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Pistre N, Schreck B, Grall-Bronnec M, Fatseas M. Should problematic sexual behavior be viewed under the scope of addiction? A systematic review based on DSM-5 substance use disorder criteria. Addict Behav Rep 2023; 18:100510. [PMID: 37519859 PMCID: PMC10374865 DOI: 10.1016/j.abrep.2023.100510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 06/19/2023] [Accepted: 07/15/2023] [Indexed: 08/01/2023] Open
Abstract
Despite similarities between compulsive sexual disorder and substance use disorder, the issue whether problematic sexual behavior should be viewed within an addiction framework continues to be a subject of debate with no consensus regarding its conceptualization and diagnosis criteria. Examining the presence of addiction criteria among clinical and no clinical samples in the existing literature could permit to ascertain clinical validity of sex addiction diagnosis and support its overlapping feature with other addictive disorders. The aim of this systematic review was to examine this issue by assessing DSM-5 criteria of substance use disorder among individuals engaged in problematic sexual activity. Methods: Using PRISMA criteria, three databases were comprehensively searched up to April 2022, in order to identify all candidate studies based on broad key words. Resulting studies were then selected if they examined problematic sexual behavior within the framework of DSM-5 addiction criteria. Results: Twenty articles matched the selection criteria and were included in this review. DSM-5 criteria of addictive disorders were found to be highly prevalent among problematic sex users, particularly craving, loss of control over sex use, and negative consequences related to sexual behavior. Exposition to sexual cues was also shown to trigger craving, with an association to problematic use and symptom severity. Conclusions: More studies should been done to assess homogeneously according to the DSM-5 criteria the addiction-like features of problematic sexual behaviors in clinical and no-clinical populations. Furthermore, this work argues for the need of further research to examine the extent to which anti-craving interventions could be effective in improving clinical outcomes.
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Affiliation(s)
- Natasha Pistre
- Department of Addictology, CHU Bordeaux, F-33000 Bordeaux, France
| | - Benoît Schreck
- Nantes Université, CHU Nantes, UIC Psychiatrie et Santé Mentale, F-44000 Nantes, France
- Nantes Université, Univ Tours, CHU Nantes, INSERM, MethodS in Patient-Centered Outcomes and HEalth ResEarch, SPHERE, F-44000 Nantes, France
| | - Marie Grall-Bronnec
- Nantes Université, CHU Nantes, UIC Psychiatrie et Santé Mentale, F-44000 Nantes, France
- Nantes Université, Univ Tours, CHU Nantes, INSERM, MethodS in Patient-Centered Outcomes and HEalth ResEarch, SPHERE, F-44000 Nantes, France
| | - Melina Fatseas
- Department of Addictology, CHU Bordeaux, F-33000 Bordeaux, France
- Department of Addictology, CH Charles Perrens, F-33000 Bordeaux, France
- Univ. Bordeaux, CNRS, INCIA, UMR 5287, F-33000 Bordeaux, France
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2
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Özal Z, Mancini G, De Fino G, Ambrosini F, Biolcati R, Truzoli R. "I Can't Do without You": Treatment Perspectives for Affective Dependence: A Scoping Review. J Clin Med 2023; 12:6769. [PMID: 37959234 PMCID: PMC10648727 DOI: 10.3390/jcm12216769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 10/21/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023] Open
Abstract
Affective Dependence (AD) is a problematic model of the love relationship that is becoming increasingly prevalent and evident in the context of couple relationships. Similarly, the phenomenon is being observed with growing frequency in daily clinical practice, making it increasingly necessary to identify treatment guidelines that can help clinicians in dealing with AD, while waiting for the literature to reach a consensus on its definition and nosographic profile. The main objective of this work is to explore the existing evidence of effectiveness regarding feasible treatments for Affective Dependence through a scoping review of the international literature carried out using the main scientific databases and following the PRISMA-ScR (PRISMA Extension for Scoping Reviews) guidelines. Seven studies were included in this review, and the results show that several pharmaceuticals, as well as different types of individual and group therapies, are proposed as treatment plans for AD. However, there is a lack of clinical trials that can verify the efficacy of the AD treatments reported so far in the literature. Some reflections that may help to distinguish a "healthy" addiction from a dysfunctional or markedly pathological one are considered alongside potential prevention perspectives.
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Affiliation(s)
- Zeynep Özal
- Department of Education Sciences “G.M. Bertin”, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy; (Z.Ö.); (F.A.); (R.B.)
| | - Giacomo Mancini
- Department of Education Sciences “G.M. Bertin”, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy; (Z.Ö.); (F.A.); (R.B.)
| | - Greta De Fino
- Department of Biomedical and Clinical Sciences, University of Milan, 20157 Milano, Italy; (G.D.F.); (R.T.)
| | - Federica Ambrosini
- Department of Education Sciences “G.M. Bertin”, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy; (Z.Ö.); (F.A.); (R.B.)
| | - Roberta Biolcati
- Department of Education Sciences “G.M. Bertin”, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy; (Z.Ö.); (F.A.); (R.B.)
| | - Roberto Truzoli
- Department of Biomedical and Clinical Sciences, University of Milan, 20157 Milano, Italy; (G.D.F.); (R.T.)
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Lozano-Madrid M, Granero R, Lucas I, Sánchez I, Sánchez-González J, Gómez-Peña M, Moragas L, Mallorquí-Bagué N, Tapia J, Jiménez-Murcia S, Fernández-Aranda F. Impulsivity and compulsivity in gambling disorder and bulimic spectrum eating disorders: Analysis of neuropsychological profiles and sex differences. Eur Psychiatry 2023; 66:e91. [PMID: 37855168 PMCID: PMC10755579 DOI: 10.1192/j.eurpsy.2023.2458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 08/07/2023] [Accepted: 09/06/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Gambling disorder (GD) and bulimic spectrum eating disorders (BSDs) not only share numerous psychopathological, neurobiological, and comorbidity features but also are distinguished by the presence of inappropriate behaviours related to impulsivity and compulsivity. This study aimed to emphasise the differences and similarities in the main impulsivity and compulsivity features between GD and BSD patients, and to analyse the potential influence of sex in these domains. METHODS Using self-reported and neurocognitive measures, we assessed different impulsive-compulsive components in a sample of 218 female and male patients (59 with BSD and 159 with GD) and 150 healthy controls. RESULTS We observed that GD and BSDs exhibited elevated levels of impulsivity and compulsivity in all the dimensions compared to healthy controls. Moreover, these disorders showed differences in several personality traits, such as high novelty seeking in GD, and low persistence and high harm avoidance in BSDs. In addition, patients with BSDs also displayed a trend towards greater impulsive choice than GD patients. Regarding sex effects, GD women presented higher overall impulsivity and compulsivity than GD men. Nevertheless, no sex differences were found in BSDs. CONCLUSIONS Clinical interventions should consider these deficits to enhance their effectiveness, including adjunctive treatment to target these difficulties. Our findings also provide support to the relevance of sex in GD, which should also be considered in clinical interventions.
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Affiliation(s)
- María Lozano-Madrid
- Clinical Psychology Department, University Hospital of Bellvitge – ICS, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
| | - Roser Granero
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
- Departament de Psicobiologia i Metodologia, Universitat Autònoma de Barcelona, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Ignacio Lucas
- Clinical Psychology Department, University Hospital of Bellvitge – ICS, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Isabel Sánchez
- Clinical Psychology Department, University Hospital of Bellvitge – ICS, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Jéssica Sánchez-González
- Clinical Psychology Department, University Hospital of Bellvitge – ICS, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Mónica Gómez-Peña
- Clinical Psychology Department, University Hospital of Bellvitge – ICS, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Laura Moragas
- Clinical Psychology Department, University Hospital of Bellvitge – ICS, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Nuria Mallorquí-Bagué
- Clinical Psychology Department, University Hospital of Bellvitge – ICS, Barcelona, Spain
- Department of Psychiatry, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Spain
| | - Javier Tapia
- Clinical Psychology Department, University Hospital of Bellvitge – ICS, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Clinical Psychology Department, University Hospital of Bellvitge – ICS, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Fernando Fernández-Aranda
- Clinical Psychology Department, University Hospital of Bellvitge – ICS, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
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Khani P, Ansari Dezfouli M, Nasri F, Rahemi M, Ahmadloo S, Afkhami H, Saeidi F, Tereshchenko S, Bigdeli MR, Modarressi MH. Genetic and epigenetic effects on couple adjustment in context of romantic relationship: A scoping systematic review. Front Genet 2023; 14:1002048. [PMID: 36816018 PMCID: PMC9937082 DOI: 10.3389/fgene.2023.1002048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 01/02/2023] [Indexed: 01/26/2023] Open
Abstract
Introduction: Couples' relationships defined by a complex interaction between the two partners and their intrapersonal traits. Romantic; relationships and love are associated with marital satisfaction and stability, as well as couples' happiness and health. Personality traits influence romantic relationships and, personality influenced by genetical and non-genetically factors. The roles of non-genetically factors such as socioeconomic position and external appearance have revealed in determining the quality of romantic relationships. Methods: We; performed a scoping systematic review to assess the association between genetics and epigenetic factors and romantic relationship. Relevant articles were identified by PubMed, EMBASE, Web of Science, Scopus, and the APA PsycInfo searching between inception and 4 June 2022. Results: Different studies evaluated the associated polymorphisms in 15 different genes or chromosomal regions. In the first step; we classified them into four groups: (1) Oxytocin-related signaling pathway (OXTR, CD38, and AVPR1A); (2) Serotonin-related signaling pathway (SLC6A4, HTR1A, and HTR2A); (3) Dopamine and catecholamine-related signaling pathway (DRD1, DRD2, DRD4, ANKK1, and COMT); and (4) other genes (HLA, GABRA2, OPRM1, and Y-DNA haplogroup D-M55). Then, we evaluated and extracted significant polymorphisms that affect couple adjustment and romantic relationships. Discussion: Overall, the findings suggest that genetic and epigenetics variants play a key role in marital adjustment and romantic relationships over time.
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Affiliation(s)
- Pouria Khani
- Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Mitra Ansari Dezfouli
- Department of Neuroscience, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Farzad Nasri
- Immunology Research Center, Iran University of Medical Sciences, Tehran, Iran,Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Rahemi
- Department of stem cell technology and tissue regeneration, Faculty of Science, Tehran University, Tehran, Iran
| | - Salma Ahmadloo
- Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran,Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - Hamed Afkhami
- Department of Medical Microbiology, Faculty of Medicine, Shahed University of Medical Sciences, Tehran, Iran
| | - Farzane Saeidi
- Department of Medical Genetics, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Sergey Tereshchenko
- Research Institute of Medical Problems of the North, Federal Research Center “Krasnoyarsk Science Center of the Siberian Branch of the Russian Academy of Sciences”, Krasnoyarsk, Russia,*Correspondence: Sergey Tereshchenko, ; Mohammad Reza Bigdeli, ; Mohammad Hossein Modarressi,
| | - Mohammad Reza Bigdeli
- Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran,Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran,*Correspondence: Sergey Tereshchenko, ; Mohammad Reza Bigdeli, ; Mohammad Hossein Modarressi,
| | - Mohammad Hossein Modarressi
- Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran,*Correspondence: Sergey Tereshchenko, ; Mohammad Reza Bigdeli, ; Mohammad Hossein Modarressi,
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Kwak MJ, Kim WY, Jung SH, Chung YJ, Kim JH. Differential transcriptome profile underlying risky choice in a rat gambling task. J Behav Addict 2022; 11:845-857. [PMID: 36094860 PMCID: PMC9872528 DOI: 10.1556/2006.2022.00068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 07/20/2022] [Accepted: 08/22/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND AND AIMS Proper measurement of expected risk is important for making rational decisions, and maladaptive decision making may underlie various psychiatric disorders. However, differentially expressed genetic profiling involved in this process is still largely unknown. A rodent version of the gambling task (rGT) has been developed to measure decision-making by adopting the same principle of Iowa Gambling Task in humans. In the present study, we examined using next-generation sequencing (NGS) technique whether there are differences in gene expression profiles in the medial prefrontal cortex (mPFC) and the nucleus accumbens (NAc) when rats make different choices toward risk in rGT. METHODS Rats were trained in a touch screen chamber to learn the relationships between 4 different light signals on the window of the screen and accompanied reward outcomes or punishments set up with different magnitudes and probabilities. Once they showed a stabilized pattern of preference upon free choice, rats were classified into risk-averse or risk-seeking groups. After performing the rGT, rats were decapitated, the mPFC and the NAc was dissected out, and NGS was performed with the total RNA extracted. RESULTS We found that 477 and 36 genes were differentially expressed (approximately 75 and 83% out of them were downregulated) in the mPFC and the NAc, respectively, in risk-seeking compared to risk-averse rats. Among those, we suggested a few top ranked genes that may contribute to promoting risky choices. DISCUSSION AND CONCLUSIONS Our findings provide insights into transcriptional components underlying risky choices in rats.
