Neuropsychological assessment of impulsive behavior in abstinent alcohol-dependent subjects

Salgado, João Vinícius; Malloy-Diniz, Leandro Fernandes; Campos, Valdir Ribeiro; Abrantes, Suzana Silva Costa; Fuentes, Daniel; Bechara, Antoine; Corrêa, Humberto

doi:10.1590/s1516-44462009000100003

Cited by 57 publications

(40 citation statements)

References 34 publications

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“…The results support studies showing that drug users have lower scores than controls in tasks involving attention, verbal learning and memory 33,34 , cognitive flexibility, impulse control 35,36 and selective processing 37 . Studies also point to the fact that adult chronic users of drugs have impaired performance in tasks involving selective attention, suggesting a slowdown in information processing and difficulty in maintaining attention to relevant stimuli 34 .…”

Section: Discussionsupporting

confidence: 86%

Avaliação da memória operacional fonológica e impulsividade de usuários de drogas atendidos em um Centro de Atenção Integrada à Saúde Mental

et al. 2011

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Purpose: to evaluate the phonological working memory abilities and check possible influences of impulsivity in patients just included in treatment at the program for Alcohol and Drug users at the Center for Integrated Mental Health Care of Irmandade da Santa Casa de Misericordia de São Paulo (ISCMSP -CAISM-SP, Portuguese initials). Method: 29 patients: 21 males and 8 females, drug users, 37,9 ± 10.5 years old, 10.59 ± 3.53 years of schooling; And 30 volunteers: 19 males and 11 female, 32,4 ± 11,9 years old and 11.07 ± 3.29 years of schooling, without psychiatric history or substance abuse participated freely. The individuals were asked to attend the specific evaluation, aiming to assess: 1) phonological working memory for words and pseudowords, 2) impulsivity in its second order factors (attentional impulsiveness, motor and non-planning). Results: performance in the evaluation of phonological working memory of the individuals of drug users group compared to the control group showed a reduction in both, auditory word and pseudowords span , as well as the total number of correct words and pseudowords recall. In the evaluation of impulsivity, the group of drug users showed higher scores comparing to control individuals in all subtypes of impulsivity, including the total score of impulsivity. There were no correlations between impulsivity scores and word and/ or pseudowords span. Conclusion: this pattern of responses indicates impairment in verbal working memory processing and high level of impulsivity in this population of chronic drug users. The poor performance of chronic drug users on tests of phonological working memory is probably not due to increased impulsivity observed. The present results could helptreatment strategies planning focused on the detected changes.

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Section: Discussionsupporting

confidence: 86%

Avaliação da memória operacional fonológica e impulsividade de usuários de drogas atendidos em um Centro de Atenção Integrada à Saúde Mental

et al. 2011

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“…This effect was independent of the type of alcohol user (heavy drinkers [26] or detoxified patients [2,[23][24][25]27] ). Having undergone two or more previous detoxifications, being a carrier of the Taq IA1 allele of the DRD2 gene, or having a cluster B personality have all been associated with more commission errors.…”

Section: Discussionmentioning

confidence: 89%

“…Recently, Salgado et al [27] assessed 31 abstinent patients with alcohol dependence (5 of them women) and 30 controls with the CPT, the Iowa Gambling Test, and the Wisconsin Card Sorting Test. This study replicated once more the finding that alcoholic patients made more commission errors in the CPT, more disadvantageous choices in the Iowa Gambling Test, and more perseverative errors in the Wisconsin Card Sorting Test.…”

Section: Studies Assessing Impulsivity In Detoxified Patientsmentioning

confidence: 99%

Laboratory Paradigms of Impulsivity and Alcohol Dependence: A Review

et al. 2010

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Impulsivity can be defined as choosing a smaller, immediate reward over a larger, delayed reward. From this perspective, addictive behaviors such as substance abuse and pathological gambling reflect a series of impulsive choices. However, impulsivity is not a homogeneous construct. Laboratory measures of impulsivity reflect two types of processes. The first is related to behavioral inhibition and refers to an individual’s ability to appropriately inhibit thoughts or actions. The second is the delay of reward dimension, namely the degree to which immediate (rewarding) consequences have more control over an individual’s behavior than consequences that are delayed. In this review, we describe how alcohol is associated with significant impairments in these paradigms. We also suggest that they may have a role in the development of alcohol dependence. These results are in agreement with a model in which delay of gratification might be a marker for early use and/or abuse of alcohol, whereas impairment in behavioral inhibition might be a marker for maintained use in time and, therefore, for progression towards alcohol dependence.

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“…Further bias stems from patients lacking the requisite capacity for self-reflection (Wilson and Dunn, 2004). It has thus been suggested that interactive, computer-based neuropsychological tests provide more reliable measures of impulsivity (Kertzman et al, 2006; Chamberlain and Sahakian, 2007). Combining such tasks with a computational model of impulsivity in a naturalistic gambling setting may allow us to go even further.…”

Section: Discussionmentioning

confidence: 99%

A model-based analysis of impulsivity using a slot-machine gambling paradigm

Paliwal

Petzschner

Schmitz

et al. 2014

Front. Hum. Neurosci.

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Impulsivity plays a key role in decision-making under uncertainty. It is a significant contributor to problem and pathological gambling (PG). Standard assessments of impulsivity by questionnaires, however, have various limitations, partly because impulsivity is a broad, multi-faceted concept. What remains unclear is which of these facets contribute to shaping gambling behavior. In the present study, we investigated impulsivity as expressed in a gambling setting by applying computational modeling to data from 47 healthy male volunteers who played a realistic, virtual slot-machine gambling task. Behaviorally, we found that impulsivity, as measured independently by the 11th revision of the Barratt Impulsiveness Scale (BIS-11), correlated significantly with an aggregate read-out of the following gambling responses: bet increases (BIs), machines switches (MS), casino switches (CS), and double-ups (DUs). Using model comparison, we compared a set of hierarchical Bayesian belief-updating models, i.e., the Hierarchical Gaussian Filter (HGF) and Rescorla–Wagner reinforcement learning (RL) models, with regard to how well they explained different aspects of the behavioral data. We then examined the construct validity of our winning models with multiple regression, relating subject-specific model parameter estimates to the individual BIS-11 total scores. In the most predictive model (a three-level HGF), the two free parameters encoded uncertainty-dependent mechanisms of belief updates and significantly explained BIS-11 variance across subjects. Furthermore, in this model, decision noise was a function of trial-wise uncertainty about winning probability. Collectively, our results provide a proof of concept that hierarchical Bayesian models can characterize the decision-making mechanisms linked to the impulsive traits of an individual. These novel indices of gambling mechanisms unmasked during actual play may be useful for online prevention measures for at-risk players and future assessments of PG.

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Neuropsychological assessment of impulsive behavior in abstinent alcohol-dependent subjects

Cited by 57 publications

References 34 publications

Avaliação da memória operacional fonológica e impulsividade de usuários de drogas atendidos em um Centro de Atenção Integrada à Saúde Mental

Avaliação da memória operacional fonológica e impulsividade de usuários de drogas atendidos em um Centro de Atenção Integrada à Saúde Mental

Laboratory Paradigms of Impulsivity and Alcohol Dependence: A Review

A model-based analysis of impulsivity using a slot-machine gambling paradigm

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