When cues take the wheel: cue-control across alcohol use disorder, binge-eating disorder, gambling disorder, and internet gaming disorder

当线索主导一切:酒精使用障碍、暴食症、赌博障碍和网络游戏障碍中的线索控制

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Abstract

Cues associated with rewarding outcomes can strongly influence behavior, shaping attention, motivation, and action selection. Across escalating and compulsive behaviors such as alcohol use disorder (AUD), binge-eating disorder (BED), and gambling disorder (GD), as well as the related case of internet gaming disorder (IGD), cue-triggered responses are commonly observed, yet their underlying behavioral mechanisms remain heterogeneous and incompletely understood. This review synthesizes evidence from experimental paradigms that probe cue-driven control over behavior, with a particular focus on Pavlovian conditioning, Pavlovian-to-Instrumental Transfer (PIT), and related Pavlovian-to-decision paradigms in humans and animals. We highlight how Pavlovian cues can invigorate instrumental responding, bias choice among available actions, or capture attention independently of current goals, and how these effects vary across reinforcer type, task structure, and individual differences. Rather than supporting a unitary cue-reactivity account, the literature points to partially overlapping processes, including incentive salience attribution, attentional capture, and Pavlovian modulation of instrumental control, that appear across disorders but are differentially expressed across subgroups. We argue that paradigms that assess cue-control provide a valuable mechanistic bridge between basic learning theory and clinically relevant behavior, while also posing methodological challenges for interpretation and translation. Understanding when and how cues gain control over action may inform more targeted, mechanism-based interventions for excessive behaviors.

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