Behavioral Dysregulation: Impact on Alcohol Cue-Reactivity and Demand for Alcohol

描述（由申请人提供）：年轻人的行为失调（BD）被广泛认为是酒精使用障碍（aud）的潜在关键预测因素。双相障碍是一种多方面的现象，其特征是对即时满足的高估、行为去抑制、冲动和感觉寻求。双相障碍和AUDs之间关系的潜在机制在很大程度上仍然未知。本文描述的R21的目的是阐明一个创新的模型，以更好地理解BD和AUDs之间关系的潜在机制。该模型基于一篇独立的文献，该文献强调了一种被称为“线索反应性”的现象在饮酒动机中的重要性。接触环境中的酒精线索会引发强烈的饮酒冲动；这种线索反应性已经在实验室条件下可靠地建立了模型，并且线索反应性的大小已被证明可以预测aud患者的饮酒行为。有趣的是，来自尼古丁依赖文献的早期证据，以及我们的初步数据，提出了双相障碍可能在增强暴露于线索的影响方面发挥重要作用的可能性，这反过来可能影响对酒精的需求，从而增加患aud的风险。事实上，双相障碍的经典概念强调，高水平双相障碍的个体在抵抗奖励线索的反应方面有很大的困难。到目前为止，还没有正式的研究检查行为失调、酒精线索反应和酒精需求之间的相互作用。我们提出了一项实验研究来测试一个新的模型，在这个模型中，双相障碍被假设以两种方式影响饮酒：1)通过增强酒精线索反应性，这反过来会预测对酒精的即时需求增加；2)通过调节酒精线索反应性和对酒精的需求之间的关系，使得线索反应性更能预测双相障碍水平较高的个体对酒精的需求增加。为了测试双相障碍预测酒精线索反应性升高的可能性，

DESCRIPTION (provided by applicant): Behavioral dysregulation (BD) in young adults has been widely cited as a potentially critical predictor of alcohol use disorders AUDs. BD is a multifaceted phenomenon characterized by the overvaluation of immediate gratification, behavioral disinhibition, impulsivity, and sensation seeking. The mechanisms underlying relations between BD and AUDs remain largely unknown. The objective of the R21 described herein is to elucidate an innovative model to better understand the mechanisms underlying relations between BD and AUDs. The model is based on an independent literature which underscores the importance of a phenomenon termed 'cue-reactivity' in the motivation to consume alcohol. Exposure to alcohol cues in the environment can trigger strong urges to drink; this cue-reactivity has been reliably modeled under laboratory conditions, and the magnitude of cue-reactivity has been shown to predict drinking behavior in persons with AUDs. Interestingly, early evidence from the nicotine dependence literature, as well as our preliminary data, have raised the possibility that BD may play an important role in potentiating the effects of exposure to cues, which in turn may impact demand for alcohol, thus increasing the risk of developing AUDs. Indeed, classic conceptualizations of BD emphasize that individuals with high levels of BD have great difficulty in resisting responses to reward cues. To date, there has been no research formally examining the interplay between behavioral dysregulation, alcohol cue-reactivity, and demand for alcohol. We propose an experimental study to test a new model in which BD is hypothesized to influence drinking in two ways: 1) by potentiating alcohol cue- reactivity, which in turn will predict increased immediate demand for alcohol, and, 2) by moderating relations between alcohol cue-reactivity and demand for alcohol, such that cue-reactivity is more strongly predictive of increased demand among individuals with higher levels of BD. Aim 1: To test the possibility that BD predicts heightened levels of alcohol cue-reactivity, which in turn predicts increased demand for alcohol. Young adult social drinkers aged 18-25 (n=160) will: 1) complete self-report and computer-task-based measures of BD, 2) participate in a classic laboratory alcohol cue-reactivity paradigm, and, 3) complete a behavioral economic assessment of demand for alcohol following the cue-exposures. Aim 2: To test the possibility that alcohol cue-reactivity is more strongly predictive of increased demand for alcohol among young adults with higher levels of BD. Statistical modeling of the moderating effects of BD on relations between cue-reactivity and demand for alcohol will be conducted, using the data from Aim 1, above.