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2 results

  • 31 - Considering the Overlap and Nonoverlap of Compulsivity, Impulsivity, and Addiction

  • from Part V - Ongoing and Future Research Directions
  • Edited by Steve Sussman, University of Southern California
  • Book:
    The Cambridge Handbook of Substance and Behavioral Addictions
    Published online:
    13 July 2020
    Print publication:
    06 August 2020, pp 373-385

  • Summary

    Impulsivity and compulsivity are the defining features of various psychiatric disorders, including attention-deficit/hyperactivity disorder, obsessive–compulsive disorder, and behavioral and substance addictions. Once thought to be diametrically opposed, compulsivity and impulsivity are increasingly recognized as orthogonal symptom dimensions that are linked by shared neurobiological mechanisms. This chapter selectively reviews impulsivity and compulsivity from a transdiagnostic perspective. It begins by discussing the neurobiology of impulsivity and compulsivity and the relationship of these constructs to addictive disorders. The chapter then discusses the clinical features of specific compulsive and impulsive disorders (as well as gambling disorder, a putative behavioral addiction), with a focus on comorbidity and treatment. The complex interrelationships among compulsive, impulsive, and addictive disorders have implications for how these disorders are assessed and treated.

  • Emotional processing and executive functions in major depressive disorder: dorsal prefrontal activity correlates with performance in the intra–extra dimensional set shift

  • Alexander Heinzel, Georg Northoff, Heinz Boeker, Peter Boesiger, Simone Grimm
  • Journal:
    Acta Neuropsychiatrica / Volume 22 / Issue 6 / December 2010
    Published online by Cambridge University Press:
    24 June 2014, pp. 269-279

  • Heinzel A, Northoff G, Boeker H, Boesiger P, Grimm S. Emotional processing and executive functions in major depressive disorder: dorsal prefrontal activity correlates with performance in the intra–extra dimensional set shift.

    Objective:

    Major depressive disorder (MDD) is characterised by predominately negatively valenced emotional symptoms that are often accompanied by cognitive impairments. We posited that cognitive impairments in MDD are related to altered emotional processing in prefrontal cortex.

    Methods:

    We compared 20 medication-free patients with MDD and 29 matched healthy controls. Both groups performed an emotional task during functional magnetic resonance imaging (fMRI). Furthermore, they completed the intra–extra dimensional set shift (IED) test probing for cognitive impairments. Then we correlated the results of the IED with the changes in fMRI BOLD signal in MDD patients and healthy subjects.

    Results:

    The subcategory of the IED applying extradimensional shift (EDS) showed a divergent performance of the MDD group committing significantly more errors than the control group. Correlating the EDS errors with fMRI signal changes, the healthy subjects showed a positive correlation with the right ventrolateral prefrontal cortex and the right orbitofrontal cortex. MDD subjects, in contrast, showed a positive correlation in right dorsolateral prefrontal cortex (DLPFC) and a negative correlation in the left dorsomedial prefrontal cortex (DMPFC).

    Conclusion:

    We hypothesise that the differential correlation in healthy controls and MDD patients may reflect the use of different strategies in their performance. The impaired executive functions, as reflected by altered processing in right DLPFC and left DMPFC, may implicitly influence emotional processing in patients suffering from MDD.