Resurgence of a target behavior suppressed by a combination of punishment and alternative reinforcement

Resurgence of ethanol seeking following voluntary abstinence produced by nondrug differential reinforcement of other behavior

Resurgence refers to the relapse of a target behavior following the worsening of a source of alternative reinforcement that was made available during response elimination. Most laboratory analyses of resurgence have used a combination of extinction and alternative reinforcement to reduce target behavior. In contingency-management treatments for alcohol use disorder, however, alcohol use is not placed on extinction. Instead, participants voluntarily abstain from alcohol use to access nondrug alternative reinforcers. Inasmuch, additional laboratory research on resurgence following voluntary abstinence is warranted. The present experiment evaluated resurgence of rats' ethanol seeking following voluntary abstinence produced by differential reinforcement of other behavior (DRO). Lever pressing produced ethanol reinforcers during baseline phases. During DRO phases, lever pressing continued to produce ethanol and food reinforcers were delivered according to resetting DRO schedules. Ethanol and food reinforcers were suspended during resurgence test phases to evaluate resurgence following voluntary abstinence. Lever pressing was elevated during baseline phases and occurred at near-zero rates during DRO phases. During the resurgence test phases, lever pressing increased, despite that it no longer produced ethanol. The procedure introduced here may help researchers better understand the variables that affect voluntary abstinence from ethanol seeking and resurgence following voluntary abstinence.

A systematic review of enhanced resurgence paradigms

Following successful treatment in which problem behavior is reduced, it may reemerge as a function of changes in contextual stimuli or the worsening of reinforcement conditions for an alternative response. Although understudied, preliminary research suggests that simultaneous changes in contextual stimuli and reinforcement conditions may represent particularly exigent treatment challenges that create the condition for additive or superadditive relapse. The purpose of the present review was to systematically examine the relapse literature involving simultaneous changes in contextual stimuli and reinforcement conditions in relapse tests and experimental preparations arranged to evaluate their effect on response recovery. We identified 16 empirical articles spanning 27 experiments. Although all experiments included at least one condition that experienced a change in contextual stimuli and worsening of alternative reinforcement conditions, only two experiments included the comparison conditions needed to precisely evaluate additive and superadditive relapse. Our findings establish the preclinical generality of relapse effects associated with simultaneous changes to reinforcement conditions and contextual stimuli across a range of subjects, schedule arrangements, response topographies, reinforcers, and types of contextual changes. We make several recommendations for future research based on our findings from this nascent and clinically relevant subdomain of the relapse literature.

Incubation of methamphetamine craving in punishment-resistant individuals is associated with activation of specific gene networks in the rat dorsal striatum

Methamphetamine use disorder (MUD) is characterized by loss of control over compulsive drug use. Here, we used a self-administration (SA) model to investigate transcriptional changes associated with the development of early and late compulsivity during contingent footshocks. Punishment initially separated methamphetamine taking rats into always shock-resistant (ASR) rats that continued active lever pressing and shock-sensitive (SS) rats that reduced their lever pressing. At the end of the punishment phase, rats underwent 15 days of forced abstinence at the end of which they were re-introduced to the SA paradigm followed by SA plus contingent shocks. Interestingly, 36 percent of the initial SS rats developed delayed shock-resistance (DSR). Of translational relevance, ASR rats showed more incubation of methamphetamine craving than DSR and always sensitive (AS) rats. RNA sequencing revealed increased striatal Rab37 and Dipk2b mRNA levels that correlated with incubation of methamphetamine craving. Interestingly, Bdnf mRNA levels showed HDAC2-dependent decreased expression in the AS rats. The present SA paradigm should help to elucidate the molecular substrates of early and late addiction-like behaviors.

A Comprehensive Systematic Review of Procedures and Analyses Used in Basic and Preclinical Studies of Resurgence, 1970-2020

Resurgence is the return of a previously reinforced response as conditions worsen for an alternative response, such as the introduction of extinction, reductions in reinforcement, or punishment. As a procedure, resurgence has been used to model behavioral treatments and understand behavioral processes contributing both to relapse of problem behavior and flexibility during problem-solving. Identifying existing procedural and analytic methods arranged in basic/preclinical research could be used by basic and preclinical researchers to develop novel approaches to study resurgence, whereas translational and clinical researchers could identify potential approaches to combating relapse during behavioral interventions. Despite the study of resurgence for over half a century, there have been no systematic reviews of the basic/preclinical research on resurgence. To characterize the procedural and analytic methods used in basic/preclinical research on resurgence, we performed a systematic review consistent with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). We identified 120 articles consisting of 200 experiments that presented novel empirical research, examined operant behavior, and included standard elements of a resurgence procedure. We reported prevalence and trends in over 60 categories, including participant characteristics (e.g., species, sample size, disability), designs (e.g., single subject, group), procedural characteristics (e.g., responses, reinforcer types, control conditions), criteria defining resurgence (e.g., single test, multiple tests, relative to control), and analytic strategies (e.g., inferential statistics, quantitative analysis, visual inspection). We make some recommendations for future basic, preclinical, and clinical research based on our findings of this expanding literature.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40614-022-00361-y.

