Ambulatory assessment of cue-reactivity during naturalistic cue exposure in gamblers.

线索反应性是指对成瘾相关线索的条件神经元和心理生理反应，在人类成瘾神经科学中发挥着核心作用，对于物质使用障碍和赌博障碍等行为成瘾都是如此。尽管这一概念的流行和大量调查线索反应性测量临床实用性的研究(例如，用于调查治疗效果或预测临床结果)，荟萃分析显示，关于所涉及的神经元系统和效果大小，存在实质性的异质性。一个促成因素可能是缺乏标准线索-反应范式的生态有效性，该范式通常涉及在实验室中暴露于简单的单峰视觉线索。在这里，我建议通过结合基于GPS的地理定位跟踪和博彩者在自然线索暴露期间的动态心理生理评估来提高主观和心理生理线索反应性测量的生态有效性。赌博与遍布城市环境的特定场所(老虎机赌场、博彩设施)相关联，我建议利用这些显著的环境线索来调查现场环境中赌徒的线索反应性。经常赌博的人和配对的对照组将沿着预先确定的城市路线移动，而主观渴望和心理生理线索反应分别使用电子瞬时评估和动态心理生理学进行评估。地理位置是通过GPS跟踪的。据预测，赌徒的主观和心理生理线索反应既受到直接接触线索位置的影响，也受到熟悉的城市路线特有的预期效应的影响。结果将揭示，线索反应性是人类成瘾神经科学的一个核心概念，是否可以在现场环境中的线索暴露期间进行测量，以及它是否像强化学习理论预测的那样是由预期塑造的。

The concept of “cue-reactivity”, which refers to conditioned neuronal and psychophysiological responses to addiction-related cues, plays a central role in human addiction neuroscience, with respect to both substance use disorders and behavioral addictions such as gambling disorder. Despite the prevalence of the concept and numerous studies investigating the clinical utility of cue-reactivity measures (e.g. for investigating treatment efficacy or prediction of clinical outcomes), meta-analyses revealed substantial heterogeneity with respect to implicated neuronal systems and effect sizes. One contributing factor might be a lack of ecological validity of the standard cue-reactivity paradigm, which typically involves exposure to simple unimodal visual cues in the lab. Here I propose to improve ecological validity of subjective and psychophysiological cue-reactivity measures by combining GPS-based geolocation tracking and ambulatory psychophysiological assessment during naturalistic cue exposure in gamblers. Gambling is linked to specific venues (slot machine casinos, betting facilities) located throughout urban environments, and I propose to leverage these salient environmental cues to investigate cue-reactivity in gamblers in a field setting. Frequent gamblers and matched controls will move along pre-determined urban routes while subjective craving and psychophysiological cue-reactivity are assessed using electronic momentary assessment and ambulatory psychophysiology, respectively. Geolocation is tracked via GPS. Subjective and psychophysiological cue-reactivity in gamblers are predicted to be shaped by both direct exposure to cue locations and expectation effects specific to familiar urban routes. Results will shed light on whether cue-reactivity, a central concept in human addiction neuroscience, can be measured during cue exposure in a field setting, and whether it is shaped by expectation, as predicted by reinforcement learning theories.