PHILADELPHIA — Most people know thatsmoking, a bad diet, and physical inactivity can lead to catastrophic personal health consequences, including cancer. Yet millions continue to smoke, eat poorly, and fail to get enough exercise. A new project led by researchers from the Perelman School of Medicine and the School of Arts and Sciences at the University of Pennsylvania aims to devise programs that help them change these risky behaviors and cut their risk of cancer.

Caryn Lerman, PhD and Joseph Kable, PhD have been awarded a $4.9 million grant through the National Cancer Institute initiative called “Provocative Questions,” which will allow them to study how the brain’s cognitive control system can be enhanced to improve decision-making processes that contribute to risky behaviors. Lerman is deputy director of the Abramson Cancer Center and Mary W. Calkins Professor in the department of Psychiatry in the Perelman School of Medicine and in the Annenberg School for Communication. Kable is the Carol and Michael Lowenstein Term Assistant Professor of Psychology in the College of Arts and Sciences at the University of Pennsylvania.

One might think that people would be scared into doing the right thing as far as protecting their own health. But for some people, changing bad behaviors proves difficult or impossible, especially when those activities involve addictions like smoking or overeating. Lerman and Kable’s proposal will break new ground by applying novel concepts and tools from behavioral economics and cognitive neuroscience to improve understanding of the brain-based decision-making that lies behind those risky behaviors.

The underlying premise, based on earlier research by Lerman, Kable, and their colleagues, is that through neurocognitive training, it is possible to improve the brain’s capacity to strengthen cognitive control circuits to alter decision-making that results in risky behaviors, which over time may lead to a variety of medical conditions, including cancer.

“If our intervention produces the effects on brain function and decision making that we anticipate, it can be readily used in a broad population,” says Lerman. “It may be possible for people to learn how to activate brain networks that help them to resist smoking or overeating.  These treatments could be stand-alone approaches or used in combination with medications, such as in the case of treatment for nicotine addiction or obesity.”

Specifically, the brain’s executive function network supports self-control via increased sustained attention to and memory of long-term goals, goal-directed decision-making, enhanced ability to weigh the pros and cons of different choices, and inhibitory control. Thus, assessing such cognitive functions as sustained attention, working memory, and response inhibition will help understand how neurocognitive training can improve decision-making processes. This information, in turn, will be valuable for designing more novel and comprehensive interventions for behavior change. In short, the research team says, changing the brain through training may change behavior and thus, improve health.

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