TY - JOUR T1 - Neural mechanisms of sexual decision-making in women with alcohol use disorder. AU - Folco,Kess L, AU - Fridberg,Daniel J, AU - Arcurio,Lindsay R, AU - Finn,Peter R, AU - Heiman,Julia R, AU - James,Thomas W, Y1 - 2021/03/19/ PY - 2020/09/29/received PY - 2021/03/01/accepted PY - 2021/3/20/pubmed PY - 2021/7/6/medline PY - 2021/3/19/entrez KW - Alcohol use disorder KW - Alcohol use disorder reward networks KW - Co-sensitization KW - Cue reactivity KW - Decision-making KW - Female sexual risk KW - Incentive sensitization KW - fMRI SP - 1867 EP - 1883 JF - Psychopharmacology JO - Psychopharmacology (Berl) VL - 238 IS - 7 N2 - RATIONALE: The co-occurrence of alcohol consumption and sexual activity is associated with increased risk for sexual assault, sexually transmitted disease, and unplanned pregnancy among young adult women with alcohol use disorder (AUD). There is considerable previous work demonstrating neural reactivity to alcohol cues in AUD. Because alcohol consumption and sexual behavior are both rewarding and tend to co-occur, sexual cues may produce similar neural reactivity in women with AUD, possibly indicating a shared mechanism underlying reactivity to both types of cues. Alternatively, reactivity to alcohol versus sexual cues may be distinct, suggesting domain-specific mechanisms. OBJECTIVES: We investigated whether the decision vulnerabilities in AUD women regarding sexual activity were related to differences in brain activation compared to control women. METHODS: Women with (n = 15) and without (n = 16) AUD completed a hypothetical decision-making task during fMRI that presented low- or high-risk scenarios involving visual sexual, appetitive, and neutral cues. RESULTS: Results showed that sexual cues were more often endorsed by women with AUD compared to controls and elicited differential brain activation patterns in frontal, visual, and reward regions. During high-risk decisions, women with AUD failed to downregulate activation, causing hyperactivation compared to controls. CONCLUSIONS: Visual sexual cues produced reactivity like that previously demonstrated for alcohol cues, suggesting a shared or domain-general mechanism for alcohol and sexual cue reactivity in women with AUD. Riskier sexual decisions in women with AUD may be a consequence of repeatedly pairing alcohol use and sexual activity, a characteristic behavior of this population. SN - 1432-2072 UR - https://www.unboundmedicine.com/medline/citation/33738536/Neural_mechanisms_of_sexual_decision_making_in_women_with_alcohol_use_disorder_ DB - PRIME DP - Unbound Medicine ER -