Effects of emotion regulation ability on inhibitory control in patients with alcohol use disorder

doi:10.3969/j.issn.1674-8115.2025.07.010

Abstract

Abstract:

Objective ·To investigate the performance and psychological mechanisms of inhibitory control in patients with alcohol use disorder (AUD) under different emotional contexts, and to examine the influence of emotion regulation difficulties on inhibitory control. Methods ·A total of 28 male AUD inpatients (AUD group) and 28 age- and education-matched healthy controls (HC group) were recruited. The emotional Go/Nogo task (angry/neutral facial expressions) was used to evaluate the subjects' behavioral inhibition, and the hierarchical drift-diffusion model (HDDM) was used to quantify the cognitive parameters (drift rate, decision threshold, and non-decision time). The Difficulties in Emotion Regulation Scale (DERS) and Alcohol Use Disorder Identification Test (AUDIT) were used for clinical evaluation. The moderated mediation effects were tested by bootstrap method. Results ·The AUD group scored higher than the HC group on the DERS total score and all sub-dimensions (goal-directed behavior, impulse control, strategy access, and emotional clarity), and the difference was statistically significant (all P<0.05). At the behavioral level, compared with the HC group, the AUD group had elevated commission error rates [F_(1,54)=8.62, P=0.005] and omission error rates [F_(1,54)=4.28, P=0.043], and the reaction time of angry face stimuli was generally prolonged [F_(1,54)=12.26, P=0.001]. Cognitive modeling showed that the drift rate of the AUD group was significantly lower than that of the HC group [F_(1,54)=15.56, P<0.001], indicating impaired information processing efficiency. The moderated mediation model showed that, under the condition of angry face stimuli, the drift rate partially mediated the relationship between group and commission error rate, and the total indirect effect value was 9.564 (95%CI 3.874‒16.387). Further analysis showed that the conditional indirect effect increased to 10.133 (95%CI 3.963‒17.927) at high levels of emotion regulation difficulty (one standard deviation above the mean), and to 9.011 (95%CI 3.778‒14.921) at low levels (one standard deviation below the mean). Conclusion ·The deficits in information processing efficiency of AUD patients partly explains the impairment of inhibitory control, and this effect is associated with individual emotion regulation capacity. It is suggested that abnormal processing of social threat information may be an important factor affecting the impairment of inhibitory control in AUD patients, especially in individuals with weak emotion regulation ability.

Key words: alcohol use disorder (AUD), inhibitory control, emotion regulation, cognitive modeling, information processing efficiency

CLC Number:

R749.6

CHENG Fei, CHEN Tianzhen, YOU Xu, XUE Baoshuang, YANG Yunbin, DU Jiang. Effects of emotion regulation ability on inhibitory control in patients with alcohol use disorder[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2025, 45(7): 883-891.

Figures/Tables 9

Fig 1 Schematic illustration of the emotional Go/Nogo task protocol

Tab 1 Comparison of demographic characteristics and clinical assessment results between AUD patients and healthy controls

Item	AUD (n=28)	HC (n=28)	t/U value	P value
Age/year	46.82±4.94	50.18±8.01	-1.89	0.065
Education/year	6.30±4.88	7.96±3.20	-1.50	0.138
Monthly income/yuan	1 000 (0, 5 250)	2 700 (2 000, 3 250)	300.00	0.132
AUDIT/score	29.61±6.14	1.21±2.30	1.00	<0.001
DERS/score	43.64±12.60	23.89±8.27	1.85	<0.001
Goal	9.75±3.40	5.61±2.77	1.34	<0.001
Impulse	9.00 (7.00, 11.00)	3.00 (3.00, 4.00)	684.00	<0.001
Strategy	12.21±3.81	6.57±2.47	0.78	<0.001
Clarity	5.25±2.72	3.61±1.87	0.34	0.011

Tab 2 Comparison of Go/Nogo task performance under different emotional conditions between the two groups

