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

NCT06701500 | Recruiting

• 1 other identifier: 40217046123
• Study Type: observational
• Target: 180
• Locations: 1 country
• Sites: 1

Brief 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

Keywords

Substance use disorder (SUD); Alcohol use disorder (AUD); Outcome-specific Pavlovian to instrumental transfer; Humans; Surveys and Questionnaires; Reward; Cues; Habit formation; Goal-directed behavior

Outcome Measures

Primary Outcomes (2)

• Behavioral single-lever Pavlovian to instrumental transfer (PIT) effect

  Strength of interference PIT effect assessed with the single-lever PIT paradigm: increased error rate in the incongruent condition as compared with the congruent condition.

  1 day, 1 hour

• Action Sequence Task (AST) day one and day two

  Habit formation: faster response time and decreased errors of preforming fixed compared to the random action sequence. Shift from goal-directed to habitual control: less choices of the high reward keys in trials in the incongruent trials where the goal-directed control and the habitual action sequence are in conflict (incongruent trials)

  2 days, 1 hour per day

Secondary Outcomes (2)

• Counting Stroop task

  1 day, 10 minutes

• Go-Nogo Simon task

  1 day, 20 minutes

Study Arms (2)

Alcohol Use Disorder (AUD) Group

Participants with alcohol use disorder (moderate to severe if no withdrawal symptoms)

Behavioral: Pavlovian-to-instrumental transfer (PIT) paradigm; Behavioral: Action Sequence Task (AST); Diagnostic Test: Basic psychological assessment (interview); Diagnostic Test: Basic psychological assessment (questionnaires); Behavioral: Neuropsychology tests

Control Group

Participants without SUD

Behavioral: Pavlovian-to-instrumental transfer (PIT) paradigm; Behavioral: Action Sequence Task (AST); Diagnostic Test: Basic psychological assessment (interview); Diagnostic Test: Basic psychological assessment (questionnaires); Behavioral: Neuropsychology tests

Interventions

Pavlovian-to-instrumental transfer (PIT) paradigm BEHAVIORAL

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.

Alcohol Use Disorder (AUD) Group; Control Group

Action Sequence Task (AST) BEHAVIORAL

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.

Alcohol Use Disorder (AUD) Group; Control Group

Basic psychological assessment (interview) DIAGNOSTIC_TEST

* 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

Alcohol Use Disorder (AUD) Group; Control Group

Basic psychological assessment (questionnaires) DIAGNOSTIC_TEST

* 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)

Alcohol Use Disorder (AUD) Group; Control Group

Neuropsychology tests BEHAVIORAL

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

Alcohol Use Disorder (AUD) Group; Control Group

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Participants recruited through the addiction in- and outpatient clinic of University Hospital Dresden as well as from our partner clinic in Radebeul.

You may qualify if:

• years of age
• AUD subjects only: meet 4 or more criteria for DSM-5 alcohol use disorder
• Sufficient motor skills and visual acuity to use PC
• Ability to consent to the study and complete the questionnaires
• Sufficient German skills

You may not qualify if:

• Lifetime diagnosis of DSM-5 bipolar disorder, schizophrenia or schizophrenia spectrum disorder
• Current diagnosis of severe major depression according to DSM-5, or presence of suicidal intention
• Pregnancy
• Severe withdrawal symptoms
• Acute drug intoxication at the appointments

Sponsors & Collaborators

• Technische Universität Dresden: lead
• Charite University, Berlin, Germany: collaborator
• Central Institute of Mental Health, Mannheim: collaborator

Study Sites (1)

Department of Psychiatry and Psychotherapy, Technische Universität Dresden

Dresden, Germany

RECRUITING

Related Publications (4)

• Belanger MJ, Chen H, Hentschel A, Garbusow M, Ebrahimi C, Knorr FG, Zech HG, Pilhatsch M, Heinz A, Smolka MN. Development of Novel Tasks to Assess Outcome-Specific and General Pavlovian-to-Instrumental Transfer in Humans. Neuropsychobiology. 2022;81(5):370-386. doi: 10.1159/000526774. Epub 2022 Nov 14.

  PMID: 36380640 BACKGROUND

• Frolich S, Esmeyer M, Endrass T, Smolka MN, Kiebel SJ. Interaction between habits as action sequences and goal-directed behavior under time pressure. Front Neurosci. 2023 Jan 13;16:996957. doi: 10.3389/fnins.2022.996957. eCollection 2022.

  PMID: 36711151 BACKGROUND

• Kronke KM, Wolff M, Benz A, Goschke T. Successful smoking cessation is associated with prefrontal cortical function during a Stroop task: A preliminary study. Psychiatry Res. 2015 Oct 30;234(1):52-6. doi: 10.1016/j.pscychresns.2015.08.005. Epub 2015 Aug 20.

  PMID: 26321462 BACKGROUND

• Chmielewski WX, Beste C. Testing interactive effects of automatic and conflict control processes during response inhibition - A system neurophysiological study. Neuroimage. 2017 Feb 1;146:1149-1156. doi: 10.1016/j.neuroimage.2016.10.015. Epub 2016 Oct 11.

  PMID: 27742599 BACKGROUND

MeSH Terms

Conditions

Alcoholism; Substance-Related Disorders

Condition Hierarchy (Ancestors)

Alcohol-Related Disorders; Chemically-Induced Disorders; Mental Disorders

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 25, 2024
• First Posted: November 22, 2024
• Study Start: March 2, 2024
• Primary Completion: March 31, 2025
• Study Completion (Estimated): June 30, 2027
• Last Updated: November 22, 2024

Record last verified: 2024-09

Locations

DE (1)