Behavioral dysregulation (BD) in young adults has been widely cited as a potentially critical predictor of alcohol use disorders AUDs. BD is a multifaceted phenomenon characterized by the overvaluation of immediate gratification, behavioral disinhibition, impulsivity, and sensation seeking. The mechanisms underlying relations between BD and AUDs remain largely unknown. The objective of the R21 described herein is to elucidate an innovative model to better understand the mechanisms underlying relations between BD and AUDs. The model is based on an independent literature which underscores the importance of a phenomenon termed 'cue-reactivity'in the motivation to consume alcohol. Exposure to alcohol cues in the environment can trigger strong urges to drink;this cue-reactivity has been reliably modeled under laboratory conditions, and the magnitude of cue-reactivity has been shown to predict drinking behavior in persons with AUDs. Interestingly, early evidence from the nicotine dependence literature, as well as our preliminary data, have raised the possibility that BD may play an important role in potentiating the effects of exposure to cues, which in turn may impact demand for alcohol, thus increasing the risk of developing AUDs. Indeed, classic conceptualizations of BD emphasize that individuals with high levels of BD have great difficulty in resisting responses to reward cues. To date, there has been no research formally examining the interplay between behavioral dysregulation, alcohol cue-reactivity, and demand for alcohol. We propose an experimental study to test a new model in which BD is hypothesized to influence drinking in two ways: 1) by potentiating alcohol cue- reactivity, which in turn will predict increased immediate demand for alcohol, and, 2) by moderating relations between alcohol cue-reactivity and demand for alcohol, such that cue-reactivity is more strongly predictive of increased demand among individuals with higher levels of BD.
Aim 1 : To test the possibility that BD predicts heightened levels of alcohol cue-reactivity, which in turn predicts increased demand for alcohol. Young adult social drinkers aged 18-25 (n=160) will: 1) complete self-report and computer-task-based measures of BD, 2) participate in a classic laboratory alcohol cue-reactivity paradigm, and, 3) complete a behavioral economic assessment of demand for alcohol following the cue-exposures.
Aim 2 : To test the possibility that alcohol cue-reactivity is more strongly predictive of increased demand for alcohol among young adults with higher levels of BD. Statistical modeling of the moderating effects of BD on relations between cue-reactivity and demand for alcohol will be conducted, using the data from Aim 1, above.
Alcohol use disorders impose a major public health burden in the United States. It is estimated that more than one in 12 Americans will suffer from a disorder related to alcohol use (e.g., abuse, dependence) this year, not to mention the prevalence and seriousness of other adverse consequences of problem drinking (e.g., traffic accidents, violence). A better understanding of behavioral mechanisms underlying risk for the development of AUDs is critical at this juncture, as efforts to prevent the development of AUDs could have profound public health implications.
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