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Impulsivity has been considered as a risk factor for alcohol dependence. Recent research is focusing on paradigms of the startle response (SR), specifically prepulse inhibition (PPI) and startle habituation (SH), as vulnerability markers for alcoholism. It has been demonstrated impairments in the PPI and the SH in offspring of alcoholics. It has also been shown, using personality questionnaires, that faster habituation may be associated with tendency toward impulsivity and behavioral disinhibition. Our goal is to study the correlation between impulsivity laboratory measures and the SR paradigms, in order to see if they could share a common base as endophenotypes for alcoholism.
The subjects were 40 abstinent alcoholic males, aged 18 to 65 years (mean age 44.73) and who had met DSM-IV criteria for Alcohol Dependence, being abstinent for more than a month at the moment they were tested. Participants underwent testing for PPI and habituation of the acoustic startle response. Impulsivity was assessed with three different laboratory measures: Continuous Performance Test (CPT), Stop-Signal Task and Differential Reinforcement for Low-Rate Responding (DRL6). Analyses were performed using SPSS v.10.0.
We found a significant positive correlation between CPT-tasks and SH (p< 0,01), and Stop-Signal Task-tasks and SH (p< 0,05), but not with DRL6-tasks. No significant correlation was demonstrated between impulsivity measures and PPI.
Our findings suggest the existence of a common base between impulsivity and SH as vulnerability markers for alcohol dependence. Further studies are needed to assess if both could share a common genetic origin.
The study of the acoustic startle reflex modulation in alcoholics subjects in the presence of positive, aversive, neutral images and images related to alcohol consumption will allow us to measure the implicit affective valence of theses cues.
To compare the emotional valence of the stimuli related to alcohol consumption between two groups of alcoholic patients (abstainers vs relapsers).
55 alcoholic patients (29 abstainers and 26 relapsers) were exposed to acoustic startle test after three weeks of detoxification treatment. Difference between the amplitude of the startle reflex associated to images related to alcohol and the one associated to neutral images was used as dependent variable (motivational value of alcohol cues=startle amplitude in the presence of alcohol images-startle amplitude of neutral images).
Abstainers patients showed a decrease of the startle reflex in the presence of visualization of alcohol associated stimuli compared to the registered ones in the presence of neutral stimuli (μ=-0.041). For the group of relapsers an increase (μ=0.034) of the amplitude of the startle reflex when they were exposed to alcohol related images was registered in contrast with the amplitude registered in the presence of neutral images. Differences between groups were significant (p<0.01).
Abstainers process alcohol-related images as positive stimuli. Conversely, relapsers will stop processing alcohol-related images as appetizing or positive stimuli.
Different neuropsychological studies have consistently found an attention, memory and executive function deficit in schizophrenic patients. The Positive and Negative Syndrome Scale (PANSS) evaluates different clinical aspects of schizophrenia. Factor analyses of this scale suggest the existence of a “cognitive factor”, constituted by several items pertaining to the different subscales. In order to have an acceptable concurrent validity, this “cognitive factor” should correlate with the execution of neuropsychological tasks. Our objective was to study the correlation between the PANSS “cognitive factor” and the execution of neuropsychological tasks evaluating attention, memory and executive functions.
Thirty-five schizophrenic patients were evaluated using the Continuous Performance Test (CPT), the Rey-Osterrieth Complex Figure Test (Rey CFT) and the Wisconsin Card Sorting Test (WCST). Bivariate partial correlation between the neuropsychological variables and the PANSS “cognitive factor” was examined. In order to obtain this cognitive component, and based on previous studies, items P2, N5, PG10 and PG11 were used.
The PANSS “cognitive factor” was significantly correlated to CPT omission errors (r=0.45; p=0.006), Rey CFT recall after 5 minutes (r=-0.34; p=0.049), Rey CFT recall after 30 minutes (r=-0.40; p=0.020), WCST perseverative responses (r=0.36; p=0.035), and WCST perseverative errors (r=0.35; p=0.041).
