Applying extinction research and theory to cue‐exposure addiction treatments

Conklin, Cynthia A.; Tiffany, Stephen T.

doi:10.1046/j.1360-0443.2002.00014.x

Cited by 641 publications

(635 citation statements)

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“…Here it was shown that merely presenting the interoceptive drug-S D alone in a standard method of Pavlovian extinction (i.e., cue exposure) may not be sufficient to minimize food-seeking behavior-"relapse" (cf. Conklin & Tiffany, 2002;Tiffany, 2009)-but this may likely vary as a function of the stimulus nature of the cue(s) and where such cues undergo extinction in relation to the primary reinforcer.…”

Section: Discussionmentioning

confidence: 99%

Pavlovian Extinction of the Discriminative Stimulus Effects of Nicotine and Ethanol in Rats Varies as a Function of Context

Troisi

2011

Psychol Rec

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Section: Discussionmentioning

confidence: 99%

Pavlovian Extinction of the Discriminative Stimulus Effects of Nicotine and Ethanol in Rats Varies as a Function of Context

Troisi

2011

Psychol Rec

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“…The technique proved to be useful in evaluating the S-O-R account of PIT; but it could also have clinical relevance. Pavlovian cues influence our behaviour in many ways -such as the role of Pavlovian cues associated with drugs in craving and relapse (Conklin & Tiffany, 2002;LeBlanc, Ostlund & Maidment, 2012). The fact that specific PIT seems insensitive to outcome devaluation (Holland, 2004) and S-O extinction (Delamater, 1996) presents a challenge for therapy.…”

Section: Figure 6 About Herementioning

confidence: 99%

The effect of conditioned inhibition on the specific Pavlovian-instrumental transfer effect.

Alarcón

Bonardi

2016

Journal of Experimental Psychology: Animal Learning and Cogniti

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Four experiments examined the effect of Pavlovian conditioned inhibition on specific Pavlovian-instrumental transfer (PIT) in human participants. The task comprised an instrumental phase in which two responses (R 1 , R 2 ) were each paired with one of two outcomes (O 1 , O 2 : R 1 -->O 1 , R 2 -->O 2 ), and a Pavlovian phase, in which two CSs, CS 1 and CS 2 each signalled one of the two outcomes (CS 1 -->O 1 , CS 2 -->O 2 ). In Experiments 1-2 a conditioned inhibitor, X, predicted the omission of one of the outcomes (e.g. CS 1 -->O 1 , CS 1 X-->nothing). In a subsequent test, performance of R 1 and R 2 was examined in the presence of CS 1 and CS 2 . A specific PIT effect was observed: R 1 was performed more than R 2 during CS 1 , and R 2 more than R 1 during CS 2 . This PIT effect was significantly reduced by the presence of the inhibitor X in Experiment 1, in which the Pavlovian phase followed the instrumental phase, and in Experiment 2 in which it preceded it. No such effect was observed when X was presented in the absence of any expectation of the outcomes during the PIT test (Experiment 3a), or when X was trained as a signal for an alternative outcome (Experiment 3b). These results are consistent with the suggestion that the specific PIT effect occurs through a stimulus-outcome-response (S-O-R) mechanism, according to which the CS evokes a representation of the outcome which in turn elicits the response (e.g. CS 1 -->O 1 -->R 1 ). The conditioned inhibitor suppresses performance of the response by suppressing activation of the outcome representation.

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“…39-48, Ainslie, 2001, and conditioning is unnecessary to account for sudden craving, as we will now argue. It is interesting also, but only suggestive, that etiologies based on conditioning promise treatments using extinction or counterconditioning, but attempts to extinguish conditioned responses have been shown in a recent meta-analysis to be useless in recovery from addiction (Conklin and Tiffany, 2002).…”

Section: Can Conditioning Do the Job?mentioning

confidence: 99%

The behavioral economics of will in recovery from addiction

Monterosso

Ainslie

2007

Drug and Alcohol Dependence

100

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Behavioral economic studies demonstrate that rewards are discounted proportionally with their delay (hyperbolic discounting). Hyperbolic discounting implies temporary preference for smaller rewards when they are imminent, and this concept has been widely considered by researchers interested in the causes of addictive behavior. Far less consideration has been given to the fact that systematic preference reversal also predicts various self-control phenomena, which may also be analyzed from a behavioral economic perspective.Here we summarize self-control phenomena predicted by hyperbolic discounting, particularly with application to the field of addiction. Of greatest interest is the phenomenon of choice bundling, an increase in motivation to wait for delayed rewards that can be expected to result from making choices in whole categories. Specifically, when a person's expectations about her own future behavior are conditional upon her current behavior, the value of these expectations is added to the contingencies for the current behavior, resulting in reduced impulsivity. Hyperbolic discounting provides a bottomup basis for the intuitive learning of choice bundling, the properties of which match common descriptions of willpower. We suggest that the bundling effect can also be discerned in the advice of 12-step programs.Recovery from addiction is a distinctly human phenomenon (Logan, 1993), can be extraordinarily abrupt without any obvious changes in contingencies (Premack, 1970, Miller andC'de Baca, 2001), and is commonly described in spiritual terms (Bien and Bien, 2002). Thus it may seem that although behavioral economic and other reductionist approaches are productively applied to the onset of addiction, they are not applicable to studying recovery from addiction (for example, see Miller's 2003 discussion of his skepticism). Here we want to make the case that behavioral economics sheds new light on recovery from addiction.Address correspondence to either: John Monterosso, PhD, Department of Psychiatry, University of California at Los Angeles, 760 Westwood Plaza; Rm C8-532, Los Angeles, CA 90024, Phone: (310) 794-1736, email: jmont@ucla.edu, George Ainslie, M.D., Department of Psychiatry, Coatesville VA Medical Center, Coatesville, PA 19320, Phone (610) 384-7711, Email: george.ainslie@va.gov. With reference to formulas 1 and 2, consider the following example. If Rate is .5 and Amount is 10 the exponential value at Delays =1, 2, 3, 4, 5, 6 will be 5, 2.5, 1.25, .625, .3125, .15625; the hyperbolic value at those Delays will be 5, 3.33, 2.5, 2., 1.67, 1.43. If a subject repeatedly is presented with an alternative reward of 4, two units of Delay before each 10 is due, the 4 will win under both formulae: 4 vs. 2.5 for exponential, 4 vs. 3.33 for hyperbolic. But if these options occur three times, two units apart, and must be chosen as a category all at once, exponential → [2.5 + .

show abstract

Applying extinction research and theory to cue‐exposure addiction treatments

Cited by 641 publications

References 57 publications

Pavlovian Extinction of the Discriminative Stimulus Effects of Nicotine and Ethanol in Rats Varies as a Function of Context

Pavlovian Extinction of the Discriminative Stimulus Effects of Nicotine and Ethanol in Rats Varies as a Function of Context

The effect of conditioned inhibition on the specific Pavlovian-instrumental transfer effect.

The behavioral economics of will in recovery from addiction

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