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Tijdschrift voor Psychiatrie 54 (2012) 8, 731 - 740

Essay

The dual process model of addiction. Towards an integrated model?

R. Vandermeeren, M. Hebbrecht

Summary
background Neurobiology and cognitive psychology have provided us with a dual process model of addiction. According to this model, behavior is considered to be the dynamic result of a combination of automatic and controlling processes. In cases of addiction the balance between these two processes is severely disturbed. Automated processes will continue to produce impulses that ensure the continuance of addictive behavior. Weak, reflective or controlling processes are both the reason for and the result of the inability to forgo addiction.
aim To identify features that are common to current neurocognitive insights into addiction and psychodynamic views on addiction.
method Recent neurocognitive literature about addiction, accessed via PubMed, is linked to earlier psychodynamic literature and a case study.
results The picture that emerges from research is not clear. There is some evidence that attentional bias has a causal effect on addiction. There is no evidence that automatic associations have a causal effect, but there is some evidence that automatic action-tendencies do have a causal effect.
conclusion Current neurocognitive views on the dual process model of addiction can be integrated with an evidence-based approach to addiction and with psychodynamic views on addiction.

keywords addiction, automatic processes, control processes, dual process model, psychodynamics