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Pisupati S, Langdon A, Konova AB, Niv Y. The utility of a latent-cause framework for understanding addiction phenomena. ADDICTION NEUROSCIENCE 2024; 10:100143. [PMID: 38524664 PMCID: PMC10959497 DOI: 10.1016/j.addicn.2024.100143] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
Computational models of addiction often rely on a model-free reinforcement learning (RL) formulation, owing to the close associations between model-free RL, habitual behavior and the dopaminergic system. However, such formulations typically do not capture key recurrent features of addiction phenomena such as craving and relapse. Moreover, they cannot account for goal-directed aspects of addiction that necessitate contrasting, model-based formulations. Here we synthesize a growing body of evidence and propose that a latent-cause framework can help unify our understanding of several recurrent phenomena in addiction, by viewing them as the inferred return of previous, persistent "latent causes". We demonstrate that applying this framework to Pavlovian and instrumental settings can help account for defining features of craving and relapse such as outcome-specificity, generalization, and cyclical dynamics. Finally, we argue that this framework can bridge model-free and model-based formulations, and account for individual variability in phenomenology by accommodating the memories, beliefs, and goals of those living with addiction, motivating a centering of the individual, subjective experience of addiction and recovery.
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Affiliation(s)
- Sashank Pisupati
- Limbic Limited, London UK
- Princeton Neuroscience Institute & Department of Psychology, Princeton University, Princeton NJ, USA
| | - Angela Langdon
- National Institute of Mental Health & National Institute on Drug Abuse, National Institutes of Health, Bethesda MD, USA
| | - Anna B Konova
- Department of Psychiatry, University Behavioral Health Care & Brain Health Institute Rutgers University, New Brunswick NJ, USA
| | - Yael Niv
- Princeton Neuroscience Institute & Department of Psychology, Princeton University, Princeton NJ, USA
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2
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Bağci B, Düsmez S, Zorlu N, Bahtiyar G, Isikli S, Bayrakci A, Heinz A, Schad DJ, Sebold M. Computational analysis of probabilistic reversal learning deficits in male subjects with alcohol use disorder. Front Psychiatry 2022; 13:960238. [PMID: 36339830 PMCID: PMC9626515 DOI: 10.3389/fpsyt.2022.960238] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 09/27/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Alcohol use disorder is characterized by perseverative alcohol use despite negative consequences. This hallmark feature of addiction potentially relates to impairments in behavioral flexibility, which can be measured by probabilistic reversal learning (PRL) paradigms. We here aimed to examine the cognitive mechanisms underlying impaired PRL task performance in patients with alcohol use disorder (AUDP) using computational models of reinforcement learning. METHODS Twenty-eight early abstinent AUDP and 27 healthy controls (HC) performed an extensive PRL paradigm. We compared conventional behavioral variables of choices (perseveration; correct responses) between groups. Moreover, we fitted Bayesian computational models to the task data to compare differences in latent cognitive variables including reward and punishment learning and choice consistency between groups. RESULTS AUDP and HC did not significantly differ with regard to direct perseveration rates after reversals. However, AUDP made overall less correct responses and specifically showed decreased win-stay behavior compared to HC. Interestingly, AUDP showed premature switching after no or little negative feedback but elevated proneness to stay when accumulation of negative feedback would make switching a more optimal option. Computational modeling revealed that AUDP compared to HC showed enhanced learning from punishment, a tendency to learn less from positive feedback and lower choice consistency. CONCLUSION Our data do not support the assumption that AUDP are characterized by increased perseveration behavior. Instead our findings provide evidence that enhanced negative reinforcement and decreased non-drug-related reward learning as well as diminished choice consistency underlie dysfunctional choice behavior in AUDP.
