Craving across the escalating impulsive/compulsive spectrum– a transdiagnostic approach

• Applicant: Professor Dr. Florian Schlagenhauf, since 2/2023
• Subject Area: Personality Psychology, Clinical and Medical Psychology, Methodology ; Biological Psychiatry ; Biological Psychology and Cognitive Neuroscience ; Clinical Psychiatry, Psychotherapy, Child and Adolescent Psychiatry
• Term: since 2022
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 498218970

Craving is a powerful urge for a particular substance or behavior and a hallmark feature of conditions characterized by escalating behavior such as substance and non-substance related addictive disorders, and certain eating disorders. Pathological craving is often elicited by cues associated with the maladaptive behavior. For instance, patients suffering from alcohol use or gambling disorder report increased craving in alcohol or gambling associated environments. Therefore, previous studies in humans have focused on disorder specific cues to induce and assess craving and tested for differences between patients and healthy controls. However, in animals, there is accumulating evidence that pathological craving is not confined to symptom-specific cues. Instead, animal models of addiction and other escalating behaviors have demonstrated that some individuals are generally more “cue-reactive” in the way that they will respond disproportionately more to all kind of reward predictive cues. Interestingly, this cue reactive phenotype might make individuals more vulnerable to develop most types of escalating behavior. Here I aim to build upon these animal findings and use computational models of decision making to test whether humans suffering from binge-eating disorder, alcohol use and gambling disorder are also generally more cue-reactive. I will use food cues to induce food craving, which is symptom relevant for binge-eating disorder but neither symptom relevant for alcohol use or gambling disorder. Moreover, because chronic overconsumption of potentially harmful substances are core symptoms of alcohol use and binge-eating disorder, but not gambling disorder, I can test if increased cue-induced craving is a transdiagnostic marker across escalating behaviors. By using a recently developed laboratory paradigm, I will test how food cues alter value-based decision-making, to infer about the computational mechanisms of cue-induced craving. Further, by assessing pupil dilatation, a reliable index of noradrenergic activity, I will study the role of this neurotransmitter system in cue-induced craving. Finally, I will test whether the computational form of craving is associated with aspects of impulsivity and compulsivity, psychological constructs that have been identified as transdiagnostic markers across escalating disorders. This proposal constitutes an innovative approach to understanding certain mental health problems by studying craving as a potential key process that spans across diagnostic categories. Thus, this approach is aimed at informing transdiagnostic intervention and disease prevention programs.

• DFG Programme: Research Grants
• International Connection: Switzerland, USA
• Co-Investigators: Professor Dr. Andreas Heinz; Professorin Dr. Nina Romanczuk-Seiferth; Professor Dr. Michael Smolka
• Cooperation Partners: Professorin Anna Konova, Ph.D.; Professor Dr. Philipp Sterzer, Ph.D.
• Ehemalige Antragstellerin: Professorin Dr. Miriam Sebold, until 2/2023