The process of relapse in severely dependent male problem drinkers

Allsop, Steve; Saunders, Bill; Phillips, Michael

doi:10.1046/j.1360-0443.2000.9519510.x

Cited by 75 publications

(53 citation statements)

References 30 publications

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“…Recently, neurocognitive disinhibition was found to be associated with the development of substance use disorders as well (Tarter et al 2004). Thus, similar neurocognitive etiologies may be involved in the development as well as the progression of and relapse in PG and substance dependence (Tapert et al 1999 ;Allsop et al 2000).…”

Section: Discussionmentioning

confidence: 99%

“…Several studies reported that a higher severity of dependence was predictive of relapse (Babor et al 1987 ;Langenbucher et al 1996 ;Simpson et al 1999 ; but see : Allsop et al 2000 ;Bottlender & Soyka, 2005). Higher levels of selfreported impulsivity are also found to be predictive of relapse and early treatment drop-out in substance dependence (Moeller et al 2001 ;Doran et al 2004).…”

Section: Introductionmentioning

confidence: 99%

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The role of self-reported impulsivity and reward sensitivity versus neurocognitive measures of disinhibition and decision-making in the prediction of relapse in pathological gamblers

et al. 2007

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Background. Disinhibition and decision-making skills play an important role in theories on the cause and outcome of addictive behaviors such as substance use disorders and pathological gambling. In recent studies, both disinhibition and disadvantageous decision-making strategies, as measured by neurocognitive tests, have been found to influence the course of substance use disorders. Research on factors affecting relapse in pathological gambling is scarce.Method. This study investigated the effect of both self-reported impulsivity and reward sensitivity, and neurocognitively assessed disinhibition and decision-making under conflicting contingencies, on relapse in a group of 46 pathological gamblers.Results. Logistic regression analysis indicated that longer duration of the disorder and neurocognitive indicators of disinhibition (Stop Signal Reaction Time) and decision-making (Card Playing Task) were significant predictors of relapse (explaining 53 % of the variance in relapse), whereas self-reported impulsivity and reward sensitivity did not significantly predict relapse. Overall classification accuracy was 76 %, with a positive classification accuracy of 76 % and a negative classification accuracy of 75 %.Conclusions. Duration of the disorder and neurocognitive measures of disinhibition and decision-making are powerful predictors of relapse in pathological gambling. The results suggest that endophenotypical neurocognitive characteristics are more promising in the prediction of relapse in pathological gambling than phenotypical personality characteristics. Neurocognitive predictors may be useful to guide treatment planning of follow-up contacts and booster sessions.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The role of self-reported impulsivity and reward sensitivity versus neurocognitive measures of disinhibition and decision-making in the prediction of relapse in pathological gamblers

et al. 2007

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“…In sum, our study not only replicates the association between alcohol dependence and utilitarian moral judgment but also reveals that defective fear and disgust decoding are key predictors of utilitarian choices in personal moral dilemmas. These findings have important clinical implications, given that poor decision-making is a well-validated predictor of alcohol and drug relapse (Allsop et al, 2000;Bechara and Damasio, 2002). Furthermore, the impairments in fear and disgust recognition could be related to clinical observations in alcohol-dependent individuals, such as the lack of disgust of vomit, and poor personal hygiene (Hazelton et al, 2003;Johnson et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

Impaired Decoding of Fear and Disgust Predicts Utilitarian Moral Judgment in Alcohol-Dependent Individuals

Carmona-Perera

Clark

Young

et al. 2014

Alcohol Clin Exp Res

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Background: Recent studies of moral reasoning in patients with alcohol use disorders have indicated a "utilitarian" bias, whereby patients are more likely to endorse emotionally aversive actions in favor of aggregate welfare (e.g., throwing a dying person into the sea to keep a lifeboat of survivors afloat). Here, we investigate the underlying psychological and neuropsychological processes.Methods: Alcohol-dependent individuals (n = 31) and healthy comparison participants (n = 34) completed a validated moral judgment task, as well as measures of impulsivity, mood symptoms (anxiety and depression), and emotional face recognition.Results: Alcohol-dependent individuals were more likely to endorse utilitarian choices in personal moral dilemmas compared with controls and rated these choices as less difficult to make. Hierarchical regression models showed that poorer decoding of fear and disgust significantly predicted utilitarian biases in personal moral dilemmas, over and above alcohol consumption. Impulsivity and mood symptoms did not predict moral decisions.Conclusions: These findings suggest that impaired fear and disgust decoding contributes to utilitarian moral decision-making in alcohol-dependent individuals.

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“…Consequently, many drug and alcohol treatments are explicitly designed to target and improve self-efficacy (Witkiewitz & Marlatt, 2004). Broad support for the role of self-efficacy as a determinant of positive treatment outcome has been found in alcohol-and drug-dependent patients (Allsop, Saunders, & Phillips, 2000;Goldbeck, Myatt, & Aitchison, 1997;Miller & Longabaugh, 2003;Rychtarik, Prue, Rapp, & King, 1992;Stephens, Wertz, & Roffman, 1993). For example, Ilgen, McKellar, and Tiet (2005) compared measures of self-efficacy to other measures of alcohol use and psychosocial functioning; high self-efficacy was the single strongest predictor of abstinence from drug and alcohol use 1 year after treatment.…”

Section: Introductionmentioning

confidence: 98%

Predictors of changes in alcohol-related self-efficacy over 16 years

McKellar

Ilgen

Moos

et al. 2008

Journal of Substance Abuse Treatment

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The process of relapse in severely dependent male problem drinkers

Abstract: It was concluded that post-treatment self-efficacy rating is a predictor of treatment outcome and time to lapse and relapse and that cognitive functioning is a predictor of treatment outcome and time to lapse.

Cited by 75 publications

References 30 publications

The role of self-reported impulsivity and reward sensitivity versus neurocognitive measures of disinhibition and decision-making in the prediction of relapse in pathological gamblers

The role of self-reported impulsivity and reward sensitivity versus neurocognitive measures of disinhibition and decision-making in the prediction of relapse in pathological gamblers

Impaired Decoding of Fear and Disgust Predicts Utilitarian Moral Judgment in Alcohol-Dependent Individuals

Predictors of changes in alcohol-related self-efficacy over 16 years

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