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See detailLet’s Open the Decision-Making Umbrella: A Framework for Conceptualizing and Assessing Features of Impaired Decision Making in Addiction
Rochat, Lucien; Maurage, Pierre; Heeren, Alexandre et al

in Neuropsychology Review (2019), 29(1), 27-51

Decision-making impairments play a pivotal role in the emergence and maintenance of addictive disorders. However, a sound conceptualization of decision making as an umbrella construct, encompassing its ... [more ▼]

Decision-making impairments play a pivotal role in the emergence and maintenance of addictive disorders. However, a sound conceptualization of decision making as an umbrella construct, encompassing its cognitive, affective, motivational, and physiological subcomponents, is still lacking. This prevents an efficient evaluation of the heterogeneity of decision-making impairments and the development of tailored treatment. This paper thus unfolds the various processes involved in decision making by adopting a critical approach of prominent dual- or triadic-process models, which postulate that decision making is influenced by the interplay of impulsive-automatic, reflective-controlled, and interoceptive processes. Our approach also focuses on social cognition processes, which play a crucial role in decision making and addictive disorders but were largely ignored in previous dual- or triadic-process models. We propose here a theoretical framework in which a range of coordinated processes are first identified on the basis of their theoretical and clinical relevance. Each selected process is then defined before reviewing available results underlining its role in addictive disorders (i.e., substance use, gambling, and gaming disorders). Laboratory tasks for measuring each process are also proposed, initiating a preliminary process-based decision-making assessment battery. This original approach may offer an especially informative view of the constitutive features of decision making impairments in addiction. As prior research has implicated these features as risk factors for the development and maintenance of addictive disorders, our processual approach sets the scene for novel and transdiagnostic experimental and applied research avenues [less ▲]

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See detailDoes change in attention control mediate the impact of tDCS on attentional bias for threat? Limited evidence from a double-blind sham-controlled experiment in an unselected sample
Coussement, Charlotte; Maurage, Pierre; Billieux, Joël UL et al

in Psychologica Belgica (2019), 59(1), 16-32

Neurocognitive models of attentional bias for threat posit that attentional bias may result from a decreased activation of the left prefrontal cortex, and especially of its dorsolateral part (dlPFC ... [more ▼]

Neurocognitive models of attentional bias for threat posit that attentional bias may result from a decreased activation of the left prefrontal cortex, and especially of its dorsolateral part (dlPFC), resulting in an impaired attention control. Consequently, a transient increase of neural activity within the left dlPFC via non-invasive brain stimulation reduces attentional bias among both anxious and nonanxious participants. Yet, it is still unclear whether the impact of dlPFC activation on attentional bias is mediated by improvement in attention control. In this experiment, we sought to test this hypothesis in an unselected sample (n = 20). Accordingly, we adopted a double-blind within-subject protocol in which we delivered a single-session of anodal versus sham transcranial Direct Current Stimulation (tDCS) over the left dlPFC during the completion of a task assessing attention control. We also assessed its subsequent impact on attentional bias. Neither attention control nor attentional bias did significantly improve following anodal tDCS. Although our results did not support our main hypothesis, we believe the present null results to be particularly useful for future meta-research in the field. We also formulated a series of methodological recommendations for future research aiming at testing the tDCS-induced modification of attentional bias. [less ▲]

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See detailIs there room for attentional impairments in binge drinking? A commentary on Carbia et al. (2018).
Lannoy, Severine; Heeren, Alexandre; Dormal, Valerie et al

in Neuroscience and biobehavioral reviews (2019), 98

Binge drinking is an excessive pattern of alcohol use, highly prevalent in adolescents and young adults. Several studies have explored the cognitive impairments associated with binge drinking, and Carbia ... [more ▼]

Binge drinking is an excessive pattern of alcohol use, highly prevalent in adolescents and young adults. Several studies have explored the cognitive impairments associated with binge drinking, and Carbia et al. (2018) recently proposed a systematic review of these impairments. Although this review offers an insightful and up-to-date synthesis of this research field, the authors concluded that binge drinking is not associated with attentional impairments. We argue that such conclusion is premature. We identified published studies not mentioned by Carbia et al. (2018), which documented attentional impairments in binge drinking. In particular, a differential exploration of attentional networks has suggested that binge drinkers not only exhibit impairments for the executive control of attention, but also for its alerting network. We thus recommend a better consideration of attention in future experimental and translational research agendas. [less ▲]