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Affiliation(s)
- Myung Ji Kwak
- Department of Medical Sciences, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul 03722, South Korea
| | - Wha Young Kim
- Department of Physiology, Yonsei University College of Medicine, Seoul 03722, South Korea
| | - Seung-Hyun Jung
- Department of Biochemistry, Cancer Evolution Research Center, The Catholic University of Korea College of Medicine, Seoul 06591, South Korea,Department of Biomedicine & Health Sciences, The Catholic University of Korea College of Medicine, Seoul 06591, South Korea,Precision Medicine Research Center, The Catholic University of Korea College of Medicine, Seoul 06591, South Korea,Corresponding authors. E-mail: , ,
| | - Yeun-Jun Chung
- Department of Biomedicine & Health Sciences, The Catholic University of Korea College of Medicine, Seoul 06591, South Korea,Precision Medicine Research Center, The Catholic University of Korea College of Medicine, Seoul 06591, South Korea,Department of Microbiology, IRCGP, The Catholic University of Korea College of Medicine, Seoul 06591, South Korea,Corresponding authors. E-mail: , ,
| | - Jeong-Hoon Kim
- Department of Medical Sciences, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul 03722, South Korea,Department of Physiology, Yonsei University College of Medicine, Seoul 03722, South Korea,Corresponding authors. E-mail: , ,
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Weinsztok S, Brassard S, Balodis I, Martin LE, Amlung M. Delay Discounting in Established and Proposed Behavioral Addictions: A Systematic Review and Meta-Analysis. Front Behav Neurosci 2021; 15:786358. [PMID: 34899207 PMCID: PMC8661136 DOI: 10.3389/fnbeh.2021.786358] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 11/03/2021] [Indexed: 11/14/2022] Open
Abstract
Steep delay discounting, or a greater preference for smaller-immediate rewards over larger-delayed rewards, is a common phenomenon across a range of substance use and psychiatric disorders. Non-substance behavioral addictions (e.g., gambling disorder, internet gaming disorder, food addiction) are of increasing interest in delay discounting research. Individual studies have reported steeper discounting in people exhibiting various behavioral addictions compared to controls or significant correlations between discounting and behavioral addiction scales; however, not all studies have found significant effects. To synthesize the published research in this area and identify priorities for future research, we conducted a pre-registered systematic review and meta-analysis (following PRISMA guidelines) of delay discounting studies across a range of behavioral addiction categories. The final sample included 78 studies, yielding 87 effect sizes for the meta-analysis. For studies with categorical designs, we found statistically significant, medium-to-large effect sizes for gambling disorder (Cohen’s d = 0.82) and IGD (d = 0.89), although the IGD effect size was disproportionately influenced by a single study (adjusted d = 0.53 after removal). Categorical internet/smartphone studies were non-significant (d = 0.16, p = 0.06). Aggregate correlations in dimensional studies were statistically significant, but generally small magnitude for gambling (r = 0.22), internet/smartphone (r = 0.13) and food addiction (r = 0.12). Heterogeneity statistics suggested substantial variability across studies, and publication bias indices indicated moderate impact of unpublished or small sample studies. These findings generally suggest that some behavioral addictions are associated with steeper discounting, with the most robust evidence for gambling disorder. Importantly, this review also highlighted several categories with notably smaller effect sizes or categories with too few studies to be included (e.g., compulsive buying, exercise addiction). Further research on delay discounting in behavioral addictions is warranted, particularly for categories with relatively few studies.
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Affiliation(s)
- Sarah Weinsztok
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS, United States
| | - Sarah Brassard
- Peter Boris Centre for Addictions Research, McMaster University, Hamilton, ON, United States
| | - Iris Balodis
- Peter Boris Centre for Addictions Research, McMaster University, Hamilton, ON, United States
| | - Laura E Martin
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS, United States.,Department of Population Health, University of Kansas Medical Center, Kansas City, KS, United States.,Hoglund Biomedical Imaging Center, University of Kansas Medical Center, Kansas City, KS, United States
| | - Michael Amlung
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS, United States.,Department of Applied Behavioral Science, University of Kansas, Lawrence, KS, United States
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El Ayoubi H, Barrault S, Gateau A, Cortese S, Frammery J, Mollat E, Bonnet-Brilhault F, Grall-Bronnec M, Ballon N, Brunault P. Adult attention-deficit/hyperactivity disorder among alcohol use disorder inpatients is associated with food addiction and binge eating, but not BMI. Appetite 2021; 168:105665. [PMID: 34455024 DOI: 10.1016/j.appet.2021.105665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/09/2021] [Accepted: 08/24/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Attention-deficit/hyperactivity disorder (ADHD) is associated with binge eating (BE), food addiction (FA), and obesity/higher BMI in individuals without alcohol use disorder (AUD). ADHD is highly prevalent in patients with AUD, but it is unknown whether the presence of comorbid AUD might change the nature of the association between ADHD, BE, FA and BMI (food and alcohol may either compete for the same brain neurocircuitry or share vulnerability risk factors). Here, we filled this gap by testing the association between ADHD and FA/BE in adult patients hospitalized for AUD, with the strength of simultaneously assessing childhood and adult ADHD. We also investigated the association between ADHD and BMI, and the other factors associated with BMI (FA/BE, AUD severity). METHODS We included 149 AUD inpatients between November 2018 and April 2019. We assessed both childhood and adulthood ADHD (Wender Utah Render Scale and Adult ADHD Self-Report Scale), FA (modified Yale Food Addiction Scale 2.0), BE (Binge Eating Scale), and BMI and AUD (clinical assessment). RESULTS In multivariable analyses adjusted for age, adult ADHD was associated with higher BE scores (p = .048), but not significant BE (9% vs. 7%; p = .70). ADHD was also associated with FA diagnosis and the number or FA symptoms, with larger effect size for adult (ORs: 9.45[95%CI: 2.82-31.74] and 1.38[1.13-1.69], respectively) than childhood ADHD (ORs: 4.45[1.37-14.46] and 1.40[1.13-1.75], respectively). In multivariable analysis, BMI was associated with both significant BE (p < .001) and FA diagnosis (p = .014), but not adult ADHD nor AUD severity. CONCLUSION In patients hospitalized for AUD, self-reported adult ADHD was associated with FA and BE, but not BMI. Our results set the groundwork for longitudinal research on the link between ADHD, FA, BE, and BMI in AUD inpatients.
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Affiliation(s)
- Hussein El Ayoubi
- CHRU de Tours, Service d'Addictologie Universitaire, Équipe de Liaison et de Soins en Addictologie, Tours, France; Centre Hospitalier Louis Sevestre, La Futaie, La Membrolle sur Choisille, France; CHRU de Tours, Service d'Addictologie Universitaire, Centre de Soins d'Accompagnement et de Prévention en Addictologie d'Indre-et-Loire (CSAPA-37), Tours, France.
| | - Servane Barrault
- CHRU de Tours, Service d'Addictologie Universitaire, Centre de Soins d'Accompagnement et de Prévention en Addictologie d'Indre-et-Loire (CSAPA-37), Tours, France; Université de Tours, Qualipsy EE 1901, Tours, France.
| | - Adrien Gateau
- CHRU de Tours, Centre Universitaire de Pédopsychiatrie, Tours, France.
| | - Samuele Cortese
- Center for Innovation in Mental Health, Academic Unit of Psychology, Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, UK; Solent NHS Trust, Southampton, UK; Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York, NY, USA; Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK.
| | - Julie Frammery
- CHRU de Tours, Service d'Addictologie Universitaire, Équipe de Liaison et de Soins en Addictologie, Tours, France; Centre Hospitalier Louis Sevestre, La Futaie, La Membrolle sur Choisille, France.
| | - Elodie Mollat
- Université de Tours, Faculté de Pharmacie Philippe Maupas, Tours, France.
| | - Fréderique Bonnet-Brilhault
- CHRU de Tours, Centre Universitaire de Pédopsychiatrie, Tours, France; UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.
| | - Marie Grall-Bronnec
- Université de Nantes, Université de Tours, Inserm, UMR 1246, France; CHU Nantes, Addictology and Psychiatry Department, Nantes, France.
| | - Nicolas Ballon
- CHRU de Tours, Service d'Addictologie Universitaire, Équipe de Liaison et de Soins en Addictologie, Tours, France; UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.
| | - Paul Brunault
- CHRU de Tours, Service d'Addictologie Universitaire, Équipe de Liaison et de Soins en Addictologie, Tours, France; Université de Tours, Qualipsy EE 1901, Tours, France; UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.
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Food Addiction, Saturated Fat Intake, and Body Mass Index in Peruvian Adults: A Cross-Sectional Survey. J Nutr Metab 2021; 2021:9964143. [PMID: 34336278 PMCID: PMC8318733 DOI: 10.1155/2021/9964143] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 07/14/2021] [Indexed: 02/07/2023] Open
Abstract
Background Cardiovascular diseases (CVDs) constitute one of the main public health problems and represent a greater risk of mortality and morbidity for the world population. The objective of the study was to determine food addiction, saturated fat intake, and body mass index (BMI) in Peruvian adults. Materials and Methods A cross-sectional online survey was applied to 394 Peruvian adults over 18 years old residing in the three regions of the country. Participant data was collected through a prestructured online electronic survey. Food addiction was assessed using the Yale Food Addiction Scale self-administered questionnaire. A validated food frequency questionnaire was used to measure saturated fat intake. Finally, the sociodemographic and anthropometric variables were collected through a registration form. Results There were no significant differences in food addiction between men and women (p < 0.05). More than half of the participants who presented food addiction are overweight (54.1%, p < 0.001). The highest proportion of those who had a high intake of saturated fat had a food addiction (62.6%, p < 0.001). The highest percentage of men who were overweight was higher compared to women (49.7% vs. 38.4%, p < 0.05). Conclusion The findings of this study suggest that addictive eating behaviors and high saturated fat intake should be considered as part of efforts to prevent problems related to eating, obesity, and CVD.
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Lardier DT, Coakley KE, Holladay KR, Amorim FT, Zuhl MN. Exercise as a Useful Intervention to Reduce Alcohol Consumption and Improve Physical Fitness in Individuals With Alcohol Use Disorder: A Systematic Review and Meta-Analysis. Front Psychol 2021; 12:675285. [PMID: 34305729 PMCID: PMC8292965 DOI: 10.3389/fpsyg.2021.675285] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 05/31/2021] [Indexed: 01/06/2023] Open
Abstract
Objective: This meta-analysis and systematic review examined the effects of exercise interventions on alcohol consumption and binge drinking in individuals with alcohol use disorder (AUD). Data sources: PubMed, Web of Science, Google Scholar, SPORTDiscus, and ERIC databases. Study Inclusion and Exclusion Criteria: Peer-reviewed randomized controlled trials published in English between 1970 and 2021. All studies compared exercise (Ex) and treatment as usual (TAU) to TAU in adults with an alcohol-related diagnosis. All forms of exercise interventions were included (e.g., aerobic exercise, yoga, resistance exercise, etc.). Data Extraction: Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols standard and the Meta-Analyses and Systematic Reviews of Observational Studies guidelines were followed. Risk of bias was assessed using the Cochrane risk-of-bias tool as described by the Cochrane Handbook for Systematic Reviews and Interventions. Results: The literature searches retrieved a combined 2527 studies, with 1,034 studies screened after removal of duplicates and 973 (94%) rejected after reviewing titles and abstracts. Full-text review was performed on 61 studies, with seven studies meeting inclusion criteria for qualitative and meta-analysis. Across seven studies (n = 492 participants), a significant effect (Z-value = -3.37; g = -0.30; 95% CI [-0.50--0.09]; p = 0.001) was found for Ex+TAU on drinking volume. There was no effect of Ex+TAU on binge drinking. The effect of Ex+TAU on physical fitness (VO2max, ml•kg-1•min-1) was significant (Z-score = 3.70; g = 0.64; 95% CI [0.19-1.08]; p < 0.001). Conclusions: Exercise interventions may decrease alcohol consumption and improve fitness and can be an effective adjunctive treatment for individuals with alcohol-related diagnoses including AUD.
