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Sidlak A, Dibble B, Dhaliwal M, Bottone P, Marino R, Henry L, Howell J. Analysis of rising cases of adolescent opioid use presentations to the emergency department and their management. Drug Alcohol Depend 2024; 258:111136. [PMID: 38518662 DOI: 10.1016/j.drugalcdep.2024.111136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 02/13/2024] [Accepted: 02/17/2024] [Indexed: 03/24/2024]
Abstract
OBJECTIVE We sought to answer the question of how adolescents (ages 12-17 years old) with opioid-related presentations are currently managed in the ED. The two main outcomes were the proportion of visits where naloxone and buprenorphine were both used and prescribed, and the rate of revisits to the emergency department in the six months following ED presentation. METHODS This was a multi-center retrospective cross-sectional study. We studied patients presenting to the ED who were 12-17 years old with an opioid-related presentation. RESULTS Two-hundred and thirty-one patients were identified out of 571 encounters screened. Of these presentations, 77/231 (33%) were girls and 154/231 (67%) were boys. The majority of patients were Latino (64%; n=147); 26% were white (n=59), 6% were middle eastern or Arab (14), and 4% were black (10). Incidence of opioid use disorder per 100,000 presentations increased by 2800% from 2014 to 2022 (21/100,000 +/- 10 [2014] to 600/100,000 +/- 50 [2022]). A plurality of cases was related to opioid withdrawal (42%; 97). On discharge from the ED, 29% of patients received naloxone. For patients in withdrawal, 4% received a prescription for buprenorphine. Twenty-nine percent of patients had a return to the ED in the six months following initial visit. CONCLUSIONS Adolescent opioid-related presentations to the ED are rapidly increasing. Increasing ED presentations, compounded by a high 6-month revisit rate, pose a management challenge amid limited outpatient resources for this population. Opioid agonist therapy and naloxone are not routinely provided. Increasing the use of both are two ways to improve the quality of care for this population.
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Affiliation(s)
- Alexander Sidlak
- Inova Fairfax Hospital, Emergency Department, Falls Church, VA, United States.
| | - Brent Dibble
- Inova Fairfax Hospital, Emergency Department, Falls Church, VA, United States
| | - Mannet Dhaliwal
- University of Virginia Medical School, Charlottesville, VA, United States
| | - Paul Bottone
- Children's Hospital of Pennsylvania, Division of Adolescent Medicine, Philadelphia, PA, United States
| | - Ryan Marino
- University Hospitals, Division of Toxicology and Addiction Medicine, Cleveland, OH, United States
| | - Linda Henry
- Inova Fairfax Hospital, Medicine Service Line, Falls Church, VA, United States
| | - John Howell
- Inova Fairfax Hospital, Emergency Department, Falls Church, VA, United States
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2
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Manuel JI, Baslock D, DeBarros T, Halliday T, Pietruszewski P, Plante A, Razaa JW, Sloyer W, Stanhope V. Factors Associated With Indirect Exposure to and Knowledge of Fentanyl Among Youth. J Adolesc Health 2024; 74:312-319. [PMID: 37921731 DOI: 10.1016/j.jadohealth.2023.08.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 08/15/2023] [Accepted: 08/28/2023] [Indexed: 11/04/2023]
Abstract
PURPOSE Using data from an online assessment of youth in the United States, this study examined factors associated with youth's indirect exposure to fentanyl; factors related to youth's level of knowledge of fentanyl; and sources of substance use information obtained by youth. METHODS This is a secondary analysis of data from a cross-sectional online assessment of youth ages 13 to 18 in the United States in 2022. Participants self-reported on substance use knowledge and concerns, indirect exposure to substance use, access to substance use information and resources, the extent to which youth discussed drug use harms with someone, and COVID-related stress. RESULTS Analyses revealed that most youth did not have knowledge of fentanyl even though they reported indirect likely exposure to fentanyl. Youth concerned about alcohol or drug use in their own life were less likely to have knowledge of fentanyl and more likely to know someone who, if using drugs, would likely be exposed to fentanyl. A significant risk factor of indirect likely exposure to fentanyl was COVID-related stress. Prevalent sources of information included the internet, social media, friends or peers, and school classes. DISCUSSION While youth may have close proximity to fentanyl exposure and a degree of understanding of fentanyl, there is a general lack of knowledge of the substance, a critical gap that future substance use prevention initiatives could fill.
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Affiliation(s)
- Jennifer I Manuel
- University of Connecticut School of Social Work, Hartford, Connecticut.
| | - Daniel Baslock
- New York University Silver School of Social Work, New York, New York
| | - Tania DeBarros
- New York University Silver School of Social Work, New York, New York
| | - Teresa Halliday
- National Council for Mental Wellbeing, Washington, District of Columbia
| | - Pam Pietruszewski
- National Council for Mental Wellbeing, Washington, District of Columbia
| | - Alexandra Plante
- National Council for Mental Wellbeing, Washington, District of Columbia
| | | | - William Sloyer
- National Council for Mental Wellbeing, Washington, District of Columbia
| | - Victoria Stanhope
- New York University Silver School of Social Work, New York, New York
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3
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Rong F, Wang M, Peng C, Cheng J, Ding H, Wang Y, Yu Y. Association between mobile phone addiction, chronotype and nonsuicidal self-injury among adolescents: A large-scale study in China. Addict Behav 2023; 144:107725. [PMID: 37087768 DOI: 10.1016/j.addbeh.2023.107725] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 03/07/2023] [Accepted: 04/12/2023] [Indexed: 04/25/2023]
Abstract
BACKGROUND Nonsuicidal self-injury (NSSI) is a serious public health and clinical problem, particularly for adolescents, and may link to problematic smartphone use (PSU) and chronotype. This study examines the independent and interaction effects of PSU and chronotype on NSSI among adolescents and identified gender differences in these associations. METHODS A total of 21,357 students aged 11-19 were recruited using stratified cluster sampling across five representative provinces in China and completed standard questionnaires to record details of PSU, chronotype, and NSSI. RESULTS A total of 38.1 % of students reported having engaged in NSSI and 17.7 % had PSU. PSU and chronotype were significantly associated with NSSI among adolescents, and this relationship was stronger in females. Interaction analysis indicated that E-type and PSU were interactively associated with increased risks of NSSI. CONCLUSION The findings suggest that E-type and PSU can increase the risk of NSSI both independently and interactively. Therefore, they should be considered in intervention programs for NSSI, especially for females.
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Affiliation(s)
- Fajuan Rong
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mengni Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chang Peng
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Junhan Cheng
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hongli Ding
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yizhen Yu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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4
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Liu J, Gao Y, Liang C, Liu X. The potential addictive mechanism involved in repetitive nonsuicidal self-injury: The roles of emotion dysregulation and impulsivity in adolescents. J Behav Addict 2022; 11:953-962. [PMID: 36287740 PMCID: PMC9881659 DOI: 10.1556/2006.2022.00077] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 08/01/2022] [Accepted: 10/08/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND AND AIMS Nonsuicidal self-injury (NSSI) is highly prevalent in adolescents and is associated with various mental health problems. Repetitive NSSI (R-NSSI), as an extreme manifestation of NSSI, is a growing concern and has been proposed as a behavioral addiction. However, little is known about the potential addictive mechanisms of NSSI. This study aimed to examine the mediating effect of emotion dysregulation and the moderating effect of impulsivity using the Interaction of Person-Affect-Cognition-Execution (I-PACE) model in adolescents who repeatedly engage in NSSI. METHODS A total of 3,915 adolescents (mean age = 13.21 years, SD = 0.87, 57.6% male) were recruited from three middle schools. Relevant questionnaires were used to evaluate childhood maltreatment, emotion dysregulation, impulsivity, and NSSI. Mediation and moderated mediation analyses were conducted separately for adolescents with occasional NSSI (O-NSSI) and R-NSSI to assess the relationship between childhood maltreatment, emotion dysregulation, impulsivity, and NSSI frequency. RESULTS Our study found that childhood maltreatment was directly related to NSSI and indirectly related to NSSI through emotion dysregulation in both the R-NSSI and O-NSSI groups. Furthermore, impulsivity played a moderating role in the relationship between emotion dysregulation and NSSI in the R-NSSI group but not in the O-NSSI group. DISCUSSION AND CONCLUSIONS The findings suggest that a high level of impulsivity and a high level of emotion dysregulation may be important risk addictive factors of NSSI through childhood maltreatment. Strengthening the emotion regulation skills and inhibitory control of adolescents with NSSI would be helpful to reduce their self-injury behaviors and maintain their mental health. This finding also supports the validity of the I-PACE model for evaluating R-NSSI.
