Samenvatting
Summary Taak 4 verslaving is een keuze
- Instelling
- Maastricht University (UM)
Taak 4 van het vak verslaving. Het vak wordt gegeven in het 3e jaar van de bachelor gezondheidswetenschappen.
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Voorbeeld 2 van de 12 pagina's
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Voorbeeld van de inhoud
Taak 4 verslaving is een keuzeBickel The Behavioral Economics and Neuroeconomics of Reinforcer Pathologies:
Implications for Etiology and Treatment of Addiction
- 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.
- behavioral economics, the integration of concepts from psychology and economics,
has provided important data about how addiction is behaviorally expressed. It has
shown that addicts demonstrate extreme valuation of their addictive reinforcer and
preference for receiving it in the short term. We refer to these patterns of reinforcer
consumption as reinforcer pathology. Second, neuroeconomics, the integration of
neuroscience, psychology, and economics, has provided a new conceptual model of
addictive behavior that explains reinforcer pathology and provides novel insights into
the etiology and treatment of addiction
Two General Characteristics of Reinforcer Pathology
- the presence of two distinct but likely interacting repertoires that tend to be at the
extremes of the distribution of behaviors. More specifically, we define reinforcer
pathologies as resulting from 1) the persistently high valuation of a reinforcer, broadly
defined to include tangible commodities and experiences; and/or 2) the excessive
preference for the immediate acquisition or consumption of a commodity despite long-
term negative outcomes
- Own-price elasticity of demand refers to the sensitivity of a person’s consumption of a
commodity (reinforcer) to the price of the commodity. Typically, the effects of a
variety of prices on consumption are measured, and from those effects, sensitivity of
consumption to price can be discerned. This can indicate the extent to which the
person values the commodity
- Cross-price elasticity of demand refers to the impact of changes in the price of one
commodity on the consumption of another fixed-price commodity. These interactions
can result in substitution, in which the increases in price of one commodity (e.g., one
brand of cola) increase the consumption of the other commodity (e.g., consumption of
another brand of cola increases), or can result in a complementary interaction in which
the increase in the price of one commodity (e.g., soup) decreases the consumption of
another commodity (e.g., soup crackers).
- delay discounting, which refers to the observation that the value of rewards decreases
as a function of delay until the time of their receipt. To measure the precise extent of
discounting entails varying the immediate amount until preference shifts from the
immediate to the later constant amount.
- excessively high valuation of a given reinforcer and severity of reinforcer pathology
are both defined by lack of diminution of consumption of the reinforcer with increases
in the price of the reinforcer. Notably, individuals suffering from reinforcer
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, pathologies typically show this insensitivity of consumption to price changes (i.e.,
demand inelasticity) for the substances that they abuse, but not for nonpathological
reinforcers.
- that the rate of delay discounting predicts several important behavioral patterns
regarding pathological reinforcers. One category of results in delay discounting
research bears upon the external validity of other research in the field and should be
considered first. The most commonly used procedures pose to human participants
several series of choice trials. In each trial, they select between two alternatives that
are both hypothetical outcomes (participants know they will not actually receive any
of their chosen alternatives). The use of hypothetical amounts makes it practical for
the experiments to assess the discounting of rewards consisting of commodities (e.g.,
illicit drugs) and in large amounts (e.g., worth $1,000) typical of the real world,
outside the experimental laboratory. assessment of delay discounting using
hypothetical rewards is a practical procedure that yields valid data
- Research using delay discounting assessment procedures has determined that
individuals who suffer from reinforcement pathologies discount delayed rewards more
than matched controls. severity of reinforcer pathology is positively related to rates of
discounting. those affected by reinforcement pathologies discount their pathological
reinforcer to a greater extent than they discount other commodities.
- The elasticity of demand (sensitivity of consumption to price) is determined in part by
the availability of substitutes. One source of substitution is intertemporal (e.g., the
individual might not choose to purchase a commodity today at a higher price if he
knows he can get it next week at a lower price). Now, if the consumer of a commodity
excessively discounts the future, then this would functionally decrease the availability
of intertemporal substitutes, which in turn should result in less price sensitivity. This
synergistic interaction between these two processes may drive the price insensitivity to
a point that characterizes reinforcer pathology
- Geld hogere elasticiteit dan trekjes van een sigaret. trekjes van een sigaret veel
stabieler. Maar als de prijs van geld hoger wordt grotere elasticiteit.
The Competing Neurobehavioral Decision Systems Theory
- Neuroeconomic data may be central to understanding the choices made by individuals
suffering from reinforcement pathologies
- when participants completed delay discounting tasks, choices for the smaller, more
immediate reinforcer were associated with relatively high levels of activation in parts
of the limbic system, whereas choices for the larger, later reinforcer were associated
with relatively high levels of activation in parts of the prefrontal cortex.
- The competing decision systems view posits that choices between immediate and
delayed reinforcers are related to the regulatory balance of activation in two neural
systems. The evolutionarily older impulsive system, which consists of portions of the
limbic and paralimbic areas, is primarily involved in the valuation of immediate
rewards. In contrast, the more recently developed executive system, which consists of
portions of the prefrontal cortices, is involved in the consideration of the future and the
selection of delayed rewards. According to the competing decision systems view, the
rate that an individual discounts delayed rewards reflects the relative strength of these
two systems. Thus, the patterns of responding associated with reinforcer pathologies
are related to a hyperactive impulsive and/or a hypoactive executive system.
- Support for competing decision systems: activation in the impulsive system is
associated with the valuation of reinforcers, and that this activation is diminished as
reinforcers are delayed. a hypoactive executive system is involved in pathological
reinforcer choice. the valuation of delayed reinforcers is related to activity in the
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