Delay discounting mediates the association between posterior insular cortex volume and social media addiction symptoms

The Effects of Social Feedback Through the "Like" Feature on Brain Activity: A Systematic Review

BACKGROUND

Problematic social media (SM) use is a growing concern, particularly among adolescents who are drawn to these platforms for social interactions important to their age group. SM dependence is characterized by excessive, uncontrolled usage that impairs personal, social, and professional aspects. Despite the ongoing debate over recognizing SM addiction as a distinct diagnostic category, the impact of social feedback, particularly through the "like" button, on brain activity remains under scrutiny.

OBJECTIVE

This systematic review aims to study the neural correlates of online social feedback, focusing on the effects of the "like" feedback on brain activity using fMRI and EEG.

METHODS

The review followed the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA).

RESULTS

The review included 11 studies with 504 participants, identifying key brain structures such as the amygdala, ventromedial prefrontal cortex (vmPFC), and ventral striatum involved in reward processing. Positive feedback ("likes") activates areas like the nucleus accumbens (NACC), vmPFC, and amygdala, with NACC correlating with increased SM use intensity. Negative feedback activates the ventrolateral prefrontal cortex (vlPFC) and left medial prefrontal cortex (mPFC). Behavioral data indicates that positive feedback influences subsequent social interactions.

CONCLUSIONS

The review highlights disparities in the literature regarding the neural response to social feedback, emphasizing the need for further research to clarify the roles of sex, personality traits, and the person giving feedback. Overall, understanding the neurobiological underpinnings of SM engagement is essential for developing effective interventions to prevent or address the negative effects of excessive SM use.

Sex differences in inter-temporal decision making and cortical thickness of the orbitofrontal and insula in young adult cannabis users: Evidence from 1111 subjects

To test for sex differences in the impact of cannabis use on decision-making and brain correlates, we employed cortical thickness (CT) analysis of brain regions involved in intertemporal decision-making namely bilateral orbitofrontal cortex(OFC) and insula in young adult nondependent cannabis-users(CU) and non-users(NU) and their scores on delay discounting task. Neuroimaging analyzes of previously collected data were performed on 608CU and 503NU. CT analysis was performed on MRI images. OFC and insula thickness, scores on the delay discounting test were compared between groups and correlated. Controlling alcohol-use and intra-cranial-volume, CU exhibited sex differences in CT. The bilateral insula was significantly thinner in male CU. OFC was thinner in females relative to controls. Female CU had thinner Right-medial OFC, Left-lateral-OFC. While male CU scored significantly lower on items within delay discounting task, female CU delay-discounting scores were within normal range. Our results demonstrate that cannabis-use differentially affects decision-making across sexes. Cortical morphology mirrors this dimorphism. CU subjects did not show a correlation between CT of OFC or insula and delay discounting, implying that thinner cortices and lower DD scores in males may be independent alterations which may be premorbid to cannabis use and may lead to cognitive deficits in later years.

When Games Influence Words: Gaming Addiction among College Students Increases Verbal Aggression through Risk-Biased Drifting in Decision-Making

Increased aggression due to gaming addiction is a widespread and highly publicized problem. The underlying processes by which verbal aggression, a more harmful and persistent subcategory of aggression, is affected by gaming addiction may differ from other types of aggression. In this study, data came from 252 randomly recruited current university students (50.79% male, mean age 19.60 years, SD: 1.44 years, range 17 to 29 years). Participants reported gaming addiction and different types of aggression through questionnaires. In addition, two important explanatory processes, inhibitory control, and risk preference, were measured through behavioral experiments. A Bayesian hierarchical drift-diffusion model was employed to interpret the data from the risk preference task. In contrast to previous work, the study found that inhibitory control did not significantly correlate with either gaming addiction or any form of aggression However, the drift rate, a measure of decision-making inclination under risk, partially mediates the relationship between gaming addiction and verbal aggression (but not other forms of aggression). The findings illuminate risk preference under adverse conditions as a key predictor of verbal aggression, offering avenues for early intervention and suggesting game design modifications to mitigate verbal aggression by adjusting reward mechanisms.

Healthy dietary choices involve prefrontal mechanisms associated with long-term reward maximization but not working memory

Taste and health are critical factors to be considered when choosing foods. Prioritizing healthiness over tastiness requires self-control. It has also been suggested that self-control is guided by cognitive control. We then hypothesized that neural mechanisms underlying healthy food choice are associated with both self-control and cognitive control. Human participants performed a food choice task and a working memory task during functional MRI scanning. Their degree of self-control was assessed behaviorally by the value discount of delayed monetary rewards in intertemporal choice. Prioritizing healthiness in food choice was associated with greater activity in the superior, dorsolateral, and medial prefrontal cortices. Importantly, the prefrontal activity was greater in individuals with smaller delay discounting (i.e. high self-control) who preferred a delayed larger reward to an immediate smaller reward in intertemporal choice. On the other hand, working memory activity did not show a correlation with delay discounting or food choice activity, which was further supported by supplementary results that analyzed data from the Human Connectome Project. Our results suggest that the prefrontal cortex plays a critical role in healthy food choice, which requires self-control, but not working memory, for maximization of reward attainments in a remote future.

Silence between words: Is solitude important for relatedness?

Chronic loneliness is a risk factor for physical and health problems, in part due to dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis and sympathetic nervous system. In contrast, temporary moments of positive solitude (passing good times alone and not feeling lonely) appear to have positive effects on mental health, social life, and creativity, and seems to be a buffer against loneliness. Herein, three ways of how solitude may have positive effects on health and relatedness are discussed, namely effects on enhancement of mind-wandering, interoceptive awareness, and spirituality. Solitude may facilitate (1) activation of the default mode network (DMN) underlying mind-wandering including daydreaming about other people; (2) activation of brain areas supporting interoceptive awareness; (3) deactivation of prefrontal cortex, or deactivation and decreased connectivity of the DMN, giving raise to susceptibility to spiritual experiences. The capacity to handle and enjoy solitude is a developmental process that may be difficult for many persons. Craving for social connections and external stimulation with digital technologies (e.g., internet, smartphones, social media) might be interfering with the development of the capacity for solitude and thereby increasing loneliness; this might be partly due to impaired interoceptive awareness and impaired functional mind-wandering (common in solitude). Congruently, overuse of digital technologies was associated with reduced activity, and reduced gray matter volume and density, in brain areas supporting interoceptive awareness, as well as with decreased connectivity of the DMN supporting creative insights. Solitude has been a relatively dismissed topic in neuroscience and health sciences, but a growing number of studies is highlighting its importance for well-being.

