An investigation of learning mechanisms in the alcohol cue-exposure therapy paradox

Abstract

Cue exposure therapy as a treatment programme for alcohol addiction has not been shown to have to same level of success as it has for treating other behavioural disorders. This discrepancy is referred to in this thesis as the Alcohol Cue Exposure Therapy Paradox (ACETP). This thesis explored several candidate explanations for the ACETP. Chapters 3 and 4 examined individual differences in acquisition, extinction, and recovery of Pavlovian conditioned responses in light, heavy, and dependent drinkers. Light and heavy drinkers did not differ but dependent drinkers showed slower extinction than light drinkers. Chapter 5 examined the effect of reinforcer type, food versus alcohol, on the acquisition, extinction, and recovery of Pavlovian conditioned responses in light and heavy drinkers. There was no evidence of differences between light and heavy drinkers with respect to conditioning with different reinforcer types and there was no difference in conditioning with the different reinforcer types. Chapter 6 looked at Pavlovian instrumental transfer (PIT) using different reinforcer types, food and alcohol, and compared light and heavy drinkers. In the Pavlovian phase of the Chapter 6 PIT study there was no evidence of differences between light and heavy drinkers with respect to conditioning the different reinforcer types, replicating the results from previous chapters. There was also no evidence of differences between light and heavy drinkers on PIT. However, conclusions about individual differences and effects of reinforcer type on devaluation were not possible due to a failure to obtain a devaluation effect. In summary these studies suggest that the ACETP cannot be understood to be due to a peculiarity of alcohol as a reinforcer nor can it be understood in terms of individual differences in PIT. Nevertheless, individual differences in Pavlovian extinction do suggest a route for further enquiry. Dependent drinkers are slower to extinguish Pavlovian conditioned responses. The implication is that cue-exposure treatments for alcohol dependence may need extending in order to achieve adequate extinction of conditioned responses to alcohol cues.

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Identifiers

ORCID for Julia Sinclair: orcid.org/0000-0002-1905-2025

ORCID for Steven Glautier: orcid.org/0000-0001-8852-3268

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