http://homepages.se.edu/cvonbergen/files/2013/01/Fifty-Years-of-the-Barratt-Impulsivenss-Scale_An-Update-and-Review.pdf

Fifty years of the Barratt Impulsiveness Scale: An update and review

The discovery of cannabinoid receptors and subsequent identification of their endogenous ligands (endocannabinoids) in early 1990s have greatly accelerated research on cannabinoid actions in the br...

Endocannabinoid-Mediated Control of Synaptic Transmission

Impulsivity as a vulnerability marker for substance-use disorders: Review of findings from high-risk research, problem gamblers and genetic association studies

Quantitative genetic studies (i.e., twin and adoption studies) suggest that genetic influences contribute substantially to the development of attention deficit hyperactivity disorder (ADHD). Over the past 15 years, considerable efforts have been made to identify genes involved in the etiology of this disorder resulting in a large and often conflicting literature of candidate gene associations for ADHD. The first aim of the present study was to conduct a comprehensive meta-analytic review of this literature to determine which candidate genes show consistent evidence of association with childhood ADHD across studies. The second aim was to test for heterogeneity across studies in the effect sizes for each candidate gene as its presence might suggest moderating variables that could explain inconsistent results. Significant associations were identified for several candidate genes including DAT1, DRD4, DRD5, 5HTT, HTR1B, and SNAP25. Further, significant heterogeneity was observed for the associations between ADHD and DAT1, DRD4, DRD5, DBH, ADRA2A, 5HTT, TPH2, MAOA, and SNAP25, suggesting that future studies should explore potential moderators of these associations (e.g., ADHD subtype diagnoses, gender, exposure to environmental risk factors). We conclude with a discussion of these findings in relation to emerging themes relevant to future studies of the genetics of ADHD.

Candidate gene studies of ADHD: a meta-analytic review.

Alcohol dependence belongs to the globally leading health risk factors Therapeutic success of psychosocial programs for relapse prevention is moderate and could be increased by an adjuvant treatment with the opioid antagonists naltrexone and nalmefene
 
The objective of this review is to determine the effectiveness and tolerability of opioid antagonists in the treatment of alcohol dependence

Opioid antagonists for alcohol dependence

Pathological gambling (PG) has been associated to both impulsiveness and attention deficit/hyperactivity disorder (ADHD) in different studies. Our objective was to compare different impulsivity and sustained attention variables, using both behavioural tasks and self-administered questionnaires, in a group of pathological gamblers with a history of childhood ADHD (PG-ADHD; n = 16), a group of pathological gamblers without this history (PG-non-ADHD; n = 39), and a control group (n = 40). As instruments of measure, we used the stop signal task (to evaluate inhibitory control/impulsivity), the differential reinforcement of Low Rate Responding Task (delay of gratification/impulsivity) and the Continuous Performance Test (sustained attention). The Barratt Impulsivity Scale (BIS-11) was used as a self-administered questionnaire to measure impulsiveness. Our results show that patients in the PG-ADHD group exhibit a significantly lower capacity to delay gratification than those in the PG-non-ADHD and control groups, and less inhibitory control than patients in the PG-non-ADHD group. On self-administered questionnaires such as the BIS-11 the PG-ADHD group obtained higher scores than the PG-non-ADHD and control groups. However, no differences were found with respect to sustained attention using the CPT. Our results suggest a possible selective implication of the prefrontal cortex in PG, which would be especially evident in those with a childhood history of ADHD.

Impulsivity and Sustained Attention in Pathological Gamblers: Influence of Childhood ADHD History

Naltrexone and acamprosate reduce relapse in alcohol dependence. They have not yet been compared in a published trial. The aim of this study was to compare the efficacy of these compounds in conditions similar to those in routine clinical practice. Random allocation to a year of treatment with naltrexone (50 mg/day) or acamprosate (1665-1998 mg/day) was made in 157 recently detoxified alcohol-dependent men with moderate dependence (evaluated using the Addictions Severity Index and Severity of Alcohol Dependence Scale). All were patients whom a member of the family would accompany regularly to appointments. Alcohol consumption, craving and adverse events were recorded weekly for the first 3 months, and then bi-weekly, by the treating psychiatrist who was not blinded. At 3-monthly intervals, investigators who were blinded to the treatment documented patients' alcohol consumption based on patients' accounts, information given by the psychiatrists when necessary, and reports from patients' families. Serum gamma-glutamyltransferase (GGT) was also measured. Efforts were made to sustain the blindness of the investigators. The same investigator did not assess the same patient twice. The integrity of the blindness was not checked. There was no difference between treatments in mean time to first drink (naltrexone 44 days, acamprosate 39 days) but the time to first relapse (five or more drinks in a day) was 63 days (naltrexone) versus 42 days (acamprosate) (P = 0.02). At the end of 1 year, 41% receiving naltrexone and 17% receiving acamprosate had not relapsed (P = 0.0009). The cumulative number of days of abstinence was significantly greater, and the number of drinks consumed at one time and severity of craving were significantly less, in the naltrexone group compared to the acamprosate group, as was the percentage of heavy drinking days (P = 0.038). More patients in the acamprosate than the naltrexone group were commenced on disulfiram during the study. Naltrexone patients attended significantly more group therapy sessions, though this could not explain their better outcome. There were non-significant trends for the naltrexone group to comply better with medication, to stay in the study longer, and to show greater improvement over baseline in serum GGT.

