Inhibitory Control and Craving in Dual Disorders and Recurrent Substance Use. Preliminary Findings

Abstract

Objective: In Dual Disorders (DD), which involves the co-occurrence of a disorder in substance use and a mental disorder, recurrent struggles with addictive behavior are frequent. Neuropsychological knowledge concerning the profile of inhibitory control and the irresistible urge to use substances (craving) within the DD patient group may contribute to the prevention of this recurrent addictive behavior.Methods: Inhibitory control and craving were assessed in 25 patients with DD and 25 healthy controls (HC). Inhibitory control tasks (Go/No-go task and Stop Signal Task) were performed combined with brain measurements (Event Related Potentials) mapping inhibitory control. Moreover, implicit and explicit measures concerning craving were administered. Statistical DD and HC comparisons, correlational and regression analyses on exploratory base were conducted.Results: DD patients committed more inhibitory control errors than HC when confronted with (alcohol) consumption-related picture stimuli. Furthermore, patients with DD showed higher levels of implicit and explicit craving. The number of inhibitory control errors was positively related to levels of implicit and explicit craving. Moreover, explicit craving and impulsivity (as a dimension of inhibitory control) predicted the severity of addictive behavior. Event Related Potential analyses did not show differences in inhibitory control-associated brain activity between DD patients and HC; both groups showed reduction of P300 amplitudes in response to alcohol pictures.Conclusions: Impulsivity and craving are elevated in DD patients and show predictive value for the severity of addictive behavior. One's level of impulsive action tendency may trigger less effort to control (recurrent) substance use. The findings may contribute to existing DD treatment indications by the promotion of impulse control training via “stop-think-act” methods for DD patients.

Neurocognitive Recovery in Abstinent Patients with Alcohol Use Disorder: A Scoping Review for Associated Factors

“…This, so-called “dual disorder”, 89 , 90 is associated with poorer prognosis (eg, greater psychopathological severity, higher frequency of psychiatric admissions) and may be accompanied by other, distinct, neuropsychological characteristics. 91 …”

“…93 Findings from this review indicate that most factors are understudied, while scarce evidence is indicative of follow-up research. In this regard, associations of neurocognitive recovery with age, gender, polysubstance use, the number of previous detoxifications, blood values, medical conditions, depression and ASPD (also studied as dual disorders 89 , 91 ) should be studied in well-controlled cross-sectional, or preferably longitudinal, designs that account for abstinence duration. Social cognition, or the recovery of social cognitive function, is an understudied neurocognitive domain that requires further research.…”