A Systematic Review of Structural and Functional MRI Studies Investigating Social Networking Site Use

An understanding of the neurocognitive profile underlying the use of social networking sites (SNSs) can help inform decisions about the classification of problematic SNS use as an addictive disorder and elucidate how/when 'SNS addiction' might develop. The present review aimed to synthesize structural and functional MRI research investigating problematic/compulsive forms of SNS use or regular (non-addicted) SNS use behaviours. We conducted a systematic search for research articles published in English using the Web of Science, PubMed, and Scopus databases up to October 2022. Studies meeting our inclusion criteria were assessed for quality and a narrative synthesis of the results was conducted. Twenty-eight relevant articles were identified comprising structural MRI (n = 9), resting-state fMRI (n = 6) and task-based fMRI studies (n = 13). Current evidence suggests that problematic SNS use might be characterised by (1) reduced volume of the ventral striatum, amygdala, subgenual anterior cingulate cortex, orbitofrontal cortex and posterior insula; (2) increased ventral striatum and precuneus activity in response to SNS cues; (3) abnormal functional connectivity involving the dorsal attention network; (4) inter-hemispheric communication deficits. Regular SNS use behaviours appear to recruit regions involved in the mentalising network, the self-referential cognition network, the salience network, the reward network and the default mode network. Such findings are at least partially consistent with observations from the substance addiction literature and provide some provisional support for the addictive potential of SNSs. Nonetheless, the present review is limited by the small number of eligible studies and large heterogeneity in the methods employed, and so our conclusions should remain tentative. Moreover, there is a lack of longitudinal evidence suggesting SNSs cause neuroadaptations and thus conclusions that problematic SNS use represents a disease process akin to substance use addictions are premature. More well-powered longitudinal research is needed to establish the neural consequences of excessive and problematic SNS use.

The influence of Facebook intrusion and task context on cognitive control

Social networking sites, especially Facebook, have become increasingly popular over the past decades. However, besides the benefits of using Facebook, negative effects in the form of Facebook intrusion are also increasingly pointed out. Much of the research focuses on personality, emotional and social factors related to Facebook intrusion. However, there has been limited research on the relationship between this type of behavioural addiction and cognitive functioning. Consequently, the current study aimed to verify the relationship between Facebook intrusion and cognitive control in light of the dual mechanism of cognitive control model. Additionally, the study aim was to verify the impact of the Facebook-related context on cognitive control (proactive and reactive modes) compared to neutral and positive contexts. The participants (N = 82 young adults, 57 female, M = 22.24 years, SD = 2.67 years, age range 18-35 years) were divided into two groups based on their level of Facebook intrusion. The Facebook intrusion scale was used to assess the level of Facebook intrusion. The AX-CPT task was used to assess proactive and reactive control modes in three task contexts: Facebook-related, neutral and positive. The current study results show that the participants with high Facebook intrusion had greater reactive control than participants with low Facebook intrusion. The differences between Facebook-related, neutral context and positive context were not found. However, the present findings demonstrate the interaction between Facebook intrusion and task context in cognitive control. More specifically, participants with low Facebook intrusion had greater proactive control than participants with high Facebook intrusion in the Facebook-related and positive context.

How distinct functional insular subdivisions mediate interacting neurocognitive systems

Recent neurocognitive models propose that the insula serves as a hub of interoceptive awareness system, modulating 2 interplaying neurocognitive systems: The posterior insula (PI) receives and integrates various interoceptive signals; these signals are then transmitted to the anterior insula for processing higher-order representations into awareness, where the dorsal anterior insula (dAI) modulates the prefrontal self-control system and the ventral anterior insula (vAI) modulates the amygdala (AMG)-striatal reward-seeking circuit. We sought to test this view using a multimodal approach. We first used a resting-state functional magnetic resonance imaging (fMRI) approach with a sample of 120 undergraduate students. Then, we unpacked the neuro-cognitive association between insular connectivity and cognitive performance during an Iowa gambling fMRI task. Lastly, an independent Open Southwest University Longitudinal Imaging Multimodal dataset was used to validate the results. Findings suggested that the dAI was predominantly connected to the prefrontal regions; the vAI was primarily connected to the AMG-ventral-striatum system; and the PI was mainly connected to the visceral-sensorimotor system. Moreover, cognitive scores were positively correlated with FC between dAI and the self-control process of ventrolateral prefrontal cortex and were negatively correlated with FC between vAI and the reward-seeking process of orbitofrontal cortex and subgenual anterior cingulate cortex. The findings highlight the roles of our theorized subinsular functionality in the overall operation of the neural cognitive systems.

Neuroimaging the effects of smartphone (over-)use on brain function and structure-a review on the current state of MRI-based findings and a roadmap for future research

The smartphone represents a transformative device that dramatically changed our daily lives, including how we communicate, work, entertain ourselves, and navigate through unknown territory. Given its ubiquitous availability and impact on nearly every aspect of our lives, debates on the potential impact of smartphone (over-)use on the brain and whether smartphone use can be "addictive" have increased over the last years. Several studies have used magnetic resonance imaging to characterize associations between individual differences in excessive smartphone use and variations in brain structure or function. Therefore, it is an opportune time to summarize and critically reflect on the available studies. Following this overview, we present a roadmap for future research to improve our understanding of how excessive smartphone use can affect the brain, mental health, and cognitive and affective functions.

Addictive and other mental disorders: a call for a standardized definition of dual disorders

The persistent difficulty in conceptualizing the relationship between addictive and other mental disorders stands out among the many challenges faced by the field of Psychiatry. The different philosophies and schools of thought about, and the sheer complexity of these highly prevalent clinical conditions make progress inherently difficult, not to mention the profusion of competing and sometimes contradictory terms that unnecessarily exacerbate the challenge. The lack of a standardized term adds confusion, fuels stigma, and contributes to a "wrong door syndrome" that captures the difficulty of not only diagnosing but also treating addictive and other mental disorders in an integrated manner. The World Association on Dual Disorders (WADD) proposes the adoption of the term "Dual Disorder" which, while still arbitrary, would help harmonize various clinical and research efforts by rallying around a single, more accurate, and less stigmatizing designation.

