned faces and voices (audio-visual condition; AV), either to the separate presentation of faces (visual, V) or voices (auditive, A). As expected, an interference effect of audition on vision was observed at a behavioral level, as the bimodal condition was performed more slowly than the visual condition. At the electrophysiological level, the subtraction (AV - (A + V)) gave prominence to three distinct cerebral activities: (1) a central positive/posterior negative wave around 110 ms, (2) a central negative/posterior positive wave around 170 ms, AND (3) a central positive wave around 270 ms. These data suggest that cross-modal cerebral interactions could be independent of behavioral facilitation or interference effects. Moreover, the implication of unimodal and multisensory convergence regions in these results, as suggested by a source localization analysis, is discussed.

Cerebral effects of binge drinking : respective influences of global alcohol intake and consumption pattern

OBJECTIVE Binge drinking is a major health concern, but its cerebral correlates are still largely unexplored. We aimed at exploring (1) the cognitive step at which these deficits appear and (2) the respective influence of global alcohol intake and specific binge-drinking consumption pattern on this deficit. METHODS On the basis of a screening phase (593 students), 80 participants were selected and distributed in four groups (control non-drinkers, daily drinkers, low and high binge drinkers). Event-related potentials (ERPs) were recorded while performing a simple visual oddball task. RESULTS Binge drinking was associated with massive ERP impairments, starting at the perceptive level (P100/N100 and N170/P2) and spreading through the attentional (N2b/P3a) and decisional (P3b) ones. Moreover, these deficits were linked with global alcohol intake and also with the specific binge-drinking consumption pattern. CONCLUSIONS Binge drinkers presented early and global ERP deficits, affecting basic and high-level cognitive stages. Moreover, we showed that binge drinking is deleterious for the brain because of alcohol consumption per se, and also because of its specific consumption pattern. SIGNIFICANCE The present results show that binge-drinking habits lead to striking brain consequences, particularly because of the repeated alternation between intense intoxications and withdrawal episodes.

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.

How can we conceptualize behavioural addiction without pathologizing common behaviours

Following the recent changes to the diagnostic category for addictive disorders in DSM-5, it is urgent to clarify what constitutes behavioural addiction to have a clear direction for future research and classification. However, in the years following the release of DSM-5, an expanding body of research has increasingly classified engagement in a wide range of common behaviours and leisure activities as possible behavioural addiction. If this expansion does not end, both the relevance and the credibility of the field of addictive disorders might be questioned, which may prompt a dismissive appraisal of the new DSM-5 subcategory for behavioural addiction. We propose an operational definition of behavioural addiction together with a number of exclusion criteria, to avoid pathologizing common behaviours and provide a common ground for further research. The definition and its exclusion criteria are clarified and justified by illustrating how these address a number of theoretical and methodological shortcomings that result from existing conceptualizations. We invite other researchers to extend our definition under an Open Science Foundation framework.

Cross-modal interactions between human faces and voices involved in person recognition

Faces and voices are key features of human recognition but the way the brain links them together is still unknown. In this study, we measured brain activity using functional magnetic resonance imaging (fMRI) while participants were recognizing previously learned static faces, voices and voice-static face associations. Using a subtraction method between bimodal and unimodal conditions, we observed that voice-face associations activated both unimodal visual and auditory areas, and specific multimodal regions located in the left angular gyrus and the right hippocampus. Moreover, a functional connectivity analysis confirmed the connectivity of the right hippocampus with the unimodal areas. These findings demonstrate that binding faces and voices rely on a cerebral network sustaining different aspects of integration such as sensory inputs processing, attention and memory.

Dissociation between affective and cognitive empathy in alcoholism : a specific deficit for the emotional dimension.

BACKGROUND Emotional impairments constitute a crucial and widely described dimension of alcoholism, but several affective abilities are still to be thoroughly explored among alcohol-dependent patients. This is particularly true for empathy, which constitutes an essential emotional competence for interpersonal relations and has been shown to be highly impaired in various psychiatric states. The present study aimed at exploring empathic abilities in alcoholism, and notably the hypothesis of a differential deficit between emotional and cognitive empathy. METHODS Empathy abilities were evaluated among 30 recently detoxified inpatients diagnosed with alcohol dependence and 30 paired healthy controls, using highly validated questionnaires (Interpersonal Reactivity Index [J Pers Soc Psychol44:113] and Empathy Quotient [J Autism Dev Disord34:163]). Correlational analyses were performed to evaluate the links between empathy scores and psychopathological measures (i.e., depression, anxiety, interpersonal problems, and alexithymia). RESULTS When psychiatric comorbities are controlled for, alcoholism is not associated with a general empathy deficit, but rather with a dissociated pattern combining impaired emotional empathy and preserved cognitive one. Moreover, this emotional empathy deficit is not associated with depression or anxiety scores, but is negatively correlated with alexithymia and the severity of interpersonal problems. CONCLUSIONS At the theoretical level, this first observation of a specific deficit for emotional empathy in alcoholism, combined with the exact inverse pattern observed in other psychiatric populations, leads to a double-dissociation, which supports the notion that emotional and cognitive empathy are 2 distinct abilities. At the clinical level, this deficit calls for considering emotional empathy rehabilitation as a crucial concern in psychotherapy.