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Affiliation(s)
- David T. Lardier
- Department of Individual, Family and Community Education, College of Education and Human Sciences, University of New Mexico, Albuquerque, NM, United States
- Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, University of New Mexico, Albuquerque, NM, United States
| | - Kathryn E. Coakley
- Department of Individual, Family and Community Education, College of Education and Human Sciences, University of New Mexico, Albuquerque, NM, United States
| | - Kelley R. Holladay
- Department of Individual, Family and Community Education, University of New Mexico, Albuquerque, NM, United States
- College of Health Sciences, Jacksonville University, Jacksonville, FL, United States
| | - Fabiano T. Amorim
- Department of Health Education and Sports Sciences College of Education and Human Sciences, University of New Mexico, Albuquerque, NM, United States
| | - Micah N. Zuhl
- School of Health Sciences, Central Michigan University, Mount Pleasant, MI, United States
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10
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Redcay A, McMahon S. Assessment of relationship addiction. SEXUAL AND RELATIONSHIP THERAPY 2021. [DOI: 10.1080/14681994.2019.1602258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Alex Redcay
- Department of Social Work, Millersville University, Millersville, Pennsylvania, USA
| | - Sheila McMahon
- School of Social Work, Barry University, Miami Shores, Florida, USA
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11
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Qiu Z, Wang J. A voxel-wise meta-analysis of task-based functional MRI studies on impaired gain and loss processing in adults with addiction. J Psychiatry Neurosci 2021; 46:E128-E146. [PMID: 33185525 PMCID: PMC7955844 DOI: 10.1503/jpn.200047] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Disturbances in gain and loss processing have been extensively reported in adults with addiction, a brain disorder characterized by obsession with addictive substances or behaviours. Previous studies have provided conflicting results with respect to neural abnormalities in gain processing in addiction, and few investigations into loss processing. METHODS We conducted voxel-wise meta-analyses of abnormal task-evoked regional activities in adults with substance dependence and gambling addiction during the processing of gains and losses not related to their addiction (mainly monetary). We identified 24 studies, including 465 participants with substance dependence, 81 with gambling addiction and 490 healthy controls. RESULTS Compared with healthy controls, all participants with addictions showed hypoactivations in the prefrontal cortex, striatum and insula and hyperactivations in the default mode network during gain anticipation; hyperactivations in the prefrontal cortex and both hyper- and hypoactivations in the striatum during loss anticipation; and hyperactivations in the occipital lobe during gain outcome. In the substance dependence subgroup, activity in the occipital lobe was increased during gain anticipation but decreased during loss anticipation. LIMITATIONS We were unable to conduct meta-analyses in the gambling addiction subgroup because of a limited data set. We did not investigate the effects of clinical variables because of limited information. CONCLUSION The current study identified altered brain activity associated with higher- and lower-level function during gain and loss processing for non-addiction (mainly monetary) stimuli in adults with substance dependence and gambling addiction. Adults with addiction were more sensitive to anticipatory gains than losses at higher- and lower-level brain areas. These results may help us to better understand the pathology of gain and loss processing in addiction.
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Affiliation(s)
- Zeguo Qiu
- From the Department of Applied Psychology, Guangdong University of Foreign Studies, Guangzhou 510006, China (Qiu, Wang); and the School of Psychology, The University of Queensland, Brisbane 4067, Australia (Qiu)
| | - Junjing Wang
- From the Department of Applied Psychology, Guangdong University of Foreign Studies, Guangzhou 510006, China (Qiu, Wang); and the School of Psychology, The University of Queensland, Brisbane 4067, Australia (Qiu)
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12
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Acevedo BP, Poulin MJ, Collins NL, Brown LL. After the Honeymoon: Neural and Genetic Correlates of Romantic Love in Newlywed Marriages. Front Psychol 2020; 11:634. [PMID: 32457675 PMCID: PMC7223160 DOI: 10.3389/fpsyg.2020.00634] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 03/17/2020] [Indexed: 12/31/2022] Open
Abstract
In Western culture, romantic love is commonly a basis for marriage. Although it is associated with relationship satisfaction, stability, and individual well-being, many couples experience declines in romantic love. In newlyweds, specifically, changes in love predict marital outcomes. However, the biological mechanisms underlying the critical transition to marriage are unknown. Thus, for the first time, we explored the neural and genetic correlates of romantic love in newlyweds. Nineteen first-time newlyweds were scanned (with functional MRI) while viewing face images of the partner versus a familiar acquaintance, around the time of the wedding (T1) and 1 year after (T2). They also provided saliva samples for genetic analysis (AVPR1a rs3, OXTR rs53576, COMT rs4680, and DRD4-7R), and completed self-report measures of relationship quality including the Eros (romantic love) scale. We hypothesized that romantic love is a developed form of the mammalian drive to find, and keep, preferred mates; and that its maintenance is orchestrated by the brain's reward system. Results showed that, at both time points, romantic love maintenance (Eros difference score: T2-T1) was associated with activation of the dopamine-rich substantia nigra in response to face images of the partner. Interactions with vasopressin, oxytocin, and dopamine genes implicated in pair-bonding (AVPR1a rs3, OXTR rs53576, COMT rs4680, and DRD4-7R) also conferred strong activation in the dopamine-rich ventral tegmental area at both time points. Consistent with work highlighting the role of sexual intimacy in relationships, romantic love maintenance showed correlations in the paracentral lobule (genital region) and cortical areas involved in sensory and cognitive processing (occipital, angular gyrus, insular cortex). These findings suggest that romantic love, and its maintenance, are orchestrated by dopamine-, vasopressin- and oxytocin-rich brain regions, as seen in humans and other monogamous animals. We also provide genetic evidence of polymorphisms associated with oxytocin, vasopressin and dopamine function that affect the propensity to sustain romantic love in early stage marriages. We conclude that romantic love maintenance is part of a broad mammalian strategy for reproduction and long-term attachment that is influenced by basic reward circuitry, complex cognitive processes, and genetic factors.
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Affiliation(s)
- Bianca P. Acevedo
- Neuroscience Research Institute and Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Michael J. Poulin
- Department of Psychology, University at Buffalo, Buffalo, NY, United States
| | - Nancy L. Collins
- Neuroscience Research Institute and Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Lucy L. Brown
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
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13
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Fugariu V, Zack MH, Nobrega JN, Fletcher PJ, Zeeb FD. Effects of exposure to chronic uncertainty and a sensitizing regimen of amphetamine injections on locomotion, decision-making, and dopamine receptors in rats. Neuropsychopharmacology 2020; 45:811-822. [PMID: 31905371 PMCID: PMC7076035 DOI: 10.1038/s41386-020-0599-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 12/22/2019] [Accepted: 12/30/2019] [Indexed: 02/06/2023]
Abstract
Gambling disorder (GD) is a behavioral addiction that may be linked to alterations in dopamine (DA) systems. Gambling involves chronic exposure to uncertain reward, which can sensitize the activity of DA systems. Here we explored how combinations of Pavlovian and instrumental uncertainty impact DA sensitization and risky decision-making. Experiment 1: 40 rats underwent 66 uncertainty exposure (UE) sessions during which they responded for saccharin. Animal responding was reinforced according to a fixed or variable (FR/VR) ratio schedule that turned on a conditioned stimulus (CS; light), which predicted saccharin on 50% or 100% of trials. Animals responded under one of the four conditions: FR-CS100% (no uncertainty), VR-CS100%, FR-CS50%, and VR-CS50% (maximal uncertainty). DA sensitization was inferred from an enhanced locomotor response to d-amphetamine (d-AMPH; 0.5 mg/kg) challenge. The rat gambling task (rGT) was used to assess decision-making. Experiment 2: 24 rats received 5 weeks of sensitizing d-AMPH or saline doses, followed by locomotor activity and rGT testing. Experiment 3: Effects of UE and a sensitizing d-AMPH regimen on DA D1, D2, and D3 receptor binding were assessed in 44 rats using autoradiography. Compared to FR-CS100%, VR-CS100% and VR-CS50% rats displayed a greater locomotor response to d-AMPH, and VR-CS50% rats demonstrated riskier decision-making. Chronic d-AMPH-treated rats mirrored the effects of VR-CS50% groups on these two indices. Both VR-CS50% and d-AMPH-treated groups had increased striatal DA D2 receptor binding. These results suggest that chronic uncertainty exposure, similar to exposure to a sensitizing d-AMPH regimen, sensitized the function of DA systems and increased risky decision-making.
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Affiliation(s)
- Victoria Fugariu
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada.
- Section of Biopsychology Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.
| | - Martin H Zack
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada
- Molecular Brain Sciences Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - José N Nobrega
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada
- Department of Psychology, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Section of Behavioral Neurobiology Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Paul J Fletcher
- Section of Biopsychology Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychology, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Fiona D Zeeb
- Section of Biopsychology Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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14
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Tang KTY, Kim HS, Hodgins DC, McGrath DS, Tavares H. Gambling disorder and comorbid behavioral addictions: Demographic, clinical, and personality correlates. Psychiatry Res 2020; 284:112763. [PMID: 31951870 DOI: 10.1016/j.psychres.2020.112763] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 12/09/2019] [Accepted: 01/04/2020] [Indexed: 11/15/2022]
Abstract
Gambling disorder (GD) frequently co-occurs with substance use disorders. However, the extent to which GD co-occurs with behavioral addictions (BAs) and the demographic, clinical, and personality correlates of comorbid GD and BA is largely unknown. The aims of the present research were to address this gap among people seeking treatment for GD (N = 458) in São Paulo, Brazil. Structured clinical interviews diagnosed individuals with GD and other psychiatric disorders. The Shorter PROMIS questionnaire was used to identify BAs (work, exercise, food bingeing, sex, and shopping). Questionnaires assessed demographic characteristics, gambling behavior, and personality. Of the total sample, 206 (45.0%) participants met the criteria of having at least one behavioral addiction (GD+BA). The most common comorbid BA was food bingeing (8.1%) with the least common being exercise (3.6%). In a multivariate logistic regression, individuals with GD+BA tended to be younger, and had greater rates of comorbid post-traumatic stress disorder and bulimia nervosa compared to participants who did not present with a comorbid BA. Taken together, individuals with GD+BA present with increased psychopathology. These results may have important implications for the assessment and treatment of individuals with GD and comorbid BAs.
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Affiliation(s)
- Karen T Y Tang
- Department of Psychology & Neuroscience, Dalhousie University, Canada.
| | - Hyoun S Kim
- Department of Psychology, University of Calgary, Canada
| | | | | | - Hermano Tavares
- Impulse Control Disorders Outpatient Unit, Institute and Department of Psychiatry, University of São Paulo, São Paulo, Brazil
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15
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Vulnerability to diet-induced obesity is associated with greater food priming-induced reinstatement of palatable food seeking. Physiol Behav 2019; 213:112730. [PMID: 31678197 DOI: 10.1016/j.physbeh.2019.112730] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 10/29/2019] [Accepted: 10/29/2019] [Indexed: 01/24/2023]
Abstract
We examined whether individual differences in weight gain during exposure to a "junk-food" diet were related to differences in later relapse-like behavior in a rat model. Following free access to a junk-food diet for 7 weeks, rats were trained to press a lever for palatable food pellets. Following extinction training, rats were tested for cue- and pellet priming-induced reinstatement. Results showed that rats prone to obesity while on the junk-food diet displayed greater pellet priming-, but not cue-, induced reinstatement relative to obesity-resistant rats, suggesting that obesity vulnerability is a factor determining one's chances for some types of relapse.
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16
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Food Addiction: Implications for the Diagnosis and Treatment of Overeating. Nutrients 2019; 11:nu11092086. [PMID: 31487791 PMCID: PMC6770567 DOI: 10.3390/nu11092086] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 08/14/2019] [Accepted: 08/21/2019] [Indexed: 12/14/2022] Open
Abstract
With the obesity epidemic being largely attributed to overeating, much research has been aimed at understanding the psychological causes of overeating and using this knowledge to develop targeted interventions. Here, we review this literature under a model of food addiction and present evidence according to the fifth edition of the Diagnostic and Statistical Manual (DSM-5) criteria for substance use disorders. We review several innovative treatments related to a food addiction model ranging from cognitive intervention tasks to neuromodulation techniques. We conclude that there is evidence to suggest that, for some individuals, food can induce addictive-type behaviours similar to those seen with other addictive substances. However, with several DSM-5 criteria having limited application to overeating, the term ‘food addiction’ is likely to apply only in a minority of cases. Nevertheless, research investigating the underlying psychological causes of overeating within the context of food addiction has led to some novel and potentially effective interventions. Understanding the similarities and differences between the addictive characteristics of food and illicit substances should prove fruitful in further developing these interventions.
