SUDs and the Family’s PreFrontal Cortex
ABSTRACT from Cited from, ‘Prefrontal Cortex Functioning of Family Members of Those with a Substance Use Disorder’
Substance use disorders (SUDs) significantly impact family systems, yet have often been treated as an individual problem. Nevertheless, family inclusion has become a treatment priority although limited research exists regarding family members. Specifically, research has yet to examine neuropsychological processes associated with family members. This study examined prefrontal cortex (PFC) activation of family members using functional near-infrared spectroscopy as they viewed images of a loved-one with a SUD. Activation patterns of an experimental group were compared against those of a control group and showed significant differences in PFC responses. Implications are discussed and demonstrate the importance of family member recovery.
In their most severe states, SUDCs are considered a multifaceted brain disease with staggering effects on indviduals struggling with the disorder, their family and society (Orford, Velleman, Natera, Templeton & Copello, 2013).
Another symptom often found with family members affected by an SUD is that any developed problematic behaviors that maintain or challenge homeostatic family functioning become a key component to one’s own identity, similarly to how using substances affects the identity of those with a SUD (Buckingham, Frings, & Albery, 2013).
As is the case with addiction (Koob & Volkow, 2010), the behaviors observed with family members affected by an SUD may be part of a reciprocal cycle of preoccupation/obsession and compulsive behaviors that are intended to alleviate and cope with stress and feelings of threat and fear. As family members engage in this cycle, examining activation of the PFC might yield important information. The PFC is considered the “doing” cortex that involves mental processes associated with decision making, planning, and action (Fuster, 2015) and has shown impairment in cases of addiction (Goldstein & Volkow, 2011). More specifically, the PFC can be thought of as part of a “stop” and “go” network in the brain. That is, a go system involving subcortical structures (e.g., nucleus accumbens) is associated with reward, craving, and hence survival, interacts with the stop system of the PFC associated with emotional and behavioral regulation. The stop system therefore involves cortical structures (e.g., PFC) associated with inhibition, evaluation, and regulation of behavior (Hoffman, Froemke, Cheever, & Nevins, 2007). When the go and stop system work together, there is balance between primal instincts and logical reasoning. Conversely, SUDs are often associated with an imbalance between these systems with the go system overwhelming the stop system. Perhaps similar PFC dysfunction may exist in family members of a loved one with a SUD as a result of the stress, fear, family environment, and interactional patterns often found in these families.
The PFC itself however is a complex center of networks responsible for different functions. In general, left-side PFC activity is thought to be associated with motivations that encourage individuals to approach a situation with a perceived sense of being able to control the outcome (Harmon-Jones, 2004). Within this region, the dorsolateral PFC (dlPFC) is responsible for risk avoidance, calculation, and choice (Yamamoto, Woo, Wager, Regner, & Tanabe, 2015). An individual experiencing craving for a substance will do anything it takes to procure that substance, even if it means sacrificing relationships, safety, or enduring other harmful consequences (Kalivas & Volkow, 2005; Volkow, Wang, Fowler, & Tomasi, 2012). Similarly, family members with co-addiction may also experience activating cues associated with their addicted loved one triggering a hyperactive PFC response and subsequent negative outcomes.Cited from: Sterling T. Shumway, Spencer D. Bradshaw, Nicholas Hayes, Sarah Schonian & Thomas G. Kimball (2018): Alcoholism Treatment Quarterly, DOI link noted below.
Contact: Spencer D. Bradshaw, spencer.bradshaw@ttu.edu Department of Community, Family, and Addiction Sciences, Texas Tech University, Lubbock, TX 79409 USA.
Link to full article: https://doi.org/10.1080/07347324.2018.1488549
