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Cited by 234Decision-Making and Behavioral EconomicsNeural and Behavioral Psychology StudiesGambling Behavior and Treatments

The behavioral economics and neuroeconomics of reinforcer pathologies: implications for etiology and treatment of addiction

Open access
Bickel, Warren K., Jarmolowicz, David P., Mueller, E. Terry, Gatchalian, Kirstin M.·2011·Current Psychiatry Reports
DOI 10.1007/s11920-011-0215-1PMC PMC4034532
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Abstract

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.

AI snapshot

Written from the paper’s full text.

TL;DR

This review proposes that addiction can be understood as reinforcer pathology: persistently high valuation of a substance or experience and/or excessive preference for immediate consumption despite long-term harm. It links these behavioral-economic patterns to an imbalance between an impulsive limbic system and a more recently evolved executive prefrontal system, and it considers treatment implications such as working memory training.

Key findings

  • Reinforcer pathology is defined by two interacting features: high valuation of a reinforcer, measured through demand/price elasticity, and excessive delay discounting, meaning delayed rewards lose value steeply.
  • Addictive reinforcers tend to be defended against price increases: for example, Johnson and Bickel found cigarette puffs were less price elastic than monetary reinforcers, and obese women showed greater reinforcing value of food than nonobese women in cited studies.
  • Individuals with addictions—including opioid, cocaine, alcohol, cigarette, gambling, and obesity-related problems—discount delayed rewards more than matched controls, and greater severity tends to be associated with steeper discounting; addicts also discount their pathological commodity more than money.
  • The competing neurobehavioral decision systems theory attributes pathological choice to a hyperactive impulsive system and/or a hypoactive executive system; preliminary evidence from stimulant addicts found that active working memory training reduced delay discounting, whereas control training did not.

Methods

  • Design: conceptual and narrative review integrating behavioral economics and neuroeconomics, not a primary empirical study.
  • Data/sample: no new sample; the paper synthesizes prior human studies on demand, delay discounting, neuroimaging, and treatment-related findings.
  • Main analysis: theoretical synthesis using own-price and cross-price elasticity, delay discounting procedures, and the competing neurobehavioral decision systems framework to explain five features of addiction.

Limitations

  • Stated: the paper does not systematically review behavioral economics because of scope and space limits; the working memory training evidence is preliminary and needs replication and extension.
  • Stated: some researchers dispute the competing decision systems view, and Kable and Glimcher’s procedures—such as using only stable discounters and selectively inviting high discounters—may have obscured executive-system effects.
  • Evident from the text: as a narrative review, it relies on cited studies rather than new data or formal meta-analysis, and treatment implications remain speculative pending studies of substance-use outcomes.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1007/s11920-011-0215-1

Cites

71 of 71 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 128 cited sources checked · 0 supported · 0 flagged

  • Premisecitation

    There is no systematic effect of reward type, real versus hypothetical, on delay discounting.

    “Lagorio and Madden [21] found no systematic effect of reward type (real or hypothetical).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [21] Lagorio CH, Madden GJ. Delay discounting of real and hypothetical rewards III: steady-state assessments, forced-choice trials, and all real rewards. Behav Process. 2005;69:173. source

      Not checked in the free run.

  • Premisecitation

    The reinforcing value of food predicted greater energy intake in obese women compared with nonobese women.

    “The reinforcing-value-of-food measure also predicted the greater energy intake in the experiment by the obese group compared with the nonobese group.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [10] Saelens BE, Epstein LH. Reinforcing value of food in obese and non-obese women. Appetite. 1996;27:41–50. source

      Not checked in the free run.

  • Premisecitation

    Smokers' consumption of cigarette puffs is less elastic than their consumption of monetary reinforcers.

    “smokers’ consumption of cigarette puffs was considerably less elastic (less price sensitive) than either of the monetary reinforcers [9, 13, 14]”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [6] Johnson MW, Bickel WK. Replacing relative reinforcing efficacy with behavioral economic demand curves. J Exp Anal Behav. 2006;85:73–93. source

      Not checked in the free run.