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17
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Burunat E. Love is a physiological motivation (like hunger, thirst, sleep or sex). Med Hypotheses 2019; 129:109225. [PMID: 31371074 DOI: 10.1016/j.mehy.2019.05.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 04/17/2019] [Accepted: 05/12/2019] [Indexed: 10/26/2022]
Abstract
The multitude of terms associated with love has given rise to a false perception of love. In this paper, only maternal and romantic love are considered. Love is usually regarded as a feeling, motivation, addiction, passion, and, above all, an emotion. This confusion has consequences in the lives of human beings, leading not only to divorces, suicides, femicides but possibly also to a number of mental illnesses and suffering. Therefore, it is crucial to first clarify what is meant by emotion, motivation and love. This work aims to finally place love within the category of physiological motivations, such as hunger, thirst, sleep, or sex, on the basis that love is also essential for human survival, especially in childhood. Love is presented from an evolutionary perspective. Some other similarities between love and other physiological motivations are pointed out, such as its importance for appropriate human development, both its ontogeny and its permanence, and the long-lasting consequences of abuse and neglect. There are summarized reasons that account for this, such as the fact that physiological motivations are essential for survival and that love is an essential motivation for the survival of human offspring. Other reasons are that minimum changes in the quantity and quality of love alters development, that there can be a variety of neurophysiological and behavioural states within a motivation, and that motivations (also love) appear and change throughout development. Also, motivations and love sometimes may lead to an addictive behaviour. Finally, it is recognized that once physiological motivations (and love) appear, they become permanent. In a third section, some potential social, cultural, clinical and scientific consequences of the proposed consideration of love as a motivation are discussed. Accordingly, love's recognition as a motivation in the clinical field would imply a better understanding of its disorders and its inclusion in classifications manuals such as The Diagnostic and Statistical Manual of Mental Disorders (DSM), or in the International Classification of Diseases (ICD). Considering love as a motivation rather than an emotion could also impact the results of scientific research (an example is included). A comprehensive understanding of these questions could potentially allow for a new therapeutic approach in the treatment of mental illness, while offering an all-inclusive evolutionary explanation of cultural phenomena such as the origin and diffusion of both language and art. Love should be understood as a physiological motivation, like hunger, sleep or sex, and not as an emotion as it is commonly considered.
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Affiliation(s)
- Enrique Burunat
- School of Health Sciences/School of Psychology, Department of Clinical Psychology, Psychobiology and Methodology, University of La Laguna, P.O. Box 456, 38200 Santa Cruz de Tenerife, Canary Islands, Spain.
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18
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Soares LS, Costa DDS, Malloy-Diniz LF, Romano-Silva MA, de Paula JJ, de Miranda DM. Investigation on the Attention Deficit Hyperactivity Disorder Effect on Infatuation and Impulsivity in Adolescents. Front Behav Neurosci 2019; 13:137. [PMID: 31354442 PMCID: PMC6630926 DOI: 10.3389/fnbeh.2019.00137] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Accepted: 06/06/2019] [Indexed: 01/03/2023] Open
Abstract
Introduction In this study, we proposed to investigate the association between infatuation/passionate love and impulsivity in a context of potential high impulsivity: adolescents with attention deficit and hyperactivity/impulsivity (ADHD) diagnosis compared with typically developing adolescents. Methods Impulsivity was understood as an exploratory and a sensation seeking behavior, a trend to engage in novel and exciting activities, and was evaluated using the UPPS Impulsive Behavior Scale. Eighty-one adolescents from 13-to-18 years old with and without ADHD diagnosis were compared regarding infatuation intensity, behavioral impulsivity, and social and educational profiles. Results After correlation analysis, we found association between higher scores on the infatuation intensity with fewer years of formal education, heightened urgency and sensation seeking. On the other hand, using the generalized equation model, we showed that the association of passionate love with behavioral urgency and sensation seeking did not change in the presence of the ADHD diagnosis. Conclusion The understanding of the relationship of impulsivity with infatuation might help to clarify why some population groups show an increased risk for many negative social outcomes.
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Affiliation(s)
- Lorrayne Stephane Soares
- Programa de Pós-Graduação em Medicina Molecular, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Danielle de Souza Costa
- Programa de Pós-Graduação em Medicina Molecular, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Leandro Fernandes Malloy-Diniz
- Programa de Pós-Graduação em Medicina Molecular, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Department of Mental Health, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Marco Aurélio Romano-Silva
- Programa de Pós-Graduação em Medicina Molecular, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Department of Mental Health, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Jonas Jardim de Paula
- Programa de Pós-Graduação em Medicina Molecular, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Department of Psychology, Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
| | - Débora Marques de Miranda
- Programa de Pós-Graduação em Medicina Molecular, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Department of Pediatrics, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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19
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Yohn SE, Galbraith J, Calipari ES, Conn PJ. Shared Behavioral and Neurocircuitry Disruptions in Drug Addiction, Obesity, and Binge Eating Disorder: Focus on Group I mGluRs in the Mesolimbic Dopamine Pathway. ACS Chem Neurosci 2019; 10:2125-2143. [PMID: 30933466 PMCID: PMC7898461 DOI: 10.1021/acschemneuro.8b00601] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Accumulated data from clinical and preclinical studies suggest that, in drug addiction and states of overeating, such as obesity and binge eating disorder (BED), there is an imbalance in circuits that are critical for motivation, reward saliency, executive function, and self-control. Central to these pathologies and the extensive topic of this Review are the aberrations in dopamine (DA) and glutamate (Glu) within the mesolimbic pathway. Group I metabotropic glutamate receptors (mGlus) are highly expressed in the mesolimbic pathway and are poised in key positions to modulate disruptions in synaptic plasticity and neurotransmitter release observed in drug addiction, obesity, and BED. The use of allosteric modulators of group I mGlus has been studied in drug addiction, as they offer several advantages over traditional orthosteric agents. However, they have yet to be studied in obesity or BED. With the substantial overlap between the neurocircuitry involved in drug addiction and eating disorders, group I mGlus may also provide novel targets for obesity and BED.
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Affiliation(s)
- Samantha E. Yohn
- Department of Pharmacology, Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, TN, 37232, United States
- Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, TN, 37232, United States
| | - Jordan Galbraith
- Department of Pharmacology, Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, TN, 37232, United States
| | - Erin S. Calipari
- Department of Pharmacology, Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, TN, 37232, United States
| | - P. Jeffrey Conn
- Department of Pharmacology, Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, TN, 37232, United States
- Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, TN, 37232, United States
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20
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Yam CW, Pakpour AH, Griffiths MD, Yau WY, Lo CLM, Ng JMT, Lin CY, Leung H. Psychometric Testing of Three Chinese Online-Related Addictive Behavior Instruments among Hong Kong University Students. Psychiatr Q 2019; 90:117-128. [PMID: 30328020 DOI: 10.1007/s11126-018-9610-7] [Citation(s) in RCA: 111] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Given that there is a lack of instruments assessing internet-related addictions among Chinese population, this study aimed to validate the Chinese version of the nine-item Internet Gaming Disorder Scales- Short Form (IGDS-SF9), Bergen Social Media Addiction Scale (BSMAS), and Smartphone Application-Based Addiction Scale (SABAS) among Hong Kong university students. Participants aged between 17 and 30 years participated in the present study (n = 307; 32.4% males; mean [SD] age = 21.64 [8.11]). All the participants completed the IGDS-SF9, BSMAS, SABAS, and the Hospital Anxiety and Depression Scale (HADS). Confirmatory factor analyses (CFAs) were used to examine the factorial structures and the unidimensionality for IGDS-SF9, BSMAS, and SABAS. CFAs demonstrated that the three scales were all unidimensional with satisfactory fit indices: comparative fit index = 0.969 to 0.992. In addition, the IGDS-SF9 and BSMAS were slightly modified based on the modification index in CFA. The Chinese IGDS-SF9, BSMAS, and SABAS are valid instruments to assess the addiction levels of internet-related activities for Hong Kong university students.
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Affiliation(s)
- Chun-Wai Yam
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Hong Kong
| | - Amir H Pakpour
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Shahid Bahounar BLV, Qazvin, 3419759811, Iran
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Wai-Yan Yau
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Hong Kong
| | - Cheuk-Long Matthew Lo
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Hong Kong
| | - Jennifer M T Ng
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Hong Kong
| | - Chung-Ying Lin
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Hong Kong.
| | - Hildie Leung
- Department of Applied Social Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
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21
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Møller A, Rømer Thomsen K, Brooks DJ, Mouridsen K, Blicher JU, Hansen KV, Lou HC. Attenuation of dopamine-induced GABA release in problem gamblers. Brain Behav 2019; 9:e01239. [PMID: 30788911 PMCID: PMC6422713 DOI: 10.1002/brb3.1239] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 01/17/2019] [Accepted: 01/18/2019] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION We have previously shown that an interaction between medial prefrontal and parietal cortices is instrumental in promoting self-awareness via synchronizing oscillations in the gamma range. The synchronization of these oscillations is modulated by dopamine release. Given that such oscillations result from intermittent GABA stimulation of pyramidal cells, it is of interest to determine whether the dopaminergic system regulates GABA release directly in cortical paralimbic regions. Here, we test the hypothesis that the regulation of the GABA-ergic system by the dopaminergic system becomes attenuated in problem gamblers resulting in addictive behaviors and impaired self-awareness. METHODS [11 C]Ro15-4513 PET, a marker of benzodiazepine α1/α5 receptor availability in the GABA receptor complex, was used to detect changes in synaptic GABA levels after oral doses of 100mg L-dopa in a double-blind controlled study of male problem gamblers (N = 10) and age-matched healthy male controls (N = 10). RESULTS The mean reduction of cortical gray matter GABA/BDZ receptor availability induced by L-dopa was significantly attenuated in the problem gambling group compared to the healthy control group (p = 0.0377). CONCLUSIONS Our findings demonstrate that: (a) Exogenous dopamine can induce synaptic GABA release in healthy controls. (b) This release is attenuated in frontal cortical areas of males suffering from problem gambling, possibly contributing to their loss of inhibitory control. This suggests that dysfunctional dopamine regulation of GABA release may contribute to problem gambling and gambling disorder.
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Affiliation(s)
- Arne Møller
- Nuclear Medicine and PET-Center, Aarhus University Hospital, Aarhus, Denmark.,Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark
| | | | - David J Brooks
- Nuclear Medicine and PET-Center, Aarhus University Hospital, Aarhus, Denmark.,Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark.,Division of Neuroscience, University of Newcastle, Tyne, UK
| | - Kim Mouridsen
- Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark
| | - Jakob U Blicher
- Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark
| | - Kim V Hansen
- Nuclear Medicine and PET-Center, Aarhus University Hospital, Aarhus, Denmark
| | - Hans C Lou
- Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark
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Drug-taking in a socio-sexual context enhances vulnerability for addiction in male rats. Neuropsychopharmacology 2019; 44:503-513. [PMID: 30337639 PMCID: PMC6333843 DOI: 10.1038/s41386-018-0235-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 09/12/2018] [Accepted: 09/30/2018] [Indexed: 02/07/2023]
Abstract
Vulnerability to develop addiction is influenced by numerous factors, including social behavior. Specifically, in human users, drug taking in a socio-sexual context appears to enhance further drug-seeking behavior. Users report heightened sexual pleasure as a motivation for further drug use and display risk behaviors even when tested in drug-free state. Here, using a preclinical model of limited voluntary drug use in rats, the hypothesis was tested that methamphetamine (Meth)-taking concurrently with socio-sexual experience increases vulnerability to addiction. Male Sprague Dawley rats were socially housed and underwent limited-access Meth self-administration (maximum 1 mg/kg/session). Meth-taking was either concurrent or non-concurrent with sexual behavior: concurrent animals were mated with a receptive female immediately after each session, while non-concurrent animals gained equivalent sexual experience the week prior. Next, drug-seeking behaviors were measured during cue reactivity, extinction, and reinstatement sessions using different extinction and reinstatement protocols in 4 separate studies. Both groups equally acquired Meth self-administration and did not differ in total Meth intake. However, drug-seeking behavior was significantly higher in concurrent animals during cue reactivity tasks, extinction sessions, and cue- or Meth-induced reinstatement tests. In addition, sexual behavior in the absence of Meth triggered reinstatement of drug-seeking in concurrent animals. These results indicate that Meth-taking in a socio-sexual context significantly enhances vulnerability for drug addiction in male rats. This preclinical paradigm of drug self-administration concurrent with socio-sexual behavior provides a useful model for studying the underlying neurobiology of socially driven vulnerability to drug addiction.