Brain structural covariation linked to screen media activity and externalizing behaviors in children

Background and Aims

Screen media activity (SMA) may impact neurodevelopment in youth. Cross-sectionally, SMA has been linked to brain structural patterns including cortical thinning in children. However, it remains unclear whether specific brain structural co-variation patterns are related to SMA and other clinically relevant measures such as psychopathology, cognition and sleep in children.

Methods

Adolescent Brain Cognitive Development (ABCD) participants with useable baseline structural imaging (N = 10,691; 5,107 girls) were analyzed. We first used the Joint and Individual Variation Explained (JIVE) approach to identify cortical and subcortical covariation pattern(s) among a set of 221 brain features (i.e., surface area, thickness, or cortical and subcortical gray matter (GM) volumes). Then, the identified structural covariation pattern was used as a predictor in linear mixed-effect models to investigate its associations with SMA, psychopathology, and cognitive and sleep measures.

Results

A thalamus-prefrontal cortex (PFC)-brainstem structural co-variation pattern (circuit) was identified. The pattern suggests brainstem and bilateral thalamus proper GM volumes covary more strongly with GM volume and/or surface area in bilateral superior frontal gyral, rostral middle frontal, inferior parietal, and inferior temporal regions. This covariation pattern highly resembled one previously linked to alcohol use initiation prior to adulthood and was consistent in girls and boys. Subsequent regression analyses showed that this co-variation pattern associated with SMA (β = 0.107, P = 0.002) and externalizing psychopathology (β = 0.117, P = 0.002), respectively.

Discussion and Conclusions

Findings linking SMA-related structural covariation to externalizing psychopathology in youth resonate with prior studies of alcohol-use initiation and suggest a potential neurodevelopmental mechanism underlying addiction vulnerability.

Structural gray matter differences in Problematic Usage of the Internet: a systematic review and meta-analysis

Problematic Usage of the Internet (PUI) has been linked to diverse structural gray matter changes in individual data studies. However, no quantitative synthesis across studies has been conducted. We aimed to identify gray matter regions showing significant spatial convergence across neuroimaging studies in PUI. We searched PubMed and PsycINFO up to 10/03/2021 and included original, cross-sectional comparative studies that examined structural gray matter imaging in PUI versus control groups; reported a whole-brain analysis; and provided peak coordinates for gray matter differences. From a total of 624 potentially relevant studies, 15 (including 355 individuals with PUI and 363 controls) were included in a meta-analysis of voxel-based morphometry studies. Anatomical likelihood estimation (ALE) meta-analysis was performed using extracted coordinates and identified significant spatial convergence in the medial/superior frontal gyri, the left anterior cingulate cortex/cingulate gyrus, and the left middle frontal/precentral gyri. Datasets contributing to these findings all indicated reduced gray matter in cases compared to controls. In conclusion, voxel-based morphometric studies indicate replicable gray matter reductions in the dorsolateral prefrontal cortex and anterior cingulate cortex in PUI, regions implicated in reward processing and top-down inhibitory control. Further studies are required to understand the nature of gray matter differences across PUI behaviors, as well as the contribution of particular mental health disorders, and the influence of variation in study and sample characteristics.

Applying network analysis to understand the relationships between impulsivity and social media addiction and between impulsivity and problematic smartphone use

BACKGROUND

Prior studies have revealed the relationships between impulsivity and social media addiction (SMA) and between impulsivity and problematic smartphone use (PSU) based on total scores on standardized self-report scales. However, there has been a lack of studies exploring how the dimensions of impulsivity and components of SMA or PSU are interrelated. The present study aimed to investigate the structural relationships between the dimensions of impulsivity and components of SMA and PSU and determine the critical bridge node using network analysis.

METHODS

A total of 325 healthy adults aged 18-36 years participated in the study. SMA and PSU were assessed using the Bergen Social Media Addiction Scale (BSMAS) and Smartphone Application-Based Addiction Scale (SABAS), respectively. Impulsivity was measured by the Barratt Impulsiveness Scale Version 11 (BIS-11). Network analysis was used to construct an SMA-Impulsivity network and a PSU-Impulsivity network. Bridge centrality (bridge expected influence, BEI) was estimated to identify influential bridge nodes.

RESULTS

In addition to relationships within each community, network analysis revealed that the dimensions of impulsivity were closely associated with the components of SMA and PSU. Particularly, I2 "motor impulsivity" had a relatively strong connection with SMA3 "mood modification" and SMA4 "relapse" in the SMA-Impulsivity network, and with PSU2 "conflict" and PSU5 "withdrawal" in the PSU-Impulsivity network. Moreover, I2 "motor impulsivity" was identified as the most critical bridge node in both networks.

CONCLUSION

These findings demonstrate potential pathways between different dimensions of impulsivity and the components of SMA and PSU, providing new evidence relevant to understanding the underlying mechanisms that account for how highly impulsive individuals develop SMA and PSU, and highlight the critical bridge node-motor impulsivity-that may be a promising and effective target for the prevention and treatment of SMA and PSU.

Problematic Social Networking Site use-effects on mental health and the brain

The association between excessive use of Social Networking Sites (SNS) and mental health is raising serious concern among health and education professionals. Problematic SNS use has been associated with an increased rate of depression, anxiety, stress, obsessive-compulsive disorder (OCD), attention-deficit/hyperactivity disorder (ADHD), and propensity to excessive alcohol use. It may also lead to vulnerability to aggression, cyberbullying and fear of missing out (FOMO). There is little evidence for cognitive impairments, but there is some preliminary event-related potentials (ERPs) evidence for inefficiency in allocating and monitoring resources and inhibitory control. Problematic SNS has been associated with the personality traits of conscientiousness agreeableness and neuroticism, and with narcissism. There is evidence for reduced sleep quality and quantity, longer sleeping latency and more sleep disturbance. The few brain imaging studies show some similarity between problematic SNS use and other addictions related to inhibitory-control mechanism, reduced gray matter volumes in the nucleus accumbens, amygdala, and the insula, suggesting rewarding effects of SNS use on the brain. Finally, there is preliminary evidence that treatment with Cognitive Behavior Therapy (CBT) can assist in short-term abstinence intervention to treat problematic SNS use. We conclude that problematic SNS use may have deleterious effects on emotional and social relationships, and more research is required on its effects on cognitive and brain function.