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See detailBehavioural Addiction Open Definition 2.0 – Using the open science framework for collaborative and transparent theoretical development
Billieux, Joël UL; Van Rooij, Antonius J; Heeren, Alexandre et al

in Addiction (2017), 112(10), 1723-1724

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See detailHow can we conceptualize behavioural addiction without pathologizing common behaviours?
Kardefelt-Winther, Daniel; Heeren, Alexandre; Schimmenti, Adriano et al

in Addiction (2017), 112(10), 1709-1715

Following the recent changes to the diagnostic category for addictive disorders in DSM-5, it is urgent to clarify what constitutes behavioural addiction to have a clear direction for future research and ... [more ▼]

Following the recent changes to the diagnostic category for addictive disorders in DSM-5, it is urgent to clarify what constitutes behavioural addiction to have a clear direction for future research and classification. However, in the years following the release of DSM-5, an expanding body of research has increasingly classified engagement in a wide range of common behaviours and leisure activities as possible behavioural addiction. If this expansion does not end, both the relevance and the credibility of the field of addictive disorders might be questioned, which may prompt a dismissive appraisal of the new DSM-5 subcategory for behavioural addiction. We propose an operational definition of behavioural addiction together with a number of exclusion criteria, to avoid pathologizing common behaviours and provide a common ground for further research. The definition and its exclusion criteria are clarified and justified by illustrating how these address a number of theoretical and methodological shortcomings that result from existing conceptualizations. We invite other researchers to extend our definition under an Open Science Foundation framework. [less ▲]

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See detailAttentional Impairments in Huntington’s Disease: A Specific Deficit for the Executive Conflict
Maurage, Pierre; Heeren, Alexandre; Lahaye, Magali et al

in Neuropsychology (2017), 31(4), 424-436

Objective: Huntington’s disease (HD) is characterized by motor and cognitive impairments including memory, executive, and attentional functions. However, because earlier studies relied on multidetermined ... [more ▼]

Objective: Huntington’s disease (HD) is characterized by motor and cognitive impairments including memory, executive, and attentional functions. However, because earlier studies relied on multidetermined attentional tasks, uncertainty still abounds regarding the differential deficit across attentional subcomponents. Likewise, the evolution of these deficits during the successive stages of HD remains unclear. The present study simultaneously explored 3 distinct networks of attention (alerting, orienting, executive conflict) in preclinical and clinical HD. Method: Thirty-eight HD patients (18 preclinical) and 38 matched healthy controls completed the attention network test, an integrated and theoretically grounded task assessing the integrity of 3 attentional networks. Results: Preclinical HD was not characterized by any attentional deficit compared to controls. Conversely, clinical HD was associated with a differential deficit across the 3 attentional networks under investigation, showing preserved performance for alerting and orienting networks but massive and specific impairment for the executive conflict network. This indexes an impaired use of executive control to resolve the conflict between task-relevant stimuli and interfering task-irrelevant ones. Conclusion: Clinical HD does not lead to a global attentional deficit but rather to a specific impairment for the executive control of attention. Moreover, the absence of attentional deficits in preclinical HD suggests that these deficits are absent at the initial stages of the disease. In view of their impact on everyday life, attentional deficits should be considered in clinical contexts. Therapeutic programs improving the executive control of attention by neuropsychology and neuromodulation should be promoted. [less ▲]

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See detailCorrelates of social exclusion in social anxiety Disorder: An fMRI study
Heeren, Alexandre; Dricot, Laurence; Billieux, Joël UL et al

in Scientific Reports (2017), 7

Cognitive models posit that social anxiety disorder (SAD) is maintained by biased informationprocessing vis-à-vis threat of social exclusion. However, uncertainty still abounds regarding the very nature ... [more ▼]

Cognitive models posit that social anxiety disorder (SAD) is maintained by biased informationprocessing vis-à-vis threat of social exclusion. However, uncertainty still abounds regarding the very nature of this sensitivity to social exclusion in SAD. Especially, brain alterations related to social exclusion have not been explored in SAD. Our primary purpose was thus to determine both the selfreport and neural correlates of social exclusion in this population. 23 patients with SAD and 23 matched nonanxious controls played a virtual game (“Cyberball”) during fMRI recording. Participants were frst included by other players, then excluded, and fnally re-included. At the behavioral level, patients with SAD exhibited signifcantly higher levels of social exclusion feelings than nonanxious controls. At the brain level, patients with SAD exhibited signifcantly higher activation within the left inferior frontal gyrus relative to nonanxious controls during the re-inclusion phase. Moreover, self-report of social exclusion correlates with the activity of this cluster among individuals qualifying for SAD diagnosis. Our pattern of fndings lends strong support to the notion that SAD may be better portrayed by a poor ability to recover following social exclusion than during social exclusion per se. These fndings value social neuroscience as an innovative procedure to gain new insight into the underlying mechanisms of SAD. [less ▲]