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Affiliation(s)
- Jinmeng Liu
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Yemiao Gao
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Chunxi Liang
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Xia Liu
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China,Corresponding author. E-mail:
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Georgieva E, Benkova K, Vlaeva N, Karamalakova Y, Miteva R, Abrashev H, Nikolova G. Is Illicit Substance Use Gender-Specific? The Basic Points of Mental and Health Disorders. TOXICS 2022; 10:toxics10070344. [PMID: 35878250 PMCID: PMC9323370 DOI: 10.3390/toxics10070344] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/15/2022] [Accepted: 06/20/2022] [Indexed: 12/20/2022]
Abstract
Among the groups of users of illicit substances, a high percentage are persons deprived of their liberty; at the same time, each social and age group is also affected, to one degree or another. The purpose of this study is to provide general data on the relationship between different psychostimulants, clinical and socio-demographic studies, and gender, both among the general population and in one of the most at-risk groups. This review identifies the use of illicit substances as gender-specific in the general population. A detailed study of the causal relationship between the use of illicit substances and gender was carried out. Electronic databases Academic Search Complete, PubMed, HealthCare, Web of Science, and Google Scholar were searched for relevant studies up to 2022 associated with drug abuse and mental and health disorders. The analysis indicated that the human population showed significant differences between the sex of the consumer as to the type of drug consumers, development of addiction, and relapse. We focus on the pathological changes caused by drug use, the personal and physiological individual traits that influence drug choice, and the extent of use in one of the most affected groups of individuals. The study may provide some guidance in developing gender-specific treatment and prevention, including response to some pharmacological and behavioral therapies. The review is intended for a wide audience of social workers, toxicologists, and pharmacologists.
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Affiliation(s)
- Ekaterina Georgieva
- Department of General and Clinical Pathology, Forensic Medicine, Deontology and Dermatovenerology, Faculty of Medicine, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria; (E.G.); (R.M.)
- Department of Medical Psychology, Social Activities and Foreign Languages, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria; (K.B.); (N.V.)
- Department of Chemistry and Biochemistry, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria;
| | - Krasimira Benkova
- Department of Medical Psychology, Social Activities and Foreign Languages, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria; (K.B.); (N.V.)
| | - Nadya Vlaeva
- Department of Medical Psychology, Social Activities and Foreign Languages, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria; (K.B.); (N.V.)
| | - Yanka Karamalakova
- Department of Chemistry and Biochemistry, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria;
| | - Radostina Miteva
- Department of General and Clinical Pathology, Forensic Medicine, Deontology and Dermatovenerology, Faculty of Medicine, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria; (E.G.); (R.M.)
| | - Hristo Abrashev
- Department of Vascular Surgery, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria;
| | - Galina Nikolova
- Department of Chemistry and Biochemistry, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria;
- Correspondence: ; Tel.: +359-897-771-301
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Jo SJ, Yim HW, Jeong H, Lee HK. Moderating Effects of Depressive Symptoms and Self-Control Trait on the Association Between Problematic Internet Gaming and Time Spent. CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2022; 25:237-244. [PMID: 35363564 DOI: 10.1089/cyber.2021.0221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This study was performed to examine whether depressive symptoms (DPs) and low self-control (LSC) traits has modifying effects on the association of time spent on Internet gaming and problematic Internet game use (PIGU). Among 1,535 middle school students, 42.1 percent reported playing ≥1.5 hours of Internet games/day on average, and 10.0 percent were classified as PIGU. Stratified multiple logistic regression analysis showed gameplay of ≥1.5 hours/day led to more PIGU in the non-LSC traits group (higher DP group, p < 0.001; lower group, p = 0.019). In LSC trait group, in contrast, time spent on Internet gamine was not associated with PIGU regardless of the level of DP. Adolescents without LSC traits, to which most youths belong, might have higher possibility of PIGU if they do not limit their time spent on Internet gaming, regardless of whether they are depressed or not. In case of LSC trait, additional strategies would be needed. ClinicalTrials.gov identifier: NCT02415322.
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Affiliation(s)
- Sun-Jin Jo
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyeon Woo Yim
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyunsuk Jeong
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hae Kook Lee
- Department of Psychiatry, The Catholic University of Korea Uijongbu St. Mary's Hospital, Seoul, Republic of Korea
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7
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Ciccarelli M, Cosenza M, Nigro G, Griffiths M, D’Olimpio F. Gaming and gambling in adolescence: the role of personality, reflective functioning, time perspective and dissociation. INTERNATIONAL GAMBLING STUDIES 2021. [DOI: 10.1080/14459795.2021.1985583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
| | - Marina Cosenza
- Università Degli Studi Della Campania “Luigi Vanvitelli”
| | - Giovanna Nigro
- Università Degli Studi Della Campania “Luigi Vanvitelli”
| | - Mark Griffiths
- Psychology Department, Nottingham Trent University, Nottingham, UK
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Bar-Or RL, Kor A, Jaljuli I, Lev-Ran S. The Epidemiology of Substance Use Disorders among the Adult Jewish Population in Israel. Eur Addict Res 2021; 27:362-370. [PMID: 33730716 DOI: 10.1159/000513776] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 12/11/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Substance use disorders (SUDs) are a leading cause of morbidity and mortality worldwide, having a profound and global impact on health, well-being, safety, and productivity. Although traditionally the prevalence of SUDs in Israel has been estimated to be lower than those in high-income countries, estimates and characteristics of individuals with SUDs in the past decade are lacking. In this work, we explored the prevalence of SUDs among the adult Jewish population in Israel, per different classes of substances across sex, age group, and other sociodemographic factors. METHODS Data from an online representative sample of 4,025 respondents were collected, including the alcohol, smoking, and substance involvement screening test (ASSIST) metric and sociodemographic data. RESULTS We found that the most common SUDs were alcohol (10.5% [9.5-11.4]), cannabis (9.0% [8.2-9.9]), and sedative (3.6% [3.0-4.2]) use disorders. Alcohol-cannabis (3.2% [2.7-3.7]) and alcohol-sedative (1.04% [0.7-1.35]) were the most prevalent co-occurring SUDs. Among those with cannabis use disorder, the prevalence of alcohol use disorder was found to be 35.3% [30.4-40.2]. The estimated risk for alcohol use disorder was found to be inversely proportional to age, cannabis use disorder increased, peaked, and decreased with age, and that of sedative use disorder increased with age, particularly among women. While older individuals (in the 51-60 years of age group) were at lower risk (OR = 0.5 [0.3, 0.8]) compared to those <20 years of age for alcohol use disorder, they were at increased risk for sedative use disorder (OR = 3.1 [1.2, 9.7]). CONCLUSIONS These findings represent substantially higher rates of SUDs in Israel than those previously reported and should affect resources allocated to addiction prevention and treatment. Further research on the role of gender, age, culture, and ethnicity in the propensity to develop SUDs is necessary for the development of more focused preventive and intervention measures. Focusing on non-Jewish populations in Israel and broadening the scope to include behavioral addictions should be addressed in future studies.
