In This Issue

Patients with heroin dependence who have been abstinent for up to 30 days commonly show impulsivity both clinically and in laboratory testing, but those abstinent for 3–24 months perform as well as healthy comparison subjects. Zhang et al. (p. 610) discovered, however, that a stress-provoking test uncovered impulsive decision making in the long-term abstinence group, while the comparison subjects were unaffected. This stress-related effect was blocked by the beta-blocker propranolol in patients who had abstained from drugs for 30 days, 12 months, or 24 months. The editorial by Kosten (p. 566) highlights the value of linking clinical observations of substance use disorder to underlying neurobiology.

Excess emotional reactivity in people with attention deficit hyperactivity disorder (ADHD) may signal a distinct familial ADHD subtype. Surman et al. (p. 617) compared adult siblings of subjects with both ADHD and deficient emotional self-regulation, relatives of subjects with ADHD only, and relatives of healthy subjects. High rates of ADHD were present in the adult siblings of both ADHD groups, but deficient self-regulation was frequent only in the relatives of subjects with both disorders: 27% compared with 5% for relatives of subjects with ADHD only and 0% for comparison relatives. The rates of bipolar and other psychiatric disorders did not differ between the relatives in the two ADHD groups.