Alcohol Cue Reactivity in the Ventral Striatum and Daily Purpose in Life Moderate the Relationship between Alcohol Craving and Consumption in College Students

Abstract

Background and Aim. Alcohol craving is an urge to consume alcohol that commonly precedes drinking. However, craving does not lead to drinking for all people under all circumstances. The current study examined potential moderators in drinking decisions, focusing on neural reactivity to alcohol cues as a risk, and purpose in daily life as a protective factor, that may influence the association between alcohol craving and the subsequent amount of consumption.

Design. We correlated functional magnetic resonance imaging (fMRI) data on neural cue reactivity and ecological momentary assessments (EMA) on purpose in life and alcohol use. Setting Two college campuses located in Philadelphia, Pennsylvania and New York, New York, USA, from January 2019 to October 2020.

Participants. A total of 54 college students recruited via campus-based groups.

Measurements. Participants underwent fMRI while naturally reacting to images of alcohol; we focused on activity within the ventral striatum, a key region of interest implicated in reward and craving. Participants then completed 28 days of EMA, during which they reported daily levels of purpose in life (once per day), and answered questions about alcohol use (twice per day), including how much they craved and consumed alcohol. Findings. Greater alcohol cue reactivity within the ventral striatum was associated with heavier alcohol use following craving in daily life, only when people were previously feeling a lower than usual sense of purpose. By contrast, at-risk individuals with heightened neural alcohol cue reactivity drank less in response to craving if they were feeling a stronger than their usual sense of purpose in the preceding moments.

Conclusions. Results highlight neural sensitivity to alcohol cues within the ventral striatum as a potential risk for unhealthy alcohol use when people feel less purposeful. Further, enhancing daily levels of purpose in life may promote alcohol moderation among at-risk individuals.