title: Biases in the Explore-Exploit Tradeoff in Addictions: The Role of Avoidance of Uncertainty.
abstract: We focus on exploratory decisions across disorders of compulsivity, a potential dimensional construct for the classification of mental disorders. Behaviors associated with the pathological use of alcohol or food, in alcohol use disorders (AUD) or binge-eating disorder (BED), suggest a disturbance in explore-exploit decision-making, whereby strategic exploratory decisions in an attempt to improve long-term outcomes may diminish in favor of more repetitive or exploitatory choices. We compare exploration vs exploitation across disorders of natural (obesity with and without BED) and drug rewards (AUD). We separately acquired resting state functional MRI data using a novel multi-echo planar imaging sequence and independent components analysis from healthy individuals to assess the neural correlates underlying exploration. Participants with AUD showed reduced exploratory behavior across gain and loss environments, leading to lower-yielding exploitatory choices. Obese subjects with and without BED did not differ from healthy volunteers but when compared with each other or to AUD subjects, BED had enhanced exploratory behaviors particularly in the loss domain. All subject groups had decreased exploration or greater uncertainty avoidance to losses compared with rewards. More exploratory decisions in the context of reward were associated with frontal polar and ventral striatal connectivity. For losses, exploration was associated with frontal polar and precuneus connectivity. We further implicate the relevance and dimensionality of constructs of compulsivity across disorders of both natural and drug rewards.
authors.affiliation: Institute of Behavioural and Clinical Neuroscience, University of Cambridge, Cambridge, UK.
authors.forename: Laurel S
authors.initials: LS
authors.lastname: Morris
authors.affiliation: Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.|Section on Functional Imaging Methods, National Institute of Mental Health, Bethesda, MD, USA.
authors.forename: Kwangyeol
authors.initials: K
authors.lastname: Baek
authors.affiliation: Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.|Section on Functional Imaging Methods, National Institute of Mental Health, Bethesda, MD, USA.|Department of Psychiatry, Brighton and Sussex Medical School, Brighton, UK.
authors.forename: Prantik
authors.initials: P
authors.lastname: Kundu
authors.affiliation: Department of Cognitive, Linguistic and Psychological Sciences, Brown Institute for Brain Science, Psychiatry and Human Behavior, Brown University, Providence, RI, USA.
authors.forename: Neil A
authors.initials: NA
authors.lastname: Harrison
authors.affiliation: Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Frank
authors.affiliation: Institute of Behavioural and Clinical Neuroscience, University of Cambridge, Cambridge, UK.|Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.|Section on Functional Imaging Methods, National Institute of Mental Health, Bethesda, MD, USA.|NIHR Cambridge Biomedical Research Centre, Cambridge, UK.
authors.forename: Valerie
authors.initials: V
authors.lastname: Voon
mesh_terms: D000328:Adult; D019973:Alcohol-Related Disorders / Q000503:physiopathology* / Q000523:psychology*; D056912:Binge-Eating Disorder / Q000503:physiopathology* / Q000523:psychology*; D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping; D003657:Decision Making / Q000502:physiology*; D005106:Exploratory Behavior / Q000502:physiology; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology / Q000523:psychology; D010296:Parietal Lobe / Q000503:physiopathology; D012201:Reward; D035501:Uncertainty