Skip to main content Accessibility help
×
Home

A study on the correlates of habit-, reward-, and fear-related motivations in alcohol use disorder

  • Marcelo Piquet-Pessôa (a1), Samuel R. Chamberlain (a2) (a3), Rico S. C. Lee (a4), Gabriela M. Ferreira (a1), Marcelo S. Cruz (a5), Ana P. Ribeiro (a5), Gabriela B. de Menezes (a1), Lucy Albertella (a4), Murat Yücel (a4) and Leonardo F. Fontenelle (a1) (a4) (a6)...

Abstract

Objective.

We assessed self-reported drives for alcohol use and their impact on clinical features of alcohol use disorder (AUD) patients. Our prediction was that, in contrast to “affectively” (reward or fear) driven drinking, “habitual” drinking would be associated with worse clinical features in relation to alcohol use and higher occurrence of associated psychiatric symptoms.

Methods.

Fifty-eight Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) alcohol abuse patients were assessed with a comprehensive battery of reward- and fear-based behavioral tendencies. An 18-item self-report instrument (the Habit, Reward and Fear Scale; HRFS) was employed to quantify affective (fear or reward) and non-affective (habitual) motivations for alcohol use. To characterize clinical and demographic measures associated with habit, reward, and fear, we conducted a partial least squares analysis.

Results.

Habitual alcohol use was significantly associated with the severity of alcohol dependence reflected across a range of domains and with lower number of detoxifications across multiple settings. In contrast, reward-driven alcohol use was associated with a single domain of alcohol dependence, reward-related behavioral tendencies, and lower number of detoxifications.

Conclusion.

These results seem to be consistent with a shift from goal-directed to habit-driven alcohol use with severity and progression of addiction, complementing preclinical work and informing biological models of addiction. Both reward-related and habit-driven alcohol use were associated with lower number of detoxifications, perhaps stemming from more benign course for the reward-related and lack of treatment engagement for the habit-related alcohol abuse group. Future work should further explore the role of habit in this and other addictive disorders, and in obsessive-compulsive related disorders.

Copyright

Corresponding author

*Address correspondence to: Leonardo F. Fontenelle, Rua Visconde de Pirajá, 547, 617, Ipanema, Rio de Janeiro-RJ 22410-003, Brazil. (Email: lfontenelle@gmail.com)

Footnotes

Hide All

This work was supported by the Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (L.F., grant numbers 211.191/2015); Conselho Nacional de Desenvolvimento Científico e Tecnológico (L.F., grant number 308237/2014-5); D’Or Institute for Research and Education (L.F.); and the David Winston Turner Endowment Fund (L.F.).

