School of Psychology, UNSW, Sydney, New South Wales, Australia.
Eur Addict Res. 2024;30(4):233-242. doi: 10.1159/000538103. Epub 2024 Jun 12.
Correctly recognising that alcohol or other substances are causing problems is a necessary condition for those problems to spur beneficial behaviour change. Yet such recognition is neither immediate nor straightforward. Recognition that one's alcohol or drug use is causing negative consequences often occurs gradually. Contemporary addiction neuroscience has yet to make progress in understanding and addressing these recognition barriers, despite evidence that a lack of problem recognition is a primary impediment to seeking treatment.
Based on our recent empirical work, this article shows how recognition barriers can emerge from dual constraints on how we learn about the negative consequences of our actions. One constraint is imposed by the characteristics of negative consequences themselves. A second constraint is imposed by the characteristics of human cognition and information processing. In some people, the joint action of these constraints causes a lack of correct awareness of the consequences of their behaviour and reduced willingness to update that knowledge and behaviour when confronted with counterevidence.
This "cognitive pathway" can drive persistent, maladaptive choice.
正确认识到酒精或其他物质是造成问题的原因，是促使有益行为改变的必要条件。然而，这种认识既不是即时的，也不是直接的。认识到自己的酒精或药物使用正在造成负面影响通常是逐渐发生的。尽管有证据表明，缺乏问题识别是寻求治疗的主要障碍，但当代成瘾神经科学在理解和解决这些识别障碍方面尚未取得进展。
基于我们最近的实证工作，本文展示了识别障碍是如何从我们了解行为负面后果的双重限制中产生的。一个限制是由负面后果本身的特征施加的。第二个限制是由人类认知和信息处理的特征施加的。在某些人中，这些限制的共同作用导致对其行为后果缺乏正确的认识，并在面对反面证据时减少了更新这些知识和行为的意愿。
这条“认知途径”可以导致持续的、适应不良的选择。
