Perceived alcohol reward value and risk: Neural correlates and treatment effects

描述(由申请者提供)：关于酒精滥用的研究几乎没有提供关于影响积极行为改变的机制的确凿证据。确定人们如何改变的困难不仅适用于寻求治疗的一小部分人口，也适用于绝大多数没有寻求治疗的重度酒精使用者。最近，人们越来越关注跨学科研究的必要性，这些研究将行为变化视为一个人的环境、思想和行为以及大脑功能之间复杂相互作用的结果。这样的研究为确定人们如何改变他们的饮酒行为提供了新的机会。本申请提出了一种多学科研究方法，以确定与酒精相关的认知在非治疗寻求重度酒精使用者的积极行为改变中的作用。这项拟议的研究将试图表征行为干预的影响，该干预包括酒精筛查和基于动机的短暂治疗对与酒精相关的奖励和风险的感知的影响。这些干预措施得到了实证研究的最有力支持，一个可能的机制是降低了酒精的感知价值，尽管这一点尚未得到直接调查。此外，奖励价值将通过功能磁共振成像(FMRI)使用行为和神经指数进行检查。到目前为止，还没有研究使用fMRI来表征与酒精相关的行为改变机制。参与者(n=60)将被随机分为单次行为干预组或不涉及饮酒问题的注意力匹配的健康教育条件组。酒精奖励价值将使用两个fMRI范式来表征，即酒精线索反应性和酒精购买任务，以进行多维评估。额外的行为测量将被用来评估回报和感知风险。酒精奖赏价值和感知风险将在基线和2周后(干预后立即)采用2(基线/干预后)×2(积极行为干预/对照)混合设计进行评估。与对照条件相比，我们假设积极干预将显著降低酒精的价值，无论是在行为表现还是在两种fMRI范式上的神经活动。我们还假设，积极干预将显着增加饮酒的感知风险。进一步假设，感知酒精奖励的减少和感知酒精风险的增加将中介1个月随访时减少饮酒量的干预效果。大脑感兴趣的区域将包括与学习和记忆、奖励敏感性和执行功能相关的区域。这项研究的发现可能会大大加深我们对短暂酒精干预中行为变化的行为和神经机制的理解。反过来，这项拟议的研究可能会为未来在普通人群中促进酗酒者积极行为改变的努力提供参考。

DESCRIPTION (provided by applicant): Research on alcohol misuse has provided little definitive evidence about the mechanisms that influence positive behavior change. The difficulty of identifying how people change applies not only to the narrow segment of the population who are treatment seekers, but also to the vast majority of heavy alcohol users who do not seek treatment. Recently, increased attention has been given to the need for cross-disciplinary research that views behavior change as the result of a complex interplay between one's environment, thoughts and behaviors, and brain function. Such research provides new opportunities to identify how people change their alcohol use behavior. This application proposes a multidisciplinary research approach to identify the role of alcohol-related cognitions in positive behavior change among non-treatment seeking heavy alcohol users. The proposed study will attempt to characterize the effects of a behavioral intervention that incorporates components of alcohol screening and a motivation-based brief therapy on perceptions of alcohol-related reward and risk. These interventions are among the most robustly supported by empirical research and a putative mechanism is reduction of the perceived value of alcohol, although this has not been directly investigated. In addition, reward value will be examined using both behavioral and neural indices via functional magnetic resonance imaging (fMRI). No studies to date have used fMRI to characterize alcohol-related mechanisms of behavior change. Participants (n=60) will be randomized to either a single-session behavioral intervention or to an attention-matched health education condition that will not address alcohol use. Alcohol reward value will be characterized using two fMRI paradigms, alcohol cue reactivity and an alcohol purchase task, for a multidimensional assessment. Additional behavioral measures will be used to assess reward and perceived risk. Alcohol reward value and perceived risks will be assessed at baseline and 2 weeks later (immediately after the intervention) using a 2 (baseline/post-intervention) x 2 (active behavioral intervention/control) mixed design. Compared to the control condition, we hypothesize that the active intervention will significantly reduce the value of alcohol, both in behavioral performance and neural activity on both fMRI paradigms. We also hypothesize that the active intervention will significantly increase the perceived risk of drinking It is further hypothesized that decreases in perceived alcohol rewards and increases in perceived alcohol risks will mediate an intervention effect on reducing quantity of alcohol use at 1-month follow-up. Brain regions of interest will include those associated with learning and memory, reward sensitivity and executive function. Findings from this research may significantly further our understanding of the behavioral and neural mechanisms of behavior change in brief alcohol interventions. In turn, the proposed study may inform future efforts to promote positive behavior change among heavy drinkers in the general population.