Delay Discounting in Established and Proposed Behavioral Addictions: A Systematic Review and Meta-Analysis

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.

The sooner the better: clinical and neural correlates of impulsive choice in Tourette disorder

Reward sensitivity has been suggested as one of the central pathophysiological mechanisms in Tourette disorder. However, the subjective valuation of a reward by introduction of delay has received little attention in Tourette disorder, even though it has been suggested as a trans-diagnostic feature of numerous neuropsychiatric disorders. We aimed to assess delay discounting in Tourette disorder and to identify its brain functional correlates. We evaluated delayed discounting and its brain functional correlates in a large group of 54 Tourette disorder patients and 31 healthy controls using a data-driven approach. We identified a subgroup of 29 patients with steeper reward discounting, characterised by a higher burden of impulse-control disorders and a higher level of general impulsivity compared to patients with normal behavioural performance or to controls. Reward discounting was underpinned by resting-state activity of a network comprising the orbito-frontal, cingulate, pre-supplementary motor area, temporal and insular cortices, as well as ventral striatum and hippocampus. Within this network, (i) lower connectivity of pre-supplementary motor area with ventral striatum predicted a higher impulsivity and a steeper reward discounting and (ii) a greater connectivity of pre-supplementary motor area with anterior insular cortex predicted steeper reward discounting and more severe tics. Overall, our results highlight the heterogeneity of the delayed reward processing in Tourette disorder, with steeper reward discounting being a marker of burden in impulsivity and impulse control disorders, and the pre-supplementary motor area being a hub region for the delay discounting, impulsivity and tic severity.

The contributions of social comparison to social network site addiction

Excessive use of social network sites (SNSs) can often lead to negative consequences of frequent upward social comparisons despite having the social network platform to present users in a favorable light. However, the existing literature gives little evidence to social comparison related antecedents and consequents of uncontrollable use of SNSs. The present study aimed to investigate the contributions of social comparison to SNS addiction. In Study 1, using a convenient sample in Austria (n = 103), we showed that the tendency to engage in social comparisons of ability (but not of opinion) predicted self-reported SNS addiction over and above the feelings of relative deprivation on social support and status. SNS addiction mediated the relations between social comparison of ability and stress, but not self-esteem. In Study 2, using a broad sample of participants in Austria (n = 500), we replicated the findings observed in Study 1 and showed that contrastive upward social comparison emotions (i.e., envy, depression) mediated the relation between SNS addiction and lower self-esteem whereas the contrastive downward social comparison emotion (i.e., contentment) mediated the relation between SNS addiction and higher self-esteem. Our findings suggest that SNS addiction closely relates to psychological constructs relevant to social comparison, mediates the link between social comparison of ability and detrimental consequences (i.e., stress, well-being) and demonstrate how social comparison emotions relate to both positive and negative associations between SNS addiction and self-esteem.

Distress Among Adolescents: An Exploration of Mattering, Social Media Addiction, and School Connectedness

This study aimed to explore the effects of mattering, social media addiction, online activity, school connectedness, age, and gender on anxiety/depressive symptomatology among U.S. adolescents. A nationally representative Qualtrics panel sample consisting of 441 adolescents ( Mage = 17.3; SDage = 1.67) participated in this study. The results of a three-step hierarchical multiple regression analysis indicated that gender, social media usage, and mattering were most strongly associated with adolescent distress (i.e., anxiety/depressive symptom reporting). For the full predictive model with all six predictors added, mattering was found to significantly improve the prediction of adolescents’ anxiety/depressive symptomatology, contributing an additional 12.8% of explained variance. For this sample, adolescent girls participants reported experiencing more anxiety/depressive symptoms. Furthermore, higher levels of social media usage, indicative of an addictive stage, and lower levels of mattering were related to more significant anxiety/depressive symptomatology. Overall, mattering was found to significantly correlate with adolescent distress, online activity, problematic social media usage, and school connectedness, evidencing its importance in addressing adolescent mental health.

Problematic social media use and social support received in real-life versus on social media: Associations with depression, anxiety and social isolation

Social media platforms allow people to connect with each other and obtain social rewards. In some individuals, these reinforcing rewards can induce maladaptive, problematic social media use, with symptoms similar to substance use disorders. This problematic social media use has been associated with poorer mental health. Previous studies have demonstrated that social support can protect against poor mental health. People can receive social support both in real-life and on social media, however, so we investigated whether these two types of social support mediate the relationship between problematic social media use and poor mental health. We conducted an online survey, collecting measures of problematic social media use and mental health (depression, anxiety, and social isolation), as well as measures of real-life social support and social support received on social media. We then performed a path analysis on these data. Our analysis revealed that problematic social media use was significantly associated with decreased real-life social support and increased social support on social media. Importantly, real-life social support was then associated with reduced depression, anxiety, and social isolation, while social support on social media was not associated with these mental health measures. Our findings reveal the value of real-life social support when considering the relationship between problematic social media use and mental health. Implications for further research and practice are discussed.

Social-networks-related stimuli interferes decision making under ambiguity: Interactions with cue-induced craving and problematic social-networks use

BACKGROUND AND AIMS

Social-networks-use disorder is discussed as a potential further type of disorders due to addictive behaviors. Theoretical models assume cue-induced craving and disadvantageous decision making to be relevant mechanisms. This study investigates if the presentation of social-networks-related cues interferes with decision making under ambiguity.

METHODS

Craving was induced with a cue-reactivity paradigm and assessed with a visual analogue scale. Participants (N = 146) played a modified Iowa Gambling Task with social-networks-related cues and neutral cues presented on the advantageous and disadvantageous decks respectively, or vice versa. Symptoms of social-networks-use disorder were measured with a modified version of the short Internet Addiction Test.

RESULTS

Overall, participants chose options with neutral cues more often than those with social-networks-related cues, even if it was disadvantageous. There was a significant interaction between decision-making performance and Iowa Gambling Task condition in predicting symptom severity. The results indicate that choosing decks with social-networks-related cues even if it was disadvantageous is associated with higher tendencies towards a social-networks-use disorder. The interaction with cue-induced craving did not explain further variance.

