Lower cognitive reappraisal capacity is related to impairments in attachment and personality structure in poly-drug use:
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ORIGINAL RESEARCH
Lower cognitive reappraisal capacity is related to impairments in attachment and personality structure in poly-drug use: an fMRI study M. Hiebler-Ragger 1,2 & C. M. Perchtold-Stefan 3 & H. F. Unterrainer 1,2,4 & J. Fuchshuber 1,2 & K. Koschutnig 3 L. Nausner 5 & H. P. Kapfhammer 1,6 & I. Papousek 3 & E. M. Weiss 7 & A. Fink 3
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Accepted: 30 October 2020 # The Author(s) 2020
Abstract Insecure attachment, impaired personality structure and impaired emotion regulation figure prominently in substance use disorders. While negative emotions can trigger drug-use and relapse, cognitive reappraisal may reduce emotional strain by promoting changes in perspective. In the present study, we explored behavioral and neural correlates of cognitive reappraisal in poly-drug use disorder by testing individuals’ capability to generate cognitive reappraisals for aversive events (Reappraisal Inventiveness Test). 18 inpatients with poly-drug use disorder and 16 controls completed the Adult Attachment Scale, the Emotion Regulation Questionnaire, the Brief Symptom Inventory, the Wonderlic Personnel Test, and the Operationalized Psychodynamic Diagnosis Structure Questionnaire, as well as two versions of the Reappraisal Inventiveness Test (during fMRI and outside the lab). Compared to controls, polydrug inpatients reported impaired personality structure, attachment and emotion regulation abilities. In the Reappraisal Inventiveness Test, poly-drug inpatients were less flexible and fluent in generating reappraisals for angereliciting situations. Corresponding to previous brain imaging evidence, cognitive reappraisal efforts of both groups were reflected in activation of left frontal regions, particularly left superior and middle frontal gyri and left supplemental motor areas. However, no group differences in neural activation patterns emerged. This suggests that despite cognitive reappraisal impairments on a behavioral level, neural reflections of these deficits in poly-drug use disorder might be more complex. Keywords Cognitive reappraisal . Polydrug use . fMRI . Attachment . Emotion regulation
Introduction * C. M. Perchtold-Stefan [email protected] 1
University Clinic of Psychiatry and Psychotherapeutic Medicine, Medical University, Auenbruggerplatz 31, 8036, Graz, Austria
2
Center for Integrative Addiction Research (CIAR), Grüner Kreis Society, Simmeringer Hauptstraße 101, 1110 Vienna, Austria
3
Institute of Psychology, University of Graz, Universitätsplatz 2, 8010 Graz, Austria
4
Department of Religious Studies, University of Vienna, Schenkenstraße 8-10, 1010 Vienna, Austria
5
Fachsektion Integrative Gestalttherapie, Österreichischer Arbeitskreis für Gruppentherapie und Gruppendynamik, Lenaugasse 3, 1080 Vienna, Austria
6
Department of Medical Psychology and Psychotherapy, Medical University of Graz, Auenbruggerplatz 43, 8036, Graz, Austria
7
Institute of Psychology, University of Innsbruck, Innrain 52f, 6020 Innsbruck, Austria
Impairments in the processing and regulation of emotion represen
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