Attention deficit hyperactivity symptoms predict problematic mobile phone use

Attention-deficit-hyperactivity disorder (ADHD) is the most commonly diagnosed childhood disorder characterised by inattention, hyperactivity/impulsivity, or both. Some of the key traits of ADHD have previously been linked to addictive and problematic behaviours. The aim of the present study was to examine the relationship between problematic mobile phone use, smartphone addiction risk and ADHD symptoms in an adult population. A sample of 273 healthy adult volunteers completed the Adult ADHD Self-Report Scale (ASRS), the Mobile Phone Problem Usage Scale (MPPUS), and the Smartphone Addiction Scale (SAS). A significant positive correlation was found between the ASRS and both scales. More specifically, inattention symptoms and age predicted smartphone addiction risk and problematic mobile phone use. Our results suggest that there is a positive relationship between ADHD traits and problematic mobile phone use. In particular, younger adults with higher level of inattention symptoms could be at higher risk of developing smartphone addiction. The implication of our findings for theoretical frameworks of problematic mobile phone use and clinical practice are discussed

Prefrontal response and frontostriatal functional connectivity to monetary reward in abstinent alcohol-dependent young adults

Although altered function in neural reward circuitry is widely proposed in models of addiction, more recent conceptual views have emphasized the role of disrupted response in prefrontal regions. Changes in regions such as the orbitofrontal cortex, medial prefrontal cortex, and dorsolateral prefrontal cortex are postulated to contribute to the compulsivity, impulsivity, and altered executive function that are central to addiction. In addition, few studies have examined function in these regions during young adulthood, when exposure is less chronic than in typical samples of alcohol-dependent adults. To address these issues, we examined neural response and functional connectivity during monetary reward in 24 adults with alcohol dependence and 24 psychiatrically healthy adults. Adults with alcohol dependence exhibited less response to the receipt of monetary reward in a set of prefrontal regions including the medial prefrontal cortex, lateral orbitofrontal cortex, and dorsolateral prefrontal cortex. Adults with alcohol dependence also exhibited greater negative correlation between function in each of these regions and that in the nucleus accumbens. Within the alcohol-dependent group, those with family history of alcohol dependence exhibited lower mPFC response, and those with more frequent drinking exhibited greater negative functional connectivity between the mPFC and the nucleus accumbens. These findings indicate that alcohol dependence is associated with less engagement of prefrontal cortical regions, suggesting weak or disrupted regulation of ventral striatal response. This pattern of prefrontal response and frontostriatal connectivity has consequences for the behavior patterns typical of addiction. Furthermore, brain-behavior findings indicate that the potential mechanisms of disruption in frontostriatal circuitry in alcohol dependence include family liability to alcohol use problems and more frequent use of alcohol. In all, these findings build on the extant literature on reward-circuit function in addiction and suggest mechanisms for disrupted function in alcohol dependence. © 2014 Forbes et al

The role of the posterior cerebellum in dysfunctional social sequencing

Recent advances in social neuroscience have highlighted the critical role of the cerebellum in social cognition, and especially the posterior cerebellum. Studies have supported the view that the posterior cerebellum builds internal action models of our social interactions to predict how other people’s actions will be executed, what our most likely responses are to these actions. This mechanism allows to better anticipate action sequences during social interactions in an automatic and intuitive way and to fine-tune these anticipations, making it easier to understand other’s social behaviors and mental states (e.g., beliefs, intentions, traits). In this paper, we argue that the central role of the posterior cerebellum in identifying and automatizing social action sequencing provides a fruitful starting point for investigating social dysfunctions in a variety of clinical pathologies, such as autism, obsessive-compulsive disorder, depression, and addiction. Our key hypothesis is that dysfunctions of the posterior cerebellum lead to under- or overuse of inflexible social routines and lack of plasticity for learning new, more adaptive, social automatisms. We briefly review past research supporting this view and propose a program of research to test our hypothesis. This approach might alleviate a variety of mental problems of individuals who suffer from inflexible automatizations that stand in the way of adjustable and intuitive social behavior, by increasing posterior cerebellar plasticity using noninvasive neurostimulation or neuro-guided training programs

Hair ethyl glucuronide is a highly accurate and objective biomarker of continued alcohol use in patients with alcoholic cirrhosis

status: publishe

Consensus international sur le dépistage, le diagnostic et le traitement des adolescents avec un trouble du déficit de l’attention avec ou sans hyperactivité en cas de comorbidité avec des troubles de l’usage de substances

