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Compulsivity Across the Pathological Misuse of Drug and Non-Drug Rewards.

Published version
Peer-reviewed

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Authors

Banca, Paula 
Harrison, Neil A 

Abstract

Behavioral adaptation is required for the successful navigation of a constantly changing environment. Impairments in behavioral flexibility are commonly observed in psychiatric disorders including those of addiction. This study investigates two distinct facets of compulsivity, namely reversal learning and attentional set shifting, implicating orbitofrontal and lateral prefrontal regions respectively, across disorders of primary and secondary rewards. Obese subjects with and without binge eating disorder (BED), individuals with compulsive sexual behaviors (CSB), alcohol dependence (AD) and pathological video-gaming (VG) were tested with two computerized tasks: the probabilistic reversal task (trials to criterion and win-stay/lose-shift errors) and the intra/extra-dimensional set shift task (IED). Individuals with AD and pathological VG were slower at reversal learning irrespective of valence, with AD subjects more likely to perseverate after losses. Compared to obese subjects without BED, BED subjects were worse at reversal learning to wins but better at losses highlighting valence effects as a function of binge eating. CSB subjects demonstrated enhanced sensitivity to reward outcomes with faster acquisition and greater perseveration with higher magnitude rewards. We further show an impairment in attentional set shifting in individuals with BED and AD relative to healthy volunteers (HV). This study provides evidence for commonalities and differences in two distinct dimensions of behavioral inflexibility across disorders of compulsivity. We summarize studies on compulsivity subtypes within this same patient population. We emphasize commonalities in AD and BED with impairments across a range of compulsivity indices, perhaps supporting pathological binge eating as a form of behavioral addiction. We further emphasize commonalities in reversal learning across disorders and the crucial role of valence effects. These findings highlight the role of behavioral inflexibility and compulsivity as a relevant domain in defining dimensional psychiatry and the identification of relevant cognitive endophenotypes as targets for therapeutic modulation.

Description

Keywords

addiction, alcohol dependence, binge eating disorder, compulsivity, reversal learning, set-shifting

Journal Title

Front Behav Neurosci

Conference Name

Journal ISSN

1662-5153
1662-5153

Volume Title

10

Publisher

Frontiers Media SA
Sponsorship
Wellcome Trust (093875/Z/10/Z)
PB was supported by the Portuguese Foundation for Science and Technology (individual fellowship: SFRH/BD/33889/2009). VV and NAH are Wellcome Trust Intermediate Fellows. The study was funded by the Wellcome Trust (WT093705/Z/10/Z).