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Impulsivity pp 227-267 | Cite as

Toward Narrative Theory: Interventions for Reinforcer Pathology in Health Behavior

  • Warren K. Bickel
  • Jeffrey S. Stein
  • Lara N. Moody
  • Sarah E. Snider
  • Alexandra M. Mellis
  • Amanda J. Quisenberry
Chapter
Part of the Nebraska Symposium on Motivation book series (NSM, volume 64)

Abstract

Reinforcer pathology describes the interaction between excessive devaluation of delayed rewards and excessive valuation of commodities such as drugs or food. In isolation, both components of reinforcer pathology increase risk for substance-use disorders and other maladaptive health behaviors (e.g., poor diet); in combination, these components synergistically increase risk. In this chapter, we review evidence that reinforcer pathology may arise from imbalance between two competing neurobehavioral decision systems (CNDS)—the impulsive system, comprising the limbic and paralimbic brain regions, and the executive system, comprising the prefrontal and parietal cortices. To correct imbalance between these systems and restore normative decision making, we introduce narrative theory, a novel intervention framework that seeks to harness humans’ unique sensitivity to language and storytelling in order to both understand and potentially treat the maladaptive decision making observed in addiction and other maladaptive health behaviors. We provide both an overview of methods used in investigations of narrative theory and a summary of effects of these methods on both discounting of delayed rewards and valuation of commodities that may damage health, such as drugs and energy-dense food.

Keywords

Temporal discounting Demand Reinforcement Addiction Health behavior Narratives 

Notes

Acknowledgements

The preparation of this chapter was, in part, supported financially by NIH grants 4R01AA021529, 5U19CA157345, 1P01CA200512, 4R01DA034755, and 5UH2DK109543, awarded to the first author (W.K.B.).

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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Warren K. Bickel
    • 1
  • Jeffrey S. Stein
    • 1
  • Lara N. Moody
    • 1
  • Sarah E. Snider
    • 1
  • Alexandra M. Mellis
    • 1
  • Amanda J. Quisenberry
    • 1
  1. 1.Virginia Tech Carilion Research InstituteRoanokeUSA

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