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PSYCHIATRIKI 21 (4), 2010 315ReviewΑνασκόπησηCognitive theories of addiction:Α narrative reviewC. KouimtsidisSection of Alcohol Research, Institute of Psychiatry, London, UKPsychiatriki 2010, 21:315–323Several theories have been developed in order to understand the phenomenon of addiction.From a science development perspective, it is important to examine theories withshared concepts within a common framework, generate and test new hypotheses. Thispaper reviews those theories and models that consider substance misuse as a decisionmaking process involving conscious and unconscious cognitive processes including simple classicalconditioning models, cue reactivity, expectancy theory, social learning theory, neuropsychologicalmodels and the new hierarchical PRIME theory. A synthetic approach has been used as to identifysimilarities and to promote the incremental value of the discussed theories.Key words: addiction, theories, cognitions, behaviourIntroductionAddiction is a socially defined concept and refers toa syndrome, the centre of which is impaired controlover a reward-seeking behaviour; impaired controlthat is leading to significant harm. West (2006) 1 suggeststhat the definition should refer to a reward-seekingbehaviour that has become out of control, whichdescribes better the observed increase over time indrive to engage in the addictive behaviour. Addictionis a broad concept that includes any behaviour satisfyingthe above mentioned three criteria. One ofsuch reward seeking behaviours is substance abuse.Substance abuse per se does not equal addiction unlessthere is loss of control and associated harm.Over the years several theories aimed at understandingand explaining the above mentioned threecomponents of the definition of substance abuse asan addiction. Most theories explore the phenomenonfrom a generic point of view and they focus onthe behaviour involved rather than the specific substanceused. The concepts of "theory" and "model"are usually used interchangeably. There is though amajor difference between the two: A model is a representationof a system or an object or set of events.