DISCUSSION AND CONCLUSIONS

The results highlight the relevance of cue reactivity, decision making, and their interaction as potential mechanisms explaining tendencies towards a social-networks-use disorder. Decision making was influenced by affective responses, which could result in a higher risk of a potential addictive behavior. This is consistent with the findings from addiction research and with theoretical approaches assuming an imbalance between affective and cognitive processes in addictive behaviors.

Perceived friendship and binge drinking in young adults: A study of the Human Connectome Project data

BACKGROUND

Peer influences figure prominently in young adult binge drinking. Women have trended to show a level of alcohol use on par with men during the last decades. It would be of interest to investigate the neural processes of social cognition that may underlie binge drinking and the potential sex differences.

METHODS

Here, we examined the data of the Human Connectome Project where we identified a total of 175 binge drinkers (125 men) and 285 non-binge drinkers (97 men) performing a social cognition task during brain imaging. We analyzed the imaging data with published routines and evaluated the results at a corrected threshold.

RESULTS

Both male and female binge relative to non-binge drinkers showed higher perceived friendship. Binge relative to non-binge drinkers demonstrated diminished activations in the anterior medial orbitofrontal cortex (amOFC) during perception of social vs. random interaction, with a more prominent effect size in women. Further, whole-brain regression identified activity of the right posterior insula (rPI) in negative correlation with perceived friendship score in non-binge drinking women. Post-hoc analyses showed significant correlation of rPI activity with perceived friendship, amOFC activity, and a summary measure of alcohol use severity identified by principal component analysis, across all subjects. Mediation and path analysis demonstrated a significant model: amOFC activity → rPI activity → perceived friendship → severity of alcohol use.

CONCLUSIONS

These findings support peer influences on binge drinking and suggest neural correlates that may relate altered social cognitive processing to alcohol misuse in young adults.

Adolescent Attachment to Parents and Peers and the Use of Instagram: The Mediation Role of Psychopathological Risk

Several studies have shown an association between adolescents’ attachment relationships and social media use. Instagram is the social media platform most used by teenagers and recent studies have shown an association between Instagram use and increased psychopathological risk. The present study aims to verify whether psychopathological risk mediates the relationship between an adolescent’s attachment to their parents and peers and their Instagram addiction. N = 372 adolescents are assessed through self-report questionnaires evaluating Instagram addiction, the adolescents’ attachments to parents and peers, and their psychopathological risk. The Bergen Instagram Addiction Scale (BIAS) is developed by adapting the Bergen Social Media Addiction Scale. Results show the validity and reliability of the BIAS, confirming a one-factor structure. Findings show that a worse attachment to parents and peers is associated with adolescents’ psychopathological risk, which is associated with Instagram addiction. This finding has important clinical implications. Being able to intervene in adolescents’ relationships with parents and peers and the ways in which adolescents feel in relation to others could allow for a reduction in adolescents’ psychological difficulties, involving reduced Instagram use as a vehicle for the expression of their psychopathological symptoms.

Deficits in executive functions but not in decision making under risk in individuals with problematic social-network use

BACKGROUND

The tendency to strive for immediate gratification by neglecting potential negative long-term outcomes characterizes addictive behaviors, such as substance use or gaming disorder. Problematic social-network use is currently discussed as another potential addictive behavior, which is considered to result from an imbalance between affective and cognitive processes, indicated by traits such as increased impulsivity and/or decreased executive functions and decision-making abilities.

METHODS

This study investigates the respective functions in social-network users by use of the Cards and Lottery Task (CLT) - a decision-making task under risk conditions in which options contain conflicting immediate and long-term outcomes at the same time. A sample of German and Spanish participants (N = 290) performed the CLT as well as the Modified Card Sorting Test (MCST), Barratt Impulsiveness Scale (BIS), the short Internet Addiction Test specified for social-networking (sIAT-SNS), and screeners on other potentially problematic behaviors.

RESULTS

Comparing extreme groups based on sIAT-SNS scores (1SD above/below mean), individuals with problematic social-network use (n = 56), as compared to those with non-problematic social-network use (n = 50), showed increased attentional impulsivity and reduced executive functions. No differences were observed in decision-making performance.

CONCLUSION

The findings indicate that problematic social-network use is related to attentional rather than general decision-making deficits. Furthermore, problematic social-network use is likely to co-occur with other problematic Internet-use behaviors, particularly gaming or shopping.

The role of the insula in internet gaming disorder

Internet gaming disorder (IGD) is a concerning issue that requires further research. Here, we seek to examine its neural etiology with an emphasis on the role of the insula. To do so, we relied on the tripartite neurocognitive model of addictive behaviors as applied to IGD. We hypothesized that (a) video game cues will elicit stronger reward system activation and weaker prefrontal activation in gamers vs controls, (b) the IGD scores of gamers will be positively associated with activation of the reward system and negatively with activation of prefrontal regions, (c) deprivation from video gaming will result in increased activation of the insula, when gamers are exposed to video game cues vs to neutral cues, and (d) in deprivation conditions, there will be positive and negative coupling, respectively, between activation of the insula and the reward and prefrontal regions in gamers. We tested these hypotheses with a design with one between-subjects factor (gamers vs controls) and two within-subjects factors: stimuli (gaming vs neutral; for all participants) and session (deprivation vs satiety; only for gamers). Findings based on functional magnetic resonance imaging (fMRI; applied to all 52 subjects, 26 gamers, and 26 controls) and psychophysiological interaction (PPI; applied to the 26 gamers) engaged in a video reactivity task supported our assertions. The IGD score positively correlated with activity in the right ventral striatum and negatively with activity in the right dorsolateral prefrontal cortex (DLPFC). Left insular cortex activity was the highest when observing video gaming cues under deprivation. Lastly, there was an increased coupling between the left insula and left ventral striatum and a decreased coupling with left DLPFC when observing video gaming cues compared with when watching control videos in the deprivation condition.

Snapchat vs. Facebook: Differences in problematic use, behavior change attempts, and trait social reward preferences

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Participants spent more time on Snapchat than Facebook.