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See detailDifferential impairments across attentional networks in binge drinking.
Lannoy, Severine; Heeren, Alexandre; Moyaerts, Nathalie et al

in Psychopharmacology (2017), 234

RATIONALE: The cognitive deficits observed in young binge drinkers have been largely documented during the last decade. Yet, these earlier studies have mainly focused on high-level cognitive abilities ... [more ▼]

RATIONALE: The cognitive deficits observed in young binge drinkers have been largely documented during the last decade. Yet, these earlier studies have mainly focused on high-level cognitive abilities (particularly memory and executive functions), and uncertainty thus still abounds regarding the integrity of less complex cognitive processes in binge drinking. This is particularly true for attentional abilities, which play a crucial role in behavior regulation and are impaired in other alcohol-related disorders. OBJECTIVES AND METHODS: To specify the attentional deficits associated with binge drinking, two groups of university students (40 binge drinkers and 40 matched controls) performed the Attention Network Task, a theoretically grounded test assessing three independent attentional networks: alerting, orienting, and executive control. RESULTS: Binge drinkers displayed preserved orienting performance but impaired alerting and executive control. Binge drinking is thus not related to a general attentional impairment but rather to specific impairments of the alerting and executive control networks. CONCLUSIONS: These results underline that, beyond the already explored high-level deficits, binge drinking is also related to impairments for attentional abilities. In view of the role played by attentional impairments in alcohol dependence, the present data also suggest that rehabilitation programs should be developed to improve attentional abilities at the early stages of alcohol-related disorders. [less ▲]

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See detailImpact of transcranial direct current stimulation on attentional bias for threat: a proof-of-concept study among individuals with social anxiety disorder.
Heeren, Alexandre; Billieux, Joël UL; Philippot, Pierre et al

in Social cognitive and affective neuroscience (2017), 21

Cognitive models posit that social anxiety disorder (SAD) is associated with and maintained by attentional bias (AB) for social threat. However, over the last years, it has been suggested that AB in SAD ... [more ▼]

Cognitive models posit that social anxiety disorder (SAD) is associated with and maintained by attentional bias (AB) for social threat. However, over the last years, it has been suggested that AB in SAD may result from a decreased activation of the left prefrontal cortex, and particularly of its dorsolateral part (dlPFC). Accordingly, a transient increase of neural activity within the left dlPFC via non-invasive brain stimulation decreases AB in non-anxious control participants. Yet, none of these studies focused on SAD. This is especially unfortunate as SAD constitutes the main target for which a genuine reduction of AB may be most appropriate. In this experiment, we sought to investigate the causal influence of left dlPFC neuromodulation on AB among 19 female individuals with a DSM-5 diagnosis of SAD. We adopted a double-blind within-subject protocol in which we delivered a single-session of anodal versus sham transcranial Direct Current Stimulation (tDCS) over the left dlPFC during the completion of a probe discrimination task assessing AB. Consistent with our hypothesis, participants demonstrated a significant decrease in AB during the anodal tDCS over the left DLPFC relative to the sham stimulation. These findings value tDCS as an innovative procedure to gain new insight into the underlying mechanisms of SAD. [less ▲]

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See detailDissociating emotional and cognitive empathy in pre-clinical and clinical Huntington's disease.
Maurage, Pierre; Lahaye, Magali; Grynberg, Delphine et al

in Psychiatry research (2016), 237

Huntington's disease (HD) is centrally characterized by motor, neurocognitive and psychiatric symptoms, but impaired emotional decoding abilities have also been reported. However, more complex affective ... [more ▼]

