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Behavioral Reactivity and Addiction: The Adaptation of Behavioral Response to Reward Opportunities

Received October 30, 2006; revised February 23 and April 4, 2007; accepted April 10, 2007. The authors are affiliated with the VA Palo Alto Healthcare System and Stanford University Medical School, Center for Health Care Evaluation, in Menlo Park, California. Address Correspondence to Jodie Trafton, Ph.D., Center for Health Care Evaluation, 795 Willow Road (152-MPD), Menlo Park, CA 94025; Jodie.Trafton{at}va.gov (e-mail).

Persons recovering from addiction must refrain from drug use even when the opportunity to use exists. Understanding how behavioral response to drug reward opportunities is modified is key to treating addiction. Most effective behavioral therapies encourage patients to increase reinforcement opportunities by engaging unidentified sources of nondrug reward. The authors integrate transdisciplinary research on the brain and behavioral effects of increasing reward availability to demonstrate one neurobiological mechanism by which behavioral therapies help patients abstain. Explicating neurobiological processes underlying psychotherapy provides predictions about the interaction between dopaminergic medications and therapy and the impact of individual differences in dopamine receptor expression on addiction vulnerability.

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