Footnotes

References

Hide All
1. Rehm, J, Mathers, C, Popova, S, Thavorncharoensap, M, Teerawattananon, Y, Patra, J. Global burden of disease and injury and economic cost attributable to alcohol use and alcohol-use disorders. Lancet. 2009; 373(9682): 22232233.
2. Galduroz, JCF, Caetano, R. Epidemiologia do uso de álcool no Brasil [Epidemiology of alcohol use in Brazil]. Rev Bras Psiquiatr. 2004; 26(Suppl I): 36.
3. Lewis, MJ. Alcohol: mechanisms of addiction and reinforcement. Adv Alcohol Subst Abuse. 1990; 9(1–2): 4766.
4. Belin, D, Jonkman, S, Dickinson, A, Robbins, TW, Everitt, BJ. Parallel and interactive learning processes within the basal ganglia: relevance for the understanding of addiction. Behav Brain Res. 2009; 199(1): 89102.
5. Kalivas, PW. Addiction as a pathology in prefrontal cortical regulation of corticostriatal habit circuitry. Neurotox Res. 2008; 14(2–3): 185189.
6. Dickinson, A, Wood, N, Smith, JW. Alcohol seeking by rats: action or habit? Q J Exp Psychol B. 2002; 55(4): 331348.
7. Corbit, LH, Janak, PH. Habitual alcohol seeking: neural bases and possible relations to alcohol use disorders. Alcohol Clin Exp Res. 2016; 40(7): 13801389.
8. Everitt, BJ, Robbins, TW. Drug addiction: updating actions to habits to compulsions ten years on. Annu Rev Psychol. 2016; 67: 2350.
9. Blaine, SK, Milivojevic, V, Fox, H, Sinha, R. Alcohol effects on stress pathways: impact on craving and relapse risk. Can J Psychiatry. 2016; 61(3): 145153.
10. Heilig, M, Thorsell, A, Sommer, WH, et al. Translating the neuroscience of alcoholism into clinical treatments: from blocking the buzz to curing the blues. Neurosci Biobehav Rev. 2010; 35(2): 334344.
11. Sebold, M, Deserno, L, Nebe, S, et al. Model-based and model-free decisions in alcohol dependence. Neuropsychobiology. 2014; 70(2): 122131.
12. Sjoerds, Z, de Wit, S, van den Brink, W, et al. Behavioral and neuroimaging evidence for overreliance on habit learning in alcohol-dependent patients. Transl Psychiatry. 2013; 3: e337.
13. Sjoerds, Z, van den Brink, W, Beekman, AT, Penninx, BW, Veltman, DJ. Cue reactivity is associated with duration and severity of alcohol dependence: an FMRI study. PLoS One. 2014; 9(1): e84560.
14. Nebe, S, Kroemer, NB, Schad, DJ, et al. No association of goal-directed and habitual control with alcohol consumption in young adults. Addict Biol. 2018; 23(1): 379393.
15. Barker, JM, Taylor, JR. Habitual alcohol seeking: modeling the transition from casual drinking to addiction. Neurosci Biobehav Rev. 2014; 47: 281294.
16. Sebold, M, Nebe, S, Garbusow, M, et al. When habits are dangerous: alcohol expectancies and habitual decision making predict relapse in alcohol dependence. Biol Psychiatry. 2017; 82(11): 847856.
17. Adams, ZW, Schacht, JP, Randall, P, Anton, RF. The Reasons for Heavy Drinking Questionnaire: factor structure and validity in alcohol-dependent adults involved in clinical trials. J Stud Alcohol Drugs. 2016; 77(2): 354361.
18. Yücel, M, Oldenhof, E, Ahmed, SH, et al. A transdiagnostic dimensional approach towards a neuropsychological assessment for addiction: an International Delphi Consensus Study. Addiction. 2018; doi: 10.1111/add.14424
19. Amorim, P. Mini International Neuropsychiatric Interview (MINI): validação de entrevista breve para diagnóstico de transtornos mentais. Rev Bras Psiquiatria. 2000; 22(3): 106115.
20. McLellan, AT, Luborsky, L, Woody, GE, O’Brien, CP. An improved diagnostic evaluation instrument for substance abuse patients: the Addiction Severity Index. J Nerv Mental Dis. 1980; 168(1): 2633.
21. Verplanken, B, Orbell, S. Reflections on past behavior: a self-report index of habit strength. J Appl Soc Psychol. 2003; 33(6): 13131330.
22. Ferreira, GM, Yucel, M, Dawson, A, Lorenzetti, V, Fontenelle, LF. Investigating the role of anticipatory reward and habit strength in obsessive-compulsive disorder. CNS Spectr. 2017; 22(3): 295304.
23. Doyle, SR, Donovan, DM. A validation study of the alcohol dependence scale. J Stud Alcohol Drugs. 2009; 70(5): 689699.
24. Carver, C, White, T. Behavioral inhibition, behavioral activation, and affective responses to impending reward and punishment: the BIS/BAS Scales. J Pers Soc Psychol. 1994; 67(2): 319333.
25. Lynam, DR, Smith, GT, Cyders, MA, Fischer, S, Whiteside, SP, Smith, GT, Cyders, MA. The UPPS-P Questionnaire Measure of Five Dispositions to Rash Action. West Lafayette, IN: Purdue University; 2006.
26. Sediyama, CYN, Moura, R, Garcia, MS, et al. Factor analysis of the Brazilian version of UPPS Impulsive Behavior Scale. Front Psychol. 2017; 8: 622.
27. Ersche, K, Lim, T, Ward, L, Robbins, T, Stochl, J. Creature of habit: a self-report measure of habitual routines and automatic tendencies in everyday life. Pers Individ Dif. 2017; 116: 7385.
28. Lovibond, S, Lovibond, P. Manual for the Depression Anxiety Stress Scales. 4th ed. Sydney, Australia: Psychology Foundation; 2004.
29. Vignola, RC, Tucci, AM. Adaptation and validation of the depression, anxiety and stress scale (DASS) to Brazilian Portuguese. J Affect Disord. 2014; 155: 104109.
30. Grant, JE, Chamberlain, SR. Clinical correlates of symptom severity in skin picking disorder. Compr Psychiatry. 2017; 78: 2530.
31. Coskunpinar, A, Dir, AL, Cyders, MA. Multidimensionality in impulsivity and alcohol use: a meta-analysis using the UPPS model of impulsivity. Alcohol Clin Exp Res. 2013; 37(9): 14411450.
32. Franken, IH, Muris, P, Georgieva, I. Gray’s model of personality and addiction. Addict Behav. 2006; 31(3): 399403.
33. Babor, TF, Caetano, R. Subtypes of substance dependence and abuse: implications for diagnostic classification and empirical research. Addiction. 2006; 101(Suppl 1): 104110.
34. Gardner, B. A review and analysis of the use of ‘habit’ in understanding, predicting and influencing health-related behaviour. Health Psychol Rev. 2015; 9(3): 277295.
35. Wood, W, Runger, D. Psychology of habit. Annu Rev Psychol. 2016; 67: 289314.

Keywords

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed