An empirical study of affective and cognitive functions in Compulsive Sexual Behavior Disorder

Background and aimsDespite the inclusion of the Compulsive Sexual Behavior Disorder (CSBD) in the International Classification of Diseases, very little is known about the underlying affective and cognitive processes. To fill this gap, we compared CSBD subjects and Healthy-Controls (HC) across negative/positive valence, cognitive and sensorimotor systems, as proposed by the Research Domain Criteria framework.Methods74 heterosexual CSBD and 66 matched HC males were studied with 10 questionnaires and 8 behavioral tasks. Analyses were conducted with frequent and Bayesian statistics.ResultsCSBD individuals showed significantly higher (than HC) punishment sensitivity, anxiety, depression, compulsivity, and impulsivity symptoms. Frequentist statistical analysis revealed significant interaction between subject group and condition in Incentive Delay Task, concerning the strength of motivation and hedonic value of erotic rewards. Bayesian analysis produced evidence for the absence of group differences in Facial Discrimination Task, Risk-Ambiguity Task, and Learning Task. Also, Bayesian methods provided evidence for group differences in the Emotional Stroop Task and the Incentive Delay Task. Sexual Discounting Task, Attentional Network Task, and Stop Signal Task produced mixed results.ConclusionsHigher punishment sensitivity and impulsivity among CSBD subjects, along with significant interaction between these groups and erotic vs. non-erotic reward processing is in line with previous findings on negative/positive valence alterations in CSBD patients. This result shows that there are similarities to substance and behavioral addictions. The absence of group differences and mixed results related to cognitive and sensorimotor systems raise concerns to what extent CSBD resembles a wide spectrum of impairments observed in disorders, and demand further research.

Does endogenous variation in stress modulate risk and time preferences?

It has been argued that one dimension of the cycle of poverty is that poverty is a state of chronic stress and that chronic stress impairs decision-making. These poor decisions, made under chronic stress, might include carrying high-interest loans, failure to buy health insurance, gambling or drug use. As such, these decisions can contribute to the cycle of poverty. More specifically, a few studies suggest that increased stress may lead to more risk-aversion and steeper delay-discounting. While the deleterious effects of chronic stress on brain function are well established, much less is known about how chronic stress influences financial decision making specifically. Here, in a longitudinal design within six weeks period we aimed to incorporate biological mechanisms to improve our understanding of how stress influences economic decisions. We used a combination of decision-making tasks, questionnaires, saliva and hair samples within-subject (N=41). We assessed time and risk preferences using hierarchical Bayesian techniques to both pool data and allow heterogeneity in decision making and compared those to cortisol levels and self-reported stress. We found only weak links between endogenous variation in stress and model-based estimates of risk and time preferences. In particular, we found that fluctuations in the stress level measured via hair sample were not only positively correlated with time preferences in the short delay task and risk preferences, but also the decision noise in the risk task. However, relationships for the risk task disappeared when an outlier was removed. Also, we found model-free task measures in the short delay task to be moderately related to both hair cortisol as well as the stressful life events questionnaire measure. For example, we observed that endogenous stress fluctuations and the life change units were negatively correlated with the proportion of later choices. Finally, we established that for the reaction times the curvilinear relationship was preferred to the linear one for those with increase in biological stress level compared to the baseline: when cortisol level increased slightly, participants decided slower, but when stress increased to higher levels, they decided quicker.

Reward-related responses and tonic craving in cocaine addiction: an imaging study of the monetary incentive delay task

Background Cocaine addiction is associated with altered sensitivity to natural reinforcers and intense drug craving. However, previous findings on reward-related responses are mixed and few studies have examined whether reward responses relate to tonic cocaine craving. Methods We combined fMRI and a monetary incentive delay task to investigate these issues. Imaging data were processed with published routines and the results were evaluated with a corrected threshold. We compared reward responses of 50 cocaine dependent individuals (CDs) and 45 healthy controls (HCs) for the ventral striatum (VS) and the whole brain. We also examined the regional responses in association with tonic cocaine craving, as assessed by the Cocaine Craving Questionnaire (CCQ) in CDs. We performed mediation analyses to evaluate the relationship between regional responses, CCQ score, and recent cocaine use. Results The VS showed higher activation to large as compared to small or no wins but this reward-related activity did not differ between CDs and HCs. The precentral gyrus (PCG), anterior insula, and supplementary motor area showed higher activation during large vs. no wins in positive correlation with the CCQ score in CDs. Mediation analyses suggested that days of cocaine use in the prior month contributed to higher CCQ scores and, in turn, PCG reward responses. Conclusions The results highlight a unique relationship between reward responses of the primary motor cortex, tonic cocaine craving and recent cocaine use. The motor cortex may partake in the cognitive motor processes critical to drug seeking behavior in addicted individuals.

