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

描述(由申请者提供)：年轻人的行为失调(BD)被广泛引用为酒精使用障碍的潜在关键预测因子。BD是一种多方面的现象，其特征是高估即时满足、行为去抑制、冲动和感觉寻求。BD和AUDS之间的潜在关系的机制在很大程度上仍不清楚。本文描述的R21的目的是阐明一种创新的模型，以更好地理解BD和AUDS之间的潜在机制。该模型基于一项独立的文献，该文献强调了一种被称为“线索-反应”的现象在饮酒动机中的重要性。暴露在环境中的酒精线索可引发强烈的饮酒冲动；这种线索反应已在实验室条件下得到可靠的模拟，线索反应的幅度已被证明可预测AUDS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BD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，这反过来可能会影响对酒精的需求，从而增加患AUDS的风险。事实上，BD的经典概念化强调高BD水平的个体很难抵抗对奖励线索的反应。到目前为止，还没有正式的研究来检验行为失调、酒精提示反应和酒精需求之间的相互作用。我们建议进行一项实验研究，以测试一个新的模型，在该模型中，BD被假设通过两种方式影响饮酒：1)通过增强酒精线索反应性，这反过来将预测对酒精的即时需求增加；以及2)通过调节酒精线索反应性和酒精需求之间的关系，使得线索反应性更强地预测BD水平较高的个人的需求增加。目标1：为了测试BD预测酒精线索反应性水平升高的可能性， 这反过来又预示着对酒精的需求将会增加。年龄在18-25岁的年轻成年社交饮酒者(n=160)将：1)完成自我报告和基于计算机任务的BD测量；2)参与经典的实验室酒精线索-反应范式；3)完成线索暴露后酒精需求的行为经济学评估。目的2：测试酒精提示反应性更强地预测BD水平较高的年轻人对酒精需求增加的可能性。将使用上述目标1的数据，对BD对线索反应性和酒精需求之间的关系的调节作用进行统计建模。

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.