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Affiliation(s)
- Ruth Lev Bar-Or
- Israel Center on Addiction (ICA), Netanya, Israel, .,Hadassah School of Public Health and Community Medicine, Hebrew University, Jerusalem, Israel,
| | - Ariel Kor
- Israel Center on Addiction (ICA), Netanya, Israel.,Interdisciplinary Center (IDC), Herzliya, Israel.,Yale School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Iman Jaljuli
- Department of Statistics and Operations Research, Tel-Aviv University, Tel-Aviv, Israel
| | - Shaul Lev-Ran
- Israel Center on Addiction (ICA), Netanya, Israel.,Lev-Hasharon Medical Center, Netanya, Israel.,Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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9
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Greenberg NR, Zhai ZW, Hoff RA, Krishnan-Sarin S, Potenza MN. Problematic shopping and self-injurious behaviors in adolescents. J Behav Addict 2020; 9:1068-1078. [PMID: 33289692 PMCID: PMC8969728 DOI: 10.1556/2006.2020.00093] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 09/27/2020] [Accepted: 10/30/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS Self-injurious behaviors (SIBs) and problematic shopping (PS) are both prevalent in adolescents. These behaviors have been proposed as behavioral addictions and linked to impulsivity (Imp) and sensation-seeking (SS). They are also associated with negative mental health and psychosocial measures. This study examined relationships between PS and SIB in adolescents. It also examined how PS and SIB relate to Imp and SS, and interactions between PS and SIB in relation to health/functioning measures. METHODS Survey data from 2,624 Connecticut high-school students were evaluated using chi-square analyses. Next, logistic regression models were used to assess relationships between PS and measures of SIB. T-tests compared Imp and SS in adolescents with and without PS and SIB. Interaction analyses assessed effects of PS on relationships between SIB and health/functioning measures. RESULTS Adolescents with PS had 3.43-fold higher odds of endorsing lifetime SIB than those without PS, and were more likely to exhibit severe SIB and disruption due to SIB. PS and SIB were associated with elevated Imp and SS. Interaction analyses revealed that in adolescents with PS, the relationships between SIB and substance use was weaker than in adolescents without PS. This suggests PS accounts for variance in relationships between SIB and substance use. DISCUSSION AND CONCLUSIONS PS is strongly related to SIB prevalence, severity, and impairment in adolescents, and weakens associations between SIB and substance use. PS should therefore be considered for prevention efforts for SIB. Further research should investigate mechanisms connecting PS and SIB and explore possible interventions targeting associated features like Imp and SS.
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Affiliation(s)
| | - Zu Wei Zhai
- Program in Neuroscience, Middlebury College, Middlebury, VT, USA,Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Rani A. Hoff
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | | | - Marc N. Potenza
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA,Connecticut Mental Health Center, New Haven, CT, USA,Connecticut Council on Problem Gambling, Wethersfield, CT, USA,Child Study Center, Yale School of Medicine, New Haven, CT, USA,Department of Neuroscience, Yale University, New Haven, CT, USA,Corresponding author.
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10
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Aly SM, Omran A, Gaulier JM, Allorge D. Substance abuse among children. Arch Pediatr 2020; 27:480-484. [PMID: 33011026 DOI: 10.1016/j.arcped.2020.09.006] [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: 04/04/2020] [Revised: 07/21/2020] [Accepted: 09/11/2020] [Indexed: 10/23/2022]
Abstract
Substance abuse (SA) among children is a recognized challenge for policymakers and law enforcement and has life-threatening consequences owing to the impact on the children's development and the consequent increase in vulnerability. This work outlines several important issues related to SA among children: (1) SA prevalence including onset, common examples, extent, and spectrum of SA; (2) the presence of new psychoactive substances, which are rapidly spreading worldwide with limitations regarding their prevalence, detection, and interventions; (3) street children and their recruitment in drug supply; (4) SA and substance use disorder pathways, risk and protective factors for the development of SA; (5) SA consequences in the case of early initiation, including deaths; and (6) current preventive interventions for the pediatric population. In conclusion, this challenge requires consistent and unremitting attention in order to execute effective prevention programs with continuous re-evaluation of the situation.
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Affiliation(s)
- Sanaa M Aly
- Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt; CHU Lille, Unité Fonctionnelle de Toxicologie, Lille, France.
| | - Ahmed Omran
- Pediatrics and Neonatology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt(d)
| | - Jean-Michel Gaulier
- CHU Lille, Unité Fonctionnelle de Toxicologie, Lille, France; Université de Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, Lille, France
| | - Delphine Allorge
- CHU Lille, Unité Fonctionnelle de Toxicologie, Lille, France; Université de Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, Lille, France
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11
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Lee A, Lo A, Li Q, Keung V, Kwong A. Health Promoting Schools: An Update. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2020; 18:605-623. [PMID: 32291699 PMCID: PMC7156290 DOI: 10.1007/s40258-020-00575-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
The concept of a Health Promoting School has been found to be effective to improve health and well-being of students as well as a help with teaching and learning in school. Effective implementation of Health Promoting School is a complex intervention involving multi-factorial and innovative activity in many domains such as curriculum, school environment and community. Many studies evaluating Health Promoting School do not include outcomes reflecting the organisational or structural change as many of those studies are quantitative in nature and the statistical assumptions are not valid reflecting the organisational structure changes. Recent global meetings of experts have reviewed the impact on student health from the perspectives of school environment, school policies on health, action competencies on healthy living and community linkage. The English Wessex Healthy School Award Scheme and the Hong Kong Healthy School Awards Scheme have developed detailed systems to analyse whether each individual school has reached the standard of a model Health Promoting School reflecting a more holistic appreciation and understanding of all the effects of school-based health promotion with positive award-related changes. However, not many schools are able to implement Health Promoting School in its entirety, so cores indicators are needed as a starting point for wider implementation. Hong Kong Healthy School Awards Scheme is still ongoing with data for analysis of indicators with significant correlation with better health and well-being. We identified the core indicators and substantiated the requirements for successful outcomes by supplementing the established award-scheme framework with a review of recent literature and documents. Framework of Health Promoting School would go beyond improvement of health literacy to enable a more efficient system for education and health on children, hence a good investment in children.
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Affiliation(s)
- Albert Lee
- Centre for Health Education and Health Promotion, The Chinese University of Hong Kong, 4th Floor, Lek Yuen Health Centre, Shatin, New Territory, Hong Kong.
- JC School of Public Health, The Chinese University of Hong Kong, Shatin, Hong Kong.
| | - Amelia Lo
- Centre for Health Education and Health Promotion, The Chinese University of Hong Kong, 4th Floor, Lek Yuen Health Centre, Shatin, New Territory, Hong Kong
| | - Queenie Li
- Centre for Health Education and Health Promotion, The Chinese University of Hong Kong, 4th Floor, Lek Yuen Health Centre, Shatin, New Territory, Hong Kong
| | - Vera Keung
- Centre for Health Education and Health Promotion, The Chinese University of Hong Kong, 4th Floor, Lek Yuen Health Centre, Shatin, New Territory, Hong Kong
| | - Amy Kwong
- Centre for Health Education and Health Promotion, The Chinese University of Hong Kong, 4th Floor, Lek Yuen Health Centre, Shatin, New Territory, Hong Kong
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Kumar R, Kumar KJ, Benegal V, Roopesh BN, Ravi GS. Integrated intervention program for alcoholism improves impulsiveness and disadvantageous reward processing/risk-taking. Indian J Psychiatry 2020; 62:384-391. [PMID: 33165375 PMCID: PMC7597712 DOI: 10.4103/psychiatry.indianjpsychiatry_103_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 03/23/2020] [Accepted: 04/10/2020] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Impulsivity and aberrant reward processing are the core features of substance use disorders, including alcoholism. The present study examined the effects of an Integrated Intervention Program for Alcoholism (IIPA) on impulsiveness and disadvantageous reward processing/risk-taking in persons with alcoholism. MATERIALS AND METHODS The study adopted age- and education-matched (±1 year) randomized control design with the pre-post comparison. The sample comprised 50 persons with alcoholism. They were allotted randomly into two groups, the intervention (IIPA) group and treatment as usual (TAU) group (n = 25 in each). Participants were assessed at pre-intervention on impulsivity (Barratt's Impulsiveness Scale) and decision-making task, which reflects reward processing deficits (modified Iowa gambling task [mIGT]). The TAU group received usual treatment for alcoholism (i.e., pharmacotherapy; three sessions in a week group therapy on relapse prevention and six sessions in week yoga) for 18 days. The intervention group received IIPA along with usual treatment (except yoga). Outcome assessment was repeated after 18 days of intervention. RESULTS Both groups were comparable at pre-intervention (baseline). However, the intervention (IIPA) group showed a significant reduction in impulsivity and selection from disadvantageous decks on mIGT at post-intervention, while the TAU group had no significant change. CONCLUSION The findings suggest that IIPA could improve impulsivity and disadvantageous reward processing/risk-taking in persons with alcoholism. These are core features of substance use disorders and could pose a high chance for relapse after treatment. Further studies may examine improving these characteristics with IIPA and its impact on treatment outcomes such as relapse rate and maintaining sobriety.
