title: Negative reinforcement learning is affected in substance dependence.
abstract: BACKGROUND
  Negative reinforcement results in behavior to escape or avoid an aversive outcome. Withdrawal symptoms are purported to be negative reinforcers in perpetuating substance dependence, but little is known about negative reinforcement learning in this population. The purpose of this study was to examine reinforcement learning in substance dependent individuals (SDI), with an emphasis on assessing negative reinforcement learning. We modified the Iowa Gambling Task to separately assess positive and negative reinforcement. We hypothesized that SDI would show differences in negative reinforcement learning compared to controls and we investigated whether learning differed as a function of the relative magnitude or frequency of the reinforcer.
  
  
  METHODS
  Thirty subjects dependent on psychostimulants were compared with 28 community controls on a decision making task that manipulated outcome frequencies and magnitudes and required an action to avoid a negative outcome.
  
  
  RESULTS
  SDI did not learn to avoid negative outcomes to the same degree as controls. This difference was driven by the magnitude, not the frequency, of negative feedback. In contrast, approach behaviors in response to positive reinforcement were similar in both groups.
  
  
  CONCLUSIONS
  Our findings are consistent with a specific deficit in negative reinforcement learning in SDI. SDI were relatively insensitive to the magnitude, not frequency, of loss. If this generalizes to drug-related stimuli, it suggests that repeated episodes of withdrawal may drive relapse more than the severity of a single episode.
authors.affiliation: University of Colorado School of Medicine, Department of Psychiatry, Aurora, CO 80045, USA.
authors.forename: Laetitia L
authors.initials: LL
authors.lastname: Thompson
authors.forename: Eric D
authors.initials: ED
authors.lastname: Claus
authors.forename: Susan K
authors.initials: SK
authors.lastname: Mikulich-Gilbertson
authors.forename: Marie T
authors.initials: MT
authors.lastname: Banich
authors.forename: Thomas
authors.initials: T
authors.lastname: Crowley
authors.forename: Theodore
authors.initials: T
authors.lastname: Krmpotich
authors.forename: David
authors.initials: D
authors.lastname: Miller
authors.forename: Jody
authors.initials: J
authors.lastname: Tanabe
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D003071:Cognition / Q000502:physiology; D003657:Decision Making; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005715:Gambling / Q000523:psychology; D006801:Humans; D007175:Impulsive Behavior; D007858:Learning / Q000502:physiology*; D008297:Male; D009483:Neuropsychological Tests; D011597:Psychomotor Performance / Q000502:physiology; D012054:Reinforcement, Psychology; D012309:Risk-Taking; D019966:Substance-Related Disorders / Q000523:psychology*
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