The Interaction of Person-Affect-Cognition-Execution (I-PACE) model for addictive behaviors: Update, generalization to addictive behaviors beyond internet-use disorders, and specification of the process character of addictive behaviors

• Published in: Neuroscience and biobehavioral reviews Vol. 104; pp. 1 - 10
• Main Authors: Brand, Matthias, Wegmann, Elisa, Stark, Rudolf, Müller, Astrid, Wölfling, Klaus, Robbins, Trevor W., Potenza, Marc N.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Ltd 01.09.2019
• Subjects: Amygdala - physiopathology; Behavior, Addictive - physiopathology; Behavioral addictions; Buying-shopping disorder; Cue-reactivity; Decision Making - physiology; Executive Function - physiology; Gambling disorder; Gaming disorder; Humans; Inhibition, Psychological; Inhibitory control; Models, Theoretical; Prefrontal Cortex - physiopathology; Problematic pornography use; Ventral Striatum - physiopathology; Problematic pornography use; Gambling disorder; Inhibitory control; Behavioral addictions; Buying-shopping disorder; Cue-reactivity; Gaming disorder
• ISSN: 0149-7634; 1873-7528; 1873-7528
• DOI: 10.1016/j.neubiorev.2019.06.032

•Addictive behaviors are linked to cue-reactivity and craving.•Addictive behaviors are associated with diminished inhibitory control.•Habitual behaviors are developed in the process of addictive behaviors.•An imbalance between fronto-striatal circuits contributes to addictive behaviors. We propose an updated version of the Interaction of Person-Affect-Cognition-Execution (I-PACE) model, which we argue to be valid for several types of addictive behaviors, such as gambling, gaming, buying-shopping, and compulsive sexual behavior disorders. Based on recent empirical findings and theoretical considerations, we argue that addictive behaviors develop as a consequence of the interactions between predisposing variables, affective and cognitive responses to specific stimuli, and executive functions, such as inhibitory control and decision-making. In the process of addictive behaviors, the associations between cue-reactivity/craving and diminished inhibitory control contribute to the development of habitual behaviors. An imbalance between structures of fronto-striatal circuits, particularly between ventral striatum, amygdala, and dorsolateral prefrontal areas, may be particularly relevant to early stages and the dorsal striatum to later stages of addictive processes. The I-PACE model may provide a theoretical foundation for future studies on addictive behaviors and clinical practice. Future studies should investigate common and unique mechanisms involved in addictive, obsessive-compulsive-related, impulse-control, and substance-use disorders.