Loss and Frontal Striatal Reactivities Characterize Alcohol Use Severity and Rule-Breaking Behavior in Young Adult Drinkers

  • Guangfei Li
    Department of Biomedical Engineering, Faculty of Environment and Life Sciences, Beijing University of Technology, Beijing, China

    Department of Biomedical Engineering, School of Life Sciences, Beijing Institute of Technology, Beijing, China
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  • Yu Chen
    Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
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  • Shefali Chaudhary
    Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
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  • Xiaoying Tang
    Xiaoying Tang, Ph.D.
    Department of Biomedical Engineering, School of Life Sciences, Beijing Institute of Technology, Beijing, China
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  • Chiang-Shan R. Li
    Address correspondence to Chiang-Shan R. Li, Ph.D., M.D.
    Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut

    Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut

    Interdepartmental Neuroscience Program, Yale University School of Medicine, New Haven, Connecticut

    Wu Tsai Institute, Yale University, New Haven, Connecticut
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      Alcohol misuse is associated with externalizing behaviors, including rule breaking. Studies have implicated altered reward processing in externalizing behaviors and alcohol misuse. Here, we investigated whether reward or punishment reactivity more significantly influenced alcohol use severity and rule-breaking behavior in young adult drinkers.


      We curated data from the Human Connectome Project and identified 181 binge (132 men) and 288 nonbinge (97 men) drinkers performing a gambling task during brain imaging. Alcohol use severity was quantified by the first principal component of principal-component analysis of all drinking measures. We analyzed the imaging data using published routines and evaluated the results at a corrected threshold. We examined the interrelationship between imaging and clinical metrics with mediation and path analyses.


      Compared with nonbingers, bingers showed more severe rule-breaking behavior and responded significantly faster during post-loss than during post-win trials. Compared with nonbingers, bingers demonstrated greater inferior/middle frontal gyrus and cerebellum activations in loss-predominating blocks but no differences in regional responses to win-predominating blocks, relative to an interblock baseline. The right caudate body showed loss reactivity that was positively correlated with the rule-breaking score. No regional responses to wins were significantly correlated with the rule-breaking score. Mediation and path analyses demonstrated significant models with inferior/middle frontal gyrus and caudate reactivity to loss interrelating rule breaking and alcohol use severity.


      Punishment rather than reward reactivity was associated with alcohol use severity and rule breaking in young adults. The findings highlight the roles of negative emotions in psychological models of externalizing behaviors and alcohol misuse.


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        A single dose of escitalopram blunts the neural response in the thalamus and caudate during monetary loss.
        J Psychiatry Neurosci. 2021; 46: E319-E327

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      • Investigating the Neurobiological and Cognitive Effects of Binge Drinking: Concerns and Considerations
        Biological Psychiatry: Cognitive Neuroscience and NeuroimagingVol. 7Issue 10
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          Binge drinking—defined as repeated bouts of excessive alcohol consumption followed by periods of abstinence—has garnered significant recognition as an at-risk drinking behavior. While approximately 16% of drinkers worldwide engage in this pattern of heavy episodic consumption (1), epidemiological evidence has revealed a particularly high prevalence of binge drinking in young adults. In large-scale national surveys, 37% to 44% of university students in the United States (2), and similar proportions across Europe and Australia (3,4), regularly engage in binge drinking.
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