Carrots and sticks fail to change behavior in cocaine addiction.
Cocaine addiction is a major public health problem that is particularly difficult to treat. Without medically proven pharmacological treatments, interventions to change the maladaptive behavior of addicted individuals mainly rely on psychosocial approaches. Here we report on impairments in cocaine-addicted patients to act purposefully toward a given goal and on the influence of extended training on their behavior. When patients were rewarded for their behavior, prolonged training improved their response rate toward the goal but simultaneously rendered them insensitive to the consequences of their actions. By contrast, overtraining of avoidance behavior had no effect on patient performance. Our findings illustrate the ineffectiveness of punitive approaches and highlight the potential for interventions that focus on improving goal-directed behavior and implementing more desirable habits to replace habitual drug-taking.
Departments of Psychiatry, Psychology, and Clinical Neurosciences and the Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK. ke220@cam.ac.uk.
Karen D
KD
Ersche
Departments of Psychiatry, Psychology, and Clinical Neurosciences and the Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK. Department of Psychology, New York University, 6 Washington Place, New York, NY 10003, USA.
Claire M
CM
Gillan
Departments of Psychiatry, Psychology, and Clinical Neurosciences and the Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK.
P Simon
PS
Jones
Departments of Psychiatry, Psychology, and Clinical Neurosciences and the Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK.
Guy B
GB
Williams
Departments of Psychiatry, Psychology, and Clinical Neurosciences and the Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK.
Laetitia H E
LH
Ward
Behavioural Science Institute, Radboud University, Nijmegen, Netherlands.
Maartje
M
Luijten
Department of Clinical Psychology, University of Amsterdam, Amsterdam, Netherlands.
Sanne
S
de Wit
Departments of Psychiatry, Psychology, and Clinical Neurosciences and the Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK.
Barbara J
BJ
Sahakian
Departments of Psychiatry, Psychology, and Clinical Neurosciences and the Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK. Cambridgeshire and Peterborough National Health Service Foundation Trust, Cambridge, UK. Immunopsychiatry Discovery Performance Unit, Alternative Discovery and Development Division, GlaxoSmithKline R&D, Stevenage SG1 2NY, UK.
Edward T
ET
Bullmore
Departments of Psychiatry, Psychology, and Clinical Neurosciences and the Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK.
Trevor W
TW
Robbins
D000328:Adult; D001362:Avoidance Learning; D001521:Behavior Therapy / Q000379:methods*; D003042:Cocaine / Q000009:adverse effects*; D019970:Cocaine-Related Disorders / Q000523:psychology* / Q000628:therapy*; D003216:Conditioning, Operant; D005260:Female; D006040:Goals; D006184:Habits; D006801:Humans; D008297:Male; D008875:Middle Aged; D011678:Punishment; D012201:Reward
D003042:Cocaine