Perceived alcohol reward value and risk: Neural correlates and treatment effects

描述（由申请人提供）：关于酒精滥用的研究几乎没有提供关于影响积极行为改变的机制的确切证据。确定人们如何改变的困难不仅适用于寻求治疗的少数人群，而且适用于绝大多数不寻求治疗的重度酒精使用者。最近，越来越多的注意力已经给予需要跨学科的研究，认为行为变化是一个人的环境，思想和行为，以及大脑功能之间的复杂相互作用的结果。这些研究提供了新的机会，以确定人们如何改变他们的酒精使用行为。本申请提出了一个多学科的研究方法，以确定酒精相关的认知的作用，积极的行为变化之间的非治疗寻求重度酒精使用者。拟议的研究将试图描述行为干预的影响，包括酒精筛查和基于动机的短期治疗对酒精相关的奖励和风险的看法的组成部分。这些干预措施是最有力的支持实证研究和一个假定的机制是减少酒精的感知价值，虽然这还没有直接调查。此外，奖励价值将通过功能性磁共振成像（fMRI）使用行为和神经指标进行检查。迄今为止，还没有研究使用功能磁共振成像来表征酒精相关的行为改变机制。参与者（n=60）将被随机分配到单次行为干预或注意力匹配的健康教育条件下，不会解决酒精使用。酒精奖励值将使用两个功能磁共振成像范例，酒精线索反应和酒精购买任务，进行多维评估。将使用其他行为措施来评估奖励和感知风险。将在基线和2周后（干预后立即）使用2（基线/干预后）x 2（主动行为干预/对照）混合设计评估酒精奖励值和感知风险。与控制条件相比，我们假设，积极干预将显着降低酒精的价值，无论是在行为表现和神经活动的功能磁共振成像范例。我们还假设，积极干预将显着增加饮酒的感知风险。进一步假设，减少感知酒精奖励和增加感知酒精风险将介导干预效果，减少1个月随访时的酒精使用量。感兴趣的大脑区域将包括那些与学习和记忆，奖励敏感性和执行功能相关的区域。这项研究的结果可能会显着加深我们对短暂酒精干预中行为变化的行为和神经机制的理解。反过来，这项拟议中的研究可能会为未来的努力提供信息，以促进普通人群中重度饮酒者的积极行为改变。

DESCRIPTION (provided by applicant): Research on alcohol misuse has provided little definitive evidence about the mechanisms that influence positive behavior change. The difficulty of identifying how people change applies not only to the narrow segment of the population who are treatment seekers, but also to the vast majority of heavy alcohol users who do not seek treatment. Recently, increased attention has been given to the need for cross-disciplinary research that views behavior change as the result of a complex interplay between one's environment, thoughts and behaviors, and brain function. Such research provides new opportunities to identify how people change their alcohol use behavior. This application proposes a multidisciplinary research approach to identify the role of alcohol-related cognitions in positive behavior change among non-treatment seeking heavy alcohol users. The proposed study will attempt to characterize the effects of a behavioral intervention that incorporates components of alcohol screening and a motivation-based brief therapy on perceptions of alcohol-related reward and risk. These interventions are among the most robustly supported by empirical research and a putative mechanism is reduction of the perceived value of alcohol, although this has not been directly investigated. In addition, reward value will be examined using both behavioral and neural indices via functional magnetic resonance imaging (fMRI). No studies to date have used fMRI to characterize alcohol-related mechanisms of behavior change. Participants (n=60) will be randomized to either a single-session behavioral intervention or to an attention-matched health education condition that will not address alcohol use. Alcohol reward value will be characterized using two fMRI paradigms, alcohol cue reactivity and an alcohol purchase task, for a multidimensional assessment. Additional behavioral measures will be used to assess reward and perceived risk. Alcohol reward value and perceived risks will be assessed at baseline and 2 weeks later (immediately after the intervention) using a 2 (baseline/post-intervention) x 2 (active behavioral intervention/control) mixed design. Compared to the control condition, we hypothesize that the active intervention will significantly reduce the value of alcohol, both in behavioral performance and neural activity on both fMRI paradigms. We also hypothesize that the active intervention will significantly increase the perceived risk of drinking It is further hypothesized that decreases in perceived alcohol rewards and increases in perceived alcohol risks will mediate an intervention effect on reducing quantity of alcohol use at 1-month follow-up. Brain regions of interest will include those associated with learning and memory, reward sensitivity and executive function. Findings from this research may significantly further our understanding of the behavioral and neural mechanisms of behavior change in brief alcohol interventions. In turn, the proposed study may inform future efforts to promote positive behavior change among heavy drinkers in the general population.