Methadone maintenance patients show a selective deficit to reverse positive outcomes in drug-related conditions compared to medication free prolonged opiate abstinence

Levy-Gigi, Einat; Kéri, Szabolcs; Shapiro, Alla R.; Sason, Anat; Adelson, Miriam; Peles, Einat

doi:10.1016/j.drugalcdep.2014.08.016

Cited by 6 publications

(4 citation statements)

References 52 publications

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“…• In this task (Levy-Gigi et al, 2014), stimuli (e.g. everyday objects) are shown in boxes overlaid on a neutral or salient (e.g.…”

Section: Stimulus Context Reversal Paradigm 17mentioning

confidence: 99%

How adverse childhood experiences get under the skin: A systematic review, integration and methodological discussion on threat and reward learning mechanisms

Ruge,

Ehlers,

Kastrinogiannis

et al. 2023

Preprint

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Exposure to adverse childhood experiences (ACEs) is a major risk factor for the development of behavioral, somatic and psychopathological conditions. Learning is the central mechanism through which environmental inputs shape emotional and cognitive processes as well as behavior. In this review, we lay out a systematic and methodological overview and integration of the impact of ACEs on threat and reward learning processes in experimental paradigms based on systematic literature search (following PRISMA guidelines) which resulted in a total of 65 publications (threat: N=37, reward: N=28). Across the threat and reward learning fields, we observed a converging pattern of blunted learning in individuals exposed to ACEs independent of sample characteristics, ACE subtypes and outcome measures. Specifically, blunted threat learning was reflected in reduced discrimination between threat and safety cues, primarily driven by blunted responding to threat cues, while attenuated reward learning manifested in reduced accuracy and learning rate. Importantly, this pattern emerged despite substantial heterogeneity in ACE assessment and operationalization. we conclude that blunted threat and reward learning may represent two mechanistic routes by which ACEs may become biologically embedded and ultimately increase the risk for psychopathology. In closing, we discuss potentially fruitful future directions for the research field, including methodological and assessment considerations.

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“…• In this task (Levy-Gigi et al, 2014), stimuli (e.g. everyday objects) are shown in boxes overlaid on a neutral or salient (e.g.…”

Section: Stimulus Context Reversal Paradigm 17mentioning

confidence: 99%

How adverse childhood experiences get under the skin: A systematic review, integration and methodological discussion on threat and reward learning mechanisms

Ruge,

Ehlers,

Kastrinogiannis

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Stimulus context reversal paradigm ( Weiss et al, 2019 ) In this task ( Levy-Gigi et al, 2014 ), stimuli (e.g. everyday objects) are shown in boxes overlaid on a neutral or salient (e.g.…”

Section: Methodsmentioning

confidence: 99%

How adverse childhood experiences get under the skin: A systematic review, integration and methodological discussion on threat and reward learning mechanisms

Ruge,

Ehlers,

Kastrinogiannis

et al. 2024

eLife

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Adverse childhood experiences (ACEs) are a major risk factor for the development of multiple psychopathological conditions, but the mechanisms underlying this link are poorly understood. Associative learning encompasses key mechanisms through which individuals learn to link important environmental inputs to emotional and behavioral responses. ACEs may impact the normative maturation of associative learning processes, resulting in their enduring maladaptive expression manifesting in psychopathology. In this review, we lay out a systematic and methodological overview and integration of the available evidence of the proposed association between ACEs and threat and reward learning processes. We summarize results from a systematic literature search (following PRISMA guidelines) which yielded a total of 81 articles (threat: n=38, reward: n=43). Across the threat and reward learning fields, behaviorally, we observed a converging pattern of aberrant learning in individuals with a history of ACEs, independent of other sample characteristics, specific ACE types, and outcome measures. Specifically, blunted threat learning was reflected in reduced discrimination between threat and safety cues, primarily driven by diminished responding to conditioned threat cues. Furthermore, attenuated reward learning manifested in reduced accuracy and learning rate in tasks involving acquisition of reward contingencies. Importantly, this pattern emerged despite substantial heterogeneity in ACE assessment and operationalization across both fields. We conclude that blunted threat and reward learning may represent a mechanistic route by which ACEs may become physiologically and neurobiologically embedded and ultimately confer greater risk for psychopathology. In closing, we discuss potentially fruitful future directions for the research field, including methodological and ACE assessment considerations.

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“…One study found no improvement in cognitive flexibility (trail making test) when comparing opiate dependent participants at baseline and again following 2 months on methadone maintenance therapy (142) and surprisingly, in one study improved flexibility (trail making test) was found as methadone dose increased (134). A further study compared former opiate dependent participants that had been medication free for 10 years with those whom had been on methadone maintenance for the past 10 years (143). This study demonstrated that methadone maintenance was associated with a selective flexibility deficit.…”

Section: Pharmacotherapies For Opioid Use Disordermentioning

confidence: 99%

“…This study demonstrated that methadone maintenance was associated with a selective flexibility deficit. While both groups were able to acquire and reverse information about positive and negative outcomes under neutral conditions, Levy-Gigi et al (143) found that the methadone-maintained group were impaired at reversing positive outcomes when these were presented in a drug-related context.…”

Section: Pharmacotherapies For Opioid Use Disordermentioning

confidence: 99%

Impact of Substance Use Disorder Pharmacotherapy on Executive Function: A Narrative Review

Butler

Foll

2019

Front. Psychiatry

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Substance use disorders are chronic, relapsing, and harmful conditions characterized by executive dysfunction. While there are currently no approved pharmacotherapy options for stimulant and cannabis use disorders, there are several evidence-based options available to help reduce symptoms during detoxification and aid long-term cessation for those with tobacco, alcohol and opioid use disorders. While these medication options have shown clinical efficacy, less is known regarding their potential to enhance executive function. This narrative review aims to provide a brief overview of research that has investigated whether commonly used pharmacotherapies for these substance use disorders (nicotine, bupropion, varenicline, disulfiram, acamprosate, nalmefene, naltrexone, methadone, buprenorphine, and lofexidine) effect three core executive function components (working memory, inhibitory control and cognitive flexibility). While pharmacotherapy-induced enhancement of executive function may improve cessation outcomes in dependent populations, there are limited and inconsistent findings regarding the effects of these medications on executive function. We discuss possible reasons for the mixed findings and suggest some future avenues of work that may enhance the understanding of addiction pharmacotherapy and cognitive training interventions and lead to improved patient outcomes.

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Methadone maintenance patients show a selective deficit to reverse positive outcomes in drug-related conditions compared to medication free prolonged opiate abstinence

Cited by 6 publications

References 52 publications

How adverse childhood experiences get under the skin: A systematic review, integration and methodological discussion on threat and reward learning mechanisms

How adverse childhood experiences get under the skin: A systematic review, integration and methodological discussion on threat and reward learning mechanisms

How adverse childhood experiences get under the skin: A systematic review, integration and methodological discussion on threat and reward learning mechanisms

Impact of Substance Use Disorder Pharmacotherapy on Executive Function: A Narrative Review

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