The detrimental effects of emotional process dysregulation on decision-making in substance dependence

Abstract

Substance dependence is complex and multifactorial, with many distinct pathways involved in both the development and subsequent maintenance of addictive behaviors. Various cognitive mechanisms have been implicated, including impulsivity, compulsivity, and impaired decision-making. These mechanisms are modulated by emotional processes, resulting in increased likelihood of initial drug use, sustained substance dependence, and increased relapse during periods of abstinence. Emotional traits, such as sensation-seeking, are risk factors for substance use, and chronic drug use can result in further emotional dysregulation via effects on reward, motivation, and stress systems. We will explore theories of hyper and hypo sensitivity of the brain reward systems that may underpin motivational abnormalities and anhedonia. Disturbances in these systems contribute to the biasing of emotional processing toward cues related to drug use at the expense of natural rewards, which serves to maintain addictive behavior, via enhanced drug craving. We will additionally focus on the sensitization of the brain stress systems that result in negative affect states that continue into protracted abstinence that is may lead to compulsive drug-taking. We will explore how these emotional dysregulations impact upon decision-making controlled by goal-directed and habitual action selections systems, and, in combination with a failure of prefrontal inhibitory control, mediate maladaptive decision-making observed in substance dependent individuals such that they continue drug use in spite of negative consequences. An understanding of the emotional impacts on cognition in substance dependent individuals may guide the development of more effective therapeutic interventions.

Theories of practice and public health: understanding (un)healthy practices

“…We argue that even though addiction is an important part of smoking this makes it no less a 'social' practice, or any less amenable to analysis in these terms. It has been well documented (Murphy, Taylor, & Elliott, 2012) that addiction is multiplex, and that different social, psychological and physiological factors produce a range of addictive responses in different people. A focus on smoking as a social practice draws attention to the multiple ways in which addiction is reproduced (MacAndrew & Edgerton, 1969, take a similar approach to alcohol consumption).…”

Psychosocial Determinants of Cannabis Dependence: A Systematic Review of the Literature

“…This prevalence was similar to the years before, ranging between 1.6 and 1.8% [16] . If one compares rates of cannabis use with those of dependence, for most people, use of cannabis is controlled and limited to a short period of time and does not result in abuse or dependence [22,23] .…”

Positive affective states and alcohol consumption: The moderating role of trait positive urgency

“…Secondly, despite the laboratory setting providing stringent control over Examining the way in which emotion states lead to engagement in risky behaviours will help to better understand the role of positive affect in impulsive actions, and may help guide prevention and intervention strategies. Interventions that focus on modifying decisionmaking when in a heightened emotional state, and that seek to modify alcohol-related cognitive biases that become activated when in an aroused emotional state, may be particularly relevant for those who score highly on measures of positive urgency (Murphy et al, 2012;Wiers et al, 2013). The current study suggests that level of emotional arousal may play a crucial part in determining the degree to which the urgency traits affect potentially risky behaviour.…”