Huntington's disease (HD) is centrally characterized by motor, neurocognitive and psychiatric symptoms, but impaired emotional decoding abilities have also been reported. However, more complex affective abilities are still to be explored, and particularly empathy, which is essential for social relations and is impaired in various psychiatric conditions. This study evaluates empathic abilities and social skills in pre-clinical and clinical HD, and explores the distinction between two empathy sub-components (emotional-cognitive). Thirty-six HD patients (17 pre-clinical) and 36 matched controls filled in the Empathy Quotient Scale, while controlling for psychopathological comorbidities. At the clinical stage of HD, no global empathy impairment was observed but rather a specific deficit for the cognitive sub-component, while emotional empathy was preserved. A deficit was also observed for social skills. Pre-clinical HD was not associated with any empathy deficit. Emotional deficits in clinical HD are thus not limited to basic emotion decoding but extend towards complex interpersonal abilities. The dissociation between impaired cognitive and preserved emotional empathy in clinical HD reinforces the proposal that empathy subtypes are sustained by distinct processes. Finally, these results underline the extent of distinct affective and social impairments in HD and the need to grasp them in clinical contexts. [less ▲]

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See detailAbstract and concrete repetitive thinking modes in alcohol-dependence.
Grynberg, Delphine; de Timary, Philippe; Philippot, Pierre et al

in Journal of addictive diseases (2016), 35(4), 238-243

Emotional and interpersonal deficits play a crucial role in alcohol-related disorders as they predict alcohol consumption and relapse. Recent models of emotion regulation in psychopathology postulate that ... [more ▼]

Emotional and interpersonal deficits play a crucial role in alcohol-related disorders as they predict alcohol consumption and relapse. Recent models of emotion regulation in psychopathology postulate that these deficits are centrally related to increased abstract/analytic repetitive thinking, combined with reduced concrete/experiential repetitive thinking. As this assumption has not been tested in addictions, this study aimed at investigating repetitive thinking modes in a large sample of alcohol-dependent individuals. One hundred recently detoxified alcohol-dependent individuals (29 females; mean age = 49.51-years-old) recruited during the 3rd week of their treatment in a detoxification center were compared to 100 healthy controls (29 females; mean age = 48.51-years-old) recruited in the experimenters' social network, matched at the group level for age, gender, and educational level. All participants completed the Mini Cambridge Exeter Repetitive Thought Scale measuring abstract/analytic and concrete/experiential repetitive thinking modes as well as complementary psychopathological measures (Beck Depression Inventory and State/Trait Anxiety Inventory). Alcohol-dependent individuals have similar levels of concrete repetitive thinking as controls but report significantly higher levels of abstract repetitive thinking (p < 0.001; d = 1.28). This effect remains significant after controlling for depression and anxiety. Relative to healthy controls, alcohol-dependent patients report more frequent use of abstract/analytic repetitive thinking, with preserved concrete/experiential thinking. Despite the cross-sectional nature of the study, the frequent use of abstract repetitive thinking thus appears to constitute a main feature of alcohol-dependence. [less ▲]

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See detailAre we overpathologizing everyday life? A tenable blueprint for behavioral addiction research.
Billieux, Joël UL; Schimmenti, Adriano; Khazaal, Yasser et al

in Journal of Behavioral Addictions (2015), 4(3), 119-23

Background Behavioral addiction research has been particularly flourishing over the last two decades. However, recent publications have suggested that nearly all daily life activities might lead to a ... [more ▼]

Background Behavioral addiction research has been particularly flourishing over the last two decades. However, recent publications have suggested that nearly all daily life activities might lead to a genuine addiction. Methods and aim In this article, we discuss how the use of atheoretical and confirmatory research approaches may result in the identification of an unlimited list of "new" behavioral addictions. Results Both methodological and theoretical shortcomings of these studies were discussed. Conclusions We suggested that studies overpathologizing daily life activities are likely to prompt a dismissive appraisal of behavioral addiction research. Consequently, we proposed several roadmaps for future research in the field, centrally highlighting the need for longer tenable behavioral addiction research that shifts from a mere criteria-based approach toward an approach focusing on the psychological processes involved. [less ▲]

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See detailApprendre à négliger le mauvais côté des choses: La modification des biais cognitifs
Ceschi, Grazia; Heeren, Alexandre; Billieux, Joël UL et al

in Van der Linden, Martial; Ceschi, Grazia; Billieux, Joël (Eds.) Interventions psychologiques en psychopathologie cognitive (2015)

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See detailAttentional alterations in alcohol dependence are underpinned by specific executive control deficits.
Maurage, Pierre; de Timary, Philippe; Billieux, Joël UL et al

in Alcoholism, clinical and experimental research (2014), 38(7), 2105-12

BACKGROUND: Attentional biases and deficits play a central role in the development and maintenance of alcohol dependence, but the underlying attentional processes accounting for these deficits have been ... [more ▼]

