Disrupted Regulation of Social Exclusion in Alcohol-Dependence: An fMRI Study

Abstract

Alcohol-dependence is associated with cognitive and biological alterations, and also with interpersonal impairments. Although overwhelming in clinical settings and involved in relapse, these social impairments have received little attention from researchers. Particularly, brain alterations related to social exclusion have not been explored in alcohol-dependence. Our primary purpose was to determine the neural correlates of social exclusion feelings in this population. In all, 44 participants (22 abstinent alcohol-dependent patients and 22 paired controls) played a virtual game ('cyberball') during fMRI recording. They were first included by other players, then excluded, and finally re-included. Brain areas involved in social exclusion were identified and the functional connectivity between these areas was explored using psycho-physiological interactions (PPI). Results showed that while both groups presented dorsal anterior cingulate cortex (dACC) activations during social exclusion, alcohol-dependent participants exhibited increased insula and reduced frontal activations (in ventrolateral prefrontal cortex) as compared with controls. Alcohol-dependence was also associated with persistent dACC and parahippocampal gyrus activations in re-inclusion. PPI analyses showed reduced frontocingulate connectivity during social exclusion in alcohol-dependence. Alcohol-dependence is thus linked with increased activation in areas eliciting social exclusion feelings (dACC-insula), and with impaired ability to inhibit these feelings (indexed by reduced frontal activations). Altered frontal regulation thus appears implied in the interpersonal alterations observed in alcohol-dependence, which seem reinforced by impaired frontocingulate connectivity. This first exploration of the neural correlates of interpersonal problems in alcohol-dependence could initiate the development of a social neuroscience of addictive states.

Sensitivity for Self-Discrepancy Predicts Alcohol Consumption in Alcohol- Dependent Inpatients with High Self-Consciousness

“…Then, for each characteristic, they indicate a percentage that represents the extent to which they believe to match with the characteristic. Participants also indicate on a 7-point Likert scale the extent to which they experience actual/ideal discrepancy [ [1] no discrepancy or very slight discrepancy to [7] extreme discrepancy]. Finally, they evaluate the distress caused by this discrepancy on a 7-point Likert [1] not at all to [7] extremely].…”

“…Participants also indicate on a 7-point Likert scale the extent to which they experience actual/ideal discrepancy [ [1] no discrepancy or very slight discrepancy to [7] extreme discrepancy]. Finally, they evaluate the distress caused by this discrepancy on a 7-point Likert [1] not at all to [7] extremely]. Secondly, they fill in the questionnaire again in the same fashion for characteristics that others would like that they have or not.…”

“…Each item is rated on 5-point Likert scale ranging from [1] very slightly or not at all to [5] extremely [12,17].…”

“…The CERQ measures cognitive aspects of emotion regulation and consists of 36-items, each of which rated on a 5-point Likert scale ranging from [1] almost never to [5] almost always. This measure comprises 9 subscales: Self-blame, Blaming others, Rumination, Catastrophizing, Putting into Perspective, Positive Refocusing, Positive Reappraisal, Acceptance and Refocus on planning.…”

“…Clinicians working with alcohol-dependent (AD) individuals are familiar with the fact that their patients present with a specific sensitivity to self-threatening situations and in particular to situations of self-rejection [1]. Furthermore, situations of social distress are known to be a major cause of relapse in abstinent AD subjects [2].…”