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Tsumura H, Kanda H, Sugaya N, Tsuboi S, Fukuda M, Takahashi K. Problematic Internet Use and Its Relationship with Psychological Distress, Insomnia, and Alcoholism Among Schoolteachers in Japan. CYBERPSYCHOLOGY, BEHAVIOR, AND SOCIAL NETWORKING 2018. [DOI: 10.1089/cyber.2018.0233] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Hideki Tsumura
- Graduate School of Technology, Industrial and Social Sciences, Tokushima University, Tokushima, Japan
| | - Hideyuki Kanda
- Department of Environmental Medicine and Public Health, Faculty of Medicine, Shimane University, Shimane, Japan
| | - Nagisa Sugaya
- Unit of Public Health and Preventive Medicine, School of Medicine, Yokohama City University, Yokohama, Japan
| | - Satoshi Tsuboi
- Department of Epidemiology, Fukushima Medical University, Fukushima, Japan
| | - Mari Fukuda
- Department of Environmental Medicine and Public Health, Faculty of Medicine, Shimane University, Shimane, Japan
| | - Kenzo Takahashi
- Teikyo University Graduate School of Public Health, Tokyo, Japan
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24
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Stark R, Klucken T, Potenza MN, Brand M, Strahler J. A Current Understanding of the Behavioral Neuroscience of Compulsive Sexual Behavior Disorder and Problematic Pornography Use. Curr Behav Neurosci Rep 2018. [DOI: 10.1007/s40473-018-0162-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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25
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Geisel O, Hellweg R, Wiedemann K, Müller CA. Plasma levels of leptin in patients with pathological gambling, internet gaming disorder and alcohol use disorder. Psychiatry Res 2018; 268:193-197. [PMID: 30041134 DOI: 10.1016/j.psychres.2018.06.042] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 06/14/2018] [Accepted: 06/16/2018] [Indexed: 01/12/2023]
Abstract
Leptin has been suggested to be involved in the pathophysiology of addictive disorders via modulation of mesolimbic reward pathways. Previous studies in patients with substance use disorders (alcohol, tobacco, cocaine) found positive correlations of leptin blood levels with craving. Here, we investigated leptin blood levels in patients with non-substance related addictive disorders such as pathological gambling (PG) and internet gaming disorder (IGD) in comparison to patients with alcohol use disorder (AUD) and healthy controls. Plasma levels of leptin were measured in male patients with PG (n = 14), male patients with IGD (n = 11), male patients with AUD (n = 39) and male healthy controls (n = 12). Additionally, correlation analyses with blood levels of HPA axis hormones were performed. Leptin plasma levels of patients with PG, IGD or AUD and healthy controls did not differ significantly across groups. In patients with PG, leptin plasma levels were correlated with copeptin, a surrogate for arginine vasopressin. Our findings do not suggest an involvement of leptin in abstinent patients with AUD or in patients with active IGD. In patients with active PG, leptin blood levels were not related to craving for gambling, but leptin might be involved in PG via an interaction with the HPA axis.
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Affiliation(s)
- Olga Geisel
- Department of Psychiatry, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany.
| | - Rainer Hellweg
- Department of Psychiatry, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Klaus Wiedemann
- Department of Psychiatry, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Christian A Müller
- Department of Psychiatry, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
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26
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A potential link between gambling addiction severity and central dopamine levels: Evidence from spontaneous eye blink rates. Sci Rep 2018; 8:13371. [PMID: 30190487 PMCID: PMC6127194 DOI: 10.1038/s41598-018-31531-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 08/16/2018] [Indexed: 01/06/2023] Open
Abstract
Accumulating evidence points at similarities between substance use disorders (SUD) and gambling disorder on the behavioral and neural level. In SUD, attenuation of striatal D2/3-receptor availability is a consistent finding, at least for stimulating substances. For gambling disorder, no clear association with striatal D2/3-receptor availability has been unveiled so far. With its presumably negligible dopaminergic toxicity, possible differences in receptor availability in gambling disorder might constitute a vulnerability marker. Spontaneous eye blink rate (sEBR) is discussed as a potential proxy measure for striatal dopamine D2/3-receptor availability. Here we examined sEBR in 21 male problem gamblers and 20 healthy control participants. In addition, participants completed a screening questionnaire for overall psychopathology and self-reported measures of alcohol and nicotine consumption. We found no significant difference in sEBR between gamblers and controls. However, in gamblers, sEBR was negatively associated with gambling severity and positively associated with psychopathology. A final exploratory analysis revealed that healthy controls with low sEBR displayed higher alcohol and nicotine consumption than healthy participants with high sEBR. Although the exact association between dopamine transmission and sEBR is still debated, our findings reveal that sEBR is sensitive to inter-individual differences in gambling disorder severity in problem gamblers.
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27
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Dutta E, Naphade NM. Hypersexuality - a cause of concern: A case report highlighting the need for psychodermatology liaison. Indian J Sex Transm Dis AIDS 2018; 38:180-182. [PMID: 30148274 PMCID: PMC6085926 DOI: 10.4103/ijstd.ijstd_27_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Sexual addictions are behavioral addictions. Hypersexuality is used to describe non-paraphilic “excesses” of sexual behavior. Hypersexual disorder (HSD) can be accompanied by clinically significant social, personal distress, and medical morbidity. Common medical comorbidities seen with HSD are the sexually transmitted diseases (STDs). We present one such case with management. A psychodermatology liaison clinic would be the ideal one-stop for screening patients with STDs for HSD.
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Affiliation(s)
- Era Dutta
- Department of Mental and Behavioural Sciences, Fortis Group of Hospitals, Mumbai, Maharashtra, India
| | - Nilesh M Naphade
- Department of Psychiatry, Bharati Hospital, Bharati Vidyapeeth Medical College, Deemed University, Pune, Maharashtra, India
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Nilsson A, Magnusson K, Carlbring P, Andersson G, Gumpert CH. The Development of an Internet-Based Treatment for Problem Gamblers and Concerned Significant Others: A Pilot Randomized Controlled Trial. J Gambl Stud 2018; 34:539-559. [PMID: 28699054 PMCID: PMC5938305 DOI: 10.1007/s10899-017-9704-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Problem gambling creates significant harm for the gambler and for concerned significant others (CSOs). While several studies have investigated the effects of individual cognitive behavioral therapy (CBT) for problem gambling, less is known about the effects of involving CSOs in treatment. Behavioral couples therapy (BCT) has shown promising results when working with substance use disorders by involving both the user and a CSO. This pilot study investigated BCT for problem gambling, as well as the feasibility of performing a larger scale randomized controlled trial. 36 participants, 18 gamblers and 18 CSOs, were randomized to either BCT or individual CBT for the gambler. Both interventions were Internet-delivered self-help interventions with therapist support. Both groups of gamblers improved on all outcome measures, but there were no differences between the groups. The CSOs in the BCT group lowered their scores on anxiety and depression more than the CSOs of those randomized to the individual CBT group did. The implications of the results and the feasibility of the trial are discussed.
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Affiliation(s)
- Anders Nilsson
- Department of Clinical Neuroscience, Stockholm Center for Psychiatry Research and Education, Karolinska Institutet, Stockholm, Sweden.
| | - Kristoffer Magnusson
- Department of Clinical Neuroscience, Stockholm Center for Psychiatry Research and Education, Karolinska Institutet, Stockholm, Sweden
| | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Gerhard Andersson
- Department of Clinical Neuroscience, Stockholm Center for Psychiatry Research and Education, Karolinska Institutet, Stockholm, Sweden
- Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden
| | - Clara Hellner Gumpert
- Department of Clinical Neuroscience, Stockholm Center for Psychiatry Research and Education, Karolinska Institutet, Stockholm, Sweden
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29
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Kim HS, von Ranson KM, Hodgins DC, McGrath DS, Tavares H. Demographic, psychiatric, and personality correlates of adults seeking treatment for disordered gambling with a comorbid binge/purge type eating disorder. EUROPEAN EATING DISORDERS REVIEW 2018; 26:508-518. [PMID: 29797743 DOI: 10.1002/erv.2606] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 02/26/2018] [Accepted: 05/06/2018] [Indexed: 02/06/2023]
Abstract
Preliminary evidence suggests that binge/purge type eating disorders and gambling disorder may commonly co-occur. However, this dual-diagnosis population remains understudied. The present research examined the prevalence rates and correlates of binge/purge type eating disorders (i.e., bulimia nervosa, binge-eating disorder, and anorexia nervosa binge/purge type) among adults seeking treatment for their gambling (N = 349). In total, 11.5% of the sample (n = 40) met criteria for a binge/purge type eating disorder, most commonly bulimia nervosa (n = 33). There was a higher preponderance of binge/purge type eating disorders in women. People with a comorbid binge/purge type eating disorder reported more days gambling, gambling-related cognitive distortions, impulsivity, suicidality, and other current psychiatric comorbidities including addictive behaviours. These findings suggest that binge/purge type eating disorders in people seeking treatment for gambling may be more common than previously believed. Furthermore, the increased psychopathology among people with binge/purge type eating disorder and gambling disorder identify vulnerabilities of this dual-diagnosed population that may require clinical attention.
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Affiliation(s)
- Hyoun S Kim
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | | | - David C Hodgins
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Daniel S McGrath
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Hermano Tavares
- Impulse Control Disorders Outpatient Unit, Institute and Department of Psychiatry, University of São Paulo, São Paulo, Brazil
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30
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Lemeshow AR, Rimm EB, Hasin DS, Gearhardt AN, Flint AJ, Field AE, Genkinger JM. Food and beverage consumption and food addiction among women in the Nurses' Health Studies. Appetite 2018; 121:186-197. [PMID: 29102534 PMCID: PMC5952620 DOI: 10.1016/j.appet.2017.10.038] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 10/19/2017] [Accepted: 10/27/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND AIMS Previous studies have not addressed a fundamental component of a food addiction disorder: the compulsive relationship between eating and potentially positively reinforcing foods. We aimed to evaluate the association between food consumption and food addiction. METHODS We conducted cross-sectional analyses merging data from the Nurses' Health Study (n = 58,625) and Nurses' Health Study II (n = 65,063), two prospective cohort studies of female nurses in the United States. Diet was assessed in 2006-2007 using a food frequency questionnaire, and food addiction was assessed in 2008-2009 using the Modified Yale Food Addiction Scale. RESULTS The prevalence of food addiction was 5.4%. The odds of food addiction were strongest among nurses consuming 5+ servings/week (compared with <1 serving/month) of hamburgers (multivariable odds ratio (MVOR) 4.08; 95% CI, 2.66-6.25), French fries (MVOR, 2.37; 95% CI, 1.59-3.51) and pizza (MVOR, 2.49; 95% CI, 1.67-3.69). Consumption of red/processed meat, low/no fat snacks/desserts, and low calorie beverages was positively associated with food addiction, while consumption of refined grains, sugar-sweetened beverages and fruits, vegetables, and legumes was inversely associated with food addiction. CONCLUSIONS This epidemiologic study was the largest to examine food consumption and food addiction. Food addiction was positively associated with consumption of many hypothesized positively reinforcing foods that include a combination of carbohydrates and fats such as snacks, "fast foods," and candy bars. However, it was inversely or not associated with certain sweet foods, refined grains, and sugar-sweetened beverages, which is consistent with literature suggesting that carbohydrates (without other ingredients) are less associated with food addiction. Longitudinal analyses will help untangle the temporal order between food consumption and food addiction, as some relationships in our analyses were difficult to interpret due to the cross-sectional design.
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Affiliation(s)
- Adina R Lemeshow
- Department of Epidemiology, Columbia University, New York, NY, United States; Institute of Human Nutrition, Columbia University, New York, NY, United States.
| | - Eric B Rimm
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, United States.
| | - Deborah S Hasin
- Department of Epidemiology, Columbia University, New York, NY, United States.
| | - Ashley N Gearhardt
- Department of Psychology, University of Michigan, Ann Arbor, MI, United States.
| | - Alan J Flint
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, United States.
| | - Alison E Field
- Department of Epidemiology, Brown University, Providence, RI, United States.
| | - Jeanine M Genkinger
- Department of Epidemiology, Columbia University, New York, NY, United States; Herbert Irving Comprehensive Cancer Center, New York, NY, United States.
