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

Author(s): A. Verdejo-Garcia, M. Perez-Garcia, A. Bechara.

Journal Name: Current Neuropharmacology

Volume 4 , Issue 1 , 2006

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Abstract:

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, somatic states, craving, ventromedial prefrontal cortex, amygdala, dopamine, serotonin

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Article Details

VOLUME: 4
ISSUE: 1
Year: 2006
Page: [17 - 31]
Pages: 15
DOI: 10.2174/157015906775203057

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