Item	Emotion type	AUD (n=28)	HC (n=28)	Statistical test result
Reaction time/ms	Angry	545.80±106.08	492.67±87.66	Group: F_(1,54)=3.75, P=0.058, $η P 2$ =0.064 Emotion: F_(1,54)=12.26, P=0.001, $η P 2$ =0.003 Interaction: F_(1,54)=2.84, P=0.098, $η P 2$ =0.001
Reaction time/ms	Neutral	530.13±96.12	487.18±82.39
Comission error rate/%	Angry	6.25 (0, 12.50)	0 (0, 6.25)	Group: F_(1,54)=8.62, P=0.005, $η P 2$ =0.127 Emotion: F_(1,54)=1.12, P=0.295, $η P 2$ =0.002 Interaction: F_(1,54)=0.14, P=0.712, $η P 2$ <0.001
Comission error rate/%	Neutral	7.50 (0, 15.00)	0 (0, 5.00)
Omission error rate/%	Angry	0 (0, 2.23)	0 (0, 1.79)	Group: F_(1,54)=4.28, P=0.043, $η P 2$ =0.073 Emotion: F_(1,54)=1.90, P=0.173, $η P 2$ <0.001 Interaction: F_(1,54)=2.61, P=0.111, $η P 2$ =0.001
Omission error rate/%	Neutral	1.92 (0, 3.85)	0 (0, 1.92)

Tab 2 Comparison of Go/Nogo task performance under different emotional conditions between the two groups

Item	Emotion type	AUD (n=28)	HC (n=28)	Statistical test result
Reaction time/ms	Angry	545.80±106.08	492.67±87.66	Group: F_(1,54)=3.75, P=0.058, $η P 2$ =0.064 Emotion: F_(1,54)=12.26, P=0.001, $η P 2$ =0.003 Interaction: F_(1,54)=2.84, P=0.098, $η P 2$ =0.001
Reaction time/ms	Neutral	530.13±96.12	487.18±82.39
Comission error rate/%	Angry	6.25 (0, 12.50)	0 (0, 6.25)	Group: F_(1,54)=8.62, P=0.005, $η P 2$ =0.127 Emotion: F_(1,54)=1.12, P=0.295, $η P 2$ =0.002 Interaction: F_(1,54)=0.14, P=0.712, $η P 2$ <0.001
Comission error rate/%	Neutral	7.50 (0, 15.00)	0 (0, 5.00)
Omission error rate/%	Angry	0 (0, 2.23)	0 (0, 1.79)	Group: F_(1,54)=4.28, P=0.043, $η P 2$ =0.073 Emotion: F_(1,54)=1.90, P=0.173, $η P 2$ <0.001 Interaction: F_(1,54)=2.61, P=0.111, $η P 2$ =0.001
Omission error rate/%	Neutral	1.92 (0, 3.85)	0 (0, 1.92)

Tab 3 Between-group comparison of cognitive parameters across emotional conditions

Parameter	Emotion type	AUD (n=28)	HC (n=28)	Statistical test result
Decision threshold	Angry	2.28±0.82	2.23±0.94	Group: F_(1,54)=0.31, P=0.582, $η P 2$ =0.006 Emotion: F_(1,54)=1.61, P=0.210, $η P 2$ =0.029 Interaction: F_(1,54)=1.11, P=0.298, $η P 2$ =0.020
Decision threshold	Neutral	1.96±0.69	2.20±0.86
Drift rate	Angry	3.13±2.00	4.39±1.61	Group: F_(1,54)=15.56, P<0.001, η $P 2$ =0.223 Emotion: F_(1,54)=2.66, P=0.108, $η P 2$ =0.047 Interaction: F_(1,54)=2.85, P=0.097, $η P 2$ =0.050
Drift rate	Neutral	3.12±1.32	5.12±1.98
Non-decision time/s	Angry	0.26±0.07	0.28±0.07	Group: F_(1,54)=0.47, P=0.494, $η P 2$ =0.009 Emotion: F_(1,54)=1.29, P=0.261, $η P 2$ =0.023 Interaction: F_(1,54)=0.02, P=0.880, $η P 2$ <0.001
Non-decision time/s	Neutral	0.25±0.10	0.27±0.09

