Reduced calibration between subjective and objective measures of episodic future thinking in alcohol use disorder

Abstract

Background A reduced capacity to mentally simulate future scenarios could be of clinical importance in alcohol use disorder (AUD). However, little is known about the mechanisms underlying episodic future thinking (EFT) impairment in AUD. Methods We tested patients with severe AUD using two measures of EFT: the individual's own subjective experience of their imaginings (phenomenology) and the objective number of details included in imagined events, as assessed by an independent observer (examination). The comparison between the two measures allowed us to investigate the extent to which the subjective and objective characteristics of EFT are calibrated in healthy and AUD participants matched for age, education, and gender. The possible impact of cognitive functioning and disturbed mood on EFT measures was also investigated. Results In terms of objective details of EFT, patients with AUD (n = 40) generated fewer episodic components and more non‐episodic components than control participants (n = 40), even when controlling for cognitive functioning. However, self‐ratings of phenomenological characteristics indicated that participants with AUD perceived imagined future events at a similar level of detail as control participants. Additionally, there was a significant correlation between objective and subjective measures in healthy individuals but not in the AUD group. A higher depression score in the AUD group was not associated with the EFT measures. Conclusions These results suggest a distorted self‐assessment of the richness of imagined future events in individuals with AUD. We discuss these apparent limitations in metacognitive abilities and verbal descriptions of imagined events among individuals with AUD and their clinical implications.

Drinking to Cope is Uniquely Associated with Less Specific and Bleaker Future Goal Generation in Young Hazardous Drinkers

“…It is worth noting that there was no association between self-rated goal quality and experimenter-coded goal specificity. This finding is consistent with a recent experiment in which no correlation was found between self- and experimenter-ratings of future events in individuals with alcohol use disorder, in contrast to healthy controls in which these measures did correlate (Noël et al, 2022 ). One possible explanation is that individuals with more severe symptoms lack insight into the reduced quality of their goals, so self- and experimenter-rated indices of goal quality diverge as level of severity increases.…”

“…Compared to healthy controls, individuals with alcohol use disorder showed reduced specificity for both the past and future events, suggesting a more general reduction in specificity of episodic thinking. Another three studies have shown that individuals with alcohol use disorder generated less detailed descriptions of future events compared to healthy controls (Mercuri et al, 2016 ; Nandrino & El Haj, 2019 ; Noël et al, 2022 ), although one study has reported a null difference (Moustafa et al, 2018 ). Finally, Mercuri et al ( 2018 ) observed reduced specificity of future event descriptions in regular but not recreational cannabis users compared to controls, suggesting that this characteristic may increase with dependence severity.…”

Aldehyde dehydrogenase 2 polymorphism is associated with chemotherapy‐related cognitive impairment in patients with breast cancer who receive chemotherapy

“…52 Therefore, there are differences in the degree of cognitive impairment caused by aldehyde accumulation during chemotherapy. 53,54 Recent studies have confirmed that ALDH2 in astrocytes is involved in the regulation of behavioural and cognitive functions related to ethanol metabolism in the brain. 55 Both chemotherapy-and ethanol metabolisminduced cognitive impairment can be caused by aldehydes 42,56 ; thus, ALDH2 in the brain may also affect CRCI by participating in aldehyde regulation.…”

“… 52 Therefore, there are differences in the degree of cognitive impairment caused by aldehyde accumulation during chemotherapy. 53 , 54 …”

“…A possible reason is that patients with different ALDH2 genotypes have different abilities to metabolise aldehydes 52 . Therefore, there are differences in the degree of cognitive impairment caused by aldehyde accumulation during chemotherapy 53,54 …”