Using Neuroeconomics to Understand Alcohol Overvaluation in Alcohol Use Disorder

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PROJECT SUMMARY/ABSTRACT The novel field of neuroeconomics integrates concepts and methods from psychology, economics, and cognitive neuroscience to understand the neurobiological foundations of decision making, and has been increasingly applied to understanding alcohol use disorder (AUD). A novel focus in neuroeconomics is alcohol demand, or the value of alcohol as measured by cost-benefit preferences. Behaviorally, alcohol demand has been found to be elevated among individuals with higher levels of alcohol misuse and to predict treatment response. In addition, alcohol demand can also be dynamically increased via acute stress. These findings are consistent with theoretical perspectives that emphasize both stable tonic and acute phasic aspects of motivation. The overall goal of the proposed studies is to characterize the neural activity that subserves these established behavioral findings using a novel functional magnetic resonance imaging paradigm. The first aim is to examine how the brain represents the value of alcohol in individuals with AUD compared to a control group. To do so, the first study will use a between-subjects case-control design to identify differences in neural activity associated with elevations in alcohol demand in individuals with AUD (i.e., cases) versus individuals who drink regularly but do not have an AUD and are matched on key variables (i.e., controls). The second aim is to investigate the changes in neural activity associated with stress-elicited increases in the value of alcohol. To do so, a second study will use a within-subjects design, comparing demand-associated neural activity following a neutral induction to neural activity following a stress induction in individuals with AUD. The third aim is to investigate the relationship between patterns of neural activity during alcohol demand decision making and intervention response. To do so, all participants with AUD in Study #1 and Study #2 will receive Motivational Enhancement Therapy, a previously validated four-session manualized motivational interviewing intervention, and neural activity during the alcohol demand paradigm will be used to predict subsequent drinking at 1-month and 6-month follow-up. Collectively, these aims will systematically apply a novel neuroeconomic approach to diverse aspects of AUD across the translational spectrum, from basic differences in neural activity to predictors of intervention response.