Symmetrical effects of amphetamine and alpha-flupenthixol on conditioned punishment and conditioned reinforcement: contrasts with midazolam

Killcross, A.S., Everitt, B.J., & Robbins, T.W. (1997). Symmetrical effects of amphetamine and alpha-flupenthixol on conditioned punishment and conditioned reinforcement: contrasts with midazolam. Psychopharmacology, 129, 141-152.

There is evidence to suggest that forebrain dopaminergic systems are likely to be involved in both appetitive and aversive motivation. These authors studied the effects of dopamine (DA) agents on conditioned punishment (aversive learning) and conditioned reinforcement (appetitive learning) paradigms using DA agonists and antagonists injected systemically. In conditioned punishment, a Pavlovian CS predicting punishment is added to an instrumental bar-pressing paradigm, but only on one of the bars. Normal animals will adjust their bar-pressing away from this lever. (Note: These authors, however, implemented a punishment procedure by presenting a CS and shock upon bar-press, rather than a conditioned punishment procedure which would only present the CS upon bar-press). In conditioned reinforcement, a CS predicting reward is added to the instrumental bar-pressing paradigm on one of the bars. Animals will naturally come to favor this bar paired with the appetitive CS.

DA agonists increased the effect of a punishing CS, causing the animals to further decrease their bar pressing. DA agonists also enhanced the effect of an appetitive CS, increasing bar pressing. DA antagonists, on the other hand, decreased the effect of a punishing CS. They also reduced the effect of an appetitive CS. Thus, it appears dopaminergic agents modulate the behavioral impact of both appetitively and aversively motivated conditioned stimuli on instrumental performance. Systemic benzodiazepene administration was also explored with results showing a selective impact on aversively-motivated stimuli (i.e. no effect on the appetitive CS).

Relapse Prevention for Alcohol and Drug Problems

Witkiewitz, K. & Marlatt, G.A. (2004). Relapse Prevention for Alcohol and Drug Problems. American Psychologist, 59, 4, 224-235.

Relapse prevention (RP) is a cognitive-behavioral approach with the goal of identifying and preventing high-risk situations such as substance abuse, obsessive-compulsive behavior, sexual offending, obesity, and depression. Relapse is seen as both an outcome and as a transgression in the process of behavior change. An initial setback (lapse) may either translate into a return to the previous problematic behavior (relapse) or into the individual turning again towards positive change (prolapse). That individuals commonly experience lapses, and even relapses, is not contested. However, an understanding of this phenomenon continues to evolve.

Relapse is thought to be multi-determined, especially by self-efficacy, outcome expectancies, craving, motivation, coping, emotional states, and interpersonal factors. High self-efficacy, negative outcome expectancies, potent availability of coping skills following treatment, positive affect, and functional social support are expected to predict positive outcome. Craving has not historically been shown to serve as a strong predictor.

The article proposes a new reconceptualization of relapse as a multidimensional, complex system. Such a nonlinear dynamical system is believed to be able to best predict the data witnessed, which commonly includes cases where small changes introduced into the equation seem to have large effects. The model also introduces concepts of self-organization, feedback loops, timing/context effects, and interplay between tonic and phasic processes. The effectiveness and efficacy of RP for various goals is also discussed in the article.

(I, Doug Girard, am the author of this article, Relapse Prevention, and I release its content under the terms of the GNU Free Documentation License, Version 1.2 and later.)

Marijuana use as a coping response

Preston, P. (2006). Marijuana use as a coping response to psychological strain: racial, ethnic, and gender differences among young adults. Deviant Behavior, 27, 397-420.

Besides tobacco and alcohol, marijuana is the most frequently used and abused substance. This study used data taken from the National Household Survey of Drug Abuse (from all 50 states), and examined 4601 subjects between the ages of 18-25 who used marijuana within the past year. Their dependent variable was marijuana use frequency, defined as either recreational or chronic, with chronic being greater than 12 times per month. Independent variables measured included strain, economic strain, norms favorable to drug use, number of friends who use drugs, and attitudes towards risky behavior. Results were also examined through the lenses of gender, ethnicity, marital status, employment status, and education.

Results indicate that social learning factors have the strongest effect on chronic marijuana use, operationalized as the number of friends who use drugs and a personal approval of drug use. Strain (operationalized as social nervousness) had the next strongest effect. Self control had a weak effect overall. High school dropouts and the unmarried were found to be particularly at risk for becoming chronic users. Strain appeared to have a stronger effect on minority groups, possibly suggesting fewer alternative coping strategies in this population. Minority women experience a "double-whammy", more likely than their nonminority counterparts to be chronic users and also more likely to be affected by social learning and self control variables.

