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Philosophers speculated that assocations might be crucial in guiding behavior, but it was Pavlov who first explored this question experimentally. He discovered that dogs would begin to salivate to stimuli that preceded the delivery of food; the greater the contiguity of these stimuli with food, the stronger the conditioning. He also discovered fundamental properties of conditioning including extinction, inhibition, second-order conditioning, counterconditioning, discrimination, and generalization. Watson and Raynor extended his research by showing that conditioning also occurred in humans; they showed that fear could be conditioned in an infant who became famous as Little Albert. Subsequent research used random and unpaired control groups to determine if a change in behavior was truly due to conditioning, or to sensitization or pseudoconditioning. Three responses proved particularly useful in this later research: fear conditioning (CER) and taste-aversion learning in rats, and the galvanic skin response (GSR) in humans.
Alcohol use disorders can be conceptualised as a learned pattern of maladaptive alcohol-consumption behaviours. The memories encoding these behaviours centrally contribute to long-term excessive alcohol consumption and are therefore an important therapeutic target. The transient period of memory instability sparked during memory reconsolidation offers a therapeutic window to directly rewrite these memories using targeted behavioural interventions. However, clinically-relevant demonstrations of the efficacy of this approach are few. We examined key retrieval parameters for destabilising naturalistic drinking memories and the ability of subsequent counterconditioning to effect long-term reductions in drinking.
Methods
Hazardous/harmful beer-drinking volunteers (N = 120) were factorially randomised to retrieve (RET) or not retrieve (No RET) alcohol reward memories with (PE) or without (No PE) alcohol reward prediction error. All participants subsequently underwent disgust-based counterconditioning of drinking cues. Acute responses to alcohol were assessed pre- and post-manipulation and drinking levels were assessed up to 9 months.
Results
Greater long-term reductions in drinking were found when counterconditioning was conducted following retrieval (with and without PE), despite a lack of short-term group differences in motivational responding to acute alcohol. Large variability in acute levels of learning during counterconditioning was noted. ‘Responsiveness’ to counterconditioning predicted subsequent responses to acute alcohol in RET + PE only, consistent with reconsolidation-update mechanisms.
Conclusions
The longevity of behavioural interventions designed to reduce problematic drinking levels may be enhanced by leveraging reconsolidation-update mechanisms to rewrite maladaptive memory. However, inter-individual variability in levels of corrective learning is likely to determine the efficacy of reconsolidation-updating interventions and should be considered when designing and assessing interventions.
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