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• W185019898 abstract "Opiate dependence is one of the most severe and intractable forms of drug addiction, and the treatment options currently available are limited in both range and effectiveness. There is growing evidence for the mediation of addictive behaviour via complex mechanisms involving neuropsychological, socio-cognitive, and genetic factors, and an understanding of how these factors interact may lead to the development of more effective treatment options. To date, the most intensively researched gene associated with addiction is the D2 dopamine Al allele. The D2 dopamine Al allele has been identified as a genetic marker for addiction severity, and may be a key mediator of the addiction process through its impact on dopaminergic functioning and the behaviours (eg. neuropsychological and socio-cognitive processes) that dopamine systems influence. A review of recent opiate dependence research in Chapter 2 identifies dysexecutive functioning as a key cognitive component related to dopamine function. The first study of this thesis (Chapter 3) presents a psychometric evaluation of the BADS DEX questionnaire, the first available published self-report measure of dysexecutive functioning, based on a combined sample of both university students and opiate dependent individuals. The second study (Chapter 4) validates the utility of the BADS DEX and other self-report measures of mood and impulsivity in distinguishing between opiate users and non-users. Consistent differences between these two groups on these measures were found, confirming the utility of the construct of dysexecutive function. The basis of the manifestation of this impulsivity in terms of drug related reinforcement is examined in the third study (Chapter 5). Chapter 5 investigates social-cognitive influences in opiate dependence using a new self-report measure of heroin expectancy and refusal self-efficacy, the Heroin Expectancy Profile (HEP). This study validates the HEP and indicates that there is a significant relationship between heroin expectancies, executive cognitive functioning, affect, and drug use severity within opiate users. The relationship between these differences in expectancies, executive functioning, affect and drug use severity with treatment outcome and different genotypes within opiate users is subsequently explored in the fourth study (Chapter 6). Specifically, this final study compares performance and treatment outcome in opiate dependent individuals with and without the Dopamine D2 receptor Al allele, using both self-report measures of behavioural correlates identified in earlier chapters as well as neuropsychological assessments of executive functioning. This final study attempts to make the link between the Al allele genotype and the clinical correlates that it putatively mediates. The concluding chapter (Chapter 7) reviews the main findings across these studies and their implications, including suggestions for future directions in this exciting and new area of research. These findings specifically suggest a role for executive dysfunction as a key vulnerability factor in the onset and maintenance of substance misuse, along with other associated behavioural symptoms of impulsivity and affective disturbance. These may form common features of a core disturbance in behavioural self-regulation. Future research could investigate these symptoms across different drug using populations using more sophisticated measures such as fMRI to explore more directly the link between these symptoms and the underlying neurobiological mechanisms that are likely to mediate such characteristics." @default.
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• W185019898 date "2004-01-01" @default.
• W185019898 modified "2023-09-27" @default.
• W185019898 title "Factors associated with opiate dependence : an interaction of cognitive, genetic and psychosocial influences on acquisition and outcome" @default.
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