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Alcohol dependence and anxiety increase error-related brain activity

Authors

  • Arnt F. A. Schellekens,

    Corresponding author
    1. Department of Psychiatry, University Medical Centre St Radboud, Nijmegen, the Netherlands,
    2. Nijmegen Institute for Science Practitioners in Addiction, Radboud University Nijmegen, Nijmegen, the Netherlands
    3. Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, the Netherlands
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  • Ellen R. A. De Bruijn,

    1. Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, the Netherlands
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  • Christa A. A. Van Lankveld,

    1. Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, the Netherlands
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  • Wouter Hulstijn,

    1. Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, the Netherlands
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  • Jan K. Buitelaar,

    1. Department of Psychiatry, University Medical Centre St Radboud, Nijmegen, the Netherlands,
    2. Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, the Netherlands
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  • Cor A. J. De Jong,

    1. Nijmegen Institute for Science Practitioners in Addiction, Radboud University Nijmegen, Nijmegen, the Netherlands
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  • Robbert J. Verkes

    1. Department of Psychiatry, University Medical Centre St Radboud, Nijmegen, the Netherlands,
    2. Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, the Netherlands
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Arnt F. A. Schellekens, Radboud Medical Centre Nijmegen, Department of Psychiatry (966), PO Box 9101, Reinier Postlaan 10, 6500 HB, Nijmegen, the Netherlands. E-mail: a.f.a.schellekens@psy.umcn.nl

ABSTRACT

Aims  Detection of errors is crucial for efficient goal-directed behaviour. The ability to monitor behaviour is found to be diminished in patients with substance dependence, as reflected in decreased error-related brain activity, i.e. error-related negativity (ERN). The ERN is also decreased in other psychiatric disorders with impaired response inhibition, such as attention-deficit hyperactivity disorder and borderline personality disorder, but increased in anxiety disorders. The objective of the current study was to assess error monitoring in alcohol-dependent patients in relation to psychiatric comorbidity. We expected decreased error monitoring in alcohol-dependent patients with impulse control disorders and increased error monitoring in anxious alcohol-dependent patients.

Design  In a case–control design alcohol-dependent patients were compared with healthy controls.

Setting and participants  A consecutive series of 29 male alcohol-dependent patients, between 18 and 55 years of age, applying for in-patient detoxification were recruited at Novadic Kentron Center for Addiction Treatment. Fifteen age-matched healthy controls were recruited through advertisements in regional newspapers.

Measurements  Event-related potentials were recorded while performing a speeded choice-reaction task, from which ERN amplitudes were calculated. Axis-I and -II psychiatric comorbidity were assessed using the MINI International Neuropsychiatric Interview and the Structured Interview for DSM-IV Personality disorders. All participants completed the Temperament and Character Inventory and Profile of Mood States.

Findings  ERN amplitudes were increased for alcohol-dependent patients compared to healthy controls, particularly in patients with comorbid anxiety disorders.

Conclusions  Increased error monitoring in alcohol-dependent patients, particularly those with comorbid anxiety disorders, is in contrast with previous studies that suggested decreased error monitoring to be a general feature in substance use disorders. Psychiatric disorders co-occurring with alcohol dependence, such as anxiety disorders, may indicate subpopulations of alcohol-dependent patients, with distinct neurobiological and genetic characteristics, possibly requiring different treatment strategies.

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