BACKGROUND: Attentional biases and deficits play a central role in the development and maintenance of alcohol dependence, but the underlying attentional processes accounting for these deficits have been very little explored. Importantly, the differential alterations across the 3 attentional networks (alerting, orienting, and executive control) remain unclear in this pathology. METHODS: Thirty recently detoxified alcohol-dependent individuals and 30 paired controls completed the Attention Network Test, which allow exploring the attentional alterations specifically related to the 3 attentional networks. RESULTS: Alcohol-dependent individuals presented globally delayed reaction times compared to controls. More centrally, they showed a differential deficit across attention networks, with a preserved performance for alerting and orienting networks but impaired executive control (p < 0.001). This deficit was not related to psychopathological comorbidities but was positively correlated with the duration of alcohol-dependence habits, the number of previous detoxification treatments and the mean alcohol consumption before detoxification. CONCLUSIONS: These results suggest that attentional alterations in alcohol dependence are centrally due to a specific alteration of executive control. Intervention programs focusing on executive components of attention should be promoted, and these results support the frontal lobe hypothesis. [less ▲]

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See detailIs there an all-embracing construct of emotion reactivity? Adaptation and validation of the emotion reactivity scale among a French-speaking community sample.
Lannoy, Severine; Heeren, Alexandre; Rochat, Lucien et al

in Comprehensive psychiatry (2014), 55(8), 1960-7

BACKGROUND: Emotion reactivity is defined as the extent to which an individual experiences emotions in response to a wide array of stimuli, intensely, and for a prolonged period. This construct is a key ... [more ▼]

BACKGROUND: Emotion reactivity is defined as the extent to which an individual experiences emotions in response to a wide array of stimuli, intensely, and for a prolonged period. This construct is a key psychological factor in the development and maintenance of psychopathological disorders. The aim of the current study was to develop and validate a French version of the Emotion Reactivity Scale (ERS), which gauges three aspects of emotion reactivity: (1) emotional sensitivity, (2) emotional intensity, and (3) emotional persistence. METHOD: The French ERS and both concurrent and divergent validated scales were administered to 258 participants from the community. RESULTS: Confirmatory factor analyses revealed good fit indices for: (1) a single-factor model, (2) a three-factor model, and (3) a hierarchical three-factor solution with a single-factor solution as a second-order latent variable for a generic construct of emotion reactivity. The French version of the Emotion Reactivity Scale also exhibits acceptable internal scale score reliability (total scale and subscales). Eventually, meaningful relationships were found between factors of emotion reactivity and depression, distinct aspects of impulsive behaviors, and maladaptive emotion regulation strategies. CONCLUSION: Findings of the confirmatory factor analyses are consistent with previous studies suggesting that the ERS is mainly captured by a single major construct of emotion reactivity. [less ▲]

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See detailProbing smoking craving with a multidimensional approach: validation of the 12-item French-language version of the Questionnaire on Smoking Urges.
Dethier, Vincent; Heeren, Alexandre; Galanti, Laurence et al

in Neuropsychiatric disease and treatment (2014), 10

BACKGROUND: The current study examined the psychometric properties of the 12-item French-language version of the Questionnaire on Smoking Urges (QSU-12), a widely used multidimensional measure of ... [more ▼]

BACKGROUND: The current study examined the psychometric properties of the 12-item French-language version of the Questionnaire on Smoking Urges (QSU-12), a widely used multidimensional measure of cigarette craving. METHODS: Daily smokers (n=230) completed the QSU-12, the Fagerstrom Test for Nicotine Dependence, and items about addiction-related symptoms. Additional participants (n=40) completed the QSU-12 and the Fagerstrom Test for Nicotine Dependence and were assessed for expired carbon monoxide. RESULTS: Consistent with studies validating the English version of the scale, confirmatory factor analyses supported a two-factor solution in the French version of the scale. Good scale and subscales reliabilities were observed, and convergent validity was evidenced through relationships with dependence and addiction-related symptoms. CONCLUSION: The French-language version of the QSU-12 is an adequate instrument to assess the multidimensional construct of craving in both research and clinical practice. [less ▲]

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See detailImplication des biais d’attention sélective dans l’alcoolo-dépendance : une revue conceptuelle et empirique
Deleuze, Jory; Heeren, Alexandre; Billieux, Joël UL et al

in Alcoologie et Addictologie (2013), 35(2), 127-135

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