The Interaction of Person-Affect-Cognition-Execution (I-PACE) model for addictive behaviors: Update, generalization to addictive behaviors beyond internet-use disorders, and specification of the process character of addictive behaviors

Abstract

We propose an updated version of the Interaction of Person-Affect-Cognition-Execution (I-PACE) model, which we argue to be valid for several types of addictive behaviors, such as gambling, gaming, buying-shopping, and compulsive sexual behavior disorders. Based on recent empirical findings and theoretical considerations, we argue that addictive behaviors develop as a consequence of the interactions between predisposing variables, affective and cognitive responses to specific stimuli, and executive functions, such as inhibitory control and decision-making. In the process of addictive behaviors, the associations between cue-reactivity/craving and diminished inhibitory control contribute to the development of habitual behaviors. An imbalance between structures of fronto-striatal circuits, particularly between ventral striatum, amygdala, and dorsolateral prefrontal areas, may be particularly relevant to early stages and the dorsal striatum to later stages of addictive processes. The I-PACE model may provide a theoretical foundation for future studies on addictive behaviors and clinical practice. Future studies should investigate common and unique mechanisms involved in addictive, obsessivecompulsive-related, impulse-control, and substance-use disorders.

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Affiliated Institutions

• Johannes Gutenberg University Mainz DE
• University of Duisburg-Essen DE
• University Medical Center of the Johannes Gutenberg University Mainz DE
• Justus-Liebig-Universität Gießen DE
• University of Cambridge GB
• Connecticut Mental Health Center US
• Yale University US
• Medizinische Hochschule Hannover DE
• Erwin L. Hahn Institute for Magnetic Resonance Imaging DE

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