Contextual processing and its alterations in patients with addictive disorders

Contextual processing is implicated in the pathophysiology of addictive disorders, but the nature of putative deficiencies remains unclear. We assessed some aspects of contextual processing across multimodal experimental procedures with detoxified subjects who were dependent on opioids (n = 18), alcohol- (n = 20), both opioids and alcohol (n = 22) and healthy controls (n = 24) using a) facial- and b) emotionally laden images; c) gambling task and d) sucrose solutions. Healthy subjects displayed consistent response pattern throughout all categories of the presented stimuli. As a group, dependent subjects rated (i.e., valuated) attractive and average faces respectively more and less attractive in comparison to controls. Dependent subjects' motivational effort, measured in the units of computer keypress to determine the attractive faces' viewing time, accorded the valuational context but was diminished relatively to the average faces’ valuation. Dependent subjects’ motivational effort for pleasant and aversive images respectively mirrored the attractive and average faces; their neutral images’ motivational effort was incongruent with the valuational context framed by the intermixed images. Also, dependent subjects’ emotional responses to counterfactual comparisons of gambling outcomes were unmatched by the riskiness context. Moreover, dependent subjects failed to show greater liking of sweet solutions that normally accompanies low sweetness perceptual context indicative of higher sucrose concentration needed for maximal hedonic experience. Consistent differences among the dependent groups (opioid vs. alcohol vs. comorbid) on the above procedures were not observed. The present findings suggest that opioid and/or alcohol dependence may be associated with amplified hedonic and motivational valuation of pleasant stimuli and with a disrupted link between behavioral/emotional responsivity and contextual variations. Further research is warranted to unravel the distinctive features of contextual processing in opioid- vis-à-vis alcohol addiction and how these features may interrelate in comorbid conditions.