The Behavioral Economics and Neuroeconomics of Reinforcer Pathologies: Implications for Etiology and Treatment of Addiction
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The current paper presents a novel approach to understanding and treating addiction. Drawing from work in behavioral economics and developments in the new field of neuroeconomics, we describe addiction as pathological patterns of responding resulting from the persistently high valuation of a reinforcer and/or an excessive preference for the immediate consumption of that reinforcer. We further suggest that, as indicated by the competing neurobehavioral decision systems theory, these patterns of pathological choice and consumption result from an imbalance between two distinct neurobehavioral systems. Specifically, pathological patterns of responding result from hyperactivity in the evolutionarily older impulsive system (which values immediate and low-cost reinforcers) and/or hypoactivity in the more recently evolved executive system (which is involved in the valuation of delayed reinforcers). This approach is then used to explain five phenomena that we believe any adequate theory of addiction must address.
KeywordsAddiction Treatment Pathology Behavioral economics Neuroeconomics Neural systems Theory Impulsivity Reinforcer Executive function Human
Dr. Bickel has received grant support from the National Institutes of Health/National Institute on Drug Abuse (grant nos. 5 R01 DA012997-11 [principal investigator], 1 R01 DA024080-01A1 [principal investigator], 1 R01 DA026817-01A1 [co–principal investigator], and 1 R01 DA022386-01A1 [co-investigator]) and the National Institute on Alcohol Abuse and Alcoholism (grant no. 3R01DA024080-02S1).
Dr. Bickel has received honoraria for presentations made at the Providence Regional Medical Center’s 13th Annual Fundamentals of Addiction Medicine Conference, the Duke Institute for Brain Sciences Addiction Research Group Seminar Series, the Association for Behavioral Analysis International Behavioral Economics Conference, and at Texas A&M University (colloquia speaker).
Dr. Jarmolowicz, Dr. Mueller, and Ms. Gatchalian reported no potential conflicts of interest relevant to this article.
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