University Clinic of Psychiatry and Psychotherapeutic Medicine, Medical University, Auenbruggerplatz 31, 8036, Graz, Austria.
Center for Integrative Addiction Research (CIAR), Grüner Kreis Society, Simmeringer Hauptstraße 101, 1110, Vienna, Austria.
Brain Imaging Behav. 2021 Aug;15(4):2187-2198. doi: 10.1007/s11682-020-00414-3. Epub 2020 Nov 21.
Insecure attachment, impaired personality structure and impaired emotion regulation figure prominently in substance use disorders. While negative emotions can trigger drug-use and relapse, cognitive reappraisal may reduce emotional strain by promoting changes in perspective. In the present study, we explored behavioral and neural correlates of cognitive reappraisal in poly-drug use disorder by testing individuals' capability to generate cognitive reappraisals for aversive events (Reappraisal Inventiveness Test). 18 inpatients with poly-drug use disorder and 16 controls completed the Adult Attachment Scale, the Emotion Regulation Questionnaire, the Brief Symptom Inventory, the Wonderlic Personnel Test, and the Operationalized Psychodynamic Diagnosis Structure Questionnaire, as well as two versions of the Reappraisal Inventiveness Test (during fMRI and outside the lab). Compared to controls, polydrug inpatients reported impaired personality structure, attachment and emotion regulation abilities. In the Reappraisal Inventiveness Test, poly-drug inpatients were less flexible and fluent in generating reappraisals for anger-eliciting situations. Corresponding to previous brain imaging evidence, cognitive reappraisal efforts of both groups were reflected in activation of left frontal regions, particularly left superior and middle frontal gyri and left supplemental motor areas. However, no group differences in neural activation patterns emerged. This suggests that despite cognitive reappraisal impairments on a behavioral level, neural reflections of these deficits in poly-drug use disorder might be more complex.
不安全的依恋、受损的人格结构和受损的情绪调节在物质使用障碍中尤为突出。虽然负面情绪会引发药物使用和复发，但认知重评可以通过改变视角来减轻情绪压力。在本研究中，我们通过测试个体对厌恶事件产生认知重评的能力（再评价创造力测试），来探讨多药使用障碍中的认知重评的行为和神经相关性。18 名多药使用障碍患者和 16 名对照者完成了成人依恋量表、情绪调节问卷、简明症状量表、Wonderlic 人事测验、操作性心理动力学诊断结构问卷以及再评价创造力测试的两个版本（在 fMRI 期间和实验室外）。与对照组相比，多药使用障碍患者报告说他们的人格结构、依恋和情绪调节能力受损。在再评价创造力测试中，多药使用障碍患者在产生愤怒诱发情境的再评价时灵活性和流畅性较差。与之前的脑成像证据相对应，两组的认知重评努力都反映在左额叶区域的激活，特别是左额上回、中回和左辅助运动区。然而，两组的神经激活模式没有差异。这表明，尽管在行为层面上存在认知重评障碍，但多药使用障碍中这些缺陷的神经反射可能更为复杂。
