Inter-Temporal Trade-offs in the Risky Decisions of Cocaine Addicts

可卡因成瘾者风险决策的跨期权衡

• 批准号: 8447117
• 负责人: Warren K Bickel
• 金额: $ 69.26万
• 依托单位: VIRGINIA POLYTECHNIC INST AND ST UNIV
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-01 至 2015-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8447117
• 关键词: AIDS/HIV problem; Address; Age; Applications Grants; Badger; Behavior; Behavior Control; Behavior assessment; Behavioral; Brain; Brain region; Choice Behavior; Chronic; Cocaine; Cocaine Dependence; Cocaine Users; Cognitive; Communities; Cues; Data; Decision Making; Disease; Documentation; Drug abuse; Drug usage; Economic Models; Equilibrium; Event; Exhibits; Female; Food; Functional Magnetic Resonance Imaging; Functional disorder; Future; Gender; HIV; HIV risk; Individual; Infection; Lead; Learning; Location; Measures; Mediating; Modeling; Multiple Partners; Needle Sharing; Outcome; Participant; Pathologic; Pattern; Pharmaceutical Preparations; Population; Population Sizes; Prefrontal Cortex; Procedures; Process; Psychostimulant dependence; Relapse; Relative (related person); Research; Rewards; Risk Behaviors; Role; Sex Behavior; Sexually Transmitted Diseases; Shelter facility; Specific qualifier value; Substance abuse problem; System; Testing; Time; Treatment outcome; Work; addiction; age group; base; cocaine use; condoms; design; discount; discounting; frontal lobe; high risk behavior; high risk sexual behavior; improved; insight; interest; male; neural model; neurobehavioral; novel; novel strategies; preference; premature; public health relevance; reinforcer; relating to nervous system; research study; reward processing; sex; social; transmission process

DESCRIPTION (provided by applicant): Cocaine use and its associated risky sexual behaviors (e.g., sex with multiple partners, inconsistent condom use, trading sex for drugs or money) represent a significant contributor to the ongoing spread of HIV. However, little is known about how sex, drugs, and money are valued in this population, nor about the perturbed neural processes mediating these tradeoffs. In this application, we directly address the objective of PAS-07-324 to increase understanding of processes of cocaine addiction that influence decisions about high-risk sexual behavior. We propose to explore this via the convergence of behavioral and neural underpinnings of the pathological decisions made by Chronic Cocaine Users (CCUs) not in treatment using a model-based approach, behavioral decision tasks, and functional magnetic resonance imaging (fMRI). Our overall hypothesis is that the processes of addiction result in a dysfunctional decision system that underlies the risky sexual behavior engaged in by CCUs; in other words, CCUs engage in risky sexual behavior because they discount future outcomes as a result of a hypoactive executive system (in prefrontal cortex) and a hyperactive impulsive system (in limbic brain circuits). To improve our understanding of cocaine addiction processes that influence decisions about risky sexual behavior, we will obtain critically needed information about the CCU's valuation of relevant commodities (sex, drugs, money), recognizing that these commodities serve multiple functions and may interact with one another in novel ways. We will study valuation and inter-temporal choice within and across different commodities to gain new insights into the decisions made by CCUs, including decisions closely tied to the high-risk behavior of trading sex for drugs or money, and how they differ from Recreational Cocaine Users (RCUs) and Community Control Participants (CCPs). We hypothesize that different commodities will show different profiles of effect depending on availability of other commodities (same or different commodities), their temporal location (immediate or later), and the subject group (CCUs, RCUs, CCPs). Additionally, given the existing data, we anticipate systematically replicating that the discounting of money (money now vs. later) will be predictive of HIV risk behavior in a new population (CCUs). The inclusion of neural correlates will permit us to identify for the first time the role of different neurobehavioral decision systems in decision making predictive of HIV risk behavior. By comparing money discounting to discounting of drug and sexual activity within and across commodities, we will determine whether novel discounting procedures and associated neural processes are more predictive of risky behavior than money discounting. Completion of this project will provide substantial new information about neural valuation systems that are altered by addiction and lead to risky sexual behavior. Understanding how the commodities of interest interact with one another and the neural systems that participate in that valuation may suggest new approaches to alter the pathologic valuation and impact risky behavior associated with the spread of HIV.

描述（由申请人提供）：可卡因使用及其相关的危险性行为（例如，与多个性伙伴发生性关系、不经常使用避孕套、以性换取毒品或金钱）是艾滋病毒持续传播的一个重要因素。然而，关于性、毒品和金钱在这一人群中的价值，以及介导这些权衡的扰动神经过程，我们知之甚少。在本申请中，我们直接解决PAS-07-324的目标，以增加对可卡因成瘾过程的理解，这些过程会影响高风险性行为的决定。我们建议通过使用基于模型的方法、行为决策任务和功能性磁共振成像（fMRI），对慢性可卡因使用者（CCU）做出的病理决定的行为和神经基础进行融合。我们的总体假设是，成瘾的过程导致了一个功能失调的决策系统，这是CCU参与危险性行为的基础;换句话说，CCU参与危险性行为是因为他们低估了未来的结果，这是执行系统（前额叶皮层）和冲动系统（边缘脑回路）过度活跃的结果。为了提高我们对影响危险性行为决策的可卡因成瘾过程的理解，我们将获得有关CCU对相关商品（性，毒品，金钱）估值的急需信息，认识到这些商品具有多种功能，并可能以新颖的方式相互作用。我们将研究不同商品内部和之间的估值和跨期选择，以获得对CCU所做决策的新见解，包括与毒品或金钱交易性行为的高风险行为密切相关的决策，以及它们与Recommended Coordinate用户（RCU）和社区控制参与者（CCP）的不同之处。我们假设，不同的商品将显示不同的效果，这取决于其他商品（相同或不同的商品）的可用性，其时间位置（立即或稍后），以及受试者组（CCU，RCU，CCP）。此外，根据现有数据，我们预计系统地复制金钱折扣（现在与以后的金钱）将预测新人群（CCU）中的艾滋病毒风险行为。神经相关的纳入将使我们能够首次确定不同的神经行为决策系统在预测HIV风险行为的决策中的作用。通过比较货币贴现与商品内部和商品之间的毒品和性活动的贴现，我们将确定新的贴现程序和相关的神经过程是否比货币贴现更能预测风险行为。这个项目的完成将提供大量关于神经评估系统的新信息，这些系统被成瘾改变并导致危险的性行为。了解感兴趣的商品如何相互作用，以及参与这种评估的神经系统可能会提出新的方法来改变病理评估并影响与艾滋病毒传播相关的风险行为。