    • cites [9] Johnson MW, Bickel WK. The behavioral economics of cigarette smoking: the concurrent presence of a substitute and an independent reinforcer. Behav Pharmacol. 2003;14:137–44. source

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    • cites [13] Bickel WK, Madden GJ, DeGrandpre RJ. Modeling the effects of combined behavioral and pharmacological treatment on cigarette smoking: behavioral-economic analyses. Exp Clin Psychopharmacol. 1997;5:334–43. source

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  • Premisecitation

    Individuals with reinforcement pathologies discount delayed rewards more than matched controls.

    “individuals who suffer from reinforcement pathologies discount delayed rewards more than matched controls.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [22] Kirby KN, Petry NM, Bickel WK. Heroin addicts have higher discount rates for delayed rewards than non-drug using controls. J Exp Psychol Gen. 1999;128:78–87. source

      Not checked in the free run.

    • cites [32] Madden GJ, Petry NM, Badger GJ, Bickel WK. Impulsive and self-control choices in opioid-dependent patients and non-drug-using control participants: drug and monetary rewards. Exp Clin Psychopharmacol. 1997;5:256–62. source

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    • cites [23] Weller RE, Cook III EW, Avsar KB, Cox JE. Obese women show greater delay discounting than healthy-weight women. Appetite. 2008;51:563–9. source

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  • Premisecitation

    Delay discounting rates from hypothetical rewards are comparable to those from potentially real rewards.

    “the assessed discounting rates from procedures using all hypothetical rewards were comparable to those from the potentially real procedures [15–20].”
    Quote in the paperSubstantial claim0 of 6 sources checked
    • cites [15] Baker F, Johnson MW, Bickel WK. Delay discounting in current and never-before cigarette smokers: similarities and differences across commodity, sign, and magnitude. J Abnorm Psychol. 2003;112:382–92. source

      Not checked in the free run.

    • cites [16] Bickel WK, Pitcock JA, Yi R, Angtuaco EJC. Congruence of BOLD response across intertemporal choice conditions: fictive and real money gains and losses. J Neurosci. 2009;29:8839–46. source

      Not checked in the free run.

    • cites [17] Johnson MW, Bickel WK. Within-subject comparison of real and hypothetical money rewards in delay discounting. J Exp Anal Behav. 2002;77:129–46. source

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    • cites [18] Johnson MW, Bickel WK, Baker F. Moderate drug use and delay discounting: a comparison of heavy, light, and never smokers. Exp Clin Psychopharmacol. 2007;15:187–94. source

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    • cites [19] Madden GJ, Begotka AM, Raiff BR, Kastern LL. Delay discounting of real and hypothetical rewards. Exp Clin Psychopharmacol. 2003;11:139–45. source

      Not checked in the free run.

    • cites [20] Madden GJ, Raiff BR, Laforio CH, et al. Delay disocounting of potentially real and hypothetical rewards: II. Between-and within-subject comparison. Exp Clin Psychopharmacol. 2004;12:251–6. source

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  • Classified as probably not a substantial claim. 21
  • May combine two claims. 19

  • Classified as probably not a substantial claim.

    Interpretationcitation

    The first feature of reinforcer pathology is persistently high valuation of a reinforcer, including tangible commodities and experiences.

    “we define reinforcer pathologies as resulting from 1) the persistently high valuation of a reinforcer, broadly defined to include tangible commodities and experiences”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [1••]

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    Premisecitation

    Assessment of delay discounting using hypothetical rewards is a practical procedure that yields valid data.

    “The results across these studies have led to the conclusion that assessment of delay discounting using hypothetical rewards is a practical procedure that yields valid data [15–21].”
    Quote in the paperSubstantial claim0 of 7 sources checked
    • cites [15] Baker F, Johnson MW, Bickel WK. Delay discounting in current and never-before cigarette smokers: similarities and differences across commodity, sign, and magnitude. J Abnorm Psychol. 2003;112:382–92. source

      Not checked in the free run.

    • cites [16] Bickel WK, Pitcock JA, Yi R, Angtuaco EJC. Congruence of BOLD response across intertemporal choice conditions: fictive and real money gains and losses. J Neurosci. 2009;29:8839–46. source

      Not checked in the free run.

    • cites [17] Johnson MW, Bickel WK. Within-subject comparison of real and hypothetical money rewards in delay discounting. J Exp Anal Behav. 2002;77:129–46. source

      Not checked in the free run.

