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Review
. 2019 Jul 24;8(8):1086.
doi: 10.3390/jcm8081086.

Addiction as Learned Behavior Patterns

Andreas Heinz  1 , Anne Beck  1 , Melissa Gül Halil  1 , Maximilian Pilhatsch  2 , Michael N Smolka  2   3 , Shuyan Liu  4
Affiliations
Review

Addiction as Learned Behavior Patterns

Andreas Heinz et al. J Clin Med. .

Abstract

Individuals with substance use disorders (SUDs) have to cope with drug-related cues and contexts which can affect instrumental drug seeking, as shown with Pavlovian-to-instrumental transfer (PIT) tasks among humans and animals. Our review addresses two potential mechanisms that may contribute to habitual or even compulsive drug seeking and taking. One mechanism is represented by Pavlovian and PIT effects on drug intake. The other is a shift from goal-directed to habitual drug intake, which can be accessed via model-based versus model-free decision-making in respective learning tasks. We discuss the impact of these learning mechanisms on drug consumption. First, we describe how Pavlovian and instrumental learning mechanisms interact in drug addiction. Secondly, we address the effects of acute and chronic stress exposure on behavioral and neural PIT effects in alcohol use disorder (AUD). Thirdly, we discuss how these learning mechanisms and their respective neurobiological correlates can contribute to losing versus regaining control over drug intake. Utilizing mobile technology (mobile applications on smartphones including games that measure learning mechanisms, activity bracelets), computational models, and real-world data may help to better identify patients with a high relapse risk and to offer targeted behavioral and pharmacotherapeutic interventions for vulnerable patients.

Keywords: alternative reward; animal and computational models; behavioral control; craving and relapse; cue exposure; habit formation; substance use disorders.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The Pavlovian-to-instrumental (PIT) effect. (A) The unrelated Pavlovian stimulus (conditioned stimulus (CS)) presented in the background is negatively valued because it has previously been paired with passive monetary loss. (B) The PIT effect is indicated by the number of button presses (instrumental response) as a function of the value of the respective Pavlovian background stimulus (−€2, −€1, €0, +€1, +€2). (C) Combining the shell with a positive Pavlovian cue in the background of the screen increases approach behavior (number of button presses) in the unrelated instrumental task. (D) The PIT effect was significantly stronger in subjects with alcohol use disorder (AUD) compared to healthy controls (HC).
Figure 2
Figure 2
Conflict between Pavlovian and instrumental control: Subjects with alcohol use disorder (AUD) compared to controls. ER = error rates.
See this image and copyright information in PMC

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