/pdf/naltrexone-versus-acamprosate-one-year-follow-up-of-alcohol-4n9ntfabnm.pdf

Naltrexone versus acamprosate: one year follow-up of alcohol dependence treatment

Aims: To determine the clinically ascertained variables that are related to satisfactory response to naltrexone (NTX) treatment of alcohol dependence after detoxification. Methods: The use of intake and outcome variables were measured in a randomized 3-month open-controlled trial comparing the effects of naltrexone plus psychotherapy treatment versus psychotherapy treatment alone on the maintenance of abstinence in the final 28 days (n = 336, all male). Results: Predictors of a positive response to NTX treatment were family history of alcoholism (P = 0.010), early age at onset of drinking problems (P = 0.014) and comorbid use of other drugs of abuse (P < 0.001). Among the subjects not treated with NTX, the greater the number of predictor variables, the lower the final 28 days abstinence rates (P = 0.00003), but this was not the case in patients treated with NTX (P = 0.844). Conclusions: Patients with these features, suggesting biological vulnerability overall have poorer outcomes, but this can be reduced with NTX treatment. The type of alcoholism should be considered before deciding on the pharmacological strategy.

Clinical predictors of response to naltrexone in alcoholic patients: who benefits most from treatment with naltrexone?

Background 

The TaqI-A polymorphism of the ANKK1 gene, adjacent to the DRD2 gene, has been associated with alcoholism and other psychiatric conditions, although other DRD2 gene variants, such as the C957T polymorphism, could be related to these phenotypic traits.

Aims 

To investigate the contribution of the TaqI-A and the C957T polymorphisms to the presence of psychopathic traits in patients with alcoholism.

Method 

We performed association and interaction analyses of the polymorphisms in 150 controls and 176 male alcohol-dependent patients assessed for the presence of dissocial personal disorder, using the Psychopathy Checklist–Revised (PCL–R).

Results 

There was a significant association of the TaqI-A and C957T polymorphisms when both genotypes were present, with PCL–R scores of F 1-171=0.13 ( P =0.01) and a frequency of dissocial personal disorder OR=10.52, P <0.001.

Conclusions 

The TaqI-A of the ANKK1 gene and the C957T of the DRD2 gene are epistatically associated with psychopathic traits in alcohol-dependent patients.

/pdf/drd2-and-ankk1-genotype-in-alcohol-dependent-patients-with-5g66hslab5.pdf

DRD2 and ANKK1 genotype in alcohol-dependent patients with psychopathic traits: association and interaction study

Introduction Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most common neuropsychiatric disorders in the early ages. Recently, it has been verified that presence of ADHD in early ages could be a vulnerability factor for developing different psychiatric disorders in adults, such as substance abuse and personality disorders. The retrospective diagnosis of this disorder in early ages of adult patients is specially problematic. Objective The Wender Utah Rating Scale (WURS) has been translated and adaptated with the purpose of validating it in the Spanish population. Patients and method It was administered the questionnaire to 266 patients of an Addictive Behaviours Unit. In 82 cases it was realized a clinical diagnosis of ADHD in early ages, and others 184 cases did not show antecedents of this disorder. Results 25 items which better discriminate cases from controls were chosen. The Cronbach s coefficient for this subscale was 0.94. The cut off 32 optimized sensitivity (91.5%) and specificity (90.8%). The positive and negative predictive values was 81% and 96% respectively. The total of incorrectly classified subjects was 9%. Conclusions Our version of the WURS shows an adequate psychometric characteristics, that indicate an adequate validity for the detection of adult patients with antecedents of ADHD in early ages. In our population of patients with addictive behaviours, it has demonstrated to be very useful to differentiate an important subgroup of patients with antecedents of ADHD in early ages. It would be very interesting the replication of this study in other psychopathological and neurological conditions.

[Validation in the adult Spanish population of the Wender Utah Rating Scale for the retrospective evaluation in adults of attention deficit/hyperactivity disorder in childhood].

G. Ponce

Papers

Impulsivity and Sustained Attention in Pathological Gamblers: Influence of Childhood ADHD History

Naltrexone versus acamprosate: one year follow-up of alcohol dependence treatment

Clinical predictors of response to naltrexone in alcoholic patients: who benefits most from treatment with naltrexone?

DRD2 and ANKK1 genotype in alcohol-dependent patients with psychopathic traits: association and interaction study

[Validation in the adult Spanish population of the Wender Utah Rating Scale for the retrospective evaluation in adults of attention deficit/hyperactivity disorder in childhood].