Assessing Habitual, Goal-Directed, and Pavlovian Influences in Alcohol Use Disorder

Summary

The first aim of this study is to establish the role of maladaptive reliance on habits for impaired control in addiction, employing a novel task - the Action-Sequence-Task (AST), which assesses interference between habitual and goal-directed control. The AST, along with the developed computational model, will be employed to test whether participants with Alcohol Use Disorder (AUD) and control participants differ with respect to task performance and estimated model parameters. The investigators hypothesize stronger habitual behavior (increased habitual tendency) and an increased susceptibility to conflict between habitual and goal-directed control, measured as increased interference, are associated with AUD.

The second aim of the study is to understand whether Pavlovian-to-Instrumental Transfer (PIT) reflects more of a controlled, goal-directed process, or a more automatic, habitual process. The investigators will use the single-lever PIT task as it is an efficient tool for testing the interaction between Pavlovian cues and instrumental behavior, especially when they are in conflict. In these trials, top-down control must be allocated to successfully overcome the conflict, which may share some common underlying mechanisms with the arbitration between goal-directed and habitual behavior during conflict, as assessed by the novel AST. The third aim of the study is to investigate whether severely dependent AUD patients would show a stronger PIT effect compared to a control group, consistent with the investigators' previous findings.

Conditions

• Alcohol Use Disorder (AUD)
• Alcoholism
• Substance Use Disorders

Interventions

BEHAVIORAL

Pavlovian-to-instrumental transfer (PIT) paradigm

The paradigm consists of four parts: In the first part, an instrumental learning task is completed in which subjects must learn which stimuli require a response and which do not. In the second part, a classical (Pavlovian) conditioning task is then completed in which subjects learn by passive viewing which stimuli are associated with certain amounts of money. The third part measures to which instrumental responses (learned in Part 1) are modulated by the presentation of the classically conditioned stimuli (learned in Part 2). At the same time drug-associated stimuli are presented in the background measuring to which extent they conflict with the learned instrumental behavior. In the last part, query trials are implemented in which the participants have to choose between two pictures to assess the relative cue value.

BEHAVIORAL

Action Sequence Task (AST)

Participants need to press four keys according to the cue location; two keys are associated with high reward, while the other two are associated with low reward in case of correct and timely responses. The explicit goal is to maximize the reward. While in half of the trials the cues are presented in a random order, in the other half of the trials, participants repeatedly perform a fixed action sequence of 12 elements (habit condition). The degree of action sequence chunking (i.e. automation) is assessed via the differences in error rates and reaction times between the random and fixed order condition (habit parameter). Importantly, 15% of all trials are dual- target trials. In these the goal-directed system (press high reward key) and the action sequence (press sequence key) can either be in line (congruent trials) or in conflict (incongruent trials) with each other, thus the interference between goal-directed and habitual control can be tested.

DIAGNOSTIC_TEST

Basic psychological assessment (interview)

* Structured Clinical Interview for DSM Disorders (SCID) Current Depression: * SCID Mania * SCID alcohol use disorder (AUD) * SCID tobacco use disorder (TUD) * Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) * Alcohol quantity-frequency * Tobacco quantity-frequency * Cannabis and other substances quantity-frequency

DIAGNOSTIC_TEST

Basic psychological assessment (questionnaires)

* Sociodemographics * Edinburgh Handedness Inventory (EHI) * Fagerström Test for Nicotine depend (FTND) * Barratt Impulsiveness Scale - Kurzversion (BIS-15) * Alcohol Use Disorders Identification Test (AUDIT) * Cannabis Use Disorders Identification Test (CUDIT) * Adult ADHD Self-Report Scale (ASRS)

BEHAVIORAL

Neuropsychology tests

* Digit-Symbol-Test (DST) * Go/Nogo Simon task * Counting Stroop Task * Value-based decision-making task (VBDM)

Sponsors & Collaborators

• Charite University, Berlin, Germany

  collaborator OTHER

• Central Institute of Mental Health, Mannheim

  collaborator OTHER

• Technische Universität Dresden

  lead OTHER

Eligibility

Min Age

18 Years

Max Age

65 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2024-03-02

Primary Completion

2025-03-31

Completion

2027-06-30

Countries

• Germany

Study Locations