May April C, Jacobus Joanna, Stewart Jennifer L, Simmons Alan N, Paulus Martin P, Tapert Susan F
San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA 92120, USA.
Department of Psychiatry, University of California, San Diego, San Diego, CA 92093, USA.
Brain Sci. 2020 Apr 5;10(4):214. doi: 10.3390/brainsci10040214.
Alcohol and cannabis use are highly prevalent among adolescents and associated with negative consequences. Understanding motivations behind substance use in youth is important for informing prevention and intervention efforts. The present study aims to examine negative reinforcement principles of substance use among adolescent cannabis and alcohol users by pairing a cue reactivity paradigm with an aversive interoceptive stimulus. Adolescents (ages 15-17), classified as controls (CTL; = 18), cannabis and/or alcohol experimenters (CAN+ALC-EXP; = 16), or individuals meeting clinical criteria for cannabis and/or alcohol use disorder (CAN+ALC-SUD; = 13) underwent functional magnetic resonance imaging during which they experienced an aversive interoceptive probe delivered via breathing load while simultaneously performing a cue reactivity paradigm. Participants also provided self-report ratings of how their substance use is positively or negatively reinforced. While experiencing the breathing load, CAN+ALC-SUD exhibited greater ( < 0.05) deactivation in the right amygdala, the left inferior frontal gyrus, and the left parahippocampal gyrus than CAN+ALC-EXP and CTL, who did not differ. Across all substance users, activation during the breathing load within the left parahippocampal gyrus negatively correlated with cannabis and alcohol lifetime use episodes and the left inferior frontal gyrus activity negatively correlated with lifetime alcohol use episodes. CAN+ALC-SUD reported experiencing more positive and negative reinforcement of using their substance of choice than CAN+ALC-EXP; both user groups reported higher levels of positive than negative reinforcement. Adolescents with a cannabis/alcohol use disorder demonstrate an altered response to interoceptive perturbations. However, adolescent cannabis/alcohol use does not appear to be driven by negative reinforcement, as viewing substance images did not dampen this response. Based on self-report data, the experience of positive reinforcement may be stronger for adolescents. Future studies should examine whether positive reinforcement contributes to adolescent substance use.
酒精和大麻的使用在青少年中非常普遍，且会带来负面后果。了解青少年使用物质背后的动机对于指导预防和干预工作很重要。本研究旨在通过将线索反应范式与厌恶的内感受性刺激配对，来检验青少年大麻和酒精使用者中物质使用的负强化原则。青少年（年龄在15 - 17岁）被分为对照组（CTL；n = 18）、大麻和/或酒精实验者（CAN + ALC - EXP；n = 16）或符合大麻和/或酒精使用障碍临床标准的个体（CAN + ALC - SUD；n = 13），他们接受了功能磁共振成像，在此期间，他们在同时进行线索反应范式时，经历了通过呼吸负荷传递的厌恶内感受性探测。参与者还提供了关于他们的物质使用如何得到正性或负性强化的自我报告评分。在经历呼吸负荷时，CAN + ALC - SUD在右侧杏仁核、左侧额下回和左侧海马旁回的失活程度比CAN + ALC - EXP和CTL更大（p < 0.05），而CAN + ALC - EXP和CTL之间没有差异。在所有物质使用者中，左侧海马旁回在呼吸负荷期间的激活与大麻和酒精的终生使用次数呈负相关，左侧额下回的活动与终生酒精使用次数呈负相关。CAN + ALC - SUD报告称，与CAN + ALC - EXP相比，他们在使用所选物质时经历了更多的正性和负性强化；两个使用者组报告的正性强化水平均高于负性强化。患有大麻/酒精使用障碍的青少年对内感受性扰动的反应有所改变。然而，青少年大麻/酒精使用似乎并非由负强化驱动，因为观看物质图像并未减弱这种反应。基于自我报告数据，正性强化的体验对青少年可能更强。未来的研究应考察正性强化是否促成青少年物质使用。
