Figure 1. Interactions between cognitive-behavioral processes that drive addiction.

A number of models have proposed that the development of addiction, including alcohol use disorders, results from a transition from controlled behavior to uncontrolled drug seeking behavior. Innate risk for addictive behavior has been shown to be related to differences in impulsivity and cue-reactivity that exist prior to any drug exposure. These differences can initiate entry into the spiral toward addiction. Across alcohol exposure, dysregulation in limbic corticostriatal circuitry is expected to drive drug seeking, which acts to exacerbate deficits in behavioral control, ultimately facilitating the disease state. In addition to impulsivity and habitual reward seeking, addiction is characterized by compulsive behaviors. Compulsivity can be defined as either behaviors that persist despite or because of the negative consequences of drug taking. In other words, compulsive behaviors continue despite negative results of drug-taking or those negative results create an aversive state that can be relieved by ongoing drug-taking. Importantly, habit models a behavior that is more similar to the former in which drug-seeking is elicited by environmental stimuli rather than a desire to seek positive or negative reinforcement. Alternatively, the aversive state created by withdrawal may come to serve as an interoceptive stimulus, driving habitual reward seeking behavior. To our knowledge, the precise relationship between these behaviors has not been elucidated (though see Everitt, 2014; Koob & Volkow, 2010).