The understanding of decision-making systems has come together in recent years to form a unified theory of decision-making in the mammalian brain as arising from multiple, interacting systems (a planning system, a habit system, and a situation-recognition system). This unified decision-making system has multiple potential access points through which it can be driven to make maladaptive choices, particularly choices that entail seeking of certain drugs or behaviors. We identify 10 key vulnerabilities in the system: (1) moving away from homeostasis, (2) (...) changing allostatic set points, (3) euphorigenic signals, (4) overvaluation in the planning system, (5) incorrect search of situation-action-outcome relationships, (6) misclassification of situations, (7) overvaluation in the habit system, (8) a mismatch in the balance of the two decision systems, (9) over-fast discounting processes, and (10) changed learning rates. These vulnerabilities provide a taxonomy of potential problems with decision-making systems. Although each vulnerability can drive an agent to return to the addictive choice, each vulnerability also implies a characteristic symptomology. Different drugs, different behaviors, and different individuals are likely to access different vulnerabilities. This has implications for an individual's susceptibility to addiction and the transition to addiction, for the potential for relapse, and for the potential for treatment. (shrink)

The model proposed by Redish et al. considers vulnerabilities within decision systems based on expectancy-value assumptions. Further understanding of processes leading to addiction can be gained by considering other inputs to decision-making, particularly affective associations with behaviors. This consideration suggests additional decision-making vulnerabilities that might explain addictive behaviors.

. The approach of experiential realism could indicate where science and faith deal with the same reality, where science questions faith assumptions, and where faith goes beyond the mandate and method of science. Although prescientific, Martin Luther's theology is the classical prototype of an experiential theology. We experience God's creative power in all of reality. We discern its regularities through observation and reason. So faith opens up all the space needed by science. However, experienced reality is highly ambiguous. It obscures (...) God's intentions. God's intentions are revealed in the proclamation of the gospel: God is unconditionally for us and with us and not against us. This proclamation is a promise, appropriated in faith, and geared to a vision of what ought to become. It is based on the interpretation of a catastrophe—the cross of Christ—as God's pivotal redemptive act in human history. It goes beyond the mandate and method of science, yet it is capable of giving the latter a sense of purpose, criteria of acceptability, and authority to act in the interests of humanity and the earth. Theology challenges science to acknowledge the necessity of a transcendent frame of reference and moral accountability. Scientific insight challenges theology to reconceptualize its assumptions on God, creation, and eschatology to integrate best science. (shrink)

In our target article, we proposed that addiction could be envisioned as misperformance of a decision-making machinery described by two systems (deliberative and habit systems). Several commentators have argued that Pavlovian learning also produces actions. We agree and note that Pavlovian action-selection will provide several additional vulnerabilities. Several commentators have suggested that addiction arises from sociological parameters. We note in our response how sociological effects can change decision-making variables to provide additional vulnerabilities. Commentators generally have agreed that our theory provides (...) a framework within which to site addiction and treatment, but additional work will be needed to determine whether our taxonomy will help identify and treat subpopulations within the addicted community. (shrink)