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Affiliation(s)
- Başak Bağci
- Department of Psychiatry, Katip Celebi University Ataturk Education and Research Hospital, İzmir, Turkey
| | - Selin Düsmez
- Department of Psychiatry, Midyat State Hospital, Mardin, Turkey
| | - Nabi Zorlu
- Department of Psychiatry, Katip Celebi University Ataturk Education and Research Hospital, İzmir, Turkey
| | - Gökhan Bahtiyar
- Department of Psychiatry, Bingöl State Hospital, Bingöl, Turkey
| | - Serhan Isikli
- Department of Psychiatry, Katip Celebi University Ataturk Education and Research Hospital, İzmir, Turkey
| | - Adem Bayrakci
- Department of Psychiatry, Katip Celebi University Ataturk Education and Research Hospital, İzmir, Turkey
| | - Andreas Heinz
- Department of Psychiatry and Neurosciences, Charité Campus Mitte (CCM), Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Daniel J Schad
- Department of Psychology, Health and Medical University, Potsdam, Germany
| | - Miriam Sebold
- Department of Psychiatry and Neurosciences, Charité Campus Mitte (CCM), Charité-Universitätsmedizin Berlin, Berlin, Germany
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Gueguen MCM, Schweitzer EM, Konova AB. Computational theory-driven studies of reinforcement learning and decision-making in addiction: What have we learned? Curr Opin Behav Sci 2020; 38:40-48. [PMID: 34423103 DOI: 10.1016/j.cobeha.2020.08.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Computational psychiatry provides a powerful new approach for linking the behavioral manifestations of addiction to their precise cognitive and neurobiological substrates. However, this emerging area of research is still limited in important ways. While research has identified features of reinforcement learning and decision-making in substance users that differ from health, less emphasis has been placed on capturing addiction cycles/states dynamically, within-person. In addition, the focus on few behavioral variables at a time has precluded more detailed consideration of related processes and heterogeneous clinical profiles. We propose that a longitudinal and multidimensional examination of value-based processes, a type of dynamic "computational fingerprint", will provide a more complete understanding of addiction as well as aid in developing better tailored and timed interventions.
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Affiliation(s)
- Maëlle C M Gueguen
- Department of Psychiatry, University Behavioral Health Care, & the Brain Health Institute, Rutgers University-New Brunswick, Piscataway, USA
| | - Emma M Schweitzer
- Department of Psychiatry, University Behavioral Health Care, & the Brain Health Institute, Rutgers University-New Brunswick, Piscataway, USA.,Graduate Program in Cell Biology & Neuroscience, Rutgers University-New Brunswick, Piscataway, USA
| | - Anna B Konova
- Department of Psychiatry, University Behavioral Health Care, & the Brain Health Institute, Rutgers University-New Brunswick, Piscataway, USA
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Groefsema MM, Engels RC, Voon V, Schellekens AF, Luijten M, Sescousse G. Brain responses to anticipating and receiving beer: Comparing light, at-risk, and dependent alcohol users. Addict Biol 2020; 25:e12766. [PMID: 31066137 PMCID: PMC7187239 DOI: 10.1111/adb.12766] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 02/26/2019] [Accepted: 03/30/2019] [Indexed: 12/15/2022]
Abstract
Impaired brain processing of alcohol‐related rewards has been suggested to play a central role in alcohol use disorder. Yet, evidence remains inconsistent and mainly originates from studies in which participants passively observe alcohol cues or taste alcohol. Here, we designed a protocol in which beer consumption was predicted by incentive cues and contingent on instrumental action closer to real life situations. We predicted that anticipating and receiving beer (compared with water) would elicit activity in the brain reward network and that this activity would correlate with drinking level across participants. The sample consisted of 150 beer‐drinking males, aged 18 to 25 years. Three groups were defined based on alcohol use disorders identification test (AUDIT) scores: light drinkers (n = 39), at‐risk drinkers (n = 64), and dependent drinkers (n = 47). fMRI measures were obtained while participants engaged in the beer incentive delay task involving beer‐ and water‐predicting cues followed by real sips of beer or water. During anticipation, outcome notification and delivery of beer compared with water, higher activity was found in a reward‐related brain network including the dorsal medial prefrontal cortex, orbitofrontal cortex, and amygdala. Yet, no activity was observed in the striatum, and no differences were found between the groups. Our results reveal that anticipating, obtaining, and tasting beer activates parts of the brain reward network, but that these brain responses do not differentiate between different drinking levels.