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Participants reported more problematic use of Snapchat than Facebook.

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Participants reported more attempts to quit Facebook than Snapchat.

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Trait social rewards were positively associated with problematic social media use.

Introduction

Facebook and Snapchat employ different features for encouraging repeated, reinforced use of their platforms. Importantly, this repeated use can become maladaptive and problematic. We sought to understand differences between these platforms in regard to problematic use, and its motivations and outcomes. We specifically focused on trait social reward preferences as important yet overlooked motivations. We also focused on quit and use reduction attempts as important yet overlooked outcomes.

Methods

Participants (N = 472) responded to an online survey that assessed their Snapchat and Facebook use, as well as trait social reward preferences.

Results

Our findings, with individuals who used both Snapchat and Facebook, revealed that (a) participants reported more time on Snapchat than Facebook, as well as more problematic use of Snapchat than Facebook, nevertheless (b) they reported more attempts to quit Facebook than Snapchat, with no difference in use reduction attempts between platforms, and (c) trait social reward dimensions – admiration, negative social potency, and sociability – were positively associated with problematic Snapchat use, and only negative social potency was positively associated with problematic Facebook use.

Conclusions

These findings demonstrate the relevance of social media platform features and social reward preferences in problematic social media use. Implications for further research and practice are discussed.

Cognitive Correlates in Gaming Disorder and Social Networks Use Disorder: a Comparison

Purpose of Review

This overview aims at summarizing studies, which investigated cognitive correlates of gaming disorder and of a problematic use of social networks by using behavioral experimental paradigms and brain imaging techniques.

Recent Findings

Based on theoretical models, inhibition/inhibitory control, attentional bias, executive functions, decision-making, and working memory capabilities have been identified as cognitive components, which are assumed to play a crucial role in the development and maintenance of an addictive behavior. A systematic search shows that various studies have already examined the involvement of different cognitive components in both types of potential addictive behaviors. However, the number of studies addressing cognitive correlates of social networks use disorder is very much lower compared with gaming disorder, even if there is a positive trend in terms of new publications in recent years.

Summary

Cognitive correlates have been frequently investigated in gaming disorder, as in many other disorders due to substance use or addictive behaviors. Studies on cognitive aspects involved in a problematic social networks use are still rare, but they are needed in order to further show if this phenomenon may also deserve a classification as addictive disorder. Interactions between different cognitive and affective processes are still understudied in both gaming disorder and problematic social networks use.

Interactions between decision-making and emotion in behavioral-variant frontotemporal dementia and Alzheimer's disease

Negative and positive emotions are known to shape decision-making toward more or less impulsive responses, respectively. Decision-making and emotion processing are underpinned by shared brain regions including the ventromedial prefrontal cortex (vmPFC) and the amygdala. How these processes interact at the behavioral and brain levels is still unclear. We used a lesion model to address this question. Study participants included individuals diagnosed with behavioral-variant frontotemporal dementia (bvFTD, n = 18), who typically present deficits in decision-making/emotion processing and atrophy of the vmPFC, individuals with Alzheimer’s disease (AD, n = 12) who present with atrophy in limbic structures and age-matched healthy controls (CTRL, n = 15). Prior to each choice on the delay discounting task participants were cued with a positive, negative or neutral picture and asked to vividly imagine witnessing the event. As hypothesized, our findings showed that bvFTD patients were more impulsive than AD patients and CTRL and did not show any emotion-related modulation of delay discounting rate. In contrast, AD patients showed increased impulsivity when primed by negative emotion. This increased impulsivity was associated with reduced integrity of bilateral amygdala in AD but not in bvFTD. Altogether, our results indicate that decision-making and emotion interact at the level of the amygdala supporting findings from animal studies.

Neuromarketing as an Emotional Connection Tool Between Organizations and Audiences in Social Networks. A Theoretical Review

Currently, there is an important debate on how social networks have affected relations between organizations and their audiences: originally complementary –since organizations had full control over the messages that they sent to users, who were mere consumers of information–, they are now symmetric –since users produce and disseminate information about organizations on a global scale through social media–. Therefore, one of the main concerns of organizations when investing in social networks is to connect with their target audience, to have virality, greater visibility and scope. Likewise, neuromarketing is gaining significant importance when it comes to predicting user behavior through biometric measurements, so it can be an essential tool for developing content that engages organizations and their audiences. The main objective of this work is to conduct a theoretical review of the main scientific research on the effectiveness of neuromarketing as a tool to improve the emotional connection between organizations and users in social networks. Thus, the scientific literature on the object under study available on the Web Of Science has been extensively reviewed. The results of the analysis of the main researches in this field reveal the importance of neuromarketing: some of them agree that the communicative effectiveness between organizations and audiences in social networks depends more on sociology and psychology than on technology itself. Neuromarketing has also allowed to demonstrate the relevance of the so-called social influence in social networks: users tend to imitate the behaviors of others, under the premise that these actions reflect the appropriate procedure. That is, when a user sees that others in their environment comment or share a post, they tend to replicate that action in order to avoid the fear of being the only one who behaves differently.

Directing Technology Addiction Research in Information Systems

Technology-related addictions have become common in many societies. Consequently, IS research has started examining such issues. In these embryonic stages of research, this line of work has already shown some promise in terms of understanding and tackling technology addiction problems. Nevertheless, there is a need to step back and understand the roots of technology-related addictions and how their foundations evolved in reference disciplines in order to be able to conduct more scientifically informed research on such issues. This study, therefore, explains the concept of behavioral addictions (the family of addictions to which technology-related addictions presumably belong), reviews the field's history and evolution, explains the relevant brain circuitry, and discusses similarities and differences between behavioral and substance addictions. A synthesis of this information provides eight key observations and recommendations that should help the field move forward.

Cognitive biases and excessive use of social media: The facebook implicit associations test (FIAT)

Many theoretical accounts of addictive behaviors, including models of Internet use disorders, implicate cognitive biases in the formation and maintenance of excessive behaviors. Yet, little empirical evidence regarding the role of such biases, including implicit attitude, in the development and maintenance of excessive use of social media exists. We seek to bridge this gap in this study. To this end, we present the development of the Facebook Implicit Association Test (FIAT) and employ it in a sample of 220 Facebook users. The results (1) confirm the validity of the concept of implicit attitude and its measure in the context of social media, (2) demonstrate that implicit attitude is significantly positively associated with excessive use scores, in a magnitude similar to that observed for associations with substance use, and (3) show that implicit attitude is sheltered against social desirability bias, unlike self-reported and explicit measures, such as excessive use. Overall, this study builds theoretical and methodological foundations for further inquiries into the role of implicit attitude in research on the excessive use of social media.