Nondrug reinforcers contingent on alternative behavior or abstinence increase resistance to extinction and reinstatement of ethanol-maintained behavior

The effects of delivering nondrug alternative reinforcement on resistance to extinction and reinstatement of rats' ethanol-maintained lever pressing were evaluated in two experiments. In both, rats self-administered ethanol by lever pressing in a two-component multiple schedule during baseline. In the Rich component, alternative food reinforcement was made available for performing an alternative response (Experiment 1) or according to a differential-reinforcement-of-other-behavior schedule for lever pressing (Experiment 2). In the Lean component, only ethanol was available. Moreover, the frequency of alternative reinforcement was manipulated across conditions in Experiment 1. Following baseline, lever pressing was extinguished in both components by suspending ethanol reinforcement, and alternative food reinforcers were discontinued. Finally, to test for reinstatement, ethanol reinforcers were delivered independently of lever pressing in both components. In both experiments, proportion-of-baseline response rates were higher during extinction and reinstatement testing in the Rich component than in the Lean component (although differentiation was not observed at the lowest frequency of alternative reinforcement in Experiment 1). Thus, alternative nondrug reinforcers increased resistance to extinction and reinstatement of rats' ethanol-maintained lever pressing, even when those reinforcers were delivered contingently on an alternative response or on abstinence from lever pressing.

Can we enhance the clinical efficacy of cognitive and psychological approaches to treat substance use disorders through understanding their neurobiological mechanisms?

Despite decades of research in the field of addiction, relapse rates for substance use disorders remain high. Consequently, there has been growing focus on providing evidence-based treatments for substance use disorders, resulting in the increased development and use of cognitive and psychological interventions. Such treatment approaches, including contingency management, community-reinforcement approach, and cognitive bias modification, have shown promising clinical efficacy in reducing substance use and promoting abstinence during treatment. However, these interventions are still somewhat limited in achieving sustained periods of abstinence post-treatment. The neurobiological mechanisms underpinning these treatment approaches remain largely unknown and under-studied, in part, due to a lack of translational animal models. The adoption of a reverse translational approach may assist in development of more representative models that can facilitate elucidation of the mechanisms behind these clinically relevant interventions. This review examines our current understanding of addiction neurobiology from clinical, preclinical research and existing animal models, and considers how the efficacy of such behavioral-oriented interventions alone, or in combination with pharmacotherapy, may be enhanced to improve treatment outcomes.

Effects of repeated exposure to escalating versus constant punishment intensity on response allocation

The present experiment investigated the effects of 1) repeated exposures to escalating punishment intensities and 2) repeated exposure to punishment after periods of vacation on response allocation between punished and unpunished responding in three groups of rats. The first group (intensity + vacation) experienced repeated exposures to escalating punishment intensities after a period of vacation (i.e., return to baseline) from punishment. The second group (intensity-only) experienced repeated exposures to escalating punishment intensities without vacation from punishment. The third group (vacation-only) experienced repeated exposures to a constant punishment intensity after a period of vacation from punishment. Results showed that superimposition of punishment on one of two concurrently available responses decreased allocation toward the punished response and increased allocation toward the unpunished response. Furthermore, greater changes in allocation were observed with the introduction of a moderate constant intensity than with the introduction of a low intensity that increased across sessions. Reexposure to punishment had different effects between the groups. Although there was evidence that high shock intensities can enhance the efficacy of lower intensities to shift allocation away from the punished response and toward the unpunished response, there was little evidence of changes in response allocation with reintroduction of punishment after a period of vacation.

Modeling resurgence with an evolutionary theory of behavior dynamics

McDowell's (2004) Evolutionary Theory of Behavior Dynamics (ETBD) is a computational theory that has reproduced a wide variety of behavioral phenomena observed in material reality. Here, we extended the generality of the ETBD by successfully replicating laboratory studies of resurgence with live animals using artificial organisms (AOs) animated by the theory. We ran AOs on concurrent random-interval random-interval (conc RI RI) schedules of reinforcement wherein one alternative (i.e., a target behavior) was reinforced while the other alternative (i.e., an alternative behavior) was not reinforced. Then, we placed the target behavior on extinction and reinforced the alternative response, producing a shift in allocation of responding from the target behavior to the alternative response. Finally, schedule thinning of the alternative response (i.e., downshifts) resulted in resurgence of target behavior. Our findings indicated that resurgence increased as a function of the relative downshift in reinforcement rate and magnitude, replicating findings from previous studies with live animals. These results further illustrate the utility of the ETBD for generating dynamic behavioral data and serve as a proof-of-concept for a novel computational approach for studying and understanding resurgence in future studies.

