Comorbidity of alcoholism and antisocial personality disorder
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Comorbidity of Alcoholism and Antisocial Personality Disorder. R.O. Pihl McGill University. Alcoholism & ASPD. Lets avoid the definitional quagmire. Lets agree there is a significant correlation between Alcoholism and ASPD.

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Comorbidity of alcoholism and antisocial personality disorder

Comorbidity of Alcoholism and Antisocial Personality Disorder

R.O. Pihl

McGill University


Alcoholism aspd
Alcoholism & ASPD Disorder

  • Lets avoid the definitional quagmire.

  • Lets agree there is a significant correlation between Alcoholism and ASPD.

  • Lets agree that the nature of the relationship is well understood.


The role of different motivational systems
The Role of Different Motivational Systems Disorder

  • Motivational system responding to threat

  • The Cognitive Control System

  • Motivational system responding to reward


Behavior Disorder

(Behaviorally-linked)

Sensory information

Aggression

Threatening or punishing

behavior

Executive Cognitive Functions

Facilitory:

Cue for Reward

Inhibitory:

Cue for Punishment


Behavior Disorder

(Behaviorally-linked)

Sensory information

Inhibits

Aggression

Threatening or punishing

behavior

Executive Cognitive Functions

Facilitory:

Cue for Reward

Inhibitory:

Cue for Punishment

Acute

Alcohol

Intoxication


Behavior Disorder

(Behaviorally-linked)

Sensory information

Inhibits

Aggression

Threatening or punishing

behavior

Executive Cognitive Functions

Disorganizes

Facilitory:

Cue for Reward

Inhibitory:

Cue for Punishment

Acute

Alcohol

Intoxication


Behavior Disorder

(Behaviorally-linked)

Sensory information

Inhibits

Aggression

Threatening or punishing

behavior

Executive Cognitive Functions

Disorganizes

Facilitory:

Cue for Reward

Inhibitory:

Cue for Punishment

Acute

Alcohol

Intoxication

Potentiates


The role of different motivational systems1
The Role of Different Motivational Systems Disorder

  • Environmental triggers

    • Threat, anxiety (novelty, cues of punishment, etc…)

    • Monotony (lack of immediate reinforcement)

  • Genetically influenced susceptibility

    • Anxiety

    • Boredom

  • Desired alcohol reinforcement

    • Anxiolysis (serotonin & GABA effects)

    • Stimulation (Dopaminergic effects)


Family Pedigree Disorder


Subjects with a high heart rate response to alcohol challenge
Subjects with a High Heart rate Response to Alcohol Challenge

  • Self-rate more of a positive response

  • Drink more

  • Remember more words learned before drinking

  • Release more dopamine in the Ventral Striatum



Alcohol Promotes Dopamine Release in the Human Nucleus Accumbens

…and this release is associated to an increased HR response to alcohol


Background
Background Accumbens

Phenylalanine and tyrosine, two amino acids (AA)found in dietary protein, are the essential building blocks for the production of dopamine in the brain.

Ingesting an AA mixture deficient in P&T reduces DA production by 1)causes protein synthesis diminishing the body’s stores of these AA 2) increasing competition of other AAs for transport across the blood brain barrier.

Peek effect of depletion occur 4-5 hours following the ingestion of the AA mixture



Figure 1 - Mean group differences (+ SE) between Low (n = 19) and High (n = 19) Heart Rate Responders in the average of age 10 to 17 delinquency scores


Figure 2 - Mean group differences (+ SE) between Low (n = 18) and High (n = 20) Heart Rate Responders in Goldberg's Adjective Markers of the Big Five assessed at age 19


Figure 3 - Mean group differences (+ SE) between Low (n = 20) and High (n = 22) Heart Rate Responders in Subjective High Assessment Scale (SHAS) at age 19


Apparatus taylor aggression paradigm tap
Apparatus: Taylor Aggression Paradigm (TAP) 20) and High (n = 22) Heart Rate Responders in Subjective High Assessment Scale (SHAS) at age 19


TAP - Mean Shock Level Selected 20) and High (n = 22) Heart Rate Responders in Subjective High Assessment Scale (SHAS) at age 19


Commonalities alcoholism aspd
Commonalities Alcoholism & ASPD 20) and High (n = 22) Heart Rate Responders in Subjective High Assessment Scale (SHAS) at age 19

  • Unusual high heart rate response to high dose of alcohol.

  • High activation of the Cue for Reward System.

  • A system that is dopamine mediated.

  • Reduced ECF functioning.


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