    • cites [18] Johnson MW, Bickel WK, Baker F. Moderate drug use and delay discounting: a comparison of heavy, light, and never smokers. Exp Clin Psychopharmacol. 2007;15:187–94. source

      Not checked in the free run.

    • cites [19] Madden GJ, Begotka AM, Raiff BR, Kastern LL. Delay discounting of real and hypothetical rewards. Exp Clin Psychopharmacol. 2003;11:139–45. source

      Not checked in the free run.

    • cites [20] Madden GJ, Raiff BR, Laforio CH, et al. Delay disocounting of potentially real and hypothetical rewards: II. Between-and within-subject comparison. Exp Clin Psychopharmacol. 2004;12:251–6. source

      Not checked in the free run.

    • cites [21] Lagorio CH, Madden GJ. Delay discounting of real and hypothetical rewards III: steady-state assessments, forced-choice trials, and all real rewards. Behav Process. 2005;69:173. source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationcitation

    Addiction can be understood as pathological response patterns that arise from persistently high valuation of a reinforcer and/or an excessive preference for immediate consumption of that reinforcer.

    “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.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [1••]

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    Premisecitation

    Individuals with reinforcer pathologies typically show demand inelasticity for abused substances but not for nonpathological reinforcers.

    “individuals suffering from reinforcer 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.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [6] Johnson MW, Bickel WK. Replacing relative reinforcing efficacy with behavioral economic demand curves. J Exp Anal Behav. 2006;85:73–93. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationnone given

    Reinforcer pathology consists of two distinct but likely interacting behavioral repertoires that lie at the extremes of the distribution.

    “Reinforcer pathology, as we define it, refers to the presence of two distinct but likely interacting repertoires that tend to be at the extremes of the distribution of behaviors.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Interpretationcitation

    The second feature of reinforcer pathology is excessive preference for immediate acquisition or consumption of a commodity despite long-term negative outcomes.

    “and/or 2) the excessive preference for the immediate acquisition or consumption of a commodity despite long-term negative outcomes [1••].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [1••]

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    Premisecitation

    The impulsive system is evolutionarily older, consists of limbic and paralimbic areas, and is primarily involved in valuation of immediate rewards.

    “The evolutionarily older impulsive system, which consists of portions of the limbic and paralimbic areas, is primarily involved in the valuation of immediate rewards.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [1••]

      Not checked in the free run.

    • cites [40] Jentsch JD, Taylor JR. Impulsivity resulting from frontostriatal dysfunction in drug abuse: implications for the control of behavior by reward-related stimuli. Psychopharmacology. 1999;146:373–90. source

      Not checked in the free run.

    • cites [41] •• Bickel WK, Mueller ET, Jarmolowicz DP: What is addiction? In Addictions: A Comprehensive Guidebook, Second Edition. Edited by McCrady B, Epstein E. 2011 (2011). This chapter provides an extended description of the competing neurobehavioral decisions systems theory, its genesis, and its adequacy in explaining relevant features of addiction.

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Activation in the impulsive system is associated with valuation of reinforcers and diminishes as reinforcers are delayed.

    “several studies have found that activation in the impulsive system is associated with the valuation of reinforcers [16, 42, 43, 46, 47], and that this activation is diminished as reinforcers are delayed [42, 43].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [16] Bickel WK, Pitcock JA, Yi R, Angtuaco EJC. Congruence of BOLD response across intertemporal choice conditions: fictive and real money gains and losses. J Neurosci. 2009;29:8839–46. source

      Not checked in the free run.

    • cites [42] Kable JW, Glimcher PW. The neural correlates of subjective value during intertemporal choice. Nat Neurosci. 2007;10:1625–33. source

      Not checked in the free run.

    • cites [43] Kable JW, Glimcher PW. An “as soon as possible” effect in human intertemporal decision making: behavioral evidence and neural mechanisms. J Neurophysiol. 2010;103:2513–31. source

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Functional MRI enables precise measurement of brain activity as humans perform experimental tasks.

    “the development of functional MRI has enabled the precise measurement of brain activity as humans perform experimental tasks [36].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [36] Raichle ME. A brief history of human brain mapping. Trends Neurosci. 2009;32:118–26. source

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  • May combine two claims.

