RP7: Implicit associations and altered cue-associated impulse control in gaming disorder, gambling disorder, and alcohol-use disorder

成瘾的双过程理论区分了与成瘾行为有关的外显认知和内隐认知。他们还区分了受控(反思)和自动(冲动)系统，并认为受控加工与外显认知有关，而自动加工与内隐认知有关。外显认知经常与执行功能有关，这可能是自上而下的过程，与前额叶皮质的完整性有关，潜在地控制着内隐认知和情感过程，如渴望和激励突显。执行功能缺陷被认为既是成瘾行为发展的脆弱因素，也是物质使用障碍的潜在后果。此外，有人认为，可能被描述为情感过程(如渴望)和外显认知(如抑制控制)之间相互作用的决策在物质使用障碍和成瘾行为中受到损害，这表现为对短期奖励选择的偏好，这可能与长期的负面后果有关。本研究旨在探讨游戏障碍、赌博障碍和酒精使用障碍患者的内隐认知、刺激特异性抑制控制、刺激特异性监控功能与成瘾相关刺激对抗决策之间的关系。这三种障碍在ICD-11中被归类为因药物使用或成瘾行为造成的障碍类别。有可靠的证据，包括荟萃分析的结果，表明患有游戏障碍、赌博障碍和物质使用障碍(例如酒精使用障碍)的人的内隐和外显认知发生了变化。以往的研究大多集中在内隐或外显认知功能的单个方面，而没有考虑成瘾相关线索中内隐认知和外显认知之间的交互作用。这些相互作用将被调查并在所有三种提到的障碍之间进行比较。这项研究将包括四组参与者：1)游戏障碍患者，2)赌博障碍患者，3)酒精使用障碍患者，4)健康对照组。除了针对核心电池的诊断、实验和神经心理学任务的调查和结构化访谈外，还将实施内隐联想测试、平衡切换任务、爱荷华州赌博任务以及额外评估皮肤电导反应的任务，每项任务都使用与成瘾相关的刺激。该研究项目与Rp4评估游戏障碍和色情使用障碍下的模糊决策密切相关，Rp5评估购买购物障碍和社交网络使用障碍的内隐认知，RP8评估社交网络使用障碍和烟草使用障碍的内隐认知。

Dual-process theories of addiction differentiate between explicit and implicit cognitions involved in addictive behaviors. They also distinguish between a controlled (reflective) and an automatic (impulsive) system and argue that controlled processing is associated with explicit cognitions, while automatic processing is linked to implicit cognitions. Explicit cognitions are frequently associated with executive functions, which may act as top-down processes linked to prefrontal cortex integrity, potentially controlling implicit cognitions and affective processes like craving and incentive salience. Deficits in executive functions have been considered both as vulnerability factors for the development of addictive behaviors and as potential consequences of substance-use disorders. Furthermore, it is argued that decision making, which may be characterized as the result of the interaction between affective processes (e.g., craving) and explicit cognitions (e.g., inhibitory control) is impaired in substance use disorders and addictive behaviors in terms of a preference for short-term rewarding options which may be linked to negative consequences in the long term. This project aims at investigating the relationships between implicit cognitions, stimulus-specific inhibitory control, stimulus-specific monitoring functions, and decision making upon confrontation with addiction-related stimuli in gaming disorder, gambling disorder, and alcohol-use disorder. These three disorders have been classified in the ICD-11 within the category of disorders due to substance use or addictive behaviors. There is reliable evidence, including results from meta-analyses, of altered implicit and explicit cognitions in individuals with gaming disorder, gambling disorder and substance-use disorders (e.g., alcohol-use disorder). Most previous studies focused on single aspects of either implicit or explicit cognitive functions and did not consider interactions among implicit and explicit cognitions when addiction-related cues are involved. These interactions will be investigated and compared between all three mentioned disorders. Four groups of participants will be included in the study: patients with 1) gaming disorder, 2) gambling disorder, 3) alcohol-use disorder, and 4) healthy controls. Besides the surveys and structured interviews for the diagnostics and the experimental and neuropsychological tasks of the core battery, an Implicit Association Test, the Balanced Switching Task, the Iowa Gambling Task with additional assessment of skin conductance response, each task using addiction-related stimuli, will be administered. The research project is strongly linked to RP4 assessing decision making under ambiguity in gaming disorder and pornography-use disorder, RP5 assessing implicit cognitions in buying-shopping disorder and social-networks-use disorder, and RP8 assessing implicit cognitions in social-networks-use disorder and tobacco-use disorder.