Sexual incentive delay in the scanner: Sexual cue and reward processing, and links to problematic porn consumption and sexual motivation

Background and aimsThe use of pornography, while unproblematic for the majority, can grow into addiction-like behavior which in its extreme form is labeled as compulsive sexual behavioral disorder in the ICD-11 (WHO, 2018). The aim of this study was to investigate the addiction-specific reactivity to cues in order to better understand underlying mechanisms in the development of this disorder.MethodsWe have used an optimized Sexual Incentive Delay Task to study brain activity in reward associated brain areas during an anticipation phase (with cues predicting pornographic videos, control videos or no videos) and a corresponding delivery phase in healthy men. Correlations to indicators of problematic pornography use, the time spent on pornography use, and trait sexual motivation were analyzed.ResultsThe results of 74 men showed that reward-related brain areas (amygdala, dorsal cingulate cortex, orbitofrontal cortex, nucleus accumbens, thalamus, putamen, caudate nucleus, and insula) were significantly more activated by both the pornographic videos and the pornographic cues than by control videos and control cues, respectively. However, we found no relationship between these activations and indicators of problematic pornography use, time spent on pornography use, or with trait sexual motivation.Discussion and conclusionsThe activity in reward-related brain areas to both visual sexual stimuli as well as cues indicates that optimization of the Sexual Incentive Delay Task was successful. Presumably, associations between reward-related brain activity and indicators for problematic or pathological pornography use might only occur in samples with increased levels and not in a rather healthy sample used in the present study.

Der Effekt von Belohnungen auf die intraindividuelle Variabilität der Reaktionszeit bei erwachsenen ADHS-Patienten : eine Analyse anhand des Ex-Gauß’schen Verteilungsmodells

Increased intraindividual variability of reaction time is a main cognitive feature of Attention Deficit Hyperactivity Disorder. It is associated with deficits in sustained attention. While traditionally, mean and variance were used to characterize reaction time distributions, the ex-gaussian distributional model allows a more sophisticated analysis of reaction time series. Reaction time distributions are separated in a normal and an exponential component. The present study investigates the impact of incentives on reaction time variability in a sample of adult ADHD patients. ADHD is associated with increased Tau, the output parameter of the ex-gaussian model characterizing the exponential part of the distribution. Tau is linked to “lapses of attention”, which are more frequent in ADHD patients. It is known that tau can be modulated in ADHD Patients. It was therefore postulated that tau would be higher in ADHD Patients in a paradigm where quick answers were required but could be modulated by monetary incentives. In addition, the effect of “delay discounting”, which is more distinct in ADHD patients, on reaction time variability was investigated. Eventually, the association of variability measures with strength of ADHD symptoms was tested. To this end, reaction time distributions of 62 adult ADHD patients and 45 healthy controls from two different reaction time paradigms were analyzed. The monetary incentive delay task, by comprehending a control – and a win condition, allows an investigation of the effect of incentives on reaction times. Subjects had to react as fast as possible by keypress to a stimulus, after a cue signaled a possible monetary reward. During the Delay-Discounting-Task, subjects had to choose between sooner, but smaller, and higher delayed monetary rewards, during which they could use as much time for consideration as desired. Results show that an increased Tau in the control condition of the monetary- incentive-delay-task could be replicated, while a distinct influence of the win condition emerged. Subjects with ADHD showed an improvement of Tau in the win condition even below the level of healthy controls. However, they showed increased variability of the “regular” responses around the mean of the normal component of the distribution, represented by sigma. Moreover, it was indicated by trend a higher reaction time variability in ADHD patients during choices of delayed rewards. Tau was associated the current symptom strength as well as with the strength of ADHD-Symptoms during childhood, assessed by questionnaire. While the present results could have implications for etiological models of the disease, they may also contribute to the development of novel diagnostic methods. In advanced studies, neural correlates of sophisticated measures of reaction time variability should be investigated. Furthermore, they should be associated with genetic risk factors with regard to possible endophenotypes. Possible implications for clinical handling of patients should be explored.