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      Testing the transdiagnostic hypothesis of inhibitory control deficits in addictions: An experimental study on gambling disorder

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          Abstract

          Background and aims

          Many psychopathologies, including addictions, are characterized by inhibitory control deficits. In this regard, recent studies on substance-related disorders (SRD) have shown an impairment in the ability to inhibit potentially interfering memories, despite preserved motor inhibition. To investigate whether the same dissociation could also characterize gambling disorder (GD) in a transdiagnostic perspective, we tested both cognitive and motor inhibitory processes through dedicated tasks, for the first time in this behavioral addiction.

          Methods

          30 outpatients with GD and 30 healthy controls performed a go/no-go task addressing the integrity of motor inhibition, and the Retrieval Practice Paradigm, a task addressing the integrity of memory inhibition as indexed by the Retrieval-Induced Forgetting (RIF) effect. Self-report questionnaires assessing impulsivity were also administered.

          Results

          Whereas RIF was similar across the two groups, patients showed more commission errors in the go/no-go task, and higher self-rated scores of impulsivity than controls.

          Discussion

          The present findings suggest preserved memory inhibition and impaired motor response inhibition in GD, a pattern of inhibitory deficits opposite to that previously reported for SRD. Therefore, although both GD and SRD are characterized by altered inhibitory processing, a more fine-grained analysis revealed a specific inhibitory profile indicating vulnerability in different inhibitory components.

          Conclusion

          The present study highlights the need to investigate the multifaceted construct of inhibition more thoroughly, using performance measures able to assess its various components. This approach would enable to both better characterize different psychopathologies and orient their treatment.

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          Most cited references42

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          Executive Functions

          Executive functions (EFs) make possible mentally playing with ideas; taking the time to think before acting; meeting novel, unanticipated challenges; resisting temptations; and staying focused. Core EFs are inhibition [response inhibition (self-control—resisting temptations and resisting acting impulsively) and interference control (selective attention and cognitive inhibition)], working memory, and cognitive flexibility (including creatively thinking “outside the box,” seeing anything from different perspectives, and quickly and flexibly adapting to changed circumstances). The developmental progression and representative measures of each are discussed. Controversies are addressed (e.g., the relation between EFs and fluid intelligence, self-regulation, executive attention, and effortful control, and the relation between working memory and inhibition and attention). The importance of social, emotional, and physical health for cognitive health is discussed because stress, lack of sleep, loneliness, or lack of exercise each impair EFs. That EFs are trainable and can be improved with practice is addressed, including diverse methods tried thus far.
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            Research domain criteria (RDoC): toward a new classification framework for research on mental disorders.

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              The endophenotype concept in psychiatry: etymology and strategic intentions.

              Endophenotypes, measurable components unseen by the unaided eye along the pathway between disease and distal genotype, have emerged as an important concept in the study of complex neuropsychiatric diseases. An endophenotype may be neurophysiological, biochemical, endocrinological, neuroanatomical, cognitive, or neuropsychological (including configured self-report data) in nature. Endophenotypes represent simpler clues to genetic underpinnings than the disease syndrome itself, promoting the view that psychiatric diagnoses can be decomposed or deconstructed, which can result in more straightforward-and successful-genetic analysis. However, to be most useful, endophenotypes for psychiatric disorders must meet certain criteria, including association with a candidate gene or gene region, heritability that is inferred from relative risk for the disorder in relatives, and disease association parameters. In addition to furthering genetic analysis, endophenotypes can clarify classification and diagnosis and foster the development of animal models. The authors discuss the etymology and strategy behind the use of endophenotypes in neuropsychiatric research and, more generally, in research on other diseases with complex genetics.
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                Author and article information

                Contributors
                Journal
                J Behav Addict
                J Behav Addict
                JBA
                Journal of Behavioral Addictions
                Akadémiai Kiadó (Budapest )
                2062-5871
                2063-5303
                June 2020
                16 June 2020
                : 9
                : 2
                : 339-346
                Affiliations
                [1 ]deptDepartment of Life Sciences, University of Trieste , Via Weiss, 21, I-34128, Trieste, Italy
                [2 ]deptDepartment of Developmental and Social Psychology, University of Padova , Via Venezia, 8, I-35131, Padova, Italy
                [3 ]Unità Locale Socio Sanitaria , Belluno, Italy
                [4 ]Azienda per l'Assistenza Sanitaria 2 Bassa Friulana-Isontina , Italy
                Author notes
                [* ]Corresponding author. E-mail: bpenolazzi@ 123456units.it
                [** ]Corresponding author. E-mail: giovanni.galfano@ 123456unipd.it
                Author information
                https://orcid.org/0000-0001-8717-6233
                https://orcid.org/0000-0001-5327-4062
                Article
                10.1556/2006.2020.00021
                8939424
                32554838
                aa4e155e-2b0c-42ff-83e7-ec29c08b659e
                © 2020 The Author(s)

                Open Access statement. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited, a link to the CC License is provided, and changes – if any – are indicated.

                History
                : 18 January 2020
                : 04 April 2020
                : 08 March 2020
                : 11 April 2020
                Page count
                Tables: 02, References: 42, Pages: 08
                Funding
                Funded by: University of Padova
                Categories
                Full-length Report

                gambling,addictive disorders,substance-related disorders,response inhibition,retrieval-induced forgetting,transdiagnostic approach

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