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Affiliation(s)
- Martine M. Groefsema
- Executive BoardRadboud University, Behavioural Science Institute Nijmegen The Netherlands
| | | | - Valerie Voon
- Cambridge University, Behavioural and Clinical Neuroscience Institute Cambridge United Kingdom
| | | | - Maartje Luijten
- Executive BoardRadboud University, Behavioural Science Institute Nijmegen The Netherlands
| | - Guillaume Sescousse
- Radboud University, Donders Institute for Brain, Cognition and Behaviour Nijmegen The Netherlands
- Centre de Recherche en Neurosciences de Lyon, INSERM U1028, CNRS UMR5292, PSYR2 Team Lyon France
- CH Le Vinatier, Service Universitaire d'Addictologie Bron France
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Perales JC, King DL, Navas JF, Schimmenti A, Sescousse G, Starcevic V, van Holst RJ, Billieux J. Learning to lose control: A process-based account of behavioral addiction. Neurosci Biobehav Rev 2019; 108:771-780. [PMID: 31846653 DOI: 10.1016/j.neubiorev.2019.12.025] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 12/13/2019] [Accepted: 12/13/2019] [Indexed: 12/24/2022]
Abstract
Learning psycho(bio)logy has developed a solid corpus of evidence and theory regarding behavior control modes. The present article briefly reviews that literature and its influence on recent models in which the transition from goal-directed to compulsive behavior is identified as the main process underlying substance use disorders. This literature is also relevant to non-substance addictive disorders, and serves as basis to propose a restricted definition of behavioral addiction relying on the presence of behavior-specific compulsivity. Complementarily, we consider whether some activities can become disordered while remaining mostly goal-driven. Based on reinforcement learning models, relative outcome utility computation is proposed as an alternative mechanism through which dysfunctional behaviors (even not qualifying as addictive) can override adaptive ones, causing functional impairment. Beyond issues of conceptual delimitation, recommendations are made regarding the importance of identifying individual etiological pathways to dysregulated behavior, the necessity of accurately profiling at-risk individuals, and the potential hazards of symptom-based diagnosis. In our view, the validity of these recommendations does not depend on the position one takes in the nosological debate.
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Affiliation(s)
- José C Perales
- Department of Experimental Psychology, Mind Brain and Behavior Research Center (CIMCYC), University of Granada, Spain
| | - Daniel L King
- College of Education, Psychology, & Social Work, Flinders University, Australia
| | - Juan F Navas
- Department of Basic Psychology, Autonomous University of Madrid, Spain; Universitat Oberta de Catalunya, Spain.
| | | | - Guillaume Sescousse
- Lyon Neuroscience Research Center - INSERM U1028 - CNRS UMR5292, PSYR2 Team, University of Lyon, France
| | - Vladan Starcevic
- University of Sydney, Faculty of Medicine and Health, Sydney Medical School, Nepean Clinical School, Discipline of Psychiatry, Australia
| | - Ruth J van Holst
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Institute for Addiction Research, Netherlands
| | - Joël Billieux
- Addictive and Compulsive Behaviours Lab. Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg; Institute of Psychology, University of Lausanne, Lausanne, Switzerland; Centre for Excessive Gambling, Lausanne University Hospitals (CHUV), Lausanne, Switzerland
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Tanabe J, Regner M, Sakai J, Martinez D, Gowin J. Neuroimaging reward, craving, learning, and cognitive control in substance use disorders: review and implications for treatment. Br J Radiol 2019; 92:20180942. [PMID: 30855982 PMCID: PMC6732921 DOI: 10.1259/bjr.20180942] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 02/13/2019] [Accepted: 02/21/2019] [Indexed: 01/17/2023] Open
Abstract
Substance use disorder is a leading causes of preventable disease and mortality. Drugs of abuse cause molecular and cellular changes in specific brain regions and these neuroplastic changes are thought to play a role in the transition to uncontrolled drug use. Neuroimaging has identified neural substrates associated with problematic substance use and may offer clues to reduce its burden on the patient and society. Here, we provide a narrative review of neuroimaging studies that have examined the structures and circuits associated with reward, cues and craving, learning, and cognitive control in substance use disorders. Most studies use advanced MRI or positron emission tomography (PET). Many studies have focused on the dopamine neurons of the ventral tegmental area, and the regions where these neurons terminate, such as the striatum and prefrontal cortex. Decreases in dopamine receptors and transmission have been found in chronic users of drugs, alcohol, and nicotine. Recent studies also show evidence of differences in structure and function in substance users relative to controls in brain regions involved in salience evaluation, such as the insula and anterior cingulate cortex. Balancing between reward-related bottom-up and cognitive-control-related top-down processes is discussed in the context of neuromodulation as a potential treatment. Finally, some of the challenges for understanding substance use disorder using neuroimaging methods are discussed.
