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Toward Narrative Theory: Interventions for Reinforcer Pathology in Health Behavior

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Impulsivity

Part of the book series: Nebraska Symposium on Motivation ((NSM,volume 64))

Abstract

Reinforcer pathology describes the interaction between excessive devaluation of delayed rewards and excessive valuation of commodities such as drugs or food. In isolation, both components of reinforcer pathology increase risk for substance-use disorders and other maladaptive health behaviors (e.g., poor diet); in combination, these components synergistically increase risk. In this chapter, we review evidence that reinforcer pathology may arise from imbalance between two competing neurobehavioral decision systems (CNDS)—the impulsive system, comprising the limbic and paralimbic brain regions, and the executive system, comprising the prefrontal and parietal cortices. To correct imbalance between these systems and restore normative decision making, we introduce narrative theory, a novel intervention framework that seeks to harness humans’ unique sensitivity to language and storytelling in order to both understand and potentially treat the maladaptive decision making observed in addiction and other maladaptive health behaviors. We provide both an overview of methods used in investigations of narrative theory and a summary of effects of these methods on both discounting of delayed rewards and valuation of commodities that may damage health, such as drugs and energy-dense food.

O God, that men should put an enemy in their mouths to steal away their brains!

—the character Cassio from Shakespeare’s Othello, Act II Scene iii

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Acknowledgements

The preparation of this chapter was, in part, supported financially by NIH grants 4R01AA021529, 5U19CA157345, 1P01CA200512, 4R01DA034755, and 5UH2DK109543, awarded to the first author (W.K.B.).

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    Warren K. Bickel, Jeffrey S. Stein, Lara N. Moody, Sarah E. Snider, Alexandra M. Mellis & Amanda J. Quisenberry

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Correspondence to Warren K. Bickel .

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    Jeffrey R. Stevens

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Bickel, W.K., Stein, J.S., Moody, L.N., Snider, S.E., Mellis, A.M., Quisenberry, A.J. (2017). Toward Narrative Theory: Interventions for Reinforcer Pathology in Health Behavior. In: Stevens, J. (eds) Impulsivity. Nebraska Symposium on Motivation, vol 64. Springer, Cham. https://doi.org/10.1007/978-3-319-51721-6_8

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