title: Understanding and shifting drug-related decisions: contributions of automatic decision-making processes.
abstract: While substance use is common, only a minority of individuals who use drugs or alcohol develop problematic use. An understanding of the factors underlying the transition from substance use to misuse may improve prevention and intervention efforts. A key feature of substance misuse is ongoing decisions to use drugs or alcohol despite escalating negative consequences. Research findings highlight the importance of both relatively automatic, associative cognitive processes and relatively controlled, deliberative, and rational-analytic cognitive processes, for understanding situational decisions to use drugs. In this review, we discuss several cognitive component processes that may contribute to decision-making that promotes substance use and misuse, with a focus on more automatic processes. A growing body of evidence indicates that relative differences in the strength of these component processes can account for individual differences in the transition from substance use to misuse and may offer important avenues for developing novel intervention strategies.
authors.affiliation: Department of Psychiatry, Columbia University Medical Center, Center for Motivation and Change, Division on Substance Abuse, New York State Psychiatric Institute, 1051 Riverside Drive, MC 120, New York, NY, 10032, USA, carpent@nyspi.columbia.edu.
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Carpenter
authors.forename: Gillinder
authors.initials: G
authors.lastname: Bedi
authors.forename: Nehal P
authors.initials: NP
authors.lastname: Vadhan
mesh_terms: D001288:Attention; D003071:Cognition; D003657:Decision Making; D006801:Humans; D007175:Impulsive Behavior; D065812:Interoception; D011613:Psychotherapy / Q000379:methods*; D019966:Substance-Related Disorders / Q000523:psychology* / Q000628:therapy*