When habits are dangerous: alcohol expectancies and habitual decision making predict relapse in alcohol dependence
| Autor: | Christian Sommer, Daniel J. Schad, Michael A. Rapp, Maria Garbusow, Robin Frank, Anne Beck, Michael N. Smolka, Stephan Nebe, Soeren Kuitunen-Paul, Ulrich S. Zimmermann, Andreas Heinz, Matthias Guggenmos, Miriam Sebold, Peter Neu, Florian Schlagenhauf, Quentin J. M. Huys |
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| Přispěvatelé: | University of Zurich, Sebold, Miriam |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male 0301 basic medicine medicine.medical_specialty Subsequent Relapse media_common.quotation_subject Decision Making Prefrontal Cortex Alcohol 610 Medicine & health Neuropsychological Tests Habits 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Reward Recurrence Surveys and Questionnaires Image Processing Computer-Assisted medicine Department Sport- und Gesundheitswissenschaften Humans Prefrontal cortex Psychiatry Biological Psychiatry media_common Neural correlates of consciousness medicine.diagnostic_test Addiction Alcohol dependence Timeline Followback Method Middle Aged Magnetic Resonance Imaging Oxygen Alcoholism 030104 developmental biology chemistry 10054 Clinic for Psychiatry Psychotherapy and Psychosomatics Female Psychology Functional magnetic resonance imaging 2803 Biological Psychiatry 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Biological Psychiatry |
| DOI: | 10.5167/uzh-147717 |
| Popis: | BackgroundAddiction is supposedly characterized by a shift from goal-directed to habitual decision making, thus facilitating automatic drug intake. The two-step task allows distinguishing between these mechanisms by computationally modeling goal-directed and habitual behavior as model-based and model-free control. In addicted patients, decision making may also strongly depend upon drug-associated expectations. Therefore, we investigated model-based versus model-free decision making and its neural correlates as well as alcohol expectancies in alcohol-dependent patients and healthy controls and assessed treatment outcome in patients.MethodsNinety detoxified, medication-free, alcohol-dependent patients and 96 age- and gender-matched control subjects underwent functional magnetic resonance imaging during the two-step task. Alcohol expectancies were measured with the Alcohol Expectancy Questionnaire. Over a follow-up period of 48 weeks, 37 patients remained abstinent and 53 patients relapsed as indicated by the Alcohol Timeline Followback method.ResultsPatients who relapsed displayed reduced medial prefrontal cortex activation during model-based decision making. Furthermore, high alcohol expectancies were associated with low model-based control in relapsers, while the opposite was observed in abstainers and healthy control subjects. However, reduced model-based control per se was not associated with subsequent relapse.ConclusionsThese findings suggest that poor treatment outcome in alcohol dependence does not simply result from a shift from model-based to model-free control but is instead dependent on the interaction between high drug expectancies and low model-based decision making. Reduced model-based medial prefrontal cortex signatures in those who relapse point to a neural correlate of relapse risk. These observations suggest that therapeutic interventions should target subjective alcohol expectancies. |
| Databáze: | OpenAIRE |
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