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Affiliation(s)
- Rajesh Kumar
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Keshav J Kumar
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Vivek Benegal
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Bangalore N Roopesh
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Girikematha S Ravi
- Department of Biostatistics, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Abstract
BACKGROUND Exercise dependence (EXD) can be considered an addictive behaviour because it presents signs typical of other addictive behaviours. Despite possible health problems related to EXD, the prevalence of risk for EXD has never been systematically reviewed. OBJECTIVE This article aimed to systematically review the prevalence of risk for EXD. METHODS Studies were identified from searches in the ERIC, PsycINFO, PubMed, Scopus, SPORTDiscus, and Web of Science electronic databases up to June 2018. Empirical studies were selected if (1) they included the outcomes of the prevalence of EXD; (2) participants were regular exercisers; and (3) they were published in either the English, French, Portuguese, or Spanish languages. A total of 34 articles met the inclusion criteria. RESULTS The prevalence of risk for EXD was estimated to be between 3 and 7% of regular exercisers and the university student population, and between 6 and 9% of the athlete population. CONCLUSION The results of this review indicated that the prevalence of risk for EXD varies with the characteristics of the exerciser, but an overall prevalence of 3-9% is estimated. Risk for EXD is a cause for concern and, from a public health point of view, is a problem that has to be addressed.
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Datta U, Schoenrock SE, Bubier JA, Bogue MA, Jentsch JD, Logan RW, Tarantino LM, Chesler EJ. Prospects for finding the mechanisms of sex differences in addiction with human and model organism genetic analysis. GENES, BRAIN, AND BEHAVIOR 2020; 19:e12645. [PMID: 32012419 PMCID: PMC7060801 DOI: 10.1111/gbb.12645] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 01/26/2020] [Accepted: 01/27/2020] [Indexed: 02/06/2023]
Abstract
Despite substantial evidence for sex differences in addiction epidemiology, addiction-relevant behaviors and associated neurobiological phenomena, the mechanisms and implications of these differences remain unknown. Genetic analysis in model organism is a potentially powerful and effective means of discovering the mechanisms that underlie sex differences in addiction. Human genetic studies are beginning to show precise risk variants that influence the mechanisms of addiction but typically lack sufficient power or neurobiological mechanistic access, particularly for the discovery of the mechanisms that underlie sex differences. Our thesis in this review is that genetic variation in model organisms are a promising approach that can complement these investigations to show the biological mechanisms that underlie sex differences in addiction.
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Affiliation(s)
- Udita Datta
- Center for Systems Neurogenetics of Addiction, The Jackson LaboratoryBar HarborMaine
| | - Sarah E. Schoenrock
- Center for Systems Neurogenetics of Addiction, Department of GeneticsUniversity of North Carolina at Chapel HillChapel HillNorth Carolina
| | - Jason A. Bubier
- Center for Systems Neurogenetics of Addiction, The Jackson LaboratoryBar HarborMaine
| | - Molly A. Bogue
- Center for Systems Neurogenetics of Addiction, The Jackson LaboratoryBar HarborMaine
| | - James D. Jentsch
- Center for Systems Neurogenetics of Addiction, PsychologyState University of New York at BinghamtonBinghamtonNew York
| | - Ryan W. Logan
- Center for Systems Neurogenetics of Addiction, PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPennsylvania
| | - Lisa M. Tarantino
- Center for Systems Neurogenetics of Addiction, Department of GeneticsUniversity of North Carolina at Chapel HillChapel HillNorth Carolina
| | - Elissa J. Chesler
- Center for Systems Neurogenetics of Addiction, The Jackson LaboratoryBar HarborMaine
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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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16
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Chung T, Sum S, Chan M, Lai E, Cheng N. Will esports result in a higher prevalence of problematic gaming? A review of the global situation. J Behav Addict 2019; 8:384-394. [PMID: 31553236 PMCID: PMC7044624 DOI: 10.1556/2006.8.2019.46] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS Video gaming is highly prevalent in modern culture, particularly among young people, and a healthy hobby for the majority of users. However, in recent years, there has been increasing global recognition that excessive video gaming may lead to marked functional impairment and psychological distress for a significant minority of players. Esports is a variant of video gaming. It is a relatively new phenomenon but has attracted a considerable number of followers across the world and is a multimillion dollar industry. The aim of this briefing paper is to review the global situation on esports and related public health implications. METHODS A non-systematic review was conducted. Information obtained from the Internet and PubMed was collated and presented as genres of games, varieties and magnitudes of impacts, popularity, fiscal impact in monetary terms, government involvement, and public health implications. RESULTS There are several different kinds of esports but there was no clear categorization on the genre of games. Many tournaments have been organized by gaming companies across the world with huge prize pools, and some of these events have government support. Little information on the health effects associated with esports was identified. DISCUSSION AND CONCLUSIONS A majority of the sources of information were from commercial settings, and failed to declare conflicts of interest, which may result in a biased picture of the current situation. When gaming activity is being further promoted under the umbrella of esports, it seems reasonable to expect an increase in problematic gaming and thus increased prevalence of gaming disorder and hazardous gaming. With increasing demand for treatment services for gaming addition/disorder in different countries across the world, it is a significant public health concern. More empirically based research on this topic is needed.
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Affiliation(s)
- Thomas Chung
- Student Health Service, Department of Health, Hong Kong SAR, China,Corresponding author: Thomas Chung; Consultant Community Medicine; Family and Student Health Services, Department of Health, 4/F Lam Tin Polyclinic, 99 Kai Tin Road, Kwun Tong, Hong Kong SAR, China; Phone: +852 3163 4608; Fax: +852 2717 1720; E-mail:
| | - Simmy Sum
- Student Health Service, Department of Health, Hong Kong SAR, China
| | - Monique Chan
- Student Health Service, Department of Health, Hong Kong SAR, China
| | - Ely Lai
- Student Health Service, Department of Health, Hong Kong SAR, China
| | - Nanley Cheng
- Student Health Service, Department of Health, Hong Kong SAR, China
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Abstract
BACKGROUND Impulsivity is considered to be a vulnerability marker for substance use disorders, including alcoholism, in offspring with familial alcoholism. However, it is not adequately explored whether different age groups offspring at high risk for alcoholism differ in their impulsivity. The present study examined trait impulsivity in offspring at high risk for alcoholism, and further examined impulsivity by categorizing these offspring into different age groups. The study also examined the association between impulsivity and age, and the association of executive functions with age and education. MATERIALS AND METHODS Sample consisted of alcohol-naïve offspring at high (n = 34) and low (n = 34) risk for alcoholism. Participants were matched on age (±1 year), education (±1 year), and gender. The measures included were: Mini-international neuropsychiatric interview, family interview for genetic studies, sociodemographic data sheet, Annett's handedness questionnaire, Barratt's Impulsiveness Scale-version 11, and tests assessing executive functions. RESULTS Offspring at high risk for alcoholism demonstrated significantly high impulsivity. Furthermore, offspring at high risk were categorized into three subgroups with age. Results showed no significant difference between the subgroups with respect to impulsivity. Correlation analysis revealed no significant association between impulsivity and age. However, executive functions (concept formation, working memory, and safe decision-making) showed significant positive association, while perseveration and risky decision-making showed a negative association with age and education in both the groups. CONCLUSION The present study demonstrates high impulsivity trait in offspring at high risk for alcoholism. The high impulsivity could pose a risk for addiction and may require preventive intervention.