Serotonin and Hallucinogens

Aghajanian, G.K. & Marek, G.J. (1999). Serotonin and Hallucinogens. Neuropsychopharamcology, Vol. 21, No. 2S.

Many possibilities are offered as to how LSD and other hallucinogens create their unusual psychoactive effects. The article gets very specific with different serotonin sub-types in different brain regions being implicated. I find the article and the facts confusing enough to assume that the complicated effect enacted in the use of such psychedelics will be only be fully understood after considerably more research.

Psychedelic Medicine

Horgan, J. (February 26, 2005). Psychedelic Medicine: Mind bending, health giving. New Scientist.

A typical overview of the tumultuous history of the use of psychedelics in medicine and therapy by science writer John Horgan. I found the 'Psychedelic Healing' more interesting and informative; I would recommend reading this instead.

Psychedelic Healing?

Brown, D.J. (January 2008). Psychedelic Healing? Scientific American Mind, 66-71.

Between 1897 and 1972, many studies were conducted on the therapeutic effects of psychotropic drugs; however, there were virtually no such studies conducted between 1972 and 1990 largely due to political reasons. Since then, research has begun anew, specifically into tryptamines (e.g. LSD, psilocybin) and phenethylamines (e.g. mescaline, MDMA). Tryptamine hallucinogens are thought to bind to serotonin-2A receptors in the cortex, effectively interfering with the processing of sensory information. The beneficial effects observed, such as positive changes in mood, reduction of anxiety, and raising of the pain threshold, may arise from subsequent 5HT-2A receptor downregulation. Phenethylamines are believed to mimic the effects of the dopamine neurotransmitter, but may also bind to the same serotonin receptors activated by the tryptamines. As psychedelics are known to elicit behavioral processes that are useful in the therapeutic context, such as enhanced symbolism and imagery, increased suggestibility, increased contact between emotions and ideations, and controlled regression, with the proper set and setting drug-assisted psychotherapy may show the potential to relieve patients who suffer with treatment-resistant psychiatric disorders.

Bored?

Gosline, A. (December 2007.) Bored?, Scientific American Mind.

This article suggests boredom is not merely the result of circumstance. Instead, it may also be affected by emotional factors, personality traits, and attention. It may also come in many varieties, ranging from situational boredom to pathological boredom. People who are predisposed to boredom are more likely to suffer from ills such as depression and drug addiction; they also tend to be socially awkward and poor performers at school or work. A Boredom Proneness Scale (BPS), developed by Richard Farmer at the University of Oregon, may help clinicians to identify boredom as a component of other ailments.

Boredom is complicated, but what we have learned from research suggests low arousal and insufficient motivation both play critical roles in this cognitive state. Men are more likely to be bothered by boredom than women. "Men are more likely to say, ‘There is not enough stuff coming through the environment, and that’s why I am bored.’" Similarly, extroverts seem to be more susceptible, requiring a constant and changing supply of stimulation to achieve optimal arousal levels.

Boredom may also be related to the struggle to maintain attention, a pathological inability to focus. Scores on the BPS were correlated with measures for adult ADHD. A chronic inability to focus on activities may render them effectively meaningless. Psychologist Al Cheyne goes so far as to say, "Attention is the common link between lack of meaning, depression and boredom." Others describe boredom as the antithesis of 'flow' (when a person's skills match the challenge presented by the environment). Tasks that are too easy are quickly boring.

Emotional factors may also play a part. Obsessive mood monitoring seems to detract from intense concentration and thus full engagement in the activity at hand. And boredom can arise from an inability to identify activities that will lead to personal happiness and fulfillment. An inability to know what will make you happy can lead to a more profound existential ennui arising from a pervasive sense of meaninglessness. Existential boredom might also occur when a person abandons important drives, desires, and life goals. Thus, being bored is a form of disengagement from the world.

The article suggests methods of combating boredom on all of these axes. Changing jobs or the complexity of tasks, beginning new hobbies and interests, developing inner skills for stimulation, and being more mindful of the beauty of self and surroundings may all help.

The Quest for a Smart Pill

Hall, S. S. (September 2003). The Quest for a Smart Pill, Scientific American, Vol. 289 (Issue 3).

This article shines light on a relatively new class of drugs that has cognitive enhancement effects such as improved memory, increased alertness, and better overall mental acuity. While this may seem like good news for the many people worldwide who already suffer cognitive impairments as the result of neurodegenerative diseases, aging, stroke, or retardation, others question how these drugs may be “abused” by the normal population for daily performance enhancement. As the science and engineering pushes quickly ahead, bioethicists are left playing catch-up, contemplating and debating the social dangers of the widespread use of these substances as “lifestyle” drugs.