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Maarefvand M.,University of Social Welfare and Rehabilitation Sciences | Ghiasvand H.R.,Islamic Azad University at Saveh | Ekhtiari H.,Tehran University of Medical Sciences | Ekhtiari H.,Iranian Institute for Cognitive science Studies ICSS
Iranian Journal of Psychiatry | Year: 2013

Objective: Drug craving is defined as an urge to continue substance abuse. Drug dependents use different terms to express their subjective feeling of craving. This study was an attempt to generate an understanding of craving terminology among different groups of Persian speaking Iranian opiate dependents. Method: Terms used for the meaning of drug craving were listed by 36 ex-opiate dependents in focus group discussion meetings in the first phase of the study. These terms were composed from Craving Terms Questionnaire. In the second phase, 120 subjects in 3 groups of opiate dependents and a group of Current Opiate Abusers rated usage frequency of each term in the questionnaire under a Twelve-Step Program, Methadone Maintenance, and Other Abstinence-based Programs. Results: Eighty nine terms were categorized in stimulation and triggering, attention bias and obsession, decision making difficulty, information processing impairment, withdrawal induction, drug euphoric experience, mental urge, motor control problem, negative valancing and stigmatizing. Terms for the three categories of mental urge, attention bias and obsession and motor control problem were used more than others. Patients in Methadone Maintenance Treatment (MMT) group used different categories of craving terms in comparison to other groups. Abstinent cases reported higher total score for craving terms in comparison to other groups in Twelve-Step Program and other abstinence-based programs. Conclusion: Each craving-related term is associated with some aspects of the multidimensional concept of craving. A drug-craving thesaurus could provide a better understanding of craving nature from a drug dependent point of view. There are differences among abstinence vs. maintenance based treated opiate dependents in using craving terms. Addiction therapists will benefit from accessing drug dependents' lexicon to assess and create therapeutic alliance with their clients. Source


Mehrjerdi Z.A.,Tehran University of Medical Sciences | Bakhshi S.,Islamic Azad University at Karaj | Jafari S.,University of British Columbia | Moradi A.,University of Tehran | Ekhtiari H.,Iranian Institute for Cognitive science Studies ICSS
Basic and Clinical Neuroscience | Year: 2011

Introduction: Drug addiction could lead to severe impairments in executive and neurocognitive functions but study on the impact of hydrochloride heroin on executive functions has remained in infancy in Iran. The aim of this study was to examine the relationship between addiction to hydrochloride heroin and executive functioning in several cognitive domains including mental flexibility, abstract reasoning, impulsivity, and attention. Methods: A total of 60 cases of young male addicts aged 18 to 21 were recruited from outpatient addiction clinics in Karaj city and were matched with 60 non-drug using controls. A test battery including the Wisconsin Card Sorting Test (WCST), Porteus Maze Test (PMQS), Serial Seven Subtraction Test (SSST), and Color Trails Test (CTT) were administered respectively. Results: The patient group showed more problems in impulse control compared with the control group, while mental flexibility, abstract reasoning and attention were not affected. Discussion: The findings indicated that addiction to hydrochloride heroin had a negative effect on impulse control. This issue could reflect the role of impaired inhibitory control on drug-seeking behaviors and relapse. Special treatment programs must be tailored to control impulsivity among addicts to hydrochloride heroin during treatment. Source


Mehrjerdi Z.A.,Tehran University of Medical Sciences | Tasnim S.,Rojan Psychiatric Center | Ekhtiari H.,Tehran University of Medical Sciences | Ekhtiari H.,Iranian Institute for Cognitive science Studies ICSS
Basic and Clinical Neuroscience | Year: 2011