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Affiliation(s)
- Rajesh Kumar
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Keshav J Kumar
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Vivek Benegal
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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18
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Fineberg NA, Demetrovics Z, Stein DJ, Ioannidis K, Potenza MN, Grünblatt E, Brand M, Billieux J, Carmi L, King DL, Grant JE, Yücel M, Dell'Osso B, Rumpf HJ, Hall N, Hollander E, Goudriaan A, Menchon J, Zohar J, Burkauskas J, Martinotti G, Van Ameringen M, Corazza O, Pallanti S, Chamberlain SR. Manifesto for a European research network into Problematic Usage of the Internet. Eur Neuropsychopharmacol 2018; 28:1232-1246. [PMID: 30509450 PMCID: PMC6276981 DOI: 10.1016/j.euroneuro.2018.08.004] [Citation(s) in RCA: 167] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 07/18/2018] [Accepted: 08/07/2018] [Indexed: 12/24/2022]
Abstract
The Internet is now all-pervasive across much of the globe. While it has positive uses (e.g. prompt access to information, rapid news dissemination), many individuals develop Problematic Use of the Internet (PUI), an umbrella term incorporating a range of repetitive impairing behaviours. The Internet can act as a conduit for, and may contribute to, functionally impairing behaviours including excessive and compulsive video gaming, compulsive sexual behaviour, buying, gambling, streaming or social networks use. There is growing public and National health authority concern about the health and societal costs of PUI across the lifespan. Gaming Disorder is being considered for inclusion as a mental disorder in diagnostic classification systems, and was listed in the ICD-11 version released for consideration by Member States (http://www.who.int/classifications/icd/revision/timeline/en/). More research is needed into disorder definitions, validation of clinical tools, prevalence, clinical parameters, brain-based biology, socio-health-economic impact, and empirically validated intervention and policy approaches. Potential cultural differences in the magnitudes and natures of types and patterns of PUI need to be better understood, to inform optimal health policy and service development. To this end, the EU under Horizon 2020 has launched a new four-year European Cooperation in Science and Technology (COST) Action Programme (CA 16207), bringing together scientists and clinicians from across the fields of impulsive, compulsive, and addictive disorders, to advance networked interdisciplinary research into PUI across Europe and beyond, ultimately seeking to inform regulatory policies and clinical practice. This paper describes nine critical and achievable research priorities identified by the Network, needed in order to advance understanding of PUI, with a view towards identifying vulnerable individuals for early intervention. The network shall enable collaborative research networks, shared multinational databases, multicentre studies and joint publications.
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Affiliation(s)
- N A Fineberg
- Hertfordshire Partnership University NHS Foundation Trust, Rosanne House, Welwyn Garden City, Hertfordshire AL8 6HG, UK; Center for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK; School of Clinical Medicine, University of Cambridge, Cambridge, UK.
| | - Z Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - D J Stein
- Department of Psychiatry and Mental Health at the University of Cape Town and South African MRC Unit on Risk & Resilience in Mental Disorders, Cape Town, South Africa
| | - K Ioannidis
- Department of Psychiatry, University of Cambridge, Cambridge, UK; Cambridge & Peterborough NHS Foundation Trust, Cambridge, UK
| | - M N Potenza
- Connecticut Mental Health Center and Departments of Psychiatry, Neuroscience and Child Study Center, Yale School of Medicine, New Haven, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA
| | - E Grünblatt
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland; Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - M Brand
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), Department of Computer Science and Applied Cognitive Science Faculty of Engineering, University of Duisburg-Essen, Duisburg, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
| | - J Billieux
- Addictive and Compulsive Behaviours Lab, Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg; Addiction Division, Department of Mental Health and Psychiatry, University Hospitals of Geneva, Switzerland; Centre for Excessive Gambling, Lausanne University Hospitals (CHUV), Lausanne, Switzerland
| | - L Carmi
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - D L King
- School of Psychology, University of Adelaide, Adelaide, Australia
| | - J E Grant
- Department of Psychiatry, University of Chicago, Chicago, USA
| | - M Yücel
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - B Dell'Osso
- Department of Pathophysiology and Transplantation, University of Milan, Fondazione IRCCS Ca' Granda and CRC "Aldo Ravelli" for neurotechnology and experimental brain therapeutics, Milan, Italy; Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy; Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA; CRC "Aldo Ravelli" for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Milan, Italy
| | - H J Rumpf
- University of Lübeck, Department of Psychiatry and Psychotherapy, Centre for Integrative Psychiatry, Lübeck, Germany
| | - N Hall
- Center for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - E Hollander
- Department of Psychiatry and Compulsive, Impulsive and Autism Spectrum Program, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - A Goudriaan
- Department of Psychiatry, Academisch Medisch Centrum (AMC), University of Amsterdam, Amsterdam, Netherlands; Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Institute for Addiction Research, Meibergdreef 9, Amsterdam, Netherlands; Arkin, Amsterdam, The Netherlands
| | - J Menchon
- Department of Psychiatry, Bellvitge University, Hospital-IDIBELL, University of Barcelona, Cibersam, Barcelona, Spain
| | - J Zohar
- Sackler Medical School, Tel Aviv University, and Chaim Sheba Medical Center Tel Hashomer, Tel Aviv, Israel
| | - J Burkauskas
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Palanga, Lithuania
| | - G Martinotti
- Department of Neuroscience, Imaging, Clinical Science, University G.d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - M Van Ameringen
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Ontario, Canada
| | - O Corazza
- Center for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - S Pallanti
- Albert Einstein College of Medicine, New York, USA; University of Florence, Italy
| | - S R Chamberlain
- Department of Psychiatry, University of Cambridge, Cambridge, UK; Cambridge & Peterborough NHS Foundation Trust, Cambridge, UK
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Kozak K, Lucatch AM, Lowe DJE, Balodis IM, MacKillop J, George TP. The neurobiology of impulsivity and substance use disorders: implications for treatment. Ann N Y Acad Sci 2018; 1451:71-91. [PMID: 30291624 DOI: 10.1111/nyas.13977] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 09/11/2018] [Accepted: 09/13/2018] [Indexed: 12/20/2022]
Abstract
Impulsivity is strongly associated with substance use disorders (SUDs). Our review discusses impulsivity as an underlying vulnerability marker for SUDs, and treatment of co-occurring impulsivity in SUDs. Three factors should be considered for the complex relationship between impulsivity and a SUD: (1) the trait effect of impulsivity, centering on decreased cognitive and response inhibition, (2) the state effect resulting from either acute or chronic substance use on brain structure and function, and (3) the genetic and environmental factors (e.g., age and sex) may influence impulsive behavior associated with SUDs. Both subjective and objective measures are used to assess impulsivity. Together, treatment developments (pharmacological, behavioral, and neurophysiological) should consider these clinically relevant dimensions assessed by a variety of measures, which have implications for treatment matching in individuals with SUD. Despite its heterogeneity, impulsivity is a marker associated with SUDs and may be understood as an imbalance of bottom-up and top-down neural systems. Further investigation of these relationships may lead to more effective SUD treatments.
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Affiliation(s)
- Karolina Kozak
- Addictions Division, Centre for Addiction and Mental Health (CAMH), University of Toronto, Toronto, Ontario, Canada.,Division of Brain and Therapeutics, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Aliya M Lucatch
- Addictions Division, Centre for Addiction and Mental Health (CAMH), University of Toronto, Toronto, Ontario, Canada
| | - Darby J E Lowe
- Addictions Division, Centre for Addiction and Mental Health (CAMH), University of Toronto, Toronto, Ontario, Canada
| | - Iris M Balodis
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - James MacKillop
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Tony P George
- Addictions Division, Centre for Addiction and Mental Health (CAMH), University of Toronto, Toronto, Ontario, Canada.,Division of Brain and Therapeutics, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
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20
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Yip SW, Potenza MN. Application of Research Domain Criteria to childhood and adolescent impulsive and addictive disorders: Implications for treatment. Clin Psychol Rev 2018; 64:41-56. [PMID: 27876165 PMCID: PMC5423866 DOI: 10.1016/j.cpr.2016.11.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 03/18/2016] [Accepted: 11/07/2016] [Indexed: 12/30/2022]
Abstract
The Research Domain Criteria (RDoC) initiative provides a large-scale, dimensional framework for the integration of research findings across traditional diagnoses, with the long-term aim of improving existing psychiatric treatments. A neurodevelopmental perspective is essential to this endeavor. However, few papers synthesizing research findings across childhood and adolescent disorders exist. Here, we discuss how the RDoC framework may be applied to the study of childhood and adolescent impulsive and addictive disorders in order to improve neurodevelopmental understanding and to enhance treatment development. Given the large scope of RDoC, we focus on a single construct highly relevant to addictive and impulsive disorders - initial responsiveness to reward attainment. Findings from genetic, molecular, neuroimaging and other translational research methodologies are highlighted.
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Affiliation(s)
- Sarah W Yip
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States; The National Center on Addiction and Substance Abuse, Yale University School of Medicine, New Haven, CT, United States
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States; The National Center on Addiction and Substance Abuse, Yale University School of Medicine, New Haven, CT, United States; Child Study Center, Yale University School of Medicine, New Haven, CT, United States; Department of Neurobiology, Yale University School of Medicine, New Haven, CT, United States.
