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A critical review of front‐loading: A maladaptive drinking pattern driven by alcohol's rewarding effects
Author(s) -
Ardinger Cherish E.,
Lapish Christopher C.,
Czachowski Cristine L.,
Grahame Nicholas J.
Publication year - 2022
Publication title -
alcoholism: clinical and experimental research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.267
H-Index - 153
eISSN - 1530-0277
pISSN - 0145-6008
DOI - 10.1111/acer.14924
Subject(s) - alcohol , front (military) , reinforcement , alcohol use disorder , psychology , mechanism (biology) , cognitive psychology , developmental psychology , medicine , social psychology , engineering , biology , mechanical engineering , biochemistry , philosophy , epistemology
Front‐loading is a drinking pattern in which alcohol intake is skewed toward the onset of reward access. This phenomenon has been reported across several different alcohol self‐administration protocols in a wide variety of species, including humans. The hypothesis of the current review is that front‐loading emerges in response to the rewarding effects of alcohol and can be used to measure the motivation to consume alcohol. Alternative or additional hypotheses that we consider and contrast with the main hypothesis are that: (1) front‐loading is directed at overcoming behavioral and/or metabolic tolerance and (2) front‐loading is driven by negative reinforcement. Evidence for each of these explanations is reviewed. We also consider how front‐loading has been evaluated statistically in previous research and make recommendations for defining this intake pattern in future studies. Because front‐loading may predict long‐term maladaptive alcohol drinking patterns leading to the development of alcohol use disorder (AUD), several future directions are proposed to elucidate the relationship between front‐loading and AUD.