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Themenschwerpunkt

Wege in die Abhängigkeit

Studiendesign zu Risikofaktoren für die Entwicklung einer Alkoholabhängigkeit

Published Online:August 26, 2013https://doi.org/10.1024/0939-5911.a000254

Abstract

Hintergrund: Riskanter Alkoholkonsum und Alkoholabhängigkeit treten in Industrieländern häufig auf und manifestieren sich oft bereits im jungen Erwachsenenalter. Wir prüfen in dieser Studie den Einfluss dysfunktionaler Lernmechanismen und deren Modulation durch verschiedene Stressoren, wie z. B. die Menge des Alkoholkonsums, auf die Entstehung, den Verlauf und ggf. die Aufrechterhaltung der Abhängigkeitserkrankung. Zielsetzung: Bisher bekannte ätiologische Faktoren, die im Zusammenhang mit der Entwicklung einer Alkoholabhängigkeit stehen, betreffen sowohl genetische (z. B. die genetisch bedingte geringe Sensitivität gegenüber der akuten Alkoholwirkung oder eine positive Familiengeschichte bezüglich Alkoholabhängigkeit) als auch umweltbedingten Faktoren (z. B. Stress, Trauma, dysfunktionale familiäre Strukturen und der Einfluss der Peers). Belohnungsabhängige Lernmechanismen könnten mit dem veränderten Alkoholkonsum in Adoleszenz und jungem Erwachsenenalter assoziiert sein und somit ebenfalls zu den prädisponierenden Faktoren für die Entwicklung einer Alkoholabhängigkeit zählen. Unser Wissen über diese Mechanismen ist bisher jedoch begrenzt. Im Rahmen der Studie „Learning in Alcohol Dependence“ (LeAD) sollen Lernmechanismen und ihre Bedeutung für die Entstehung exzessiven Alkoholkonsums untersucht werden. Zudem wird im Längsschnitt erfasst, wie sich der Alkoholkonsum selbst wieder auf diese Lernmechanismen auswirkt. Methodik: Eine Kohorte 18-jähriger Männer mit hohem versus niedrigem Risiko an einer Alkoholabhängigkeit zu erkranken, wird im Längsschnitt untersucht, wobei unter anderem bereits bekannte Risikofaktoren erfasst werden. Lernmechanismen werden mithilfe verschiedener Paradigmen (dem Pavlow’schen und instrumentellen Lernen, Habituierung und Devaluation sowie Risikoverhalten) behavioral und mittels funktioneller Bildgebung untersucht. Schlussfolgerungen: Bisher existieren keine Untersuchungen beim Menschen, in denen spezifische Veränderungen des Lernverhaltens mit prädisponierenden Faktoren für die Entwicklung einer Alkoholabhängigkeit in Zusammenhang gebracht werden. Durch die LeAD-Studie sollen diese Faktoren weiter aufgeklärt werden, wodurch eine zielgerichtete Prävention besser möglich werden könnte. Dadurch ließen sich speziell in dieser Altersgruppe Prävalenz und Schwere der Alkoholabhängigkeit beeinflussen.


Pathways Leading to Addiction: Study Design for the Assessment of Risk Factors for Developing an Alcohol Addiction

Background: High risk drinking and alcohol addiction are highly prevalent in industrialized countries and their development often starts early in adulthood. We test the hypothesis that excessive alcohol intake is associated with deficit learning mechanisms and their respective modulation by e. g. stress factors and drug intake itself. Aim: Genetic (e. g. high tolerance regarding acute alcohol effects and positive family history) as well as environmental factors (stress, trauma, dysfunctional family structures and peers) play a key role in the development of excessive alcohol intake and dependence. Reward-associated learning mechanisms are supposed to be related to altered alcohol consumption in adolescence and early adulthood and thus contribute to the development of alcohol addiction. Our knowledge about these mechanisms is limited so far. Our research group “Learning in Alcohol Dependence“ (LeAD) investigates the impact of altered learning strategies on developing an alcohol addiction. Furthermore, we analyze the role of alcohol-related changes of learning mechanisms which could contribute to the maintenance of addictive behavior. Methods: We will examine a cohort of 18 year old male subjects with high versus low risk to develop an alcohol addiction, assessing well-known risk factors. Learning mechanisms are examined behaviorally and with functional imaging using tasks on operant and Pavlovian conditioning, habitization, devaluation and risk-taking. Conclusions: So far, specific alterations of learning strategies have not been linked with risk factors to develop an alcohol addiction. The LeAD study will help to improve our knowledge about these putative predisposing factors, thus adjust therapeutic intervention procedures which may help to target prevalence and severity of alcohol addiction in young adults.

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