Learning and decision-making as predictors for the development of alcohol use disorders

有害酒精使用和酒精使用障碍（AUDs）在工业化国家很普遍，仅在德国就影响到大约600万人。鉴于AUDs的发病主要发生在青春期和成年早期，有针对性的预防是可取的，特别是在发生AUDs的高风险年轻人中。目前，人们对AUD易感性的因素知之甚少；因此，本项目旨在确定功能失调酒精消费（即危险酒精使用、酒精滥用和酒精依赖）的潜在责任机制。基于成瘾是一种归因于异常学习和决策的障碍的假设，我们预测学习行为和决策的个体间差异与对AUD的责任和恢复力有关。为了验证我们的假设，我们在第一个资助期对200名18岁的年轻男性进行了特征分析，并将在三年的随访期间前瞻性地评估酒精消费和AUDs的发展；在21岁时，所有受试者将通过行为测试和成像进行重新评估。在基线上，我们研究了三组预测变量：(i)个体学习参数，通过学习任务（如巴甫洛夫-工具迁移和两阶段马尔可夫决策任务）中的行为表现的计算建模来估计；（ii）在学习过程中通过脑功能成像评估这些学习参数的个体神经相关性；（三）确定的风险因素，如酗酒家族史以及冲动和基于价值的决策的不同方面。

Hazardous alcohol use and alcohol use disorders (AUDs) are prevalent in industrialized countries, affecting approximately 6 million individuals in Germany alone. Given that the onset of AUDs predominantly occurs during adolescence and early adulthood, targeted prevention is desirable, especially in young people who are at high risk of developing AUDs. Currently, little is known about the factors that predispose individuals to AUD; therefore this project aims to identify mechanisms underlying liability for dysfunctional alcohol consumption (i.e. hazardous alcohol use, alcohol abuse and alcohol dependence). Based on the hypothesis that addiction is a disorder attributed to aberrant learning and decision-making, we predict that inter-individual differences in learning behaviour and decision-making are associated with liability for, as well as resilience against AUD. To test our hypotheses, we characterized 200 young men at age 18 during the first funding period, and will prospectively assess alcohol consumption and development of AUDs during the three year follow-up period; at age 21 all subjects will be reassessed with behavioural tests and imaging. At baseline, we studied three clusters of predictive variables: (i) individual learning parameters, estimated by computational modelling of behavioural performance in learning tasks such as Pavlovian-to-instrumental transfer and a two stage Markov decision task; (ii) individual neural correlates of these learning parameters, assessed by functional brain imaging during learning; and (iii) established risk factors such as family history of alcoholism and different facets of impulsivity and value-based decision-making.