The impact of alcohol priming on craving and motivation to drink: a meta-analysis

The need for multi-participant alcohol administration studies

Laboratory alcohol administration studies have largely neglected the social context in which drinking typically occurs. To advance our understanding of alcohol use and its associated harms, we need more multi-participant studies that examine alcohol’s effects in social settings and how social contexts influence alcohol use.

Modular Maximization Theory: A functional account of economic behavior in laboratory animal models with applications to drug-seeking behavior

Substance abuse research depends on precise and sensitive assessments of reinforcer efficacy in animal models. However, conventional methods often lack theoretical rigor and specificity to support these assessments. To address these gaps, the Modular Maximization Theory (MMT) is introduced as a comprehensive framework for understanding instrumental behavior. Like earlier maximization theories, MMT posits that behavior is distributed across alternatives to maximize utility over time. This concept is structured through five foundational postulates that define alternative actions and rules for choosing between them as budget constraints and utility functions. A key innovation of MMT is its incorporation of reinforcer utilization-encompassing both consummatory and post-consummatory activities-into the budget-constraint function. A model of ratio-schedule performance is developed under the assumption that utilization is proportional to demand, with utility represented as an additive power function of reinforcer magnitude. This model, termed PURSPU (Proportional Utilization, Ratio Schedule, Power Utility), effectively explains how reinforcer magnitude, response effort, non-contingent reinforcement, and income influence demand curves, behavior-output functions, dose-response relationships, and progressive-ratio breakpoints, while accounting for rate-dependent effects. The model also offers novel insights into choice behavior, including concurrent-schedule performance, income dependency, and delay discounting, as well as post-reinforcement pauses and run rates. Variations in budget constraints and utility functions are proposed as alternative models. Potential theoretical advancements, more targeted assessments of drug abuse liability, and the broader role of MMT in understanding human drug abuse are explored.

A cue reactivity experiment: Exposure to images of alcoholic beverages and social contexts on alcohol cravings, motivations, attitudes, approval, and behavior

The incentive-sensitization theory of addiction postulates that relevant cues can trigger alcohol cravings, tendencies, and related outcomes. Additionally, consistent with the encoding specificity principle and social impact theory, social contexts depicting people can activate pro-alcohol reactions and tendencies. This randomized experiment tested the cue reactivity effects of exposure to images depicting variations in the number of people consuming alcoholic or nonalcoholic beverages on alcohol-related cravings and outcomes. The sample consisted of 594 adult alcohol users who passed manipulation checks. Participants were randomly assigned to a condition in a 2 (beverage type cue manipulation: alcoholic vs. nonalcoholic) × 3 (social context cue manipulation: beverage-only [no people] vs. solitary drinking [1 person] vs. social drinking [2 or more people]) factorial design and primed with a series of photographs. Dependent variables measured alcohol cravings, alcohol motives, alcohol attitudes, alcohol approval, and alcohol behavior. Factorial MANCOVA and ANCOVAs were performed. Main effects for the social context manipulation were found. Specifically, the social drinking condition compared to the beverage-only condition induced significantly higher pro-alcohol cravings, attitudes, and behaviors. The beverage type manipulation did not influence the dependent variables. The findings offer insights that visual cues depicting social drinking scenarios activated alcohol-related cravings and outcomes, regardless of whether the beverages shown were alcoholic or nonalcoholic. This priming experiment helps to understand the social mechanisms underlying cue reactivity and offers implications for advancing cue-based alcohol interventions.

The extrastriate symmetry response is robust to alcohol intoxication

Visual symmetry activates a network of regions in the extrastriate cortex and generates an event-related potential (ERP) called the sustained posterior negativity (SPN). Previous work has found that the SPN is robust to experimental manipulations of task, spatial attention, and memory load. In the current study, we investigated whether the SPN is also robust to alcohol-induced changes in mental state. A pilot experiment (N = 13) found that alcohol unexpectedly increased SPN amplitude. We followed this unexpected result with two new experiments on separate groups, using an alcohol challenge paradigm. One group completed an Oddball discrimination task (N = 26). Another group completed a Regularity discrimination task (N = 26). In both groups, participants consumed a medium dose of alcohol (0.65 g/kg body weight) and a placebo drink, in separate sessions. Alcohol reduced SPN amplitude in the Oddball task (contrary to the pilot results) but had no effect on SPN amplitude in the Regularity task. In contrast, the N1 wave was consistently dampened by alcohol in all experiments. Exploratory analysis indicated that the inconsistent effect of alcohol on SPN amplitude may be partly explained by individual differences in alcohol use. Alcohol reduced the SPN in light drinkers and increased it in heavier drinkers. Despite remaining questions, the results highlight the automaticity of symmetry processing. Symmetry still produces a large SPN response, even when participants are intoxicated, and even when symmetry is not task relevant.

Recurrence rates and risk factors for recurrence after first episode of acute pancreatitis: A systematic review and meta-analysis

BACKGROUND

There are a certain number of acute pancreatitis (AP) patients who may suffer from multiple episodes and develop recurrent acute pancreatitis (RAP), but recurrence rates and associated risk factors for RAP vary significantly in the published literature.

METHODS

We searched PubMed, Web of Science, Scopus, and Embase databases to identify all publications reporting AP recurrence until October 20th, 2022. Meta-analysis and meta-regression were performed to calculate the pooled estimates using the random-effects model.

RESULTS

A total of 36 studies met the inclusion criteria and all were used in pooled analyses. The overall rate of recurrence after first-time AP was 21% (95% CI, 18%- 24%), and pooled rates in biliary, alcoholic, idiopathic, and hypertriglyceridemia etiology patients were 12%, 30%, 25%, and 30%, respectively. After managing underlying causes post-discharge, the recurrence rate decreased (14% versus 4% for biliary, 30% versus 6% for alcoholic, and 30% versus 22% for hypertriglyceridemia AP). An increased risk of recurrence was reported in patients with a smoking history (odds ratio [OR] = 1.99), alcoholic etiology (OR = 1.72), male sex (hazard ratio [HR] = 1.63), and local complications (HR = 3.40), while biliary etiology was associated with lower recurrence rates (OR = 0.38).

CONCLUSION

More than one-fifth of AP patients experienced recurrence after discharge, with the highest recurrence rate in alcoholic and hypertriglyceridemia etiologies, and managing underlying causes post-discharge was related to decreased incidence. In addition, smoking history, alcoholic etiology, male gender, and presence of local complications were independent risks for the recurrence.