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Chunk #25 — Neurocognitive and Brain Functional Response Systems and Their Operational Relationships to the Undercontrol/Disinhibition Developmental Pathway

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Parsing the Undercontrol/Disinhibition Pathway to Substance Use Disorders: A Multilevel Developmental Problem.
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Existing work suggests that top-down and bottom-up responses mutually influence one another (Nigg, 2000; Rothbart & Bates, 2006) both dynamically and developmentally. Thus, incentive response also involves decision-making, but in the context of potential reward or its loss. Imaging studies of healthy adults indicate that the selection of larger later rewards involves dorsolateral prefrontal activation, whereas the selection of smaller, more immediate rewards involves ventral striatum and amygdale activation (Ballard & Knutson, 2009; Hariri et al., 2006; McClure et al., 2004). With drug use, these systems are perturbed by excitation of incentive response circuits, which can overwhelm weakened control functions (Goldstein & Volkow, 2002; Jentsch & Taylor, 1999) and appear phenotypically as behavioral undercontrol (ultimately leading to more drug use).