Modification of Pavlovian and Instrumental Learning in Human Addiction
Condition: Healthy; Alcohol Use Disorder (Mild vs. Moderate to Heavy)
MeSH terms: Alcoholism; Alcohol Drinking
Study type: Interventional

Summary: 
      The project aims at investigating modifications of environmental factors (i.e. cues and
      stress) relevant for learning mechanisms in addictive disorders.
    

Detailed description: 
      Project C02 aims at investigating modifications of environmental factors (i.e. cues and
      stress) relevant for learning mechanisms in addictive disorders. The investigators will
      examine non-treatment seeking subjects with alcohol use disorder (AUD; mild vs. moderate to
      heavy), and healthy controls with a focus on the impact of Pavlovian conditioned stimuli
      (context-related cues) on instrumental behavior (so-called Pavlovian-to-Instrumental transfer
      (PIT)) and whether the PIT effect can be systematically modified by manipulating the
      approach/ avoidance propensities of Pavlovian cues (work package (WP) 1). Concerning stress
      as a major modulator of cue reactivity in addiction, the investigators further plan to assess
      whether acute, active stress reduction modifies such PIT effects (i.e. decreasing transfer
      effects) as well as goal-directed vs. habitual behavior (i.e. strengthening goal-directed
      decisionmaking) (WP2). Lastly, this project aims at contributing to the understanding of the
      underlying neurobiological correlates of manipulation of approach/ avoidance propensities of
      Pavlovian cues and acute stress reduction by using functional magnetic resonance imaging
      (WP3) with a focus on amygdala-striatal activity (PIT) and frontostriatal processes
      (goaldirected decision-making).
    

Intervention name(s): Modified training version of the Approach / Avoidance Task (AAT, see Wiers et al., 2011); Mindfulness-based interventions (e.g. body scan)
Intervention type(s): Behavioral; Behavioral
Intervention description(s): First, a modified training version of the Approach Avoidance Task, (see Wiers et al. 2011) with arbitrary Pavlovian cues will be developed and the effectiveness of this manipulation will be assessed. In detail, positive as well as negative Pavlovian cues (derived from a Pavlovian-to-Instrumental transfer Task, see Garbusow et al. 2014, Garbusow et al. 2016) will be modified according to their approach/ avoidance propensities by 1) approaching negative stimuli (pulling joystick), 2) approaching positive stimuli (pulling joystick), 3) avoiding negative stimuli (pushing joystick) and 4) avoiding positive stimuli (pushing joystick). Thus, we aim at reversing the PIT effect (pushing positive cues/ pulling negative cues) or enhancing the PIT effect (pulling positive cues/ pushing negative cues).; Acute stress reduction will be applied in a standardized way using audio files with an anticipated duration of 20-30 minutes.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: approach / avoidance; alcohol use disorder; stress; stress reduction; goal-directed decision-making