Taking back control: fractioning the homunculus to improve our understanding of the role of 'inhibitory control' in heavy drinking

酗酒给社会带来了沉重的负担，但我们对影响饮酒行为的心理过程的了解还不够充分。这在一定程度上是因为物质使用障碍(成瘾)的心理学理论依赖于“抑制控制”的简单概念化，抑制控制被定义为停止、改变或推迟不适当行为的能力。这些理论建立在这样的假设之上，即行为由一个未指明的“抑制性小人”或中央控制系统控制，而这个小人的功能受损会导致上瘾。有充分的理由相信这一假设是不正确的。在这个项目中，我的目标是将最近的抑制控制理论框架中的预测应用到对酗酒者抑制缺陷的研究中。具体地说，为了更准确地说明酒精使用障碍中抑制性缺陷的性质，我将把抑制性“小人”分解成其组成部分的过程。在最初的研究中，我将在自然主义的酒吧实验室中调查不同的抑制子过程受酒精相关线索影响的程度，并测量这些抑制子过程与饮酒行为个体差异之间的关联。在第二项研究中，我将使用生态瞬时评估来调查情境变量(包括酒精暗示)对参与者自然环境中抑制子过程的影响，并调查哪些抑制子过程与酒精摄入量增加有关。最后，第三项研究将调查酒精暗示是否可以与抑制性控制的参与相结合，以及这种“抑制性控制训练”(ICT)是否可以在环境变化的情况下促进酒精消耗量的减少。这些研究的结果将形成对成瘾抑制控制的新的理论理解的基础。这些发现也将影响行为治疗的未来发展。

Alcohol abuse imposes a substantial burden on society, yet our understanding of the psychological processes that influence drinking behaviours is inadequate. This is partly because psychological theories of substance use disorders (addictions) rely on a simplistic conceptualization of 'inhibitory control', defined as the ability to stop, change or delay inappropriate behaviour. These theories are founded on the assumption that behaviour is controlled by an unspecified 'inhibitory homunculus' or central control system, and that impairments to the functioning of this homunculus result in addiction. There is good reason to believe that this assumption is incorrect. In this project I aim to apply predictions from a recent theoretical framework of inhibitory control to the study of inhibitory deficits in heavy drinkers. Specifically, I will break down the inhibitory 'homunculus' into its component processes in order to more precisely specify the nature of inhibitory deficits in alcohol use disorders. In an initial study, I will investigate the extent to which different inhibitory sub-processes are influenced by alcohol-related cues in a naturalistic 'bar lab', and measure the association between these inhibitory sub-processes and individual differences in drinking behaviour. In a second study I will use ecological momentary assessment to investigate the effect of situational variables (including alcohol cues) on inhibitory sub-processes in participants' natural environments, and I will investigate which inhibitory sub-processes are associated with increased alcohol consumption. Finally, a third study will investigate whether alcohol-cues can be paired with the engagement of inhibitory control, and if this 'inhibitory control training' (ICT) can prompt a reduction in alcohol consumption that survives a change in context. The results from these studies will form the basis of a new theoretical understanding of inhibitory control in addiction. Findings will also impact the future development of behavioral treatments.