ReviewThe Behavioral and brain sciences2008
A unified framework for addiction: vulnerabilities in the decision process.
Review in The Behavioral and brain sciences, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 229 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
229 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Neuropsychological Interventions for Decision-Making in Addiction: a Systematic Review.Neuropsychology review · 2019Pooled it
- Risk perception in gambling: a systematic review.Journal of gambling studies · 2014Pooled it
- Efficacy of expectancy challenge interventions to reduce college student drinking: a meta-analytic review.Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors · 2012Pooled it
- Impact of behavioral economics to improve antihypertensive therapy adherence, a pilot randomized controlled trial in Los Angeles.Scientific reports · 2025Trial
- Blunted anterior midcingulate response to reward in opioid users is normalized by prefrontal transcranial magnetic stimulation.Translational psychiatry · 2025Trial
- Reduced model-based decision-making in gambling disorder.Scientific reports · 2019Trial
- Just a Spoonful of Sugar Helps the Messages Go Down: Using Stories and Vicarious Self-Affirmation to Reduce e-Cigarette Use.Health communication · 2019Trial
- Memory-Focused Cognitive Therapy for Cocaine Use Disorder: Theory, Procedures and Preliminary Evidence From an External Pilot Randomised Controlled Trial.EBioMedicine · 2018Trial
- Behavioral and Neural Signatures of Reduced Updating of Alternative Options in Alcohol-Dependent Patients during Flexible Decision-Making.The Journal of neuroscience : the official journal of the Society for Neuroscience · 2016Trial
- An fMRI-Based Neural Signature of Decisions to Smoke Cannabis.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2015Trial
- Excessive state switching underlies reversal learning deficits in cocaine users.Drug and alcohol dependence · 2014Trial
- Dorsolateral prefrontal and orbitofrontal cortex interactions during self-control of cigarette craving.Proceedings of the National Academy of Sciences of the United States of America · 2013Trial
- Dissociating hippocampal and striatal contributions to sequential prediction learning.The European journal of neuroscience · 2012Trial
- The hippocampus is functionally connected to the striatum and orbitofrontal cortex during context dependent decision making.Brain research · 2011Trial
- Negative mood induction normalizes decision making in male cocaine dependent individuals.Psychopharmacology · 2011Trial
- Neural and behavioral mechanisms of impulsive choice in alcohol use disorder.Alcoholism, clinical and experimental research · 2011Trial
- An ethical defense of safer supply.Theoretical medicine and bioethics · 2026Article
- Dissociation of decision-making from escalated drug intake within a long-access model.Behavioural brain research · 2026Article
- The Reward Positivity Tracks Positive Reward Prediction Errors From Feedback to Cues During Reinforcement Learning.Psychophysiology · 2026Article
- Mesocorticostriatal Reinforcement Learning of State Representation and Value with Implications for the Mechanisms of Schizophrenia.The Journal of neuroscience : the official journal of the Society for Neuroscience · 2026Article
169 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
Abstract
The understanding of decision-making systems has come together in recent years to form a unified theory of decision-making in the mammalian brain as arising from multiple, interacting systems (a planning system, a habit system, and a situation-recognition system). This unified decision-making system has multiple potential access points through which it can be driven to make maladaptive choices, particularly choices that entail seeking of certain drugs or behaviors. We identify 10 key vulnerabilities in the system: (1) moving away from homeostasis, (2) changing allostatic set points, (3) euphorigenic "reward-like" signals, (4) overvaluation in the planning system, (5) incorrect search of situation-action-outcome relationships, (6) misclassification of situations, (7) overvaluation in the habit system, (8) a mismatch in the balance of the two decision systems, (9) over-fast discounting processes, and (10) changed learning rates. These vulnerabilities provide a taxonomy of potential problems with decision-making systems. Although each vulnerability can drive an agent to return to the addictive choice, each vulnerability also implies a characteristic symptomology. Different drugs, different behaviors, and different individuals are likely to access different vulnerabilities. This has implications for an individual's susceptibility to addiction and the transition to addiction, for the potential for relapse, and for the potential for treatment.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.