    Interpretationcitation

    The follow-up study used stable discounters and selectively invited the highest discounters from the earlier study; consistent with competing decision systems theory, the executive system had little influence on these individuals' high discounting.

    “Their follow-up paper [43] not only used stable discounters but also selectively invited the participants with the highest discounting rates during the previous study [42] to participate. Consistent with the competing decision systems theory, the executive system had little influence on these individuals’ high rates of discounting.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [43] Kable JW, Glimcher PW. An “as soon as possible” effect in human intertemporal decision making: behavioral evidence and neural mechanisms. J Neurophysiol. 2010;103:2513–31. source

      Not checked in the free run.

    • cites [42] Kable JW, Glimcher PW. The neural correlates of subjective value during intertemporal choice. Nat Neurosci. 2007;10:1625–33. source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Patterns of responding associated with reinforcer pathologies, such as drug addiction, are related to a hyperactive impulsive and/or hypoactive executive system.

    “Thus, the patterns of responding associated with reinforcer pathologies (e.g., drug addiction [1••, 41••, 44]) are related to a hyperactive impulsive and/or a hypoactive executive system.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [1••]

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    • cites [41••]

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    • cites [44] Bickel WK, Miller ML, Yi R, et al. Behavioral and neuroeconomics of drug addiction: competing neural systems and temporal discounting processes. Drug Alcohol Depend. 2007;90S:S85–91. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Competing neurobehavioral decision systems theory posits that choices between immediate and delayed reinforcers are related to the regulatory balance of activation in two neural systems.

    “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.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [1••]

      Not checked in the free run.

    • cites [40] Jentsch JD, Taylor JR. Impulsivity resulting from frontostriatal dysfunction in drug abuse: implications for the control of behavior by reward-related stimuli. Psychopharmacology. 1999;146:373–90. source

      Not checked in the free run.

    • cites [41] •• Bickel WK, Mueller ET, Jarmolowicz DP: What is addiction? In Addictions: A Comprehensive Guidebook, Second Edition. Edited by McCrady B, Epstein E. 2011 (2011). This chapter provides an extended description of the competing neurobehavioral decisions systems theory, its genesis, and its adequacy in explaining relevant features of addiction.

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Kable and Glimcher found that activation in the impulsive system tracked reinforcer value at all delays but found little support for the executive system.

    “They found that activation in the impulsive system tracked reinforcer value at all delays but found little support for the executive system.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [42] Kable JW, Glimcher PW. The neural correlates of subjective value during intertemporal choice. Nat Neurosci. 2007;10:1625–33. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The finding that impulsive system activation tracked value at all delays was replicated in a follow-up study.

    “These findings were replicated in a follow-up study [43]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [43] Kable JW, Glimcher PW. An “as soon as possible” effect in human intertemporal decision making: behavioral evidence and neural mechanisms. J Neurophysiol. 2010;103:2513–31. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The executive system is more recently developed, consists of prefrontal cortices, and is involved in consideration of the future and selection of delayed rewards.

    “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.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [1••]

      Not checked in the free run.

    • cites [40] Jentsch JD, Taylor JR. Impulsivity resulting from frontostriatal dysfunction in drug abuse: implications for the control of behavior by reward-related stimuli. Psychopharmacology. 1999;146:373–90. source

      Not checked in the free run.

    • cites [41] •• Bickel WK, Mueller ET, Jarmolowicz DP: What is addiction? In Addictions: A Comprehensive Guidebook, Second Edition. Edited by McCrady B, Epstein E. 2011 (2011). This chapter provides an extended description of the competing neurobehavioral decisions systems theory, its genesis, and its adequacy in explaining relevant features of addiction.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Demand measures distinguished schizophrenics from controls, while delay discounting rates did not.

    “They determined that demand measures distinguished schizophrenics from controls, while delay discounting rates did not.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [31] MacKillop J, Tidey JW: Cigarette demand and delayed reward discounting in nicotine-dependent individuals with schizophrenia and controls: an initial study. Psychopharmacology 2011;216:91–9. source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    Because only stable discounters took part in the imaging component, and stable responding may be somewhat automatic, this procedural choice may have underplayed the executive system's role.