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31
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Callaghan CK, Rouine J, O'Mara SM. Potential roles for opioid receptors in motivation and major depressive disorder. PROGRESS IN BRAIN RESEARCH 2018; 239:89-119. [DOI: 10.1016/bs.pbr.2018.07.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Antonelli M, Ferrulli A, Sestito L, Vassallo GA, Tarli C, Mosoni C, Rando MM, Mirijello A, Gasbarrini A, Addolorato G. Alcohol addiction - the safety of available approved treatment options. Expert Opin Drug Saf 2017; 17:169-177. [PMID: 29120249 DOI: 10.1080/14740338.2018.1404025] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Alcohol Use Disorders (AUD) is a leading cause of mortality and morbidity worldwide. At present disulfiram, naltrexone and acamprosate are approved for the treatment of AUD in U.S. and Europe. Nalmefene is approved in Europe and sodium oxybate is approved in Italy and Austria only. Baclofen received a 'temporary recommendation for use' in France. AREAS COVERED The safety of the above mentioned medications on liver, digestive system, kidney function, nervous system, pregnancy and lactation and their possible side effects are described and discussed. EXPERT OPINION Mechanism of action and metabolism of these drugs as well as patients' clinical characteristics can affect the safety of treatment. All approved medications are valid tools for the treatment of AUD in patients without advanced liver disease. For some drugs, attention should be paid to patients with renal failure and medications may be used with caution, adjusting the dosage according to kidney function. In patients with AUD and advanced liver disease, at present only baclofen has been formally tested in randomized controlled trials showing its safety in this population.
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Affiliation(s)
- Mariangela Antonelli
- a Alcohol Use Disorders Unit , Università Cattolica del Sacro Cuore , Rome , Italy
| | - Anna Ferrulli
- a Alcohol Use Disorders Unit , Università Cattolica del Sacro Cuore , Rome , Italy.,b Department of Endocrinology and Metabolic Disease , IRCCS Policlinico San Donato , Milan , Italy
| | - Luisa Sestito
- a Alcohol Use Disorders Unit , Università Cattolica del Sacro Cuore , Rome , Italy
| | - Gabriele A Vassallo
- a Alcohol Use Disorders Unit , Università Cattolica del Sacro Cuore , Rome , Italy
| | - Claudia Tarli
- a Alcohol Use Disorders Unit , Università Cattolica del Sacro Cuore , Rome , Italy
| | - Carolina Mosoni
- a Alcohol Use Disorders Unit , Università Cattolica del Sacro Cuore , Rome , Italy
| | - Maria M Rando
- a Alcohol Use Disorders Unit , Università Cattolica del Sacro Cuore , Rome , Italy
| | - Antonio Mirijello
- c Department of Medical Sciences , IRCCS Casa Sollievo della Sofferenza Hospital , San Giovanni Rotondo , Italy
| | - Antonio Gasbarrini
- d Department of Internal Medicine, Gastroenterology and Hepatology , Università Cattolica del Sacro Cuore , Rome , Italy
| | - Giovanni Addolorato
- a Alcohol Use Disorders Unit , Università Cattolica del Sacro Cuore , Rome , Italy.,d Department of Internal Medicine, Gastroenterology and Hepatology , Università Cattolica del Sacro Cuore , Rome , Italy
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Abstract
The inclusion of Internet Gaming Disorder as a preliminary diagnosis subsumed in Section III of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has provoked mixed reactions. On the one hand, it has been appreciated as an important sign stressing the negative health-related impact of that disorder. Likewise, the definition of diagnostic criteria helps scientists and clinicians to refer to mandatory indicators associated with a health problem. On the other hand, it has been objected that this new diagnosis bears the danger of pathologizing normal behaviors that are a feature of healthy recreational activity for many people. However, the existence of diagnostic criteria is meant to avoid this danger. This emphasizes the necessity of being able to refer to as accurate defined criteria as possible. In its current version, the DSM criteria display not only strengths but also ambiguities. Both types will be discussed and necessary ideas to resolve those ambiguities will be presented for further research.
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Affiliation(s)
- Kai W. Müller
- Outpatient Clinic for Behavioral Addiction, Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
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34
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Cullen A, Barnett A, Komesaroff P, Brown W, O'Brien K, Hall W, Carter A. A qualitative study of overweight and obese Australians' views of food addiction. Appetite 2017; 115:62-70. [DOI: 10.1016/j.appet.2017.02.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 01/31/2017] [Accepted: 02/08/2017] [Indexed: 12/25/2022]
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35
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Kim WY, Cho BR, Kwak MJ, Kim JH. Interaction between trait and housing condition produces differential decision-making toward risk choice in a rat gambling task. Sci Rep 2017; 7:5718. [PMID: 28720904 PMCID: PMC5515848 DOI: 10.1038/s41598-017-06408-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 06/21/2017] [Indexed: 11/28/2022] Open
Abstract
Poor decision-making is a core problem in psychiatric disorders such as pathological gambling and substance abuse. Both trait and environmental factors are considerably important to affect decision-making. However, it has not yet been systematically shown how they interact to affect risk preference in animal models evaluating decision-making. Here, we trained rats, housed in pairs or in isolation, in a touch screen chamber to detect the association between four different light signals on the screen and accompanied reward and punishment outcomes arranged with different schedules. Then, the rats were allowed to freely choose from 4 different light signals. Once animals showed a stabilized pattern of preference (risk-averse or risk-seeking), they were injected with saline or cocaine (a single injection per day for 7 days) followed by 2 weeks of withdrawal. Then, their preference of choice was re-tested in the touch screen chamber while they were cocaine challenged. All rats significantly changed their preference toward more risky choices when they were exposed to and challenged with cocaine, except those in the risk-averse/isolated housing group. These results indicate that the pre-existing trait toward risk and the housing condition interact to affect the quality of decision-making, and cocaine may help to aggravate this process.
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Affiliation(s)
- Wha Young Kim
- Department of Physiology, Brain Korea 21 Project for Medical Science, Brain Research Institute, Yonsei University College of Medicine, Seoul, 03722, South Korea
| | - Bo Ram Cho
- Department of Physiology, Brain Korea 21 Project for Medical Science, Brain Research Institute, Yonsei University College of Medicine, Seoul, 03722, South Korea
| | - Myung Ji Kwak
- Department of Physiology, Brain Korea 21 Project for Medical Science, Brain Research Institute, Yonsei University College of Medicine, Seoul, 03722, South Korea
| | - Jeong-Hoon Kim
- Department of Physiology, Brain Korea 21 Project for Medical Science, Brain Research Institute, Yonsei University College of Medicine, Seoul, 03722, South Korea.
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de Paiva Lima C, da Silva E Silva DA, Damasceno S, Ribeiro AF, Rocha CS, Berenguer de Matos AH, Correia D, Boerngen-Lacerda R, Brunialti Godard AL. Loss of control over the ethanol consumption: differential transcriptional regulation in prefrontal cortex. J Neurogenet 2017; 31:170-177. [PMID: 28714806 DOI: 10.1080/01677063.2017.1349121] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Alcohol use disorder (AUD) is a complex multifactorial disease with heritability of ∼50% and corresponds to the state in which the body triggers a reinforcement or reward compulsive behavior due to ethanol consumption, even when faced with negative consequences. Although several studies have shown the impact of high ethanol intake on the prefrontal cortex (PFC) gene expression, few have addressed the relationship between the patterns of gene expression underlying the compulsive behaviour associated with relapsing. In this study, we used a chronic three-bottle free-choice mouse model to investigate the PFC transcriptome in three different groups of mice drinkers: 'Light drinkers' (preference for water throughout the experiment); 'Heavy drinkers' (preference for ethanol with a non-compulsive intake), and 'Inflexible drinkers' (preference for ethanol with a compulsive drinking component). Our aim was to correlate the intake patterns observed in this model with gene expression changes in the PFC, a brain region critical for the development and maintenance of alcohol addiction. We found that the Camk2a gene showed a downregulated profile only in the Inflexible when compared to the Light drinkers group, the Camk2n1 and Pkp2 genes showed an upregulated profile only in the Inflexible drinkers when compared to the Control group, and the Gja1 gene showed an upregulated profile in the Light and Inflexible drinkers when compared to the Control group. These different transcription patterns have been associated to the presence of alcohol, in the Camk2n1 and Gja1 genes; to the amount of ethanol consumed, in the Camk2a gene; and to the loss of control in the alcohol consumption, in the Pkp2 gene. Here, we provide, for the first time, the potential involvement of the Pkp2 gene in the compulsivity and loss of control over the voluntary ethanol consumption.
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Affiliation(s)
- Carolina de Paiva Lima
- a Programa de Pós-Graduação em Genética, Departamento de Biologia Geral , Universidade Federal de Minas Gerais , Belo Horizonte , MG , Brazil
| | - Daniel Almeida da Silva E Silva
- a Programa de Pós-Graduação em Genética, Departamento de Biologia Geral , Universidade Federal de Minas Gerais , Belo Horizonte , MG , Brazil
| | - Samara Damasceno
- a Programa de Pós-Graduação em Genética, Departamento de Biologia Geral , Universidade Federal de Minas Gerais , Belo Horizonte , MG , Brazil
| | - Andrea Frozino Ribeiro
- b Programa de Pós-Graduação em Neurociências, Faculdade de Filosofia de Ciências Humanas , Universidade Federal de Minas Gerais , Belo Horizonte , MG , Brazil
| | - Cristiane S Rocha
- c Departamento de Genética Médica, Faculdade de Ciências Medicas , Universidade de Campinas, Cidade Universitária Zeferino Vaz , Campinas , SP , Brazil
| | - Alexandre H Berenguer de Matos
- c Departamento de Genética Médica, Faculdade de Ciências Medicas , Universidade de Campinas, Cidade Universitária Zeferino Vaz , Campinas , SP , Brazil
| | - Diego Correia
- a Programa de Pós-Graduação em Genética, Departamento de Biologia Geral , Universidade Federal de Minas Gerais , Belo Horizonte , MG , Brazil.,d Departamento de Farmacologia, Jardim das Américas , Universidade Federal do Paraná , Curitiba , PR , Brazil
| | - Roseli Boerngen-Lacerda
- d Departamento de Farmacologia, Jardim das Américas , Universidade Federal do Paraná , Curitiba , PR , Brazil
| | - Ana Lúcia Brunialti Godard
- a Programa de Pós-Graduação em Genética, Departamento de Biologia Geral , Universidade Federal de Minas Gerais , Belo Horizonte , MG , Brazil
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Michaud A, Vainik U, Garcia-Garcia I, Dagher A. Overlapping Neural Endophenotypes in Addiction and Obesity. Front Endocrinol (Lausanne) 2017; 8:127. [PMID: 28659866 PMCID: PMC5469912 DOI: 10.3389/fendo.2017.00127] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 05/26/2017] [Indexed: 12/27/2022] Open
Abstract
Impulsivity refers to a tendency to act rapidly without full consideration of consequences. The trait is thought to result from the interaction between high arousal responses to potential rewards and poor self-control. Studies have suggested that impulsivity confers vulnerability to both addiction and obesity. However, results in this area are unclear, perhaps due to the high phenotypic complexity of addictions and obesity. Focusing on impulsivity, the aim of this review is to tackle the putative overlaps between addiction and obesity in four domains: (1) personality research, (2) neurocognitive tasks, (3) brain imaging, and (4) clinical evidence. We suggest that three impulsivity-related domains are particularly relevant for our understanding of similarities between addiction and obesity: lower self-control (high Disinhibition/low Conscientiousness), reward sensitivity (high Extraversion/Positive Emotionality), and negative affect (high Neuroticism/Negative Emotionality). Neurocognitive studies have shown that obesity and addiction are both associated with increased impulsive decision-making and attention bias in response to drug or food cues, respectively. Mirroring this, obesity and different forms of addiction seem to exhibit similar alterations in functional MRI brain activity in response to reward processing and during self-control tasks. Overall, our review provides an integrative approach to understand those facets of obesity that present similarities to addictive behaviors. In addition, we suggest that therapeutic interventions targeting inhibitory control may represent a promising approach for the prevention and/or treatment of obesity.
