Neural Mechanisms of Behavior Change in a Community Sample of Drinkers

Although there has been intense study of pharmacological and psychosocial treatments for alcohol use disorders, up to 75% of individuals meeting criteria for an alcohol use disorder (AUD) never seek formal treatment for their drinking. However, a large proportion of these non-treatment seeking individuals are able to reduce their drinking or even quit drinking on their own. Thus, gaining a better understanding of the mechanisms of behavior change (MOBC) among people who self-change in the absence of treatment may provide some key insights into the most critical change mechanisms that could become potential targets for intervention development. While the amount of behavioral/psychosocial research on MOBC in self-changers has increased over the past decade, there has been a notable absence of research examining the neurocognitive mechanisms that contribute to behavior change. A significant body of animal and human work has investigated the neural correlates of the development and maintenance of AUDs, but there is a dearth of literature on AUD recovery. Cross-sectional research has found that networks involved in alcohol cue reactivity and stress reactivity appear to become more engaged with greater AUD severity, and those networks involved in cognitive control tend to decrease with increased AUD severity. Thus, it could be expected that as drinking quantity/frequency and AUD severity decrease, there may be a reversal of these changes. While some cross-sectional neuroimaging research suggests that recovery of function does occur after long-term abstinence, to date there is a lack of studies investigating change in functional brain response longitudinally. To address this gap, the current proposal aims to examine a community sample of heavy drinkers in a longitudinal design in order to study the psychosocial, behavioral, and neural mechanisms that underlie changes in or maintenance of heavy drinking. Multi-modal neuroimaging (functional magnetic resonance imaging (fMRI) and magnetoencephalography (MEG)) will be used to identify the regions and networks in which change occurs (i.e. fMRI) and the temporal engagement of neural networks (i.e. MEG) related to reductions in drinking over time. Comprehensive assessments of psychosocial and behavioral functioning will be obtained at baseline, and then at 3-, 9-, and 18-month follow-ups. In addition, participants will complete MRI sessions at each visit (baseline, 3, 9, and 18 months) as well as an MEG session at baseline and 18 months, during which participants will complete tasks measuring cognitive control, cue reactivity, and stress/negative affect reactivity. Psychosocial, behavioral, and neura mechanisms of behavior change will be examined using state-of-the-art data analytic techniques, many of which have been pioneered by the research team. Examining the MOBC at multiple levels of analysis in heavy drinkers who change on their own, we will be able to develop a comprehensive understanding of potential mechanisms on which to focus treatments and will provide a key comparison group for future MOBC studies.