TY  - JOUR
A1  - Sebold, Miriam Hannah
A1  - Deserno, Lorenz
A1  - Nebe, Stefan
A1  - Schad, Daniel
A1  - Garbusow, Maria
A1  - Haegele, Claudia
A1  - Keller, Juergen
A1  - Juenger, Elisabeth
A1  - Kathmann, Norbert
A1  - Smolka, Michael N.
A1  - Rapp, Michael Armin
A1  - Schlagenhauf, Florian
A1  - Heinz, Andreas
A1  - Huys, Quentin J. M.
T1  - Model-based and model-free decisions in alcohol dependence
JF  - Neuropsychobiology : international journal of experimental and clinical research in biological psychiatry, pharmacopsychiatry, Biological Psychology/Pharmacopsychology and Pharmacoelectroencephalography
N2  - Background: Human and animal work suggests a shift from goal-directed to habitual decision-making in addiction. However, the evidence for this in human alcohol dependence is as yet inconclusive. Methods: Twenty-six healthy controls and 26 recently detoxified alcohol-dependent patients underwent behavioral testing with a 2-step task designed to disentangle goal-directed and habitual response patterns. Results: Alcohol-dependent patients showed less evidence of goal-directed choices than healthy controls, particularly after losses. There was no difference in the strength of the habitual component. The group differences did not survive controlling for performance on the Digit Symbol Substitution Task. Conclusion: Chronic alcohol use appears to selectively impair goal-directed function, rather than promoting habitual responding. It appears to do so particularly after nonrewards, and this may be mediated by the effects of alcohol on more general cognitive functions subserved by the prefrontal cortex.
KW  - Alcohol dependence
KW  - Decision-making
KW  - Reinforcement learning
KW  - Dopamine
KW  - Computational psychiatry
Y1  - 2014
U6  - https://doi.org/10.1159/000362840
SN  - 0302-282X
SN  - 1423-0224
VL  - 70
IS  - 2
SP  - 122
EP  - 131
PB  - Karger
CY  - Basel
ER  - 
TY  - JOUR
A1  - Sebold, Miriam Hannah
A1  - Nebe, Stephan
A1  - Garbusow, Maria
A1  - Guggenmos, Matthias
A1  - Schad, Daniel
A1  - Beck, Anne
A1  - Kuitunen-Paul, Sören
A1  - Sommer, Christian
A1  - Frank, Robin
A1  - Neu, Peter
A1  - Zimmermann, Ulrich S.
A1  - Rapp, Michael Armin
A1  - Smolka, Michael N.
A1  - Huys, Quentin J. M.
A1  - Schlagenhauf, Florian
A1  - Heinz, Andreas
T1  - When Habits Are Dangerous: Alcohol Expectancies and Habitual Decision Making Predict Relapse in Alcohol Dependence
JF  - Biological psychiatry : a journal of psychiatric neuroscience and therapeutics ; a publication of the Society of Biological Psychiatry
N2  - BACKGROUND: Addiction is supposedly characterized by a shift from goal-directed to habitual decision making, thus facilitating automatic drug intake. The two-step task allows distinguishing between these mechanisms by computationally modeling goal-directed and habitual behavior as model-based and model-free control. In addicted patients, decision making may also strongly depend upon drug-associated expectations. Therefore, we investigated model-based versus model-free decision making and its neural correlates as well as alcohol expectancies in alcohol-dependent patients and healthy controls and assessed treatment outcome in patients. METHODS: Ninety detoxified, medication-free, alcohol-dependent patients and 96 age-and gender-matched control subjects underwent functional magnetic resonance imaging during the two-step task. Alcohol expectancies were measured with the Alcohol Expectancy Questionnaire. Over a follow-up period of 48 weeks, 37 patients remained abstinent and 53 patients relapsed as indicated by the Alcohol Timeline Followback method. RESULTS: Patients who relapsed displayed reduced medial prefrontal cortex activation during model-based decision making. Furthermore, high alcohol expectancies were associated with low model-based control in relapsers, while the opposite was observed in abstainers and healthy control subjects. However, reduced model-based control per se was not associated with subsequent relapse. CONCLUSIONS: These findings suggest that poor treatment outcome in alcohol dependence does not simply result from a shift from model-based to model-free control but is instead dependent on the interaction between high drug expectancies and low model-based decision making. Reduced model-based medial prefrontal cortex signatures in those who relapse point to a neural correlate of relapse risk. These observations suggest that therapeutic interventions should target subjective alcohol expectancies.
KW  - Alcohol dependence
KW  - Alcohol expectancy
KW  - Goal-directed control
KW  - Medial prefrontal cortex
KW  - Reinforcement learning
KW  - Treatment outcome
Y1  - 2017
U6  - https://doi.org/10.1016/j.biopsych.2017.04.019
SN  - 0006-3223
SN  - 1873-2402
VL  - 82
SP  - 847
EP  - 856
PB  - Elsevier
CY  - New York
ER  -