Therapeutic Opportunities for Self-Control Repair in Addiction and Related Disorders: Change and the Limits of Change in Trans-Disease Processes
Open accessAbstract
Contemporary neuroeconomic approaches hypothesize that self-control failure results from drugs annexing normal learning mechanisms that produce pathological reward processing and distort decision making as a result from the dysregulation of two valuation systems. An emphasis on processes shared across different diseases and disorders is at odds with the contemporary approach that assumes unique disease etiologies and treatments. Studying trans-disease processes can identify mechanisms that operate in multiple disease states and ascertain if factors that influence processes in one disease state may be applicable to all disease states. In this article we review the dual model of self-control failure, the Competing Neurobehavioral Decision System approach, the relationship of delay discounting to the relative control of these two systems, and evidence that the executive system can be strengthened. Future research that could result in more potent interventions for executive system improvement and potential constraints on the repair of self-control failure are discussed.
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Low working memory capacity is strongly associated with delay discounting, many negative health behaviors, and addictive disorders.
“Consistent with this model, low WMC is strongly linked to delay discounting and a range of negative health behaviors and addictive disorders (Bickel, Quisenberry, Moody, & Wilson, 2015; M. W. Otto et al., 2016; Sheffer et al, 2013).”
From A randomized controlled trial protocol for engaging distress tolerance and working memory to aid smoking cessation in low socioeconomic status (SES) adults (2020) · cites this paper as Bickel, Quisenberry, Moody, & Wilson, 2015
The Working Memory Training section (page unavailable) reports that working-memory training reduced delay discounting in stimulant users and that increased working-memory capacity accompanied reduced alcohol consumption in problem drinkers. The Delay Discounting section (page unavailable) links excessive discounting to addiction and several negative health behaviors. These passages do not establish the broader claim that low working-memory capacity itself is strongly associated with that whole range of behaviors and disorders. (LLM, conf=0.84)
Experimental — accuracy not yet measuredLow distress tolerance and low working memory capacity place people at risk for negative health behaviors.
“This work is based on a comprehensive accounting of the role of low DT and WMC in placing individuals at risk for negative health behaviors, and the potential improvements in health behaviors provided by ameliorating these deficits (Bickel et al., 2015; M.W. Otto et al., 2016).”
From A randomized controlled trial protocol for engaging distress tolerance and working memory to aid smoking cessation in low socioeconomic status (SES) adults (2020) · cites this paper as Bickel et al., 2015
The Working Memory Training section says working memory correlates with self-control, and The Competing Neurobehavioral Decision System section links impaired self-control to negative health behaviors. The paper does not address low distress tolerance as a risk factor. Its working-memory training example improved delay discounting but did not measure clinical health outcomes; page numbers are unavailable in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measuredEmotional reactivity, reward responsivity, emotion regulation, and delay discounting can be considered trans-disease processes that help explain clustering of HRBs within individuals.
“emotional reactivity, reward responsivity, emotion regulation, and delay discounting can be considered trans-disease processes,197 which help explain the clustering of HRBs within individuals.”
From Early life adversity and health-risk behaviors: Proposed psychological and neural mechanisms (2018) · cites this paper as [197]
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References 113 · Cited by 84
Research works printed but not linked: 1
- Baddeley AD Working Memory 1986 Oxford University Press Oxford
- Authors
- Bickel, W. K., Quisenberry, A. J., Moody, L., & Wilson, A. G.
- Affiliations
- Carilion Clinic (US)
- Venue
- Clinical Psychological Science
- Publisher
- SAGE Publications
- Published
- 2014-08-04
- Volume
- 3
- Issue
- 1
- Pages
- 140-153
- ISSN
- 2167-7026 (ISSN-L)
- 2167-7034
- PMC
- PMC4314724
- OpenAlex
- W2055905427
- Cited by
- 84
- References
- 113
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 3 · 2023: 5 · 2022: 2 · 2021: 5 · 2020: 8 · 2019: 12 · 2018: 9 · 2017: 8 · 2016: 17 · 2015: 7 · 2014: 3
- FWCI
- 18.06
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Clinical Psychological Science (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (R01AA021529)
- National Institute on Drug Abuse (R01DA024080, R01DA030241, R01DA034755)
- National Cancer Institute (U19CA157345)
- Topics
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Social Sciences › Decision Sciences › General Decision Sciences › Decision-Making and Behavioral Economics
- Keywords
- self-control failure, addiction, dual systems model, delay discounting, reward processing, executive function, decision-making, transdiagnostic mechanisms, neuroeconomics, therapeutic interventions
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