The existence of significant correlations between the PANSS “cognitive factor” and performance on neuropsychological tasks evaluating attention (CPT), memory (Rey CFT) and executive functions (WCST) supports the concurrent validity of this factor.
A high prevalence of childhood attention-deficit/hyperactivity disorder (ADHD) history has been found in alcoholic patients. Patients with this history have an earlier onset and greater intensity of alcohol use, more polysubstance use and a poorer prognosis. Our objective was to study differences in neuropsychological functioning in a group of alcoholic patients according to the presence or absence of a history of childhood ADHD.
A sample of 136 male alcoholic patients and 56 male control subjects were evaluated using the Continuous Performance Test (CPT); execution in both groups was compared. The sample of alcoholic patients was then divided into two subgroups according to the presence or absence of a history of childhood ADHD, namely the ADHD+ OH subgroup (61 patients with childhood ADHD history) and the ADHD- OH subgroup (75 patients without this history); CPT execution in these two subgroups was also compared.
The group of alcoholic patients made more omission (p=0.008) and commission (p=0.009) errors in the CPT than the control group. When comparing subgroups, ADHD+ OH patients made more omission and commission errors than ADHD- OH patients, although the differences did not reach statistical significance.
Alcoholic patients perform more poorly on the CPT than control subjects. In the sample of alcoholic patients, a history of childhood ADHD was not associated to significant differences in the execution of this test.
Alcohol Craving Scale-3Factors (ACS-3F) retrospectively assesses the period during which the subject consumed alcohol. It includes 33 descriptions grouped in three scales: positive reinforcement, negative reinforcement and impaired control. Tiffany emphasized the poor correlation between self-reported drug urges and the physiological effects of drug-associated stimuli. Our main objective in this project was to investigate the psychophysiological relationship between ACS-3F and the startle reflex modulation.
We hypothesized that the assessment of self-reported craving with ACS-3F would correlate with the non-conscious emotional response to these cues represented by the modulation of the acoustic startle response.
Sample and Methods:
55 alcoholic patients (29 abstainers and 26 relapsers) were exposed to acoustic startle test after three weeks of detoxification treatment. In this study, the difference between the amplitude of the startle reflex associated to images related to alcohol and the one associated to neutral images was used as dependent variable (motivational value of alcohol cues [MVAC]=startle amplitude in the presence of alcohol images-startle amplitude of neutral images).
The abstainer group showed a significant inverse correlation (r=-0.475, p<0.05) between craving total score in ACS-3F and the motivational value of alcohol cues [MVAC]. With regards to craving, the group of relapsers did not correlate with startle modulation.
ACS-3F has adequate properties of concurrent validity. Results in abstainers showed a good correlation between retrospective craving self-reported and non-conscious emotional response to alcohol cues.
The Positive and Negative Syndrome Scale (PANSS) evaluates different psychopathological aspects of schizophrenic patients. Scores on the negative subscale of the PANSS have been associated with clinical and neuropsychological differences in these patients. Our aim was to study the relationship between PANSS negative scores and different clinical and neuropsychological variables in a sample of schizophrenic patients.
Our sample of 174 schizophrenic patients was split into two groups according to scores on the negative subscale of the PANSS: a group of 85 patients (55 male and 30 female; mean age 38.0 years, SD 9.3) with scores below the median (“low negative PANSS” group), and a group of 89 patients (58 male and 31 female; mean age 37.3, SD 8.4) with scores above the median (“high negative PANSS” group). The neuropsychological task used was the Wisconsin Card Sorting Test.
Significant clinical differences were found between both groups. In the “high negative PANSS” group a lower age of illness onset was found (p=0.030), as well as a lower age at first psychiatric admission (p=0.002) compared to the “low negative PANSS” group, without there being significant differences in current age (p=0.570). Regarding cognitive functions, “high negative PANSS” patients achieved fewer categories (p=0.005) and made more perseverative errors (p=0.031) than “low negative PANSS” patients.
Schizophrenic patients with higher scores on the negative subscale of the PANSS had an earlier age of onset of their illness and exhibited poorer cognitive functioning than patients with lower scores.
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