Methamphetamine (MA) is a highly addictive psychostimulant drug with crucial impacts on individuals on various levels. Exposure to methamphetamine-associated cues in laboratory can elicit measureable craving and autonomic reactivity in most individuals with methamphetamine dependence and the cue reactivity can model how craving would result in continued drug seeking behaviors and relapse in real environments but study on this notion is still limited. In this brief article, the authors review studies on cue-induced craving in human methamphetamine- dependent subjects in a laboratory-based approach. Craving for methamphetamine is elicited by a variety of methods in laboratory such as paraphernalia, verbal and visual cues and imaginary scripts. In this article, we review the studies applying different cues as main methods of craving incubation in laboratory settings. The brief reviewed literature provides strong evidence that craving for methamphetamine in laboratory conditions is significantly evoked by different cues. Cue-induced craving has important treatment and clinical implications for psychotherapists and clinicians when we consider the role of induced craving in evoking intense desire or urge to use methamphetamine after or during a period of successful craving prevention program. Elicited craving for methamphetamine in laboratory conditions is significantly influenced by methamphetamine-associated cues and results in rapid craving response toward methamphetamine use. This notion can be used as a main core for laboratory-based assessment of treatment efficacy for methamphetamine-dependent patients. In addition, the laboratory settings for studying craving can bridge the gap between somehow-non-reliable preclinical animal model studies and budget demanding randomized clinical trials. Source


Mehrjerdi Z.A.,Tehran University of Medical Sciences | Ekhtiari H.,Tehran University of Medical Sciences | Ekhtiari H.,Iranian Institute for Cognitive science Studies ICSS | Mokri A.,Tehran University of Medical Sciences
Basic and Clinical Neuroscience | Year: 2011

Research on assessing craving in laboratory settings often involves inducing and then measuring craving in subjects. Cue-induced craving is studied in laboratory settings using the cue reactivity paradigm, in which drug-related photos, videos, evocative scripts, olfactory cues, and paraphernalia may induce craving. Cueinduced craving evoked by drug-related stimuli could be associated with relapse and recurrence of drug addiction. In this article, the authors review different methods of assessing craving in laboratory settings and explain how human laboratory settings can bridge the gap between randomized clinical trials (RCTs) and animal models on pharmacological treatments for drug dependence. The brief reviewed literature provides strong evidence that laboratory-based studies of craving may improve our understanding of how subjective reports of drug craving are related to objective measures of drug abuse and laboratory settings provide an opportunity to measure the degree to which they co-vary during pharmacological interventions. This issue has important implications in clinical studies. Source


Hekmat S.,Islamic Azad University at Karaj | Mehrjerdi Z.A.,Tehran University of Medical Sciences | Moradi A.,University of Tehran | Ekhtiari H.,Tehran University of Medical Sciences | And 2 more authors.
Basic and Clinical Neuroscience | Year: 2011

Introduction: Many studies have revealed that drug addicted individuals exhibit impaired performance on executive function tests but a few studies have been conducted on executive functions of drug addicts in Iran. To contribute to this understanding, the present study was designed to assess some domains related to executive functions including cognitive flexibility, attention and speed of mental processing in a sample of drug addicts in comparison with a sample of non-drug addicts. Methods: 155 male addicts between 25 to 35 years of age were selected from outpatient addiction clinics in Karaj, Iran. This group consisted of 3 subgroups of opium (n=40), hydrochloride heroin (n=63), and methamphetamine (n=52) addicts. A control group was selected matching the drug addicts in gender, age, education and scio-economic status and included 130 healthy non-drug taking males. A battery of standardized executive function tests including the Color trail making test, Stroop color word test, and Symbol digit modalities test were administered. Data analysis was conducted by performing Co-variance (MANCOVA) in SPSS.v.16.0. Results: The study findings indicated that the group of drug addicted subjects performed significantly worse compared with the controls on all executive measures. There were also significant differences among the 3 subgroups. The hydrochloride group had the worst performance compared the methamphetamine and opium groups respectively. Drug addicted subjects with longer duration of drug addiction were much worse on all measures in comparison with drug addicted subjects with shorter duration of drug addiction. Discussion: The study results confirmed that the functions of specific brain regions underlying cognitive flexibility, attention and speed of mental processing were significantly impaired in the group of drug addicted subjects. These impairments were also significantly related to type of drug used and duration of drug addiction that may contribute to most of behavioral disturbances found in drug addicts and need specific attention for intervention and treatment programs. Source

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