Slow associative learning in alcohol dependence and the alcohol cue exposure treatment paradox

• Published in: Addiction (Abingdon, England) Vol. 116; no. 4; pp. 759 - 768
• Main Authors: Buckfield, Carl, Sinclair, Julia M. A., Glautier, Julia
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.04.2021
• Subjects: ABC recovery; Addictions; Alcohol; alcohol dependence; Alcohol related disorders; Alcohol use; Alcoholism; Associative learning; Between-subjects design; Colleges & universities; Computerization; Cue exposure; Cues; Drinking behavior; Drug abuse; Drug dependence; Experiments; Extinction; Extinction behavior; Five factor model; Impulsivity; Laboratories; Pavlovian conditioning; predictive learning; Psychological extinction; Psychology; Recovery; Recovery (Medical); Substance abuse treatment; Substance use disorder; Undergraduate students; Pavlovian conditioning; associative learning; extinction; ABC recovery; alcohol dependence; cue exposure; predictive learning
• ISSN: 0965-2140; 1360-0443; 1360-0443
• DOI: 10.1111/add.15210

Aims To examine two explanations for the observation that cue–exposure treatment has not been clearly effective in the treatment of alcohol dependence: do alcohol‐dependent individuals have either (1) slower extinction and/or (2) greater contextual specificity of extinction than non‐dependent individuals? Design In two exploratory laboratory experiments we used mixed factorial designs with two‐group between‐subjects factors and within‐subjects factors corresponding to performance in different parts of a computer‐based learning task. Setting University of Southampton psychology research laboratories and two addiction treatment services in the city of Southampton, UK. Participants Experiment 1: 74 (54 female) undergraduates from the University of Southampton (age mean = 20.4 years). Experiment 2: 102 (40 female) participants from the University of Southampton, the local community, and from two Southampton alcohol treatment services (age mean = 41.3 years). Measurements The Alcohol Use Disorders Identification Test, a 1‐week time‐line follow‐back alcohol consumption questionnaire, the Barratt Impulsiveness Scale (11th edn), and a computerized learning task. Experiment 2 additionally used the 44‐item Big Five Inventory, a drug use history checklist, and the Hospital Anxiety and Depression Scale. Findings Experiment 1: light and heavy drinkers did not differ significantly in extinction [extinction block × drinking status interaction, P = 0.761, ηp2=0.005, 95% confidence interval (CI) = (0,0.028)] or on contextual control of extinction [recovery block × drinking status interaction, P = 0.514, ηp2=0.009, 95% CI =(0, 0.084)]. Experiment 2: slower extinction in abstinent alcohol‐dependent participants compared with light drinkers [extinction block × drinking status interaction, P = 0.023, ηp2=0.031, 95% CI = 0, 0.069)] but no significant difference on contextual control of extinction [recovery block × drinking status interaction, P = 0.069, ηp2=0.033, 95% CI = (0, 0.125)]. Conclusion Abstinent alcohol‐dependent people may have slower extinction learning for alcohol‐related cues than non‐dependent light drinkers.