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Affiliation(s)
- Andréanne Michaud
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Uku Vainik
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
- Faculty of Social Sciences, Institute of Psychology, University of Tartu, Tartu, Estonia
| | - Isabel Garcia-Garcia
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Alain Dagher
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
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Soares LS, Paula JJD, Malloy-diniz LF, Miranda DMD, Costa DDS. Translation, cultural adaptation, and content validity index of the Juvenile Love Scale to the Brazilian context. ARCH CLIN PSYCHIAT 2017. [DOI: 10.1590/0101-60830000000121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
| | - Jonas Jardim De Paula
- Federal University of Minas Gerais, Brazil; Faculdade de Ciências Médicas de Minas Gerais, Brazil
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Earp BD, Wudarczyk OA, Foddy B, Savulescu J. Addicted to love: What is love addiction and when should it be treated? PHILOSOPHY, PSYCHIATRY, & PSYCHOLOGY : PPP 2017; 24:77-92. [PMID: 28381923 PMCID: PMC5378292 DOI: 10.1353/ppp.2017.0011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Recent research suggests that romantic love can be literally addictive. Although the exact nature of the relationship between love and addiction has been described in inconsistent terms throughout the literature, we offer a framework that distinguishes between a narrow view and a broad view of love addiction. The narrow view counts only the most extreme, harmful forms of love or love-related behaviors as being potentially addictive in nature. The broad view, by contrast, counts even basic social attachment as being on a spectrum of addictive motivations, underwritten by similar neurochemical processes as more conventional addictions. We argue that on either understanding of love-as-addiction, treatment decisions should hinge on considerations of harm and well-being rather than on definitions of disease. Implications for the ethical use of anti-love biotechnology are considered.
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Affiliation(s)
- Brian D Earp
- Uehiro Centre for Practical Ethics, University of Oxford ; Oxford Centre for Neuroethics, University of Oxford ; Institute for Science & Ethics, University of Oxford
| | | | - Bennett Foddy
- Uehiro Centre for Practical Ethics, University of Oxford ; Oxford Centre for Neuroethics, University of Oxford
| | - Julian Savulescu
- Uehiro Centre for Practical Ethics, University of Oxford ; Oxford Centre for Neuroethics, University of Oxford
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Imperatori C, Valenti EM, Della Marca G, Amoroso N, Massullo C, Carbone GA, Maestoso G, Quintiliani MI, Contardi A, Farina B. Coping food craving with neurofeedback. Evaluation of the usefulness of alpha/theta training in a non-clinical sample. Int J Psychophysiol 2017; 112:89-97. [DOI: 10.1016/j.ijpsycho.2016.11.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 11/08/2016] [Accepted: 11/11/2016] [Indexed: 11/25/2022]
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Navas JF, Billieux J, Perandrés-Gómez A, López-Torrecillas F, Cándido A, Perales JC. Impulsivity traits and gambling cognitions associated with gambling preferences and clinical status. INTERNATIONAL GAMBLING STUDIES 2017. [DOI: 10.1080/14459795.2016.1275739] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Juan F. Navas
- Department of Experimental Psychology, University of Granada, Granada, Spain
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
| | - Joël Billieux
- Laboratory for Experimental Psychopathology, Psychology Department, Psychological Sciences Research Institute, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
- Institute for Health and Behavior, Integrative Research Unit on Social and Individual Development (INSIDE), University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Ana Perandrés-Gómez
- Department of Experimental Psychology, University of Granada, Granada, Spain
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
| | - Francisca López-Torrecillas
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
- Department of Personality, Assessment, and Psychological Treatment, University of Granada, Granada, Spain
| | - Antonio Cándido
- Department of Experimental Psychology, University of Granada, Granada, Spain
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
| | - José C. Perales
- Department of Experimental Psychology, University of Granada, Granada, Spain
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
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Pilatti A, Cupani M, Tuzinkievich F, Winfree W. Confirmatory factor analysis of the Spanish version of the Gamblers' Beliefs Questionnaire in a sample of Argentinean gamblers. Addict Behav Rep 2016; 4:44-50. [PMID: 29511723 PMCID: PMC5835980 DOI: 10.1016/j.abrep.2016.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 09/05/2016] [Accepted: 09/05/2016] [Indexed: 11/01/2022] Open
Abstract
INTRODUCTION Cognitive distortions are related to gambling frequency and gambling severity. Having a culturally sensitive measure to assess cognitive distortions will facilitate the early detection of people who might be at risk of developing problematic gambling behaviors. The Gamblers' Beliefs Questionnaire was translated into Spanish (GBQ-S) but no previous study explored the structure of the GBQ-S in a non-US sample with different levels of gambling involvement. AIM The present study examined the factor structure of the GBQ-S in a community sample of gamblers from Argentina. It also analyzed the association between cognitive distortions and type of gambling activity and frequency of gambling behaviors and the predictive utility of the GBQ-S on gambling severity. PARTICIPANTS 508 youth and adults completed the GBQ-S. RESULTS The CFA showed an overall acceptable fit to the data confirming the proposed two-factor model. Scores of the two GBQ sub-scales were positively and significantly correlated with scores on gambling severity. Cognitive distortions have a significant effect on gambling severity after controlling for frequency of engagement in gambling activities. Luck and perseverance, but not illusion of control, was positively related to gambling severity. DISCUSSION scores measured by the GBQ-S exhibit adequate psychometric properties for the accurate assessment of cognitive distortions across adults and youth from the general community of Argentina.
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Affiliation(s)
- Angelina Pilatti
- Grupo Vinculado, Centro de Investigaciones y Estudios sobre Cultura y Sociedad (CIECS), CONICET. Facultad de Psicología, Universidad Nacional de Córdoba, Argentina
| | - Marcos Cupani
- Grupo Vinculado, Centro de Investigaciones y Estudios sobre Cultura y Sociedad (CIECS), CONICET. Facultad de Psicología, Universidad Nacional de Córdoba, Argentina
| | - Francisco Tuzinkievich
- Grupo Vinculado, Centro de Investigaciones y Estudios sobre Cultura y Sociedad (CIECS), CONICET. Facultad de Psicología, Universidad Nacional de Córdoba, Argentina
| | - Walter Winfree
- Institute for Gambling Education and Research, University of Memphis, USA
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Lemeshow A, Gearhardt A, Genkinger J, Corbin WR. Assessing the psychometric properties of two food addiction scales. Eat Behav 2016; 23:110-114. [PMID: 27623221 PMCID: PMC5124537 DOI: 10.1016/j.eatbeh.2016.08.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 08/23/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND While food addiction is well accepted in popular culture and mainstream media, its scientific validity as an addictive behavior is still under investigation. This study evaluated the reliability and validity of the Yale Food Addiction Scale and Modified Yale Food Addiction Scale using data from two community-based convenience samples. METHODS We assessed the internal and test-retest reliability of the Yale Food Addiction Scale and Modified Yale Food Addiction Scale, and estimated the sensitivity and negative predictive value of the Modified Yale Food Addiction Scale using the Yale Food Addiction Scale as the benchmark. We calculated Cronbach's alphas and 95% confidence intervals (CIs) for internal reliability and Cohen's Kappa coefficients and 95% CIs for test-retest reliability. RESULTS Internal consistency (n=232) was marginal to good, ranging from α=0.63 to 0.84. The test-retest reliability (n=45) for food addiction diagnosis was substantial, with Kappa=0.73 (95% CI, 0.48-0.88) (Yale Food Addiction Scale) and 0.79 (95% CI, 0.66-1.00) (Modified Yale Food Addiction Scale). Sensitivity and negative predictive value for classifying food addiction status were excellent: compared to the Yale Food Addiction Scale, the Modified Yale Food Addiction Scale's sensitivity was 92.3% (95% CI, 64%-99.8%), and the negative predictive value was 99.5% (95% CI, 97.5%-100%). CONCLUSIONS Our analyses suggest that the Modified Yale Food Addiction Scale may be an appropriate substitute for the Yale Food Addiction Scale when a brief measure is needed, and support the continued use of both scales to investigate food addiction.
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Affiliation(s)
- Adina Lemeshow
- Department of Epidemiology, Columbia University, Mailman School of Public Health, 722 West 168th Street, New York, NY 10032, United States of America;
| | - Ashley Gearhardt
- Department of Psychology, University of Michigan, 2268 East Hall, 530 Church Street, Ann Arbor, MI 48109-1043, United States of America;
| | - Jeanine Genkinger
- Department of Epidemiology, Columbia University, Mailman School of Public Health, Herbert Irving Comprehensive Cancer Center, 722 West 168th St, Rm 803, New York, NY 10032, United States of America;
| | - William R. Corbin
- Department of Psychology, University of Arizona, 950 S McAllister, Arizona State University, Tempe, AZ 85287-1104;
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Ball KT, Miller L, Sullivan C, Wells A, Best O, Cavanaugh B, Copus T, Corrigan N, Hawkins S, Kobbe K, Schoener A, Steiger J, Vieweg L. Effects of repeated yohimbine administration on reinstatement of palatable food seeking: involvement of dopamine D 1 -like receptors and food-associated cues. Addict Biol 2016. [PMID: 26223161 DOI: 10.1111/adb.12287] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Acute exposure to the pharmacological stressor yohimbine induces relapse to both food and drug seeking in a rat model. However, no systematic studies on the effects of chronic stress on relapse have been conducted. Because chronic stress causes changes in dopamine D1 -like receptor-mediated transmission in prefrontal cortex (a relapse node), we tested the hypothesis that chronic exposure to stress increases vulnerability to relapse via dopamine-mediated mechanisms. Additionally, to determine the role of food-conditioned cues in reinstatement of food seeking, we made discrete food-paired cues either available (CS Present) or not available (CS Absent) during extinction and reinstatement testing. Rats responded for palatable food reinforcers in daily 3-hour sessions, and the behavior was extinguished. To model chronic stress, rats were injected daily with yohimbine (0.0, 2.5, or 5.0 mg/kg; i.p.) during the first 7 days of extinction. Injections were combined with SCH-23390 (0.0, 5.0, or 10.0 µg/kg; i.p.), a D1 -like receptor antagonist. Rats were then tested for reinstatement of food seeking triggered by acute yohimbine (0.0, 1.0, or 2.0 mg/kg; i.p.) and pellet priming. Rats treated previously with chronic yohimbine displayed increased responding following acute yohimbine priming relative to non-chronically stressed rats, but in the CS Absent condition only. Conversely, the lower dose of chronic yohimbine caused an increase in pellet-primed reinstatement, but this effect was more pronounced in the CS Present condition. Importantly, SCH-23390 combined with repeated yohimbine injections attenuated these effects. Thus, chronic stress may increase vulnerability to relapse under specific circumstances via a dopamine D1 -like receptor-mediated mechanism.
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Affiliation(s)
- Kevin T. Ball
- Department of Psychology; Bloomsburg University of Pennsylvania; Bloomsburg PA USA
| | - Leah Miller
- Department of Psychology; Bloomsburg University of Pennsylvania; Bloomsburg PA USA
| | - Christopher Sullivan
- Department of Psychology; Bloomsburg University of Pennsylvania; Bloomsburg PA USA
| | - Ashleigh Wells
- Department of Psychology; Bloomsburg University of Pennsylvania; Bloomsburg PA USA
| | - Olivia Best
- Department of Psychology; Bloomsburg University of Pennsylvania; Bloomsburg PA USA
| | - Brittany Cavanaugh
- Department of Psychology; Bloomsburg University of Pennsylvania; Bloomsburg PA USA
| | - Taylor Copus
- Department of Psychology; Bloomsburg University of Pennsylvania; Bloomsburg PA USA
| | - Nathan Corrigan
- Department of Psychology; Bloomsburg University of Pennsylvania; Bloomsburg PA USA
| | - Shaina Hawkins
- Department of Psychology; Bloomsburg University of Pennsylvania; Bloomsburg PA USA
| | - Krista Kobbe
- Department of Psychology; Bloomsburg University of Pennsylvania; Bloomsburg PA USA
| | - Ashley Schoener
- Department of Psychology; Bloomsburg University of Pennsylvania; Bloomsburg PA USA
| | - Johnathan Steiger
- Department of Psychology; Bloomsburg University of Pennsylvania; Bloomsburg PA USA
| | - Lauren Vieweg
- Department of Psychology; Bloomsburg University of Pennsylvania; Bloomsburg PA USA
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Song S, Zou Z, Song H, Wang Y, d'Oleire Uquillas F, Wang H, Chen H. Romantic Love Is Associated with Enhanced Inhibitory Control in an Emotional Stop-Signal Task. Front Psychol 2016; 7:1574. [PMID: 27826260 PMCID: PMC5078777 DOI: 10.3389/fpsyg.2016.01574] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 09/28/2016] [Indexed: 12/20/2022] Open
Abstract
Purpose: This study explored whether romantic lovers differ in emotion-related inhibitory control capacity from those who are single. Methods: 88 healthy undergraduate college students participated in the study. Half were currently in love and in a romantic relationship (love group, LG), and half were single and had never been in a romantic relationship (single group, SG). Based on duration of romantic relationship (i.e., love duration), the LG were further divided into two subgroups: “early stage love” and “longer periods of love”. All participants completed an emotional Stop Signal Task, consisting of a variety of human face stimuli displaying either sad or neutral affect. Results: Results found that relative to SG, lovers showed greater inhibitory control [shorter stop-signal reaction time (SSRT)] during negative emotion condition trials. Furthermore, in early stages of love, SSRT for negative emotion condition trials was significantly shorter compared to that in “longer periods of love” or SG individuals, with no significant differences between the two latter groups. Conclusion: Compared with individuals who were single, early stage lovers showed greater capacity for inhibiting action during presentation of negative emotional stimuli. Within a greater social context, greater inhibitory control capacity during early stages of love may be related to the successful formation of romantic relationships, particularly to the ability to persevere in goal-directed action despite negative emotional contexts such as that of sadness.
