The incentive-sensitization theory (IST) of addiction was first published in 1993, proposing that (a) brain mesolimbic dopamine systems mediate incentive motivation (“wanting”) for addictive drugs and other rewards, but not their hedonic impact (liking) when consumed; and (b) some individuals are vulnerable to drug-induced long-lasting sensitization of mesolimbic systems, which selectively amplifies their “wanting” for drugs without increasing their liking of the same drugs. Here we describe the origins of IST and evaluate its status 30 years on. We compare IST to other theories of addiction, including opponent-process theories, habit theories of addiction, and prefrontal cortical dysfunction theories of impaired impulse control. We also address critiques of IST that have been raised over the years, such as whether craving is important in addiction and whether addiction can ever be characterized as compulsive. Finally, we discuss several contemporary phenomena, including the potential role of incentive sensitization in behavioral addictions, the emergence of addiction-like dopamine dysregulation syndrome in medicated Parkinson's patients, the role of attentional capture and approach tendencies, and the role of uncertainty in incentive motivation.

中文翻译：

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成瘾的激励-敏感化理论 30 年后


成瘾的激励敏化理论 （IST） 于 1993 年首次发表，提出 （a） 大脑中脑边缘多巴胺系统介导对成瘾药物和其他奖励的激励动机（“想要”），但不介导它们消费时的享乐影响（喜欢）;（b） 一些个体容易受到药物诱导的中脑边缘系统的长期致敏的影响，这会选择性地放大他们对药物的“想要”，而不会增加他们对相同药物的喜欢。在这里，我们描述了 IST 的起源并评估了它 30 年后的状况。我们将 IST 与其他成瘾理论进行比较，包括对立过程理论、成瘾习惯理论和冲动控制受损的前额叶皮层功能障碍理论。我们还解决了多年来对 IST 的批评，例如渴望在成瘾中是否重要，以及成瘾是否可以被定性为强迫性。最后，我们讨论了几种当代现象，包括激励敏化在行为成瘾中的潜在作用、服用药物的帕金森病患者中成瘾样多巴胺失调综合征的出现、注意力捕获和接近倾向的作用，以及不确定性在激励动机中的作用。