Resurgence of alcohol seeking following abstinence induced by punishment in male and female rats

To better approximate the human condition, animal models of relapse to drug and alcohol seeking have increasingly employed negative consequences to generate abstinence. Here we report the first demonstration of relapse to punishment-suppressed alcohol seeking induced by loss of non-drug reward (i.e., resurgence). We also report the first examination of potential sex differences in any form of relapse to alcohol seeking following suppression by punishment. Male and female rats first pressed a lever for 20 % oral alcohol. Next, lever pressing for one group continued to produce alcohol, but also produced occasional footshock. For another group, lever pressing similarly produced alcohol and occasional footshock, and a nose-poke response produced alternative non-drug reward (i.e., food). Males showed similar suppression of alcohol seeking by punishment alone and punishment + alternative non-drug reward, whereas females showed less suppression by punishment alone. Finally, when alternative reinforcement and punishment were suspended, resurgence occurred for both sexes in the group that previously had access to non-drug reward. Exposure to and then removal of punishment alone did not produce relapse for males, but it did for females. These results suggest that loss of alternative non-drug reward can generate relapse to alcohol seeking following abstinence induced by negative consequences. Future research should further examine the role of potential sex differences in sensitivity to punishment and how such differences may contribute to relapse more broadly.

Effects of response cost magnitude on resurgence of human operant behavior

Extensive research has been dedicated to the study of resurgence following extinction and differential reinforcement of alternative behavior. Less is known about the effects of punishment on resurgence. This study extended previous research by examining whether the magnitude of response cost punishment affects resurgence of human operant behavior. College students engaged in a computer task using the three-phase resurgence procedure where points were used to reinforce target (Phase 1) or alternative (Phase 2) behavior. Across three groups, Phase 2 contingencies for the target response were manipulated. In one group, only extinction was implemented. In the other two groups, response cost was also implemented. Response cost was equal to or double the number of points that could be gained for alternative responding. Resurgence was similar in Phase 3 across the three groups, demonstrating that neither the addition nor the magnitude of punishment differentially affected response recovery under these conditions. Future research should examine other parameters of punishment (e.g., delay, schedule) and how these variables interact with different parameters of alternative reinforcement to increase our understanding of the conditions under which resurgence may be exacerbated or minimized.

Resurgence of punishment-suppressed cocaine seeking in rats

Alternative reinforcement-based treatments are among the most effective for reducing substance abuse. However, relapse often occurs when alternative reinforcement ends. Relapse following the loss of alternative reinforcement is called resurgence. An animal model has been used to study basic factors that may ultimately reduce resurgence but uses drug unavailability (i.e., extinction) to reduce drug seeking. In humans, drug abstinence is thought to be a product of aversive consequences associated with drug use rather than extinction. This discrepancy is important because the environmental and neurobiological factors involved in relapse may differ between punished and extinguished behavior. Experiment 1 evaluated resurgence of previously punished cocaine seeking. In Phase 1, rats earned cocaine for pressing levers. In Phase 2, cocaine remained available, but lever pressing also produced mild foot shocks while an alternative response produced food pellets for 1 group but not for another group. In Phase 3, alternative reinforcement and punishment were removed and resurgence of cocaine seeking occurred only in rats previously exposed to alternative reinforcement. In Experiment 2, resurgence was evaluated similarly, except that consequences of cocaine seeking (i.e., punishment and cocaine) remained available during Phase 3. Resurgence did not occur in either group during Experiment 2. The animal models of resurgence developed herein could increase translational utility and improve examination of the environmental and neurobiological factors underlying resurgence of drug seeking. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The control response in assessing resurgence: Useful or compromised tool?

Resurgence experiments sometimes include an operandum on which a history of reinforcement has not been experimentally established. The purpose of this control operandum is to rule out a generalized increase in responding when the alternative response is extinguished as being the cause of the resurgent target response. A review of the results of experiments conducted with both nonhumans and humans in which a control operandum was included shows that control- operandum responding is more common in the latter and almost nonexistent in the former. Both the presence and absence of responding on the control operandum, however, are subject to multiple interpretations thereby rendering it a compromised tool. Alternatives to using a control operandum to rule out extinction induction as the basis for resurgence include a preresurgence test control procedure and a differential resurgence procedure.