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Affiliation(s)
| | - Michael Regner
- Department of Radiology, University of Colorado Anschutz Medical Center, Aurora, CO
| | - Joseph Sakai
- Department of Psychiatry, University of Colorado Anschutz Medical Center, Aurora, CO
| | - Diana Martinez
- Department of Psychiatry, Columbia University, New York, USA
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Nebe S, Kroemer NB, Schad DJ, Bernhardt N, Sebold M, Müller DK, Scholl L, Kuitunen-Paul S, Heinz A, Rapp MA, Huys QJ, Smolka MN. No association of goal-directed and habitual control with alcohol consumption in young adults. Addict Biol 2018; 23:379-393. [PMID: 28111829 DOI: 10.1111/adb.12490] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 12/02/2016] [Accepted: 12/06/2016] [Indexed: 01/14/2023]
Abstract
Alcohol dependence is a mental disorder that has been associated with an imbalance in behavioral control favoring model-free habitual over model-based goal-directed strategies. It is as yet unknown, however, whether such an imbalance reflects a predisposing vulnerability or results as a consequence of repeated and/or excessive alcohol exposure. We, therefore, examined the association of alcohol consumption with model-based goal-directed and model-free habitual control in 188 18-year-old social drinkers in a two-step sequential decision-making task while undergoing functional magnetic resonance imaging before prolonged alcohol misuse could have led to severe neurobiological adaptations. Behaviorally, participants showed a mixture of model-free and model-based decision-making as observed previously. Measures of impulsivity were positively related to alcohol consumption. In contrast, neither model-free nor model-based decision weights nor the trade-off between them were associated with alcohol consumption. There were also no significant associations between alcohol consumption and neural correlates of model-free or model-based decision quantities in either ventral striatum or ventromedial prefrontal cortex. Exploratory whole-brain functional magnetic resonance imaging analyses with a lenient threshold revealed early onset of drinking to be associated with an enhanced representation of model-free reward prediction errors in the posterior putamen. These results suggest that an imbalance between model-based goal-directed and model-free habitual control might rather not be a trait marker of alcohol intake per se.
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Affiliation(s)
- Stephan Nebe
- Department of Psychiatry and Psychotherapy; Technische Universität Dresden; Germany
- Neuroimaging Center; Technische Universität Dresden; Germany
| | - Nils B. Kroemer
- Department of Psychiatry and Psychotherapy; Technische Universität Dresden; Germany
- Neuroimaging Center; Technische Universität Dresden; Germany
| | - Daniel J. Schad
- Department of Psychiatry and Psychotherapy; Charité - Universitätsmedizin Berlin; Germany
- Social and Preventive Medicine, Area of Excellence Cognitive Sciences; University of Potsdam; Germany
| | - Nadine Bernhardt
- Department of Psychiatry and Psychotherapy; Technische Universität Dresden; Germany
| | - Miriam Sebold
- Department of Psychiatry and Psychotherapy; Charité - Universitätsmedizin Berlin; Germany
| | - Dirk K. Müller
- Department of Psychiatry and Psychotherapy; Technische Universität Dresden; Germany
- Neuroimaging Center; Technische Universität Dresden; Germany
| | - Lucie Scholl
- Institute of Clinical Psychology and Psychotherapy; Technische Universität Dresden; Germany
| | - Sören Kuitunen-Paul
- Institute of Clinical Psychology and Psychotherapy; Technische Universität Dresden; Germany
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy; Charité - Universitätsmedizin Berlin; Germany
| | - Michael A. Rapp
- Social and Preventive Medicine, Area of Excellence Cognitive Sciences; University of Potsdam; Germany
| | - Quentin J.M. Huys
- Translational Neuromodeling Unit, Department of Biomedical Engineering; University of Zürich, and Swiss Federal Institute of Technology (ETH) Zürich; Switzerland
- Centre for Addictive Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry; University of Zürich; Switzerland
| | - Michael N. Smolka
- Department of Psychiatry and Psychotherapy; Technische Universität Dresden; Germany
- Neuroimaging Center; Technische Universität Dresden; Germany
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Computational Psychiatry: From Mechanistic Insights to the Development of New Treatments. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2016; 1:382-385. [DOI: 10.1016/j.bpsc.2016.08.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 08/01/2016] [Indexed: 12/22/2022]
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