Addiction
Conditions
Interventions
None
Sponsors
AMC, Amsterdam
Eligibility
Inclusion criteria
Inclusion criteria: Inclusion process: Potential participants are informed about the study and receive an information letter. After this, they are contacted by telephone. If interested to participate, screening for inclusion and exclusion criteria is performed, using structured diagnostic interviews, e.g. Composite International Diagnostic Interview (World Health Organisation, 1997). Relevant sections are included: demographics; alcohol use disorders; substance use disorders; depressive disorders and mania; psychotic disorders and post-traumatic stress disorder. The following sections are included from the Diagnostic Interview Schedule (DIS, Robins, 1981): pathological gambling; antisocial personality disorder. AD group: Chronic group - Recent DSM-V diagnosis of AD (3 weeks past detoxification) - Seeking treatment for at least the third time lifetime and a minimum illness duration of 7 years (chronic addiction). Non-chronic group - Recent DSM-V diagnosis of AD (3 weeks past detoxification) - Seeking treatment for the first time and with a maximum illness duration of 2 years (non-chronic addiction). PG group: Chronic group - Recent DSM-V diagnosis of PG (active gambling <3 months ago). - Seeking treatment for at least the third time lifetime and a minimum illness duration of 7 years (chronic addiction). Non-chronic group - Recent DSM-V diagnosis of PG (active gambling <3 months ago). - Seeking treatment for the first time and with a maximum illness duration of 2 years (non-chronic addiction). HC group: - No diagnosis (current or history) of AD or PG.
Exclusion criteria
Exclusion criteria: Current major depressive disorder, bipolar disorder, psychotic disorder, alcohol or substance dependence, or any cognitive disorder as assessed with the MINI neurological disorders section • IQ below 80 • insufficient command of the Dutch language • MRI contraindications such as metal implants, claustrophobia, left-handedness, pregnancy • recent (<2 weeks) use of psychotropic medication other than naltrexone (smoking and nicotine dependence is allowed in all groups). • Endocrinological disorders or regular use of corticosteroids • Current treatment with tricyclic antidepressant or antipsychotic medication • Use of other psychotropic medication (apart from SSRI's), or of recreational drugs over a period of 72 hours prior to each test session, and use of alcohol within the last 24 hours before each measurement • Irregular sleep/wake rhythm (e.g., regular nightshifts or cross timeline travel). PG group and HC group: • more than 21 alcoholic drinks/week for men and more than 15 drinks/week for women, history of AD PG group: • any other current substance dependence than PG. AD group: • current substance dependence other than AD.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| •Balance between goal-directed and habitual responding as determined by the habit task •Interaction between response inhibition and salience attribution as determined by the affective Go/NoGo task •The effect of affective stimuli on working memory performance as determined by the affective working memory task •Brain activation as measured with fMRI (Blood Oxygen Level Dependent or BOLD responses) during the habit task, the affective Go/NoGo task and the affective working memory task •Connectivity between brain areas: DLPFC-limbic reward circuitry, DLPFC-basal ganglia connectivity, during performance of a cognitive flexibility task and during performance of a cue-reactivity reduction task. •Baseline fMRI measures, and connectivity after rTMS in an fMRI session in comparison to connectivity during baseline (within subjects comparison). Differences in brain connectivity between non-chronic and chronic alcohol dependence group and pathological gambling group, and healthy control group. | — |
Secondary
| Measure | Time frame |
|---|---|
| • Alcohol use severity as measured by the Alcohol Use Diagnostic Interview Test (AUDIT) [19] and the alcohol abstinence self-efficacy scale [20] • Gambling severity as measured by the Canadian Problem Gambling Index (CPGI) questionnaire [21] • Depressive and anxiety symptoms as measured by respectively the 21 item version of the Beck Depression Inventory (BDI) [22], the State version of the state-trait anxiety inventory (STAI) [23] • Impulsivity as measured by the Barratt Impulsivity Screening (BIS-11) [24]), the Behavioral Inhibition and Behavioral Activation Scales (BIS/BAS) [25], the UPPS Impulsive Behavior Scale [26] and compulsivity measures. • Executive functioning as measured by a number of CANTAB tasks (see section 5.4 – Self report measures). | — |
Contacts
Public ContactTim van Timmeren
Outcome results
None listed