Sommer C, Garbusow M, Jünger E, Pooseh S, Bernhardt N, Birkenstock J, Schad D J, Jabs B, Glöckler T, Huys Q M, Heinz A, Smolka M N, Zimmermann U S
Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany.
Transl Psychiatry. 2017 Aug 1;7(8):e1183. doi: 10.1038/tp.2017.158.
Alcohol-related cues acquire incentive salience through Pavlovian conditioning and then can markedly affect instrumental behavior of alcohol-dependent patients to promote relapse. However, it is unclear whether similar effects occur with alcohol-unrelated cues. We tested 116 early-abstinent alcohol-dependent patients and 91 healthy controls who completed a delay discounting task to assess choice impulsivity, and a Pavlovian-to-instrumental transfer (PIT) paradigm employing both alcohol-unrelated and alcohol-related stimuli. To modify instrumental choice behavior, we tiled the background of the computer screen either with conditioned stimuli (CS) previously generated by pairing abstract pictures with pictures indicating monetary gains or losses, or with pictures displaying alcohol or water beverages. CS paired to money gains and losses affected instrumental choices differently. This PIT effect was significantly more pronounced in patients compared to controls, and the group difference was mainly driven by highly impulsive patients. The PIT effect was particularly strong in trials in which the instrumental stimulus required inhibition of instrumental response behavior and the background CS was associated to monetary gains. Under that condition, patients performed inappropriate approach behavior, contrary to their previously formed behavioral intention. Surprisingly, the effect of alcohol and water pictures as background stimuli resembled that of aversive and appetitive CS, respectively. These findings suggest that positively valenced background CS can provoke dysfunctional instrumental approach behavior in impulsive alcohol-dependent patients. Consequently, in real life they might be easily seduced by environmental cues to engage in actions thwarting their long-term goals. Such behaviors may include, but are not limited to, approaching alcohol.
与酒精相关的线索通过经典条件作用获得激励显著性，进而可显著影响酒精依赖患者的工具性 行为，促使复发。然而，尚不清楚与酒精无关的线索是否会产生类似影响。我们对116名早期戒断 的酒精依赖患者和91名健康对照者进行了测试，他们完成了一项延迟折扣任务以评估选择冲动性， 并参与了一个使用与酒精无关和与酒精相关刺激的巴甫洛夫到工具性转移（PIT）范式实验。为了 改变工具性选择行为，我们用之前通过将抽象图片与表示金钱得失的图片配对产生的条件刺激 （CS）平铺电脑屏幕背景，或者用展示酒精或水饮料的图片平铺。与金钱得失配对的CS对工具性 选择的影响不同。与对照组相比，这种PIT效应在患者中显著更明显，且组间差异主要由高冲动 性患者驱动。在工具性刺激需要抑制工具性反应行为且背景CS与金钱收益相关的试验中，PIT效应 尤其强烈。在这种情况下，患者表现出不适当的趋近行为，与他们之前形成的行为意图相反。令人 惊讶的是，酒精和水图片作为背景刺激的效果分别类似于厌恶和喜好的CS的效果。这些发现表明， 正价背景CS可在冲动性酒精依赖患者中引发功能失调的工具性趋近行为。因此，在现实生活中， 他们可能很容易被环境线索诱惑而做出阻碍其长期目标的行为。此类行为可能包括但不限于接近酒精。