    “Furthermore, only participants who exhibited stable discounting participated in the imaging component of the study. Because stable responding may be somewhat automatic, this procedural choice may have underplayed the role of the executive system.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [42] Kable JW, Glimcher PW. The neural correlates of subjective value during intertemporal choice. Nat Neurosci. 2007;10:1625–33. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Bickel and Mueller suggested that excessive discounting represents a trans-disease process.

    “Similarly, Bickel and Mueller [69] suggested that excessive discounting represents a trans-disease process”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [69] Bickel WK, Mueller ET. Toward the study of trans-disease processes: a novel approach with special reference to the study of co-morbidity. Journal of Dual Diagnosis. 2009;5:131–8. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    The above findings suggest an innovative intervention for changing the valuation of delayed reinforcers.

    “The above findings suggest an innovative intervention for changing the valuation of delayed reinforcers.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The Shaffer et al. syndrome model posits that addictions are manifestations of an abnormal underlying condition.

    “The Shaffer et al. [68] syndrome model of addiction posits that like other syndromes, addictions are a manifestation of an abnormal underlying condition.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [68] Shaffer HJ, LaPlante DA, LaBrie RA, et al. Toward a syndrome model of addiction: multiple expressions, common etiology. Harv Rev Psychiatr. 2004;12:367–74. source

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  • May combine two claims.

    Interpretationreasoning

    Just as pathological discounting of delayed reinforcers predicts unhealthy choices, pathological valuation of reinforcers also predicts consumption of those reinforcers.

    “Thus, just as pathological discounting of delayed reinforcers predicts unhealthy choices, pathological valuation of reinforcers also predicts consumption of these reinforcers.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    The results of the working memory training study must be interpreted with caution because the study is preliminary.

    “These results, however, must be interpreted with caution given the preliminary nature of the above study”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [56] •• Bickel WK, Yi R, Landes RD, et al. Remember the future: working memory training decreases delay discounting among stimulant addicts. Biol Psychiatr. 2011;69:260–5. This recent paper provides an example of a novel treatment approach derived from the competing neurobehavioral decisions systems appraoch to addiction. source

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  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationcitation

    From the competing decision systems theory, these preliminary findings are encouraging for identifying and testing new therapeutic approaches.

    “From the viewpoint of the competing decisions systems theory, these preliminary findings are encouraging in terms of identifying and testing new therapeutic approaches.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [56] •• Bickel WK, Yi R, Landes RD, et al. Remember the future: working memory training decreases delay discounting among stimulant addicts. Biol Psychiatr. 2011;69:260–5. This recent paper provides an example of a novel treatment approach derived from the competing neurobehavioral decisions systems appraoch to addiction. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    According to the competing decision systems viewpoint, the underlying process is a disruption in the regulatory balance between the executive and impulsive systems.

    “According to the competing decision systems viewpoint, this underlying process is a disruption in the regulatory balance between the executive and impulsive systems.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationcitation

    Reinforcement pathologies resulting from dysregulation in the competing decision systems can predict treatment outcomes and may inform new therapeutic approaches.

    “The reinforcement pathologies resulting from dysregulation in the competing decision systems can predict treatment outcomes and may inform new therapeutic approaches.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    In this view, a relatively strong impulsive system drives continued consumption while a relatively weak executive system fails to value deferred outcomes associated with abstinence.

    “Specifically, the relatively strong impulsive decision system drives continued consumption, whereas the relatively weak executive system fails to value deferred outcomes associated with abstinence.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Active working memory training produced significant decreases in delay discounting, while control training produced no significant changes.

    “significant decreases in delay discounting in the group that received active working memory training, but no significant changes in delay discounting in the group that received control training.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [56] •• Bickel WK, Yi R, Landes RD, et al. Remember the future: working memory training decreases delay discounting among stimulant addicts. Biol Psychiatr. 2011;69:260–5. This recent paper provides an example of a novel treatment approach derived from the competing neurobehavioral decisions systems appraoch to addiction. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    In the working memory training study, stimulant addicts receiving treatment at a local facility were randomly assigned to active working memory training or control training.

    “stimulant addicts receiving treatment at a local facility were randomly assigned to receive active working memory training or control training.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [56] •• Bickel WK, Yi R, Landes RD, et al. Remember the future: working memory training decreases delay discounting among stimulant addicts. Biol Psychiatr. 2011;69:260–5. This recent paper provides an example of a novel treatment approach derived from the competing neurobehavioral decisions systems appraoch to addiction. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    The competing decision systems theory holds that the abnormal underlying condition is an imbalance between the executive and impulsive systems.