Tab 3 Between-group comparison of cognitive parameters across emotional conditions

Parameter	Emotion type	AUD (n=28)	HC (n=28)	Statistical test result
Decision threshold	Angry	2.28±0.82	2.23±0.94	Group: F_(1,54)=0.31, P=0.582, $η P 2$ =0.006 Emotion: F_(1,54)=1.61, P=0.210, $η P 2$ =0.029 Interaction: F_(1,54)=1.11, P=0.298, $η P 2$ =0.020
Decision threshold	Neutral	1.96±0.69	2.20±0.86
Drift rate	Angry	3.13±2.00	4.39±1.61	Group: F_(1,54)=15.56, P<0.001, η $P 2$ =0.223 Emotion: F_(1,54)=2.66, P=0.108, $η P 2$ =0.047 Interaction: F_(1,54)=2.85, P=0.097, $η P 2$ =0.050
Drift rate	Neutral	3.12±1.32	5.12±1.98
Non-decision time/s	Angry	0.26±0.07	0.28±0.07	Group: F_(1,54)=0.47, P=0.494, $η P 2$ =0.009 Emotion: F_(1,54)=1.29, P=0.261, $η P 2$ =0.023 Interaction: F_(1,54)=0.02, P=0.880, $η P 2$ <0.001
Non-decision time/s	Neutral	0.25±0.10	0.27±0.09

Tab 4 Moderated mediation analysis of inhibitory control under the angry emotional condition

Variable	Drift rate			Commission error rate
Variable	B	z value	P value	B	z value	P value
Group	-2.443	-3.159	0.002	-2.624	-1.005	0.315
DERS	0.045	0.691	0.490	‒	‒	‒
Group×DERS	-0.264	-0.750	0.453	‒	‒	‒
Drift rate	‒	‒	‒	-3.914	-4.167	<0.001
Drift rate×DERS	‒	‒	‒	-0.148	-1.998	0.046
R² value		0.298			0.847
F value		7.220			16.040

Tab 5 Total effect， direct effect， and moderated mediation analysis under the angry emotional condition

Effect type	Effect value	SE	95%CI	β	P value
Total effect	6.940	3.829	0.564‒14.021	0.202	0.018
Direct effect	-2.624	2.610	-7.232‒3.202	-0.077	0.315
Total indirect effect	9.564	3.177	3.874‒16.387	0.279	0.003
Conditional indirect effect
Low DERS	9.011	2.847	3.778‒14.921	-0.031	0.002
High DERS	10.133	3.555	3.963‒17.927	0.868	0.004

Fig 2 Path analysis of the moderated mediation model under different emotional conditions

Tab 6 Moderated mediation analysis of inhibitory control under the neutral emotional condition

Variable	Drift rate			Commission error rate
Variable	B	z value	P value	B	z value	P value
Group	-1.074	-1.380	0.168	3.006	1.027	0.304
DERS	-0.007	-0.169	0.866	‒	‒	‒
Group×DERS	-0.018	-0.344	0.731	‒	‒	‒
Drift rate	‒	‒	‒	-3.308	-3.623	<0.001
Drift rate×DERS	‒	‒	‒	-0.430	-1.475	0.140
R² value	0.161			0.739
F value	3.260			11.010

Tab 7 Total effect， direct effect， and moderated mediation analysis under the neutral emotional condition

Effect type	Effect value	SE	95%CI	β	P value
Total effect	6.558	4.221	-1.856‒14.972	0.224	0.123
Direct effect	3.006	2.926	-2.949‒8.704	0.103	0.304
Total indirect effect	3.552	3.066	-0.907‒11.000	0.121	0.247
Conditional indirect effect
Low DERS	3.372	2.936	-1.023‒10.458	-0.003	0.251
High DERS	3.737	3.214	-0.736‒11.654	0.332	0.245

TrendMD

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