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Affiliation(s)
- Sensen Song
- Faculty of Psychology, Southwest University Chongqing, China
| | - Zhiling Zou
- Faculty of Psychology, Southwest University Chongqing, China
| | - Hongwen Song
- School of Humanities and Social Science, University of Science and Technology of China Anhui, China
| | - Yongming Wang
- Sino-Danish College, University of Chinese Academy of Sciences Beijing, China
| | | | - Huijun Wang
- Faculty of Psychology, Southwest University Chongqing, China
| | - Hong Chen
- Faculty of Psychology, Southwest University Chongqing, China
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Nilsson A, Magnusson K, Carlbring P, Andersson G, Hellner Gumpert C. Effects of added involvement from concerned significant others in internet-delivered CBT treatments for problem gambling: study protocol for a randomised controlled trial. BMJ Open 2016; 6:e011974. [PMID: 27670519 PMCID: PMC5051398 DOI: 10.1136/bmjopen-2016-011974] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 07/18/2016] [Accepted: 08/31/2016] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Problem gambling is a public health concern affecting ∼2.3% of the Swedish population. Problem gambling also severely affects concerned significant others (CSOs). Several studies have investigated the effect of individual treatments based on cognitive-behavioural therapy (CBT), but less is known of the effect of involving CSOs in treatment. This study aims to compare an intervention based on behavioural couples therapy (BCT), involving a CSO, with an individual CBT treatment to determine their relative efficacy. BCT has shown promising results in working with substance abuse, but this is the first time it is used as an intervention for problem gambling. Both interventions will be internet-delivered, and participants will receive written support and telephone support. METHODS AND ANALYSIS A sample of 120 couples will be randomised to either the BCT condition, involving the gambler and the CSO, or the CBT condition, involving the gambler alone. Measures will be conducted weekly and at 3, 6 and 12 months follow-up. The primary outcome measure is gambling behaviour, as measured by Timeline Followback for Gambling. This article describes the outline of the research methods, interventions and outcome measures used to evaluate gambling behaviour, mechanisms of change and relationship satisfaction. This study will be the first study on BCT for problem gambling. ETHICS AND DISSEMINATION This study has been given ethical approval from the regional ethics board of Stockholm, Sweden. It will add to the body of knowledge as to how to treat problem gambling and how to involve CSOs in treatment. The findings of this study will be published in peer-reviewed journals and published at international and national conferences. TRIAL REGISTRATION NUMBER NCT02543372; Pre-results.
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Affiliation(s)
- Anders Nilsson
- Department of Clinical Neuroscience, Stockholm Center for Psychiatry Research and Education, Karolinska Institutet, Stockholm, Sweden
| | - Kristoffer Magnusson
- Department of Clinical Neuroscience, Stockholm Center for Psychiatry Research and Education, Karolinska Institutet, Stockholm, Sweden
| | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Gerhard Andersson
- Department of Clinical Neuroscience, Stockholm Center for Psychiatry Research and Education, Karolinska Institutet, Stockholm, Sweden
- Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden
| | - Clara Hellner Gumpert
- Department of Clinical Neuroscience, Stockholm Center for Psychiatry Research and Education, Karolinska Institutet, Stockholm, Sweden
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Zou Z, Song H, Zhang Y, Zhang X. Romantic Love vs. Drug Addiction May Inspire a New Treatment for Addiction. Front Psychol 2016; 7:1436. [PMID: 27713720 PMCID: PMC5031705 DOI: 10.3389/fpsyg.2016.01436] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 09/07/2016] [Indexed: 01/06/2023] Open
Abstract
Drug addiction is a complex neurological dysfunction induced by recurring drug intoxication. Strategies to prevent and treat drug addiction constitute a topic of research interest. Early-stage romantic love is characterized by some characteristics of addiction, which gradually disappear as the love relationship progresses. Therefore, comparison of the concordance and discordance between romantic love and drug addiction may elucidate potential treatments for addiction. This focused review uses the evidences from our recent studies to compare the neural alterations between romantic love and drug addiction, moreover we also compare the behavioral and neurochemical alterations between romantic love and drug addiction. From the behavioral comparisons we find that there are many similarities between the early stage of romantic love and drug addiction, and this stage romantic love is considered as a behavioral addiction, while significant differences exist between the later stage of romantic love and drug addiction, and this stage of romantic love eventually developed into a prosocial behavior. The neuroimaging comparisons suggest that romantic love and drug addiction both display the functional enhancement in reward and emotion regulation network. Except the similar neural changes, romantic love display special function enhancement in social cognition network, while drug addiction display special dysfunction in cognitive control network. The neurochemical comparisons show that there are many similarities in the dopamine (DA) system, while significant differences in oxytocin (OT) system for romantic love and drug addiction. These findings indicate that the functional alterations in reward and emotion regulation network and the DA system may be the neurophysiological basis of romantic love as a behavioral addiction, and the functional alterations in social cognition network and the OT system may be the neurophysiological basis of romantic love as a prosocial behavior. It seems that the OT system is a critical factor for the development of addiction. So we then discuss strategies to treat drug addiction with OT, and suggest that future research should further investigate OT system interventions aiming to improve cognitive control and/or social cognition functions, in order to develop strategies designed to more effectively treat drug addiction.
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Affiliation(s)
- Zhiling Zou
- Faculty of Psychology, Southwest University Chongqing, China
| | - Hongwen Song
- Faculty of Psychology, Southwest UniversityChongqing, China; Center of Medical Physics and Technology, Hefei Institutes of Physical Science, CASHefei, China
| | - Yuting Zhang
- Chinese Academy of Sciences Key Laboratory of Brain Function and Disease, School of Life Sciences, University of Science and Technology of China Hefei, China
| | - Xiaochu Zhang
- Center of Medical Physics and Technology, Hefei Institutes of Physical Science, CASHefei, China; Chinese Academy of Sciences Key Laboratory of Brain Function and Disease, School of Life Sciences, University of Science and Technology of ChinaHefei, China; School of Humanities and Social Science, University of Science and Technology of ChinaHefei, China; Centers for Biomedical Engineering, University of Science and Technology of ChinaHefei, China
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Müller KW, Dreier M, Beutel ME, Wölfling K. Is Sensation Seeking a correlate of excessive behaviors and behavioral addictions? A detailed examination of patients with Gambling Disorder and Internet Addiction. Psychiatry Res 2016; 242:319-325. [PMID: 27322843 DOI: 10.1016/j.psychres.2016.06.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 06/02/2016] [Accepted: 06/05/2016] [Indexed: 01/14/2023]
Abstract
Sensation Seeking has repeatedly been related to substance use. Also, its role as a correlate of Gambling Disorder has been discussed although research has led to heterogeneous results. Likewise, first studies on Internet Addiction have indicated increased Sensation Seeking, to some extent contradicting clinical impression of patients suffering from internet addiction. We assessed Sensation Seeking in a clinical sample of n=251 patients with Gambling Disorder, n=243 patients with internet addiction, n=103 clients with excessive but not addictive internet use, and n=142 healthy controls. The clinical groups were further sub-divided according to the preferred type of addictive behavior (slot-machine gambling vs. high arousal gambling activities and internet gaming disorder vs. other internet-related addictive behaviors). Decreased scores in some subscales of Sensation Seeking were found among male patients compared to healthy controls with no differences between patients with Gambling Disorder and Internet Addiction. The type of preferred gambling or online activity was not related to differences in Sensation Seeking. Previous findings indicating only small associations between Sensation Seeking and Gambling Disorder were confirmed. Regarding Internet Addiction our results contradict findings from non-clinical samples. Sensation Seeking might be relevant in initiating contact to the health care system.
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Affiliation(s)
- K W Müller
- Department of Psychosomatic Medicine and Psychotherapy, Outpatient Clinic for Behavioural Addictions, University Medical Centre, Johannes Gutenberg University Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany.
| | - M Dreier
- Department of Psychosomatic Medicine and Psychotherapy, Outpatient Clinic for Behavioural Addictions, University Medical Centre, Johannes Gutenberg University Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany.
| | - M E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, Outpatient Clinic for Behavioural Addictions, University Medical Centre, Johannes Gutenberg University Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany.
| | - K Wölfling
- Department of Psychosomatic Medicine and Psychotherapy, Outpatient Clinic for Behavioural Addictions, University Medical Centre, Johannes Gutenberg University Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany.
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Park BY, Wilson G, Berger J, Christman M, Reina B, Bishop F, Klam WP, Doan AP. Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports. Behav Sci (Basel) 2016; 6:E17. [PMID: 27527226 PMCID: PMC5039517 DOI: 10.3390/bs6030017] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 07/29/2016] [Accepted: 08/02/2016] [Indexed: 01/07/2023] Open
Abstract
Traditional factors that once explained men's sexual difficulties appear insufficient to account for the sharp rise in erectile dysfunction, delayed ejaculation, decreased sexual satisfaction, and diminished libido during partnered sex in men under 40. This review (1) considers data from multiple domains, e.g., clinical, biological (addiction/urology), psychological (sexual conditioning), sociological; and (2) presents a series of clinical reports, all with the aim of proposing a possible direction for future research of this phenomenon. Alterations to the brain's motivational system are explored as a possible etiology underlying pornography-related sexual dysfunctions. This review also considers evidence that Internet pornography's unique properties (limitless novelty, potential for easy escalation to more extreme material, video format, etc.) may be potent enough to condition sexual arousal to aspects of Internet pornography use that do not readily transition to real-life partners, such that sex with desired partners may not register as meeting expectations and arousal declines. Clinical reports suggest that terminating Internet pornography use is sometimes sufficient to reverse negative effects, underscoring the need for extensive investigation using methodologies that have subjects remove the variable of Internet pornography use. In the interim, a simple diagnostic protocol for assessing patients with porn-induced sexual dysfunction is put forth.
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Affiliation(s)
- Brian Y Park
- Flight Surgeon, Fleet Logistics Support Squadron 40, Norfolk, VA 34800 Bob Wilson Drive, San Diego, CA 92592, USA.
| | - Gary Wilson
- The Reward Foundation, 5 Rose Street, Edinburgh EH2 2PR, Scotland, UK.
| | - Jonathan Berger
- Department of Urology, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92592, USA.
| | - Matthew Christman
- Department of Urology, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92592, USA.
| | - Bryn Reina
- Department of Mental Health, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92592, USA.
| | - Frank Bishop
- Department of Ophthalmology, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92592, USA.
| | - Warren P Klam
- Department of Mental Health, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92592, USA.
| | - Andrew P Doan
- Department of Mental Health, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92592, USA.
- Department of Ophthalmology, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92592, USA.
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Abstract
While considerable efforts have been made to understand the neurobiological basis of substance addiction, the potentially "addictive" qualities of repetitive behaviors, and whether such behaviors constitute "behavioral addictions," is relatively neglected. It has been suggested that some conditions, such as gambling disorder, compulsive stealing, compulsive buying, compulsive sexual behavior, and problem Internet use, have phenomenological and neurobiological parallels with substance use disorders. This review considers how the issue of "behavioral addictions" has been handled by latest revisions of the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD), leading to somewhat divergent approaches. We also consider key areas for future research in order to address optimal diagnostic classification and treatments for such repetitive, debilitating behaviors.
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