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

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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.