The effects of stress on decision-making in alcohol use disorder: A translational approach

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ABSTRACT The objective of this translational project is to test the effects of acute stress induction on cognitive flexibility and habit learning among individuals with AUD compared to matched controls. Towards elucidating the complex interplay between alcohol and stress, it is crucial to elucidate brain circuitry and mechanisms that underlie how alcohol and stress interact across a range of domains. To date, much of our understanding of such mechanisms is confined to the preclinical level of analysis. To advance the translational impact of the science of stress and AUD, this application proposes an investigation in a clinical sample with AUD, combining careful experimental manipulations of stress induction, functional magnetic resonance imaging (fMRI), and a well-defined assessment of decision making. We propose to test the effects of acute stress induction on cognitive flexibility (i.e., Wisconsin Card Sort Task; WCST) and habit learning (i.e., Sequential Decision-Making Task; SDMT) in a sample of 64 individuals, 32 non-treatment seeking individuals with AUD and 32 matched controls (no AUD). All participants will complete a chronic stress-informed battery. Baseline measures of cognitive flexibility and habit learning (WCST and SDMT) will be collected. Eligible participants will complete a neuroimaging-based stress-induction task, immediately preceded and followed by assessments of cognitive flexibility and habit learning (WCST and SDMT). The overarching goal is to test whether response to an acute stress induction is associated with decreases on cognitive flexibility and increases in habit learning in individuals with AUD compared to matched controls. If the study hypotheses are supported and acute stress decreases cognitive flexibility and enhances habit learning in individuals with AUD, compared to matched controls, we will undertake large scale (R01-level) studies in which both stress/neural conditions and decision- making measures are completed using neuroimaging paradigms so that neurocircuitry of both stress response and decision-making can be interrogated.