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21
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Kumar R, Kumar KJ, Benegal V. Cognitive and behavioural dispositions in offspring at high risk for alcoholism. Asian J Psychiatr 2018; 35:38-44. [PMID: 29775836 DOI: 10.1016/j.ajp.2018.05.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 05/07/2018] [Accepted: 05/09/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Offspring with family history of alcoholism are considered to be at high risk for alcoholism. The present study sought to expand our understanding of cognitive and behavioural dispositions associated with executive control and self-regulation in alcohol naïve offspring with and without family history of alcoholism. METHODS Sample comprised of alcohol naive offspring in two groups: (i) at high risk (n = 34) and (ii) at low risk for alcoholism (n = 34). Both groups were matched on age (+/-1 year), education (+/-1 year) and gender. Measures used were: Mini-International Neuropsychiatric Interview, Family Interview for Genetic Studies, Socio-demographic Data Sheet, Annett's Handedness Questionnaire, Barratt's Impulsiveness Scale-version 11, Digit Span Test, Spatial Span Test, Tower of London, Wisconsin Card Sorting Test, Iowa Gambling Task (IGT) and Game of Dice Task (GDT). RESULTS Results showed that alcohol naive offspring at high risk for alcoholism reported significantly high impulsivity and demonstrated significant differences on executive functions and decision making tasks. Correlation analysis revealed that high impulsivity was significantly associated with poor performance on explicit decision making task (GDT) and executive function task (WCST). There was no significant correlation between two decision making tasks (IGT and GDT) in both groups and performance on IGT was not significantly associated with impulsivity and executive functions. CONCLUSIONS The present study indicates cognitive and behavioural dispositions in alcohol naive offspring at high risk for alcoholism and support the sub-optimal balance between reflective and impulsive system responsible for addiction. Furthermore, present study supports separability between two different types of decision making tasks.
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Affiliation(s)
- Rajesh Kumar
- Clinical Psychologist, Department of Clinical Psychology, National Institute of Mental Health and Neurosciences (NIMHANS), 560029, Bangalore, India.
| | - Keshav Janakiprasad Kumar
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences (NIMHANS), 560029, Bangalore, India.
| | - Vivek Benegal
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), 560029, Bangalore, India.
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Adolescent Internet Abuse: A Study on the Role of Attachment to Parents and Peers in a Large Community Sample. BIOMED RESEARCH INTERNATIONAL 2018; 2018:5769250. [PMID: 29707572 PMCID: PMC5863292 DOI: 10.1155/2018/5769250] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 02/08/2018] [Indexed: 02/08/2023]
Abstract
Adolescents are the main users of new technologies and their main purpose of use is social interaction. Although new technologies are useful to teenagers, in addressing their developmental tasks, recent studies have shown that they may be an obstacle in their growth. Research shows that teenagers with Internet addiction experience lower quality in their relationships with parents and more individual difficulties. However, limited research is available on the role played by adolescents' attachment to parents and peers, considering their psychological profiles. We evaluated in a large community sample of adolescents (N = 1105) the Internet use/abuse, the adolescents' attachment to parents and peers, and their psychological profiles. Hierarchical regression analyses were conducted to verify the influence of parental and peer attachment on Internet use/abuse, considering the moderating effect of adolescents' psychopathological risk. Results showed that adolescents' attachment to parents had a significant effect on Internet use. Adolescents' psychopathological risk had a moderating effect on the relationship between attachment to mothers and Internet use. Our study shows that further research is needed, taking into account both individual and family variables.
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A Novel Approach to Transforming Smoking Cessation Practice for Pregnant Aboriginal Women and Girls Living in the Pilbara. Healthcare (Basel) 2018; 6:healthcare6010010. [PMID: 29360761 PMCID: PMC5872217 DOI: 10.3390/healthcare6010010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 12/08/2017] [Accepted: 12/29/2017] [Indexed: 11/30/2022] Open
Abstract
Tobacco smoking during pregnancy contributes to a range of adverse perinatal outcomes; but is a potentially modifiable behavior. In Australia Aboriginal and Torres Strait Islander women face a range of barriers that hinder; rather than support smoking cessation. Few smoking cessation programs consider the broader social determinants of women’s lives; the gendered nature of these or the complexities which impinge on behavior change in the presence of social and economic disadvantage and substantial individual and intergenerational trauma. Drawing on the salient gender and trauma-informed literature this paper describes the rationale underpinning formative research which will inform the design of a localized, culturally meaningful smoking cessation program for Aboriginal women living in the Hedland and Western Desert communities of the remote Pilbara region of Western Australia. We contend that a women-centered, trauma-informed approach to smoking cessation has much to offer those seeking to address this critical public health issue
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Nigro G, Cosenza M, Ciccarelli M. The Blurred Future of Adolescent Gamblers: Impulsivity, Time Horizon, and Emotional Distress. Front Psychol 2017; 8:486. [PMID: 28421013 PMCID: PMC5376625 DOI: 10.3389/fpsyg.2017.00486] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 03/15/2017] [Indexed: 12/29/2022] Open
Abstract
The main purpose of this study was to investigate the interplay of functional and dysfunctional impulsivity, delay discounting, time perspective, and emotional negative states on gambling severity in Italian adolescents. A second aim of the study was to analyze the developmental trajectories of gambling involvement, functional and dysfunctional impulsivity, delay discounting, consideration of future consequences, and negative affectivity in a cross-sectional perspective. One thousand and ten Italian adolescents aging between 12 and 19 years were administered the South Oaks Gambling Screen Revised for Adolescents (SOGS-RA), the Functional and Dysfunctional Impulsivity Scale (FDIS), the Monetary Choice Questionnaire (MCQ), the Consideration of Future Consequences Scale (CFC-14), and the Depression, Anxiety and Stress Scales-21 (DASS-21). Data analyses were conducted using correlational analysis, Chi-square test, analysis of variance, and hierarchical regression analysis. Results indicated that, relative to non-gamblers and non-problem gamblers, at-risk and problem gamblers showed higher levels of impulsivity, steeper delay discounting, shorter time horizon, and reported experiencing significantly higher levels of depression, anxiety, and stress. Results of hierarchical regression analysis, with SOGS-RA scores as the dependent variable, and gender, age, FDIS, MCQ, CFC-14, and DASS-21 scores as independent variables, indicated that, along with gender and age, low scores of future orientation and high scores of dysfunctional impulsivity, depression, anxiety, present orientation, and delay discounting significantly predicted gambling severity. These findings provide further evidence that the higher the gambling involvement, the greater the tendency to devalue delayed rewards and to focus on the immediate consequences of one's behavior. Interestingly, for the first time these results reveal an association between gambling severity and both dysfunctional impulsivity and negative affective states across adolescence. Finally, results of cross-sectional analyses suggest that gambling severity contributes more than age in shaping the developmental trajectories of functional and dysfunctional impulsivity, delay discounting, time perspective, and negative affective states.