Interactions of impulsivity, general executive functions, and specific inhibitory control explain symptoms of social-networks-use disorder: An experimental study

While the use of social media and online-communication applications has become an integral part of everyday life, some individuals suffer from an excessive, uncontrolled use of social media despite experiencing negative consequences. In accordance with neuropsychological models of addiction, we assume the tendency of a social-networks-use disorder to be related to an interplay of predisposing personality traits (e.g., impulsivity), and reductions in cognitive functions (e.g., executive functions, inhibitory control). The current study makes first strides towards examining this interplay. In addition to a newly developed social-networks-specific auditory Go-NoGo paradigm, other neuropsychological paradigms were used. Impulsivity and social-networks-use-disorder symptoms were assessed by standardized questionnaires. The results show that the symptom severity of a social-networks-use disorder is mainly associated with attentional impulsivity. General executive functions and specific inhibitory control of social-networks-related cues have no direct effect on symptom severity. However, moderated regression analyses emphasize that increased symptom severity is associated with higher attentional impulsivity, especially if there are additionally reductions in executive functions or specific inhibitory control. The results complement previous findings and inform future research on social-networks-use disorder. The findings support the applicability of theoretical models of addictive behaviors to the social-networks-use disorder and point to social-networks-related specificities regarding attention-related facets.

Wired to be connected? Links between mobile technology engagement, intertemporal preference and frontostriatal white matter connectivity

Youth around the world are increasingly dependent on social media and mobile smartphones. This phenomenon has generated considerable speculation regarding the impacts of extensive technology engagement on cognitive development and how these habits might be ‘rewiring’ the brains of those growing up in a heavily digital era. In an initial study conducted with healthy young adults, we utilized behavioral and self-report measures to demonstrate associations between smartphone usage habits (assessed both subjectively and objectively) and individual differences in intertemporal preference and reward sensitivity. In a follow-up neuroimaging study, we used probabilistic tractography of diffusion-weighted images to determine how these individual difference characteristics might relate to variation in white matter connectivity, focusing on two dissociable pathways—one connecting the ventral striatum (vSTR) with the ventromedial prefrontal cortex (vmPFC) and the other connecting the vSTR with the dorsolateral prefrontal cortex (dlPFC). Regression analyses revealed opposing patterns of association, with stronger vSTR–vmPFC connectivity corresponding to increased mobile technology engagement but stronger vSTR–dlPFC connectivity corresponding to decreased engagement. Taken together, the results of these two studies provide important foundational evidence for both neural and cognitive factors that can be linked to how individuals engage with mobile technology.

Food-Specific Inhibitory Control Mediates the Effect of Disgust Sensitivity on Body Mass Index

Disgust is an emotion that drives food avoidance. People vary in their responses to disgust, which is captured by their disgust sensitivity. Disgust sensitivity is clinically significant because it can influence eating behaviors, and indirectly people's body mass index (BMI). Inhibitory control can also influence BMI through the role that such reflective abilities play in governing food intake. In this study, we relied on neural models of disgust to suggest that disgust and inhibitory control are intertwined, and that inhibitory control facilitates the translation of disgust sensitivity into BMI. Mediation analyses applied to 46 subjects, including 29 normal body weight [BMI = 18.34 kg/m² (SD = 1.58)] and 17 overweight/obese [BMI = 26.03 kg/m² (SD = 2.58)] subjects, were used to test the hypothesis. Subjects completed the Chinese version of the Disgust Scale-Revised, and an inhibition control test (Food-Specific Stop-Signal Task). There were negative correlations between the disgust sensitivity score (DS) and body mass index (BMI), and between DS and stop-signal reaction time (SSRT). Moreover, BMI was positively correlated with SSRT. The mediation model results showed that disgust sensitivity was associated with BMI and that this relationship was mediated via inhibition control. There was no significant effect of DS on BMI, while the effect of SSRT on BMI was significant. This suggested that the effect of disgust sensitivity on BMI was fully mediated through food-specific inhibitory control. This supports our hypothesis that BMI is affected by disgust sensitivity and that this relationship is mediated by inhibition control. These findings reveal a key mechanism that underlies disgust sensitivity-BMI association and point to future research and potential interventions aimed at food intake management.

Lateral orbitofrontal gray matter abnormalities in subjects with problematic smartphone use

BACKGROUND AND AIMS

Smartphone use is becoming commonplace and exerting adequate control over smartphone use has become an important mental health issue. Little is known about the neurobiology underlying problematic smartphone use. We hypothesized that structural abnormalities in the fronto-cingulate brain region could be implicated in problematic smartphone use, similar to that has been reported for Internet gaming disorder and Internet addiction. This study investigated fronto-cingulate gray matter abnormalities in problematic smartphone users, particularly those who spend time on social networking platforms.

METHODS

The study included 39 problematic smartphone users with excessive use of social networking platforms via smartphone and 49 normal control male and female smartphone users. We conducted voxel-based morphometric analysis with diffeomorphic anatomical registration using an exponentiated Lie algebra algorithm. Region of interest analysis was performed on the fronto-cingulate region to identify whether gray matter volume (GMV) differed between the two groups.

RESULTS

Problematic smartphone users had significantly smaller GMV in the right lateral orbitofrontal cortex (OFC) than healthy controls, and there were significant negative correlations between GMV in the right lateral OFC and the Smartphone Addiction Proneness Scale (SAPS) score, including the SAPS tolerance subscale.

CONCLUSIONS

These results suggest that lateral orbitofrontal gray matter abnormalities are implicated in problematic smartphone use, especially in social networking platform overuse. Small GMV in the lateral OFC was correlated with an increasing tendency to be immersed in smartphone use. Our results suggest that orbitofrontal gray matter abnormalities affect regulatory control over previously reinforced behaviors and may underlie problematic smartphone use.

