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

Published online by Cambridge University Press:  27 March 2019

Marcelo Piquet-Pessôa Open the ORCID record for Marcelo Piquet-Pessôa [Opens in a new window] ,
Samuel R. Chamberlain Open the ORCID record for Samuel R. Chamberlain [Opens in a new window] ,
Rico S. C. Lee ,
Gabriela M. Ferreira ,
Marcelo S. Cruz ,
Ana P. Ribeiro ,
Gabriela B. de Menezes ,
Lucy Albertella ,
Murat Yücel  and
Leonardo F. Fontenelle
Marcelo Piquet-Pessôa
Affiliation:
Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
Samuel R. Chamberlain
Affiliation:
Department of Psychiatry, University of Cambridge, Cambridge, UK Department of Psychiatry, University of Cambridge, and Cambridge & Peterborough NHS Foundation Trust (CPFT), Cambridge, UK
Rico S. C. Lee
Affiliation:
Brain & Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Victoria, Australia
Gabriela M. Ferreira
Affiliation:
Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
Marcelo S. Cruz
Affiliation:
Substance Abuse Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
Ana P. Ribeiro
Affiliation:
Substance Abuse Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
Gabriela B. de Menezes
Affiliation:
Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
Lucy Albertella
Affiliation:
Brain & Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Victoria, Australia
Murat Yücel
Affiliation:
Brain & Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Victoria, Australia
Leonardo F. Fontenelle*
Affiliation:
Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil Brain & Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Victoria, Australia D’Or Institute for Research and Education, Rio de Janeiro, Brazil
*
*Address correspondence to: Leonardo F. Fontenelle, Rua Visconde de Pirajá, 547, 617, Ipanema, Rio de Janeiro-RJ 22410-003, Brazil. (Email: [email protected])
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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.

Keywords

Classificationdiagnosisdependencesubstance abusetypology
Type
Original Research
Information
CNS Spectrums , Volume 24 , Issue 6 , December 2019 , pp. 597 - 604
Copyright
© Cambridge University Press 2019 

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Footnotes

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.).

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