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Affiliation(s)
- Giovanna Nigro
- Department of Psychology, Università degli Studi della Campania Luigi VanvitelliCaserta, Italy
| | - Marina Cosenza
- Department of Psychology, Università degli Studi della Campania Luigi VanvitelliCaserta, Italy
| | - Maria Ciccarelli
- Department of Psychology, Università degli Studi della Campania Luigi VanvitelliCaserta, Italy
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Cosenza M, Griffiths MD, Nigro G, Ciccarelli M. Risk-Taking, Delay Discounting, and Time Perspective in Adolescent Gamblers: An Experimental Study. J Gambl Stud 2016; 33:383-395. [DOI: 10.1007/s10899-016-9623-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Yip SW, Mei S, Pilver CE, Steinberg MA, Rugle LJ, Krishnan-Sarin S, Hoff RA, Potenza MN. At-Risk/Problematic Shopping and Gambling in Adolescence. J Gambl Stud 2015; 31:1431-1447. [PMID: 25117852 PMCID: PMC4827601 DOI: 10.1007/s10899-014-9494-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Elevated levels of both pathological gambling (PG) and problem shopping (PS) have been reported among adolescents, and each is associated with a range of other negative health/functioning measures. However, relationships between PS and PG, particularly during adolescence, are not well understood. In this study, we explored the relationship between different levels of problem-gambling severity and health/functioning characteristics, gambling-related social experiences, gambling behaviors and motivations among adolescents with and without at-risk/problematic shopping (ARPS). Survey data from Connecticut high school students (n = 2,100) were analyzed using bivariate analyses and logistic regression modeling. Although at-risk/problematic gambling (ARPG) was not increased among adolescents with ARPS, adolescents with ARPG (vs non-gamblers) were more likely to report having experienced a growing tension or anxiety that could only be relieved by shopping and missing other obligations due to shopping. In comparison to the non-ARPS group, a smaller proportion of respondents in the ARPS group reported paid part-time employment, whereas a greater proportion of respondents reported excessive gambling by peers and feeling concerned over the gambling of a close family member. In general, similar associations between problem-gambling severity and measures of health/functioning and gambling-related behaviors and motivations were observed across ARPS and non-ARPS adolescents. However, associations were weaker among ARPS adolescents for several variables: engagement in extracurricular activities, alcohol and caffeine use and gambling for financial reasons. These findings suggest a complex relationship between problem-gambling severity and ARPS. They highlight the importance of considering co-occurring risk behaviors such as ARPS when treating adolescents with at-risk/problem gambling.
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Affiliation(s)
- Sarah W Yip
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Songli Mei
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- School of Public Health, Jilin University, Changchun, China
| | - Corey E Pilver
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | | | | | | | - Rani A Hoff
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- VA CT Healthcare System, West Haven, CT, USA
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Neurobiology, Yale University School of Medicine, New Haven, CT, USA
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
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Pretlow RA, Stock CM, Allison S, Roeger L. Treatment of child/adolescent obesity using the addiction model: a smartphone app pilot study. Child Obes 2015; 11:248-59. [PMID: 25760813 PMCID: PMC4485371 DOI: 10.1089/chi.2014.0124] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND The aim of this study was to test a weight loss program for young people based on an addiction treatment approach. METHODS A pilot study (n=43) was conducted of a 20-week child/adolescent obesity intervention based on an addiction treatment model (staged, incremental withdrawal from problem foods, snacking/grazing, and excessive amounts at meals) and implemented by a server-integrated smartphone app with health professional support. The primary outcome was standardized %overBMI measured at four time points. Secondary outcomes were participants' self-ratings of self-esteem, control over food, and the degree they turned to food when stressed. User satisfaction data were collected with an online questionnaire. Latent growth modeling techniques were used to identify independent variables and possible mediating treatment process variables associated with weight change. RESULTS Mean age of participants was 16 years (range, 10-21), 65% girls, and 84% Caucasian. Twenty-seven (63%) completed the program. There was a significant decrease in %overBMI over time of 7.1. There were significant improvements in participant ratings of self-esteem, control over food, and a reduction in turning to food when stressed. Males, younger participants, and participants with higher levels of program compliance achieved better weight loss. Participants who reported that calling obesity an addiction made their guilt worse experienced poorer weight loss. Females were more likely than males to report "addiction guilt," and this partly mediated the overall gender effect. CONCLUSIONS The staged, incremental food withdrawal approach was feasible to implement and was useful in helping reduce excessive weight, particularly among boys.
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Affiliation(s)
| | - Carol M. Stock
- Buntain School of Nursing, Northwest University, Kirkland, WA
| | - Stephen Allison
- Psychiatry Department, Flinders University, Adelaide, South Australia, Australia
| | - Leigh Roeger
- Psychiatry Department, Flinders University, Adelaide, South Australia, Australia
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Feda DM, Roemmich JN, Roberts A, Epstein LH. Food reinforcement and delay discounting in zBMI-discordant siblings. Appetite 2014; 85:185-9. [PMID: 25464024 DOI: 10.1016/j.appet.2014.11.023] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 11/18/2014] [Accepted: 11/19/2014] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The interaction of food reinforcement and the inability to delay gratification are related to adult energy intake and obesity. This study was designed to test the association of sibling pair differences in relative reinforcing efficacy of food and delay discounting on sibling pair differences in zBMI scores of same-gender zBMI-discordant siblings. DESIGN AND METHODS We tested main and interactive relationships between delay discounting and relative reinforcing efficacy of food on zBMI discordance in 14 zBMI-discordant biological sibling pairs (6 female pairs) using a discordant sibling study design. RESULTS Sibling pair differences in relative reinforcing efficacy of food were associated with sibling pair differences in zBMI (p= 0.046); this effect was moderated by delay discounting (p <0.002). Sibling pairs with greater differences in relative reinforcing efficacy and delay discounting had greater differences in zBMI. CONCLUSIONS The combination of greater sibling pair differences in delay discounting and relative reinforcing efficacy is associated with greater discordance in zBMI in adolescent sibling pairs.
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Affiliation(s)
- Denise M Feda
- Department of Pediatrics, University at Buffalo, Buffalo, NY 14221, United States.
| | - James N Roemmich
- USDA-ARS-NPA Grand Forks Human Nutrition Research Center, Grand Forks, ND, United States
| | - April Roberts
- Department of Pediatrics, University at Buffalo, Buffalo, NY 14221, United States
| | - Leonard H Epstein
- Department of Pediatrics, University at Buffalo, Buffalo, NY 14221, United States
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Dong G, Potenza MN. A cognitive-behavioral model of Internet gaming disorder: theoretical underpinnings and clinical implications. J Psychiatr Res 2014; 58:7-11. [PMID: 25062755 PMCID: PMC4448942 DOI: 10.1016/j.jpsychires.2014.07.005] [Citation(s) in RCA: 269] [Impact Index Per Article: 26.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 06/28/2014] [Accepted: 07/03/2014] [Indexed: 12/13/2022]
Abstract
Cognitive contributions to the behaviors observed in substance and non-substance addictions have been investigated and characterized. Based on models of drug addictions and the extant literature on Internet gaming disorder (IGD), we propose a cognitive-behavioral model for conceptualizing IGD. The model focuses on three domains and their roles in addictive behaviors. The three domains include motivational drives related to reward-seeking and stress-reduction, behavioral control relating to executive inhibition, and decision-making that involves weighing the pros and cons of engaging in motivated behaviors. Based on this model, we propose how behavioral therapies might target these domains in the treatment of IGD.
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Affiliation(s)
- Guangheng Dong
- Department of Psychology, Zhejiang Normal University, 688 Yingbin Road, Jinhua, Zhejiang Province, 321004, PR China.
| | - Marc N. Potenza
- Departments of Psychiatry, Yale University School of Medicine, New Haven, CT, USA,Neurobiology and Child Study Center, Yale University School of Medicine, New Haven, CT, USA,Correspondence: Guangheng Dong, Ph.D. Associate Professor. Department of Psychology, Zhejiang Normal University, 688 Yingbin Road, Jinhua, Zhejiang Province, P.R. China. 321004; , Marc N. Potenza, M.D., Ph.D., Professor. Departments of Psychiatry, Neurobiology and Child Study Center, Yale University School of Medicine, Connecticut Mental Health Center, 34 Park Street, New Haven, CT 06511;
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Gullo MJ, Loxton NJ, Dawe S. Impulsivity: four ways five factors are not basic to addiction. Addict Behav 2014; 39:1547-1556. [PMID: 24576666 DOI: 10.1016/j.addbeh.2014.01.002] [Citation(s) in RCA: 109] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Revised: 12/09/2013] [Accepted: 01/09/2014] [Indexed: 10/25/2022]
Abstract
Several impulsivity-related models have been applied to understanding the vulnerability to addiction. While there is a growing consensus that impulsivity is multifaceted, debate continues as to the precise number of facets and, more critically, which are most relevant to explaining the addiction-risk profile. In many ways, the current debate mirrors that which took place in the personality literature in the early 1990s (e.g., Eysenck's 'Big Three' versus Costa and McCrae's 'Big Five'). Indeed, many elements of this debate are relevant to the current discussion of the role of impulsivity in addictive behavior. Specifically, 1) the use of factor analysis as an atheoretical 'truth-grinding machine'; 2) whether additional facets add explanatory power over fewer; 3) the delineation of specific neurocognitive pathways from each facet to addictive behaviors, and; 4) the relative merit of 'top-down' versus 'bottom-up' approaches to the understanding of impulsivity. Ultimately, the utility of any model of impulsivity and addiction lies in its heuristic value and ability to integrate evidence from different levels of analysis. Here, we make the case that theoretically-driven, bottom-up models proposing two factors deliver the optimal balance of explanatory power, parsimony, and integration of evidence.