Intertemporal decision-making-related brain states predict adolescent drug abuse intervention responses

Adolescent drug misuse represents a major risk factor for long-term drug use disorders. However, wide individual differences in responses to first-line behavioral therapies targeting adolescent drug misuse limit critical early intervention. Identifying the neural signatures of those adolescents most likely to respond to an intervention would potentially guide personalized strategies for reducing drug misuse. Prior to a 14-week evidence-based intervention involving combinations of contingency management, motivational enhancement, and cognitive behavioral therapy, thirty adolescent alcohol and/or cannabis users underwent fMRI while performing a reward delay discounting (DD) task tapping an addiction-related cognition. Intervention responses were longitudinally characterized by both urinalysis and self-report measures of the percentage of days used during treatment and in post-treatment follow-up. Group independent component analysis (ICA) of task fMRI data identified neural processing networks related to DD task performance. Separate measures of wholesale recruitment during immediate reward choices and within-network functional connectivity among selective networks significantly predicted intervention-related changes in drug misuse frequency. Specifically, heightened pre-intervention engagement of a temporal lobe "reward motivation" network for impulsive choices on the DD task predicted poorer intervention outcomes, while modes of functional connectivity within the reward motivation network, a prospection network, and a posterior insula network demonstrated robust associations with intervention outcomes. Finally, the pre-intervention functional organization of the prospection network also predicted post-intervention drug use behaviors for up to 6 months of follow-up. Multiple functional variations in the neural processing networks supporting preference for immediate and future rewards signal individual differences in readiness to benefit from an effective behavioral therapy for reducing adolescent drug misuse. The implications for efforts to boost therapy responses are discussed.

The Insula: A Brain Stimulation Target for the Treatment of Addiction

Substance use disorders (SUDs) are a growing public health concern with only a limited number of approved treatments. However, even approved treatments are subject to limited efficacy with high long-term relapse rates. Current treatment approaches are typically a combination of pharmacotherapies and behavioral counselling. Growing evidence and technological advances suggest the potential of brain stimulation techniques for the treatment of SUDs. There are three main brain stimulation techniques that are outlined in this review: transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), and deep brain stimulation (DBS). The insula, a region of the cerebral cortex, is known to be involved in critical aspects underlying SUDs, such as interoception, decision making, anxiety, pain perception, cognition, mood, threat recognition, and conscious urges. This review focuses on both the preclinical and clinical evidence demonstrating the role of the insula in addiction, thereby demonstrating its promise as a target for brain stimulation. Future research should evaluate the optimal parameters for brain stimulation of the insula, through the use of relevant biomarkers and clinical outcomes for SUDs.

Little video-gaming in adolescents can be protective, but too much is associated with increased substance use

BACKGROUND

Studies have demonstrated inconsistent results regarding the association between video gaming time and substance use in teenagers. Understating intricacies of this association can help with substance use reduction in teenagers.

OBJECTIVES

This study aimed to untangle this complex relationship by theorizing and examining a U-shaped association.

METHODS

We analyzed two large samples (n₁ = 7313 [52.5% female] and n₂ = 8079 [51.6% female]) of 8th and 10th graders in the United States. Substance use was operationalized as the sum of self-reported number of lifetime use instances of 14 unprescribed substances. Video game use time (hours per week) was self-reported on a 1 (none) to 9 (40+) scale. Common covariates/risk factors were included.

RESULTS

Consistently across datasets, partial-correlation between squared video gaming time and substance use (r = .10, p < .001 in 2014 and r = .08, p < .001 in 2015) supported the hypothesized u-shaped association. Analysis of covariance revealed that teenagers playing video games for 1-5 h a week report on significantly fewer instances of substance use compared with non-gamers (p < .001-.007). Post hoc analyses revealed that those who play at least 30 h per week report on significantly (p < .001) more instances of substance use (3.92 in 2014 and 3.38 in 2015) compared with teenagers playing video games for 1-5 h a week (2.17 in 2015 and 1.96 in 2015).

CONCLUSIONS

Video gaming time and substance use follow a u-shaped association; light video gaming can be protective in terms of substance use, while too much video gaming is associated with increased substance use.

Short abstinence from online social networking sites reduces perceived stress, especially in excessive users

Online social networking sites (SNSs), such as Facebook, provide frequent and copious social reinforcers (e.g., "likes") delivered at variable time intervals. As a result, some SNS users display excessive, maladaptive behaviors on these platforms. Excessive SNS users, and typical users alike, are often aware of their intense use and psychological dependence on these sites, which may lead to elevated stress. In fact, research has demonstrated that use of SNSs alone induces elevated stress. Other research has begun to investigate the effects of short periods of SNS abstinence, revealing beneficial effects on subjective wellbeing. We aligned these two lines of research and hypothesized that a short period of SNS abstinence would induce a reduction in perceived stress, especially in excessive users. The results confirmed our hypothesis and revealed that both typical and excessive SNS users experienced reduction in perceived stress following SNS abstinence of several days. The effects were particularly pronounced in excessive SNS users. The reduction in stress was not associated with academic performance increases. These results indicate a benefit-at least temporarily-of abstinence from SNSs and provide important information for therapists treating patients who struggle with excessive SNS use.

Decision Making Deficits in Relation to Food Cues Influence Obesity: A Triadic Neural Model of Problematic Eating

In this review article we propose a model of the brain systems, the deficiency of which may underlie problematic eating. This integrative model is based on studies that have focused on discrete brain components involved in problematic eating, combined with insights from studies on the neurocognitive basis of other addictive and problematic behaviors. The model includes: (a) a hyper-functioning reward anticipation and processing system (amygdala-striatum dependent) in response to food-related cues; (b) a hypo-functioning reflective and inhibitory control system (prefrontal cortex dependent), that fails to anticipate and properly weigh future outcomes; and (c) an altered interoceptive awareness system (insular cortex dependent) that translates homeostatic violation signals into a strong consumption desire that hijacks the inhibitory system and excites the reward system. We posit that when the abovementioned systems are imbalanced in such a way that the dopamine axis is hyperactive in relation to food cues and the inhibitory system is weak, and this is further aggravated by an altered interoceptive awareness system, people may experience loss of control or inability to resist tempting/rewarding foods. This loss of control over food consumption can explain, at least in part, the development of excess weight and contribute to the obesity epidemic.