Deficits in Access to Reward Are Associated with College Student Alcohol Use Disorder

Abstract

Background Reward deprivation has been implicated in major depressive disorder and severe substance abuse, but its potential relation to alcohol use disorder (AUD) symptoms in non-treatment seeking young adult drinkers is less clear. Depression is often comorbid with alcohol misuse, so relations of AUD with reward deprivation might be due in part to the presence of depressive symptoms in young adults. Behavioral economic theory views addiction as a state that is related in part to deficits in drug-free rewards, and therefore requires an investigation into whether reward deprivation has a direct relation to alcohol misuse that is, at least partially, independent of mood. Method The current paper evaluates the contribution of two facets of reward deprivation (reward availability and experience) to alcohol use, AUD symptoms, and depression in a sample of young adult heavy episodic drinkers. Data were collected from 392 undergraduates (60.4% female, 85.1% Caucasian) who reported recent heavy drinking (83.7% with at least one AUD symptom). Results Low reward availability (environmental suppression) was significantly associated with both DSM-5 AUD symptoms and alcohol-related problems after controlling for age, gender, depressive symptomatology, and drinking level. Conclusions The current study provides support for behavioral economic models that emphasize reward deprivation as a unique risk factor for AUD that is independent of mood and drinking level. Limited access to natural rewards may be a risk and/or maintaining factor for alcohol use disorder symptoms in college student drinkers.

Access to environmental reward mediates the relation between posttraumatic stress symptoms and alcohol problems and craving.

“…The RPI includes subscales measuring both access to environmental reward and the ability to experience reward. Joyner and colleagues (2016) found that access to environmental reward , but not the ability to experience reward, predicted a greater risk for alcohol use disorder and alcohol-related problems among college student heavy drinkers. The authors suggest that those with diminished access to environmental reward may have poor access to recreational and educational resources due to poverty, and in some cases, may lack the social skills or self-regulatory capacity to engage in or to take advantage of opportunities to participate in rewarding social, leisure, or academic/community activities.…”

A dual process perspective on advances in cognitive science and alcohol use disorder

“…A key advance in behavioral economics is research testing whether the rewarding or motivational properties of alcohol may exceed that of most available drug-free rewards among individuals who misuse alcohol, leading to increasing relative valuation of alcohol (Vuchinich & Heather, 2003). A recent study with college student heavy drinkers found that AUD symptoms were uniquely associated with diminished environmental reward availability above and beyond drinking level and depression, but that ability to experience reward was intact (Joyner et al, 2016). Other research suggests that chronic alcohol and other drug use may also lead to a diminished capacity to experience natural reward.…”

Applying behavioral economic theory to problematic Internet use: An initial investigation.

“…Often, reinforcer pathology occurs in the context of diminished reinforcement from alternative activities, resulting in a greater valuation of the addictive behavior relative to available alternative activities. Thus, those with a diminished availability of alternative reward in their environment (reward deprivation) will report greater levels of addictive behaviors (Joyner et al, 2016; Vuchinich & Tucker, 1988). Research with substance-related addictions supports this, showing that greater alcohol use is related to greater levels of substance-related reinforcement relative to substance-free reinforcement (Correia, Carey, Simons, & Borsari, 2003; Joyner, Acuff, Meshesha, Patrick, & Murphy, 2018).…”