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Gullo MJ, Potenza MN. Impulsivity: mechanisms, moderators and implications for addictive behaviors. Addict Behav 2014; 39:1543-1546. [PMID: 25042111 DOI: 10.1016/j.addbeh.2014.06.005] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 06/12/2014] [Indexed: 12/21/2022]
Affiliation(s)
- Matthew J Gullo
- Centre for Youth Substance Abuse Research, The University of Queensland, Australia.
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States; Department of Neurobiology, Yale University School of Medicine, New Haven, CT, United States; Child Study Center, Yale University School of Medicine, New Haven, CT, United States
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LEEMAN ROBERTF, PATOCK-PECKHAM JULIEA, HOFF RANIA, KRISHNAN-SARIN SUCHITRA, STEINBERG MARVINA, RUGLE LOREENJ, POTENZA MARCN. Perceived parental permissiveness toward gambling and risky behaviors in adolescents. J Behav Addict 2014; 3:115-23. [PMID: 25215222 PMCID: PMC4117283 DOI: 10.1556/jba.3.2014.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Revised: 02/13/2014] [Accepted: 02/25/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS Perceived parental permissiveness toward gambling may relate to adolescents' engagement in various risky behaviors. To examine this possibility, we analyzed data from a high-school based risk-behavior survey to assess relationships between perceived parental permissiveness toward gambling and adolescent gambling behavior, substance use and related problems. We also evaluated predictions that relationships between perceived parental permissiveness toward gambling and risky behaviors would be particularly strong amongst adolescents reporting high sensation-seeking or impulsivity. METHODS High-school students (n = 2,805) provided data on risky behaviors, perceived parental permissiveness toward gambling, impulsivity and sensation-seeking. Bivariate and logistic regression analyses were conducted to examine relationships with gambling and alcohol, cigarette and marijuana use. RESULTS Perceived parental permissiveness toward gambling related significantly to adolescent gambling, all substance-use behaviors as well as alcohol and drug problems. There were significant parental-permissiveness-by-sensation-seeking interactions in multiple models. Relationships between perceived parental permissiveness toward gambling and alcohol-use frequency were particularly strong among those with high sensation-seeking. This relationship also applied to gambling and heavy cigarette smoking, albeit to a lesser extent. Impulsivity related strongly to drug problems among those who perceived their parents to be more and less permissive toward gambling. DISCUSSION AND CONCLUSIONS These findings support the relevance of perceived parental permissiveness toward gambling to adolescent risky behaviors. Parenting perceived as less permissive toward gambling appeared to have protective effects on gambling, alcohol and cigarette use, even among those with high sensation-seeking. Reducing parental permissiveness toward gambling may be a valuable intervention goal, particularly for parents of sensation-seeking adolescents.
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Affiliation(s)
- ROBERT F. LEEMAN
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA, Corresponding author: Robert F. Leeman, PhD; Yale School of Medicine, 34 Park Street, Room S200, New Haven, CT 01659 USA; Phone: +1-203-974-7373; Fax: +1-203-974-7606; E-mail:
| | | | - RANI A. HOFF
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA,VA Connecticut Healthcare System, West Haven, CT, USA
| | | | | | - LOREEN J. RUGLE
- Problem Gambling Services of Connecticut, Middletown, CT, USA
| | - MARC N. POTENZA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA,Department of Neurobiology, Yale School of Medicine, New Haven, CT, USA,Child Study Center, Yale School of Medicine, New Haven, CT, USA
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Impulsivity, sensation-seeking, and part-time job status in relation to substance use and gambling in adolescents. J Adolesc Health 2014; 54:460-6. [PMID: 24268362 PMCID: PMC4048016 DOI: 10.1016/j.jadohealth.2013.09.014] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Revised: 09/21/2013] [Accepted: 09/23/2013] [Indexed: 11/23/2022]
Abstract
PURPOSE Although impulsivity, sensation-seeking, and part-time employment have each been linked to risky behaviors in adolescents, their inter-relationships are less well-understood. We examined data from adolescents to assess the following predictions: (1) sensation-seeking would relate closely to substance use and gambling; (2) impulsivity would relate closely to alcohol, drug, and gambling problems; and (3) these relationships would be particularly strong among those holding part-time jobs. METHOD High-school students (N = 3,106) were surveyed to provide data on impulsivity, sensation-seeking, and part-time job status. Bivariate and logistic regression analyses were conducted to examine relationships with gambling, substance use (i.e., alcohol, cigarettes, and marijuana) and related problems. RESULTS Both impulsivity and sensation-seeking related significantly to substance use and impulsivity to gambling. Impulsivity had stronger associations with drug and gambling problems than sensation-seeking did. Students with paid part-time jobs were more likely to drink alcohol, binge drink, and use marijuana. Sensation-seeking had a particularly strong relationship to heavy cigarette smoking among students with part-time jobs. Conversely, there was little relationship between part-time job status and smoking among low sensation-seekers. CONCLUSIONS These findings further support the relevance of sensation-seeking, impulsivity, and part-time job status to risky behaviors among adolescents. Sensation-seeking and impulsivity had unique relationships to risky behaviors, in accordance with theory and prior evidence. Impulsive adolescents may be in particular need for interventions to reduce drug use and gambling. Although part-time jobs can be beneficial, parents and caregivers should be mindful of potential negative ramifications of paid work outside the home.
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Fineberg NA, Chamberlain SR, Goudriaan AE, Stein DJ, Vanderschuren LJ, Gillan CM, Shekar S, Gorwood PA, Voon V, Morein-Zamir S, Denys D, Sahakian BJ, Moeller FG, Robbins TW, Potenza MN. New developments in human neurocognition: clinical, genetic, and brain imaging correlates of impulsivity and compulsivity. CNS Spectr 2014; 19:69-89. [PMID: 24512640 PMCID: PMC4113335 DOI: 10.1017/s1092852913000801] [Citation(s) in RCA: 285] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Impulsivity and compulsivity represent useful conceptualizations that involve dissociable cognitive functions, which are mediated by neuroanatomically and neurochemically distinct components of cortico-subcortical circuitry. The constructs were historically viewed as diametrically opposed, with impulsivity being associated with risk-seeking and compulsivity with harm-avoidance. However, they are increasingly recognized to be linked by shared neuropsychological mechanisms involving dysfunctional inhibition of thoughts and behaviors. In this article, we selectively review new developments in the investigation of the neurocognition of impulsivity and compulsivity in humans, in order to advance our understanding of the pathophysiology of impulsive, compulsive, and addictive disorders and indicate new directions for research.
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Affiliation(s)
- Naomi A. Fineberg
- Hertfordshire Partnership NHS University Foundation Trust, Queen Elizabeth II Hospital, Howlands, Welwyn Garden City, Hertfordshire, UK
- University of Hertfordshire, School of Postgraduate Medicine, College Lane, Hatfield, Hertfordshire, UK
- Cambridge University, School of Clinical Medicine, Addenbrooke’s Hospital, Cambridge, UK
| | - Samuel R. Chamberlain
- Cambridge University, School of Clinical Medicine, Addenbrooke’s Hospital, Cambridge, UK
- Cambridge and Peterborough NHS Foundation Trust (CPFT), Cambridge, UK
| | - Anna E. Goudriaan
- Department of Psychiatry, Amsterdam Institute for Addiction Research, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- Arkin Mental Health, Amsterdam, The Netherlands
| | - Dan J. Stein
- Department of Psychiatry, University of Cape Town, S. Africa
| | - Louk J.M.J. Vanderschuren
- Dept. of Animals in Science and Society, Division of Behavioural Neuroscience, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
- Rudolf Magnus Institute of Neuroscience, Dept. of Neuroscience and Pharmacology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Claire M. Gillan
- Behavioural and Clinical Neuroscience Institute (BCNI), University of Cambridge, Cambridge, UK
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Sameer Shekar
- Hertfordshire Partnership NHS University Foundation Trust, Queen Elizabeth II Hