title: A Competing Neurobehavioral Decision Systems model of SES-related health and behavioral disparities.
abstract: We propose that executive dysfunction is an important component relating to the socio-economic status gradient of select health behaviors. We review and find evidence supporting an SES gradient associated with (1) negative health behaviors (e.g., obesity, excessive use of alcohol, tobacco and other substances), and (2) executive dysfunction. Moreover, the evidence supports that stress and insufficient cognitive resources contribute to executive dysfunction and that executive dysfunction is evident among individuals who smoke cigarettes, are obese, abuse alcohol, and use illicit drugs. Collectively these data support the dual system model of cognitive control, referred to here as the Competing Neurobehavioral Decision Systems hypothesis. The implications of these relationships for intervention and social justice considerations are discussed.
authors.affiliation: Virginia Tech Carilion Research Institute, Roanoke, VA 24016, USA. Electronic address: wkbickel@vtc.vt.edu.
authors.forename: W K
authors.initials: WK
authors.lastname: Bickel
authors.affiliation: Virginia Tech Carilion Research Institute, Roanoke, VA 24016, USA.
authors.forename: L
authors.initials: L
authors.lastname: Moody
authors.affiliation: Virginia Tech Carilion Research Institute, Roanoke, VA 24016, USA.
authors.forename: A J
authors.initials: AJ
authors.lastname: Quisenberry
authors.affiliation: Virginia Tech Carilion Research Institute, Roanoke, VA 24016, USA.
authors.forename: C T
authors.initials: CT
authors.lastname: Ramey
authors.affiliation: The City College of New York, New York, NY 10031, USA.
authors.forename: C E
authors.initials: CE
authors.lastname: Sheffer
mesh_terms: D001519:Behavior; D003071:Cognition; D003657:Decision Making; D015438:Health Behavior; D054624:Health Status Disparities; D006801:Humans; D009765:Obesity / Q000523:psychology; D012907:Smoking / Q000523:psychology; D012919:Social Behavior; D012923:Social Class; D012959:Socioeconomic Factors; D013315:Stress, Psychological; D019966:Substance-Related Disorders / Q000523:psychology; D014481:United States
keywords: Competing Neurobehavioral Decision Systems; Executive function decision system; Health disparities; Impulsive decision system; SES gradient