Mechanistic models for understanding addiction as a behavioural disorder. (original) (raw)
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Addiction requires philosophical explanation, not mere redescription
Behavioral and Brain Sciences, 1996
Research findings on addiction are contradictory. According to biographical records and widely used diagnostic manuals, addicts use drugs compulsively, meaning that drug use is out of control and independent of its aversive consequences. This account is supported by studies that show significant heritabilities for alcoholism and other addictions and by laboratory experiments in which repeated administration of addictive drugs caused changes in neural substrates associated with reward. Epidemiological and experimental data, however, show that the consequences of drug consumption can significantly modify drug intake in addicts. The disease model can account for the compulsive features of addiction, but not occasions in which price and punishment reduced drug consumption in addicts. Conversely, learning models of addiction can account for the influence of price and punishment, but not compulsive drug taking. The occasion for this target article is that recent developments in behavioral choice theory resolve the apparent contradictions in the addiction literature. The basic argument includes the following four statements: First, repeated consumption of an addictive drug decreases its future value and the future value of competing activities. Second, the frequency of an activity is a function of its relative (not absolute) value. This implies that an activity that reduces the values of competing behaviors can increase in frequency even if its own value also declines. Third, a recent experiment (Heyman & Tanz 1995) shows that the effective reinforcement contingencies are relative to a frame of reference, and this frame of reference can change so as to favor optimal or suboptimal choice. Fourth, if the frame of reference is local, reinforcement contingencies will favor excessive drug use, but if the frame of reference is global, the reinforcement contingencies will favor controlled drug use. The transition from a global to a local frame of reference explains relapse and other compulsive features of addiction.
Toward a critical neuroscience of 'addiction'
BioSocieties, 2010
Early to mid-twentieth century studies on the neurophysiology of the role of conditioned cues in relapse, conducted at the Addiction Research Center in Lexington, Kentucky, were the historical antecedents to today's neuroimaging studies. Attempts in the 1940s to see 'what's going on in the brains of these addicts' were formative for the field, as was foundational work done in the 1940s and 1950s by Abraham Wikler on conditioned cues, the role of what he called the 'limbic system' in relapse, and possible uses of narcotic antagonists to prevent relapse by extinguishing cues. This article sketches the historical context in order to situate continuities between historical antecedents and a current ethnographic case study focused on current neuroimaging studies of the role of 'craving' -and neural processes that precede conscious 'craving' and occur 'outside awareness' -in relapse conducted by Anna Rose Childress at the Treatment Research Center in Philadelphia, Pennsylvania. The article showcases the incommensurability between claims that 'addiction' is a matter of individual choice, and claims that it is a neurochemical disorder disruptive of volition. Neuroscientists offer scientific vocabulary and imagery that both shape and respond to the social experience of addiction. The conclusion considers the value of moving toward a critical neuroscience more cognizant of the social worlds in which 'addiction' occurs, not in the restricted sense of 'social factors' but through awareness of the social-situational contexts and relationships within which 'addictions' are experienced and studied.
Addiction-as-a-kind hypothesis
The International Journal of Alcohol and Drug Research, 2015
The psychiatric category of addiction has recently been broadened to include new behaviors. This has prompted critical discussion about the value of a concept that covers so many different substances and activities. Many of the debates surrounding the notion of addiction stem from different views concerning what kind of a thing addiction fundamentally is. In this essay, we put forward an account that conceptualizes different addictions as sharing a cluster of relevant properties (the syndrome) that is supported by a matrix of causal mechanisms. According to this “addiction-as-a-kind” hypothesis, several different kinds of substance and behavioral addictions can be thought of as instantiations of the same thing – addiction. We show how a clearly articulated account of addiction can facilitate empirical research and the theoretical integration of different perspectives on addiction. The causal matrix approach provides a promising alternative to existing accounts of the nature of psychiatric disorders, the traditional disease model, and its competitors. It is a positive addition to discussions about diagnostic criteria, and sheds light on how psychiatric classification may be integrated with research done in other scientific fields. We argue that it also provides a plausible approach to understanding comorbidity, and suggests how knowledge concerning specific forms of addiction could be useful in designing research as well as treatment interventions for other forms of addiction.
San Diego L. Rev., 2000
Addiction and Causation MICHAEL CORRADO* Table of Contents I. Introduction 914 A. The Causal Theory 915 B. Addiction and the Difficulty of Doing Otherwise 921 П. Theories of Addiction 926 A. Overview 926 B. Rational Choice Theories 929 1. Theories of Rational Addiction ...
2009
Neuroscience is beginning to uncover the neurochemical changes that occur within particular functional regions of the brain that are responsible for the behaviour in addiction. In doing so, neuroscience research is beginning to help us see that those who are addicted to drugs suffer from neurocognitive and motivational impairments that require treatment.
Drug and Alcohol Review
Introduction: Brain-based explanations of addiction have become a prominent explanatory model in recent decades. Although opposing views have been published, there is no large-scale study of researchers' opinions, unlike for treatment staff, the public and affected individuals. Therefore, this study aimed to examine international addiction researchers' perspectives on: (i) brain-based explanations of addiction; (ii) the perceived dominance of the concept in science, society, treatment and among those affected; and (iii) researchers' general conception of addiction in terms of ontologies and causes. Methods: A sample of 1440 international addiction researchers was compiled. Views were assessed online via LimeSurvey using a 'mixed methods light' approach (Likert-type scales, free-text fields). Qualitative content analyses of freetext comments complemented descriptive statistics. Results: One hundred and ninety researchers participated (13.19% response). The classification of substance use disorders as brain diseases/disorders was shared by about 60% of the respondents. Approximately 80% considered it the dominant view in science, but fewer in treatment, society and affected persons. Approximately 75% found it an oversimplification, but regarded it as helpful for understanding substance use disorders. Altogether, various biological, psychological and social factors were considered causal. Comments indicated that an over-simplistic nature of brain-based explanations of addiction was viewed as particularly problematic. Discussion and Conclusions: A rejection of a simplistic view of addiction in favour of a multi-causal concept in which the brain plays a role seems to be the majority view of participating researchers. Therefore, the orientation of future research, treatment and support for addicted persons need to be reconsidered accordingly.
The psychological science of addiction
Addiction, 2007
Aim To discuss the contributions and future course of the psychological science of addiction. Background The psychology of addiction includes a tremendous range of scientific activity, from the basic experimental laboratory through increasingly broad relational contexts, including patient-practitioner interactions, families, social networks, institutional settings, economics and culture. Some of the contributions discussed here include applications of behavioral principles, cognitive and behavioral neuroscience and the development and evaluation of addiction treatment. Psychology has at times been guilty of proliferating theories with relatively little pruning, and of overemphasizing intrapersonal explanations for human behavior. However, at its best, defined as the science of the individual in context, psychology is an integrated discipline using diverse methods well-suited to capture the multi-dimensional nature of addictive behavior. Conclusions Psychology has a unique ability to integrate basic experimental and applied clinical science and to apply the knowledge gained from multiple levels of analysis to the pragmatic goal of reducing the prevalence of addiction.