Strong seduction: impulsivity and the impact of contextual cues on instrumental behavior in alcohol dependence

Abstract

Alcohol-related cues acquire incentive salience through Pavlovian conditioning and then can markedly affect instrumental behavior of alcohol-dependent patients to promote relapse. However, it is unclear whether similar effects occur with alcohol-unrelated cues. We tested 116 early-abstinent alcohol-dependent patients and 91 healthy controls who completed a delay discounting task to assess choice impulsivity, and a Pavlovian-to-instrumental transfer (PIT) paradigm employing both alcohol-unrelated and alcohol-related stimuli. To modify instrumental choice behavior, we tiled the background of the computer screen either with conditioned stimuli (CS) previously generated by pairing abstract pictures with pictures indicating monetary gains or losses, or with pictures displaying alcohol or water beverages. CS paired to money gains and losses affected instrumental choices differently. This PIT effect was significantly more pronounced in patients compared to controls, and the group difference was mainly driven by highly impulsive patients. The PIT effect was particularly strong in trials in which the instrumental stimulus required inhibition of instrumental response behavior and the background CS was associated to monetary gains. Under that condition, patients performed inappropriate approach behavior, contrary to their previously formed behavioral intention. Surprisingly, the effect of alcohol and water pictures as background stimuli resembled that of aversive and appetitive CS, respectively. These findings suggest that positively valenced background CS can provoke dysfunctional instrumental approach behavior in impulsive alcohol-dependent patients. Consequently, in real life they might be easily seduced by environmental cues to engage in actions thwarting their long-term goals. Such behaviors may include, but are not limited to, approaching alcohol.

Development of Pavlovian-to-instrumental transfer (PIT) task to examine the effects of reward-predicting cues on behavioral activation in young adults

“…The current study evaluated the effects of reward-predicting cues on behavior, using a PIT task in which classical conditioning trials were optimized for fMRI. Our results are consistent with a growing number of studies demonstrating PIT effects in humans (Seabrooke et al, 2017;Sommer et al, 2017b;Verhoeven, Watson and de Wit, 2018;Vogel et al, 2018) and provide additional evidence for behavioral invigoration in presence of a classically conditioned stimulus. The current PIT paradigm was developed to allow Pavlovian conditioning to be completed in an MRI scanner.…”

“…A little more than half of the studies examined appetitive conditioning. Many of these studies have focused on examining addictive behavior, e.g., to food (Pool et al, 2015;Quail, Laurent and Balleine, 2017;Seabrooke et al, 2017;van Steenbergen et al, 2017), to nicotine (Hogarth, 2012;Hogarth, Maynard and Munafò, 2015;Manglani et al, 2017) and to alcohol (Martinovic et al, 2014;Garbusow et al, 2016;Hardy et al, 2017;Sommer et al, 2017a). Other studies have used PIT paradigms to evaluate how stress and depressed mood affect motivation (Huys et al, 2016;Quail, Laurent and Balleine, 2017), or to study the neural correlates of the transfer effects in non-disordered populations (Paredes-Olay et al, 2002;Talmi et al, 2008a;Allman et al, 2010;Geurts et al, 2013;Hebart and Gläscher, 2015;Sebold et al, 2016).…”

Decoding diagnosis and lifetime consumption in alcohol dependence from grey‐matter pattern information

“…To assess whether grey‐matter information captured the severity of the disease within the AD group, we predicted the amount of lifetime ethanol consumption based on grey‐matter data. Life time alcohol consumption was estimated using the measures provided by CAPI‐CIDI regarding drinking amounts during the last 12 months and periods of maximal alcohol consumption in combination with representative data of alcohol‐dependent patients in Germany (; see references and for previous uses of this measure). Grey‐matter data consisted of the 110 regional atlas‐based grey‐matter concentration averages of each participant.…”

Neural correlates of cue-induced changes in decision-making distinguish subjects with gambling disorder from healthy controls

“…To increase statistical power, we have omitted other conceptualization of PIT, e.g. as an interference task (Sommer et al, 2017), and hence any limbic-dorso-lateral-prefrontal connectivity (Bray et al, 2008). Future studies should explore this.…”