title: Learning from positive and negative monetary feedback in patients with alcohol dependence.
abstract: BACKGROUND
  Chronic and excessive consumption of alcohol is associated with structural, physiological, and functional changes in multiple regions of the human brain including the prefrontal cortex, the medial temporal lobe, and the structures of the reward system. The present study aimed to assess the ability of alcohol-dependent patients (ADP) to learn probabilistic stimulus-reward contingencies and to transfer the acquired knowledge to new contexts. During transfer, the relative preference to learn from positive or negative feedback was also assessed.
  
  
  METHODS
  Twenty-four recently detoxified ADP and 20 healthy controls engaged in a feedback learning task with monetary rewards. The learning performance per se and transfer performance including positive versus negative learning were examined, as well as the relationship between different learning variables and variables comprising alcohol and nicotine consumption patterns, depression, and personality traits (harm avoidance and impulsivity).
  
  
  RESULTS
  Patients did not show a significant general learning deficit in the acquisition of stimulus-response-outcome associations. Fifteen healthy subjects and 13 patients reached the transfer phase, in which ADP showed generally lower performance than healthy controls. There was no specific deficit with regard to learning from positive or negative feedback. The only near-significant (negative) correlation between learning variables and drug consumption patterns, depression, and personality traits emerged for harm avoidance and positive learning in controls.
  
  
  CONCLUSIONS
  Impaired transfer performance suggests that ADP had problems applying their acquired knowledge in a new context. Potential relations to dysfunctions of specific brain structures and implications of the finding for therapy are discussed.
authors.affiliation: Institute of Cognitive Neuroscience, Department of Neuropsychology, Ruhr University Bochum, Bochum, Germany. martina.rustemeier@rub.de
authors.forename: Martina
authors.initials: M
authors.lastname: Rustemeier
authors.forename: Juliane
authors.initials: J
authors.lastname: Römling
authors.forename: Christine
authors.initials: C
authors.lastname: Czybulka
authors.forename: Gerhard
authors.initials: G
authors.lastname: Reymann
authors.forename: Irene
authors.initials: I
authors.lastname: Daum
authors.forename: Christian
authors.initials: C
authors.lastname: Bellebaum
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000523:psychology*; D016022:Case-Control Studies; D030141:Feedback, Psychological; D005260:Female; D006801:Humans; D007858:Learning; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012201:Reward; D014163:Transfer, Psychology