    “The competing decision systems theory holds that this abnormal underlying condition is an imbalance between the executive and impulsive systems.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    The impulsive system matures in the early- to mid-teens, while the executive system typically reaches full maturity in the mid-20s.

    “Specifically, the impulsive system matures in the early- to mid-teens, whereas the executive system does not typically reach full maturity until the mid-20s [64].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [64] Steinberg L. A dual systems model of adolescent risk-taking. Dev Psychobiol. 2010;52:216–24. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    Neuroeconomics has provided an understanding of the conceptual model underlying behavior associated with reinforcer pathology.

    “We also showed how neuroeconomics has provided an understanding of the conceptual model that underlies the behavior associated with reinforcer pathology.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Reinforcement pathology consists of two processes: persistent high valuation of a commodity or substance, and preference for immediate acquisition or consumption despite long-term negative outcomes.

    “we reviewed the two constituent processes of reinforcement pathology: 1) the persistent high valuation of a commodity or substance, and 2) the preference for the immediate acquisition and/or consumption of that commodity despite long-term negative outcomes [1••].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [1••]

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  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationcitation

    The notion of reinforcer pathologies provides a means to organize and illustrate commonalities across addictions that may demonstrate the importance of trans-disease processes.

    “The notion of reinforcer pathologies provides a means to organize and illustrate commonalities across addictions that may demonstrate the importance of trans-disease processes [69].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [69] Bickel WK, Mueller ET. Toward the study of trans-disease processes: a novel approach with special reference to the study of co-morbidity. Journal of Dual Diagnosis. 2009;5:131–8. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Demand for edible reinforcers predicted the amount of food high discounters would eat when given free access, but not lower discounters.

    “Specifically, demand for edible reinforcers predicted the amount of food that high discounters would eat when given free access to food, but not participants who discounted at a lower rate.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [35] Rollins BY, Dearing KK, Epstein LH. Delay discounting moderates the effect of food reinforcement on energy intake among non-obese women. Appetite. 2010;55:420–5. source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    The two processes of reinforcement pathology are expected to act synergistically and perpetuate addictive features.

    “Additionally, on the basis of our economic understanding of these two processes, we expect that they act in a way that may be synergistic, and perpetuate addictive features.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    The competing neurobehavioral decision systems approach provides an understanding of addiction that addresses and accounts for at least five features of addiction that any conceptual or theoretical model should address.

    “That model, referred to as the competing neurobehavioral decision systems approachprovides an understanding of addiction that allows it to address and account for at least five features of addiction that we would expect any conceptual or theoretical model to address.”
    Quote in the paperNot a substantial claim
36 of 36

  • The paper relies on this without support.

    The field of addiction research has sometimes produced facts and theories that are orthogonal to each other.

    “The field on occasion has collected facts and proposed theories that have been orthogonal to each other.”

  • The authors state this as an assumption.

    An effective theory of addiction must address the cardinal aspects of addiction that the paper identifies.

    “some of the cardinal aspects of addiction that we would expect an effective theory of addiction to address.”

  • The paper relies on this without support.

    Different excessive behaviors, such as overconsumption of food, drugs, and gambling, share the same underlying reinforcer pathology.

    “Prototypical examples of reinforcer pathology include overconsumption of food and drugs either legal (e.g., cigarettes or alcohol) or illegal (e.g., cocaine or heroin).”

  • The paper relies on this without support.

    Individuals with drug addiction tend to continue excessive use of harmful substances despite recognizing that their use is problematic.

    “Second, individuals suffering from drug addiction tend to continue their excessive use of harmful substances despite the recognition of problematic consequences.”
4 of 4

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Critical to reinforcer pathology is the interaction of the temporal window of integration.

    “Indeed, critical to this concept is the interaction of the temporal window of integration [25,26].”

    From Addiction Biomarkers: Dimensional Approaches to Understanding Addiction (2018) · cites this paper as [25]

  • The concept of reinforcer pathology is a recent development in the field of the behavioral economics of addiction specifically focused on how the window of time over which reinforcers are integrated can determine the relative valuation of alcohol and drugs versus other prosocial reinforcers, such as relationships and employment.

