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Emotion, Decision-Making and Substance Dependence: A Somatic-Marker Model of Addiction

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Similar to patients with orbitofrontal cortex lesions, substance dependent individuals (SDI) show signs of impairments in decision-making, characterised by a tendency to choose the immediate reward at the expense of severe negative future consequences. The somatic-marker hypothesis proposes that decision-making depends in many important ways on neural substrates that regulate homeostasis, emotion and feeling. According to this model, there should be a link between abnormalities in experiencing emotions in SDI, and their severe impairments in decision-making in real-life. Growing evidence from neuroscientific studies suggests that core aspects of substance addiction may be explained in terms of abnormal emotional guidance of decision-making. Behavioural studies have revealed emotional processing and decision-making deficits in SDI. Combined neuropsychological and physiological assessment has demonstrated that the poorer decision-making of SDI is associated with altered reactions to reward and punishing events. Imaging studies have shown that impaired decision-making in addiction is associated with abnormal functioning of a distributed neural network critical for the processing of emotional information, including the ventromedial cortex, the amygdala, the striatum, the anterior cingulate cortex, and the insular/somato-sensory cortices, as well as non-specific neurotransmitter systems that modulate activities of neural processes involved in decision-making. The aim of this paper is to review this growing evidence, and to examine the extent of which these studies support a somatic-marker model of addiction.





Keywords: Decision-making; addiction; amygdala; craving; dopamine; serotonin; somatic states; ventromedial prefrontal cortex

Document Type: Research Article

Affiliations: Departamento de Personalidad, Evaluacion y Tratamiento Psicologico. Universidad de Granada. Campus de Cartuja S/N, 18071, Granada, Spain.

Publication date: January 1, 2006

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  • Current Neuropharmacology aims to provide current, timely and comprehensive reviews of all areas of neuropharmacology and related matters of neuroscience. The journal publishes reviews written by experts and leaders in the fields of molecular, cellular, and systems/behavioural aspects of neuropharmacology and neuroscience. The journal serves as a comprehensive, multidisciplinary expert forum for neuropharmacologists and neuroscientists.
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