Addiction & agency
Is brain-disease addiction the exception?
Open access · cc by · source: Europe PMC
Fenton and Wiers argue that Korsakoff-level brain disease is a black swan; most addiction sits on a gradual continuum of impaired control that can recover.
Key findings
Epidemiology shows most cases remit, so disease-as-rule is the wrong default. A continuous view of executive abilities is more accurate and may be a better engine for change.
Methodology
They accept that addiction involves delay-discounting and staged brain changes (reward, habit, dark-side stress) but deny that those changes automatically equal a brain disease. A gradual model moves from motivated choice toward compulsion. Extreme damage with little recovery (e.g. Korsakoff’s) may warrant the disease term.
Limitations
This is a commentary on Lewis, not a new cohort. It does not quantify how often KS-like states occur among people labelled addicted.
How this study connects
Role on claims
Each row is a claim on a concept or method page where this paper supports, challenges, or qualifies the statement. Roles are hand-checked — not a model guess.
Fenton and Wiers treat Korsakoff-level brain disease as a rare ‘black swan’; most addiction sits on a continuum of impaired control that can recover.
Evidence for the claim as stated.
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