    “The concept of reinforcer pathology is a recent development in the field of the behavioral economics of addiction specifically focused on how the window of time over which reinforcers are integrated can determine the relative valuation of alcohol and drugs versus other prosocial reinforcers, such as relationships and employment [22–24].”

    From Addiction Biomarkers: Dimensional Approaches to Understanding Addiction (2018) · cites this paper as [22]

  • Short temporal windows of integration may increase the value of intense, reliable, and brief reinforcers, such as drugs, and lead to a decline in the value of reinforcers that are less intense, variable, and accrue value over longer timeframes, such as prosocial reinforcers.

    “Short temporal windows of integration may increase the value of intense, reliable, and brief reinforcers, such as drugs, and lead to a decline in the value of reinforcers that are less intense, variable, and accrue value over longer timeframes, such as prosocial reinforcers.”

    From Addiction Biomarkers: Dimensional Approaches to Understanding Addiction (2018) · cites this paper as [25]

  • Long temporal windows of integration should reverse the valuation of drug and prosocial reinforcers.

    “Conversely, long temporal windows of integration should reverse the valuation of drug and prosocial reinforcers [25,26].”

    From Addiction Biomarkers: Dimensional Approaches to Understanding Addiction (2018) · cites this paper as [25]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Food-intake claim cites a polydrug-use study

    Minor

    The sentence attributes a comparison of food reinforcement and hedonic ratings to reference 12, but the paper's reference 12 is a study of income and polydrug use, not food intake.

1 of 1

Cites

Flagged first, then by citations

Research works printed but not linked: 2

  1. •• Bickel WK, Jarmolowicz DP, MacKillop J, et al. The behavioral economics of reinforcement pathologies. In: Shaffer HJ, editor. Addiction syndrome handbook. Washington, DC: American Psychological Association; 2011. This chapter provides an extended description of the concept of reinforcer pathologies as applied to addiction.
  2. •• Bickel WK, Mueller ET, Jarmolowicz DP: What is addiction? In Addictions: A Comprehensive Guidebook, Second Edition. Edited by McCrady B, Epstein E. 2011 (2011). This chapter provides an extended description of the competing neurobehavioral decisions systems theory, its genesis, and its adequacy in explaining relevant features of addiction.

Cited by

Sorted by citations

Related

Authors
Bickel, W. K., Jarmolowicz, D. P., Mueller, E. T., & Gatchalian, K. M.
Affiliations
Carilion Clinic (US)
Corresponding author
Bickel, Warren K.
ORCID
Venue
Current Psychiatry Reports
Publisher
Springer Science and Business Media LLC
Published
2011-07-06
Volume
13
Issue
5
Pages
406-415
ISSN
  • 1523-3812 (ISSN-L)
  • 1535-1645
DOI
10.1007/s11920-011-0215-1
PMC
PMC4034532
OpenAlex
W2036788958
Semantic Scholar
0b7d6c11a9813d349ed6b4b8fc6dfc5351dedbdc
Cited by
234
References
71
Citations by year
2026: 18 · 2025: 8 · 2024: 11 · 2023: 15 · 2022: 10 · 2021: 18 · 2020: 61 · 2019: 26 · 2018: 13 · 2017: 12 · 2016: 13 · 2015: 10 · 2014: 8 · 2013: 4 · 2012: 7
FWCI
3.35
Type
journal article
Language
en
Open access
Licence
www.springer.com/tdm (tdm)
Locations
  • Current Psychiatry Reports (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute on Drug Abuse (R01DA012997, R01DA022386, R01DA024080, R01DA030241, 1 R01 DA026817-01A1)
Topics
  • Social Sciences › Decision Sciences › General Decision Sciences › Decision-Making and Behavioral Economics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
  • Social Sciences › Psychology › Clinical Psychology › Gambling Behavior and Treatments
Keywords
addiction, behavioral economics, neuroeconomics, impulsivity, executive function, delay of gratification, causes of addiction, addiction treatment
MeSH terms
Choice Behavior, Humans, Impulsive Behavior, Models, Psychological, Motivation, Reinforcement, Psychology, Models, Economic, Substance-Related Disorders

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-05.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-05.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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