Introduction Le trouble du déficit de l’attention/hyperactivité chez l’enfant (TDAH) est un facteur de risque de mésusage et de troubles de l’usage de substances (TUS) chez l’adolescent et le jeune adulte. Le TDAH et le TUS coexistent également fréquemment chez les adolescents en demande de soins, compliquant le diagnostic et le traitement et étant associé à de mauvais résultats thérapeutiques. Les recherches concernant l’effet du traitement du TDAH chez l’enfant sur la prévention du TUS à l’adolescence sont peu concluantes et les études sur le diagnostic et le traitement des adolescents atteints de TDAH et de TUS comorbides sont rares. Ainsi, les preuves disponibles ne sont pas suffisantes pour justifier des recommandations de traitement solides. Objectif Le but de cette étude était d’aboutir à une déclaration de consensus basée sur une combinaison de données scientifiques et d’expérience clinique. Méthode La méthode Delphi modifiée a été utilisée pour parvenir à un consensus basé sur la combinaison de données scientifiques et d’expérience clinique, avec un groupe multidisciplinaire de 55 experts provenant de 17 pays. Les experts ont été invités à évaluer un ensemble d’énoncés portant sur l’effet du traitement du TDAH de l’enfant sur le TUS à l’adolescence ainsi que sur le dépistage, le diagnostic et le traitement des adolescents souffrant de TDAH et de TUS comorbides. Résultats Après trois tours de cotation et d’adaptation de 37 énoncés, un consensus a été atteint sur 36 d’entre eux, représentant six domaines : généralités (n =4), risque de développer un TUS (n =3), dépistage et diagnostic (n =7), prise en charges psychosociales (n =5), traitement pharmacologique (n =11) et traitements complémentaires (n =7). Le dépistage systématique du TDAH est recommandé auprès des patients adolescents vus en addictologie et du TUS auprès des patients adolescents souffrant de TDAH vus en santé mentale. Les stimulants à action prolongée sont recommandés comme traitement de première intention du TDAH chez les adolescents souffrant de la comorbidité TDAH-TUS et la pharmacothérapie doit de préférence être incluse dans une prise en charge psychosociale (psychoéducation, entretien motivationnel, thérapies comportementales et cognitives, prise en charge familiale). L’unique déclaration non consensuelle restante concerne l’exigence d’abstinence avant l’initiation d’un traitement pharmacologique chez les adolescents atteints de TDAH et de TUS concomitants. Contrairement à la majorité des experts, certains exigent une abstinence complète avant de débuter tout traitement pharmacologique, certains se positionnent contre l’utilisation de stimulants dans le traitement de ces patients (indépendamment de l’abstinence), tandis que d’autres n’approuvent pas l’utilisation alternative du bupropion. Conclusion Cette déclaration de consensus internationale peut être utilisée par les cliniciens et les patients dans un processus collaboratif de prise de décision partagée pour sélectionner les meilleures interventions et obtenir des résultats optimaux chez les patients adolescents souffrant de TDAH et de TUS comorbides. Background Childhood attention-deficit/hyperactivity disorder (ADHD) is a risk factor for substance misuse and substance use disorder (SUD) in adolescence and (early) adulthood. ADHD and SUD also frequently co-occur in treatment-seeking adolescents, which complicates diagnosis and treatment and is associated with poor treatment outcomes. Research on the effect of treatment of childhood ADHD on the prevention of adolescent SUD is inconclusive, and studies on the diagnosis and treatment of adolescents with ADHD and SUD are scarce. Thus, the available evidence is generally not sufficient to justify robust treatment recommendations. Objective The aim of the study was to obtain a consensus statement based on a combination of scientific data and clinical experience. Method A modified Delphi study to reach consensus based upon the combination of scientific data and clinical experience with a multidisciplinary group of 55 experts from 17 countries. The experts were asked to rate a set of statements on the effect of treatment of childhood ADHD on adolescent SUD and on the screening, diagnosis, and treatment of adolescents with comorbid ADHD and SUD. Results After 3 iterative rounds of rating and adapting 37 statements, consensus was reached on 36 of these statements representing 6 domains: general (n =4), risk of developing SUD (n =3), screening and diagnosis (n =7), psychosocial treatment (n =5), pharmacological treatment (n =11), and complementary treatments (n =7). Routine screening is recommended for ADHD in adolescent patients in substance abuse treatment and for SUD in adolescent patients with ADHD in mental healthcare settings. Long-acting stimulants are recommended as the firstline treatment of ADHD in adolescents with concurrent ADHD and SUD, and pharmacotherapy should preferably be embedded in psychosocial treatment. The only remaining no-consensus statement concerned the requirement of abstinence before starting pharmacological treatment in adolescents with ADHD and concurrent SUD. In contrast to the majority, some experts required full abstinence before starting any pharmacological treatment, some were against the use of stimulants in the treatment of these patients (independent of abstinence), while some were against the alternative use of bupropion. Conclusion This international consensus statement can be used by clinicians and patients together in a shared decision-making process to select the best interventions and to reach optimal outcomes in adolescent patients with concurrent ADHD and SUD