Washington University School of Medicine Digital Commons@Becker Presentations 2005: Alcoholism and Comorbidity 2005 Comorbidity of alcoholism and antisocial personality disorder R. O. Pihl McGill University Follow this and additional works at: hp://digitalcommons.wustl.edu/guzepresentation2005 Part of the Medicine and Health Sciences Commons is Presentation is brought to you for free and open access by the 2005: Alcoholism and Comorbidity at Digital Commons@Becker. It has been accepted for inclusion in Presentations by an authorized administrator of Digital Commons@Becker. For more information, please contact [email protected]. Recommended Citation Pihl, R. O., "Comorbidity of alcoholism and antisocial personality disorder" (2005). Presentations. Paper 3 Samuel B. Guze Symposium on Alcoholism. hp://digitalcommons.wustl.edu/guzepresentation2005/3
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Washington University School of MedicineDigital Commons@Becker
Presentations 2005: Alcoholism and Comorbidity
2005
Comorbidity of alcoholism and antisocialpersonality disorderR. O. PihlMcGill University
Follow this and additional works at: http://digitalcommons.wustl.edu/guzepresentation2005Part of the Medicine and Health Sciences Commons
This Presentation is brought to you for free and open access by the 2005: Alcoholism and Comorbidity at Digital Commons@Becker. It has beenaccepted for inclusion in Presentations by an authorized administrator of Digital Commons@Becker. For more information, please [email protected].
Recommended CitationPihl, R. O., "Comorbidity of alcoholism and antisocial personality disorder" (2005). Presentations. Paper 3 Samuel B. Guze Symposiumon Alcoholism.http://digitalcommons.wustl.edu/guzepresentation2005/3
1. Threat, anxiety (novelty, cues of punishment, etc…)
2. Monotony (lack of immediate reinforcement)
• Genetically influenced susceptibility
1. Anxiety
2. Boredom
• Desired alcohol reinforcement
1. Anxiolysis (serotonin & GABA effects)
2. Stimulation (Dopaminergic effects)
Family
Pedigree
0
2
4
6
8
10
12
14
16*
Non-SOMAHe
art
Ra
te R
espon
se to A
lcoho
l In
toxic
ation
(Perc
ent C
han
ge)
SOMA
Low-Aggressive
High-Aggressive
0
100
200
300
400
500
600
*
Non-SOMA
No. of A
lcoho
lic B
eve
rage
s p
er
year
SOMA
Low-Aggressive
High-Aggressive
0
2
4
6
8
10
12
Alc
ohol-In
duced H
R C
hange fro
m B
aselin
e (
BP
M)
NFH F (N = 49)
NFH M (N = 99)
UFH F (N = 17)
UFH M (N = 30)
MFH F (N = 20)
MFH M (N = 92)
ALC M (N = 12)
-0.4
-0.3
-0.2
-0.1
0
0.1
0.2
0.3
0.4
SP SR
Dimensions of the SPSRQ
Z s
core
s on
th
e S
PS
RQ
Low HR responders
High HR responders
-0.5
-0.4
-0.3
-0.2
-0.1
0
0.1
0.2
0.3
0.4
0.5
H/I AS IMP SS
Dimensions of the SURPS
Z s
co
res
on
th
e S
UR
PS Low HR responders
High HR responders
-0.6
-0.4
-0.2
0.0
0.2
0.4
0.6
High Heart Rate
Responders
Low Heart Rate
RespondersZscore
(N
um
ber
of
"Ris
k T
akin
g"
Responses)
Sober
Intoxicated
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
Positron Emission
Tomography
Alcohol Promotes Dopamine Release in the
Human Nucleus Accumbens
…and this release is
associated to an
increased HR response
to alcohol
Background
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
Drinks earned following APTD
0
5
10
15
Relative number of drinks compared to balanced
condition
Nu
mb
er o
f S
ub
ject
s
More
Same
Less
Alcohol consumption
0
1
2
3
4
5
High Low
Dri
nk
s
Balanced Depleted
APTD Change in Drinking and Ethanol Cardiac Response
r=.-658, p=.006
percent change in earned drinks
3002001000-100-200
pe
rce
nt
cha
ng
e in
he
art
ra
te
30
20
10
0
-10
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
-0.8
-0.6
-0.4
-0.2
0.0
0.2
0.4
0.6
0.8
* p < 0.05
*
High Heart Rate Responders
to Alcohol Intoxication
Low Heart Rate Responders
to Alcohol Intoxication
Zsco
re (
Go
ldb
erg
's A
dje
ctive
Ma
rke
rs o
f th
e B
ig F
ive
) Agreeableness
Conscientiousness
Emotional Stability
Extraversion (Surgency)
Intellect
Figure 3 - Mean group differences (+ SE) between Low (n