Subjective time dilation in abstinent patients with alcohol use disorder

Abstract

Introduction: Patients with alcohol use disorder (AUD) may have distortions in time perception. This study investigated subjective time dilation (the tendency to perceive a time interval longer than it is) and its association with craving and impulsivity in AUD. Method: Thirty abstinent male inpatients with AUD (age 29–60 years) and thirty sex-, age-, and education-matched healthy controls completed a temporal generalization task, which assessed the preference (point of subjective equality, PSE) and sensitivity of time perception in the second range. Craving for alcohol was assessed using the Alcohol Urge Questionnaire. Impulsivity was assessed using a delay discounting task and the Barratt Impulsiveness Scale-11. A comprehensive battery of neuropsychological tests was used to measure executive function (flanker task, symbol digit modalities test, trail-making test-A/B), negative emotionality (Beck Depression Inventory-II, Self-rating Anxiety Scale), and incentive salience (monetary incentive delay task) following the Addictions Neuroclinical Assessment (ANA) framework. Results: AUD patients exhibited a smaller PSE than healthy controls, perceiving a time interval 8% longer than it was. AUD patients with a smaller PSE showed a greater craving for alcohol but not greater impulsivity. Exploratory factor analysis incorporating the PSE and ANA measures revealed four latent factors. The PSE loaded highly onto a factor reflecting time perception but not three other factors reflecting executive function, negative emotionality, and incentive salience. Conclusions: AUD patients exhibit a pathological form of subjective time dilation, which is associated with a greater craving for alcohol. Time perception may be an independent functional dimension for understanding addictive behaviors in AUD.