Exploration Of Behavioral Insight Impairment In Nicotine Dependent Population And Optimization Of Measurement Paradigm

One of the reasons for the low proportion of people who take the initiative to seek treatment among addicts may be that most substance addicts are not fully aware of their drug use.The awareness of addicts’ inability to correctly understand their addiction-related problems is defined as insight.There have been a certain number of insight studies in the field of addiction,and the results show that there are some people with varying degrees of insight impairment in all kinds of substance addicts,and this insight damage is related to the severity of drug use and abstinence machine of addicts.With the development of research,different dimensions of clinical insight,cognitive insight and behavioral insight have been put forward one after another.Although the field of addiction has not divided its measured insight into which dimension for a long time.However,from the content of its measurement,researchers pay more attention to the clinical insight of addicts.However,behavioral insight impairment,as a forerunner of insight impairment,was only verified in cocaine addicts.Therefore,the first purpose of this study is to verify whether nicotine dependent patients also have behavioral insight impairment.In addition,Behavioral Insight Measure(BIM)is mainly used to measure the behavioral insight of addicts in the field of addiction.The logic of this paradigm is to let the subjects subjectively evaluate the type of pictures they choose to watch most after completing the objective picture selection task.After that,the results of subjective assessment and objective selection of picture types were compared to determine whether the addicts had behavioral insight impairment.The subjective assessment after the completion of the picture selection task may be affected by learning,memory,and other factors,resulting in the underestimation of the number of people with behavioral insight impairment.Therefore,the second purpose of this study is to optimize the BIM paradigm based on verifying the effectiveness of the paradigm in nicotine dependent people,to obtain more accurate measurement data,and then have a clearer understanding of the behavioral insight impairment of nicotine dependent people.Based on the above purpose,three experiments were designed in this study.In experiment 1,the original BIM task was used to explore whether nicotine dependent people had behavioral insight impairment,and to determine the effectiveness of this paradigm in nicotine dependent people.Experiment 2 optimizes the BIM task based on experiment 1,that is,adding a subjective report(pretest)before the objective selection of tasks.The effectiveness of the pretest method was verified by this experiment,and the results were compared with the post-test to determine whether the original BIM task underestimated the proportion of behavioral insight impairment of addicts.Based on experiment 1,the impairment of behavioral insight of nicotine dependent patients was further examined.Experiment 3 optimizes the pretest mode based on experiment 2,that is,adding a distraction task between the pretest and the formal BIM task.Through this experiment,the best way to use pretest is further determined.In experiment 1,30 nicotine dependent patients and 31 healthy controls completed the original BIM task.The results showed that compared with the control group,nicotine dependent patients could not accurately report their objective selection preference and had behavioral insight impairment.In experiment 2,30 subjects in nicotine dependent group and 30 healthy subjects in control group were selected to complete the BIM task of adding pretest.The experimental results show that there are significant differences in the number of people with or without insight between the two groups in the pretest and post-test,which indicates that the pretest is effective in the BIM task.However,there is no significant difference between the pretest and post-test results of the two groups,indicating that the pretest is not superior to the post-test.That is to say,the damage of behavioral insight of nicotine dependent patients is consistent with the results of experiment 1.In experiment 3,61 nicotine dependent patients were randomly assigned to complete BIM tasks with and without distraction tasks.The results show that there is no significant difference between the pretest results with and without distraction tasks.This shows that it is advisable to add pretest directly to the BIM task and will not be disturbed by other factors.There is no significant difference between the measurement results of the two pretest methods and the corresponding post-test results,which verifies the results of experiment 2,which shows that no matter which pretest method is adopted,it has no significant superiority over the post-test.The above results indicate that nicotine dependent patients do have behavioral insight impairment,and the insight impairment of nicotine dependent patients is not underestimated in the original BIM task.Therefore,it may be of great significance for the intervention effect to consider the behavioral insight of addicts in the future clinical intervention.In addition,the optimization results of BIM paradigm show that both pretest and post-test in the subjective reporting part of BIM paradigm can effectively distinguish whether addicts have insight or not.But the pretest method does not have the expected advantage over the post-test.In the future,researchers can choose more appropriate subjective reporting methods according to their own experimental needs.