Amsterdam Institute for Addiction Research, Amsterdam UMC, Department of Psychiatry, University of Amsterdam, The Netherlands; Habit Lab, Department of Clinical Psychology, University of Amsterdam, The Netherlands; Department of Social Health and Organizational Psychology, Utrecht University, The Netherlands.
Department of Psychology, University of Southern California, USA.
Addict Behav. 2023 May;140:107628. doi: 10.1016/j.addbeh.2023.107628. Epub 2023 Jan 24.
The development of addictive behaviors has been suggested to be related to a transition from goal-directed to habitual decision making. Stress is a factor known to prompt habitual behavior and to increase the risk for addiction and relapse. In the current study, we therefore used functional MRI to investigate the balance between goal-directed 'model-based' and habitual 'model-free' control systems and whether acute stress would differentially shift this balance in gambling disorder (GD) patients compared to healthy controls (HCs). Using a within-subject design, 22 patients with GD and 20 HCs underwent stress induction or a control condition before performing a multistep decision-making task during fMRI. Salivary cortisol levels showed that the stress induction was successful. Contrary to our hypothesis, GD patients did not show impaired goal-directed 'model-based' decision making, which remained similar to HCs after stress induction. Bayes factors provided three times more evidence against a difference between the groups or a group-by-stress interaction on the balance between model-based and model-free decision making. Similarly, no differences were found between groups and conditions on the neural estimates of model-based or model-free decision making. These results challenge the notion that GD is related to an increased reliance on habitual (or decreased goal-directed) control, even during stress.
成瘾行为的发展被认为与从目标导向决策向习惯决策的转变有关。压力是促使习惯行为产生并增加成瘾和复发风险的一个已知因素。在目前的研究中，我们使用功能磁共振成像来研究目标导向的“基于模型”和习惯的“无模型”控制系统之间的平衡，以及急性压力是否会对赌博障碍 (GD) 患者与健康对照 (HC) 之间的这种平衡产生不同的影响。我们采用了一种被试内设计，22 名 GD 患者和 20 名 HC 接受了压力诱导或对照条件，然后在 fMRI 期间进行了多步决策任务。唾液皮质醇水平表明压力诱导成功。与我们的假设相反，GD 患者并没有表现出目标导向的“基于模型”决策能力受损，这种能力在压力诱导后仍然与 HC 相似。贝叶斯因子提供了三倍多的证据，表明在基于模型和无模型决策之间的平衡方面，两组之间或组间与压力间的差异不存在。同样，在基于模型或无模型决策的神经估计方面，组间和条件间也没有差异。这些结果挑战了 GD 与习惯性（或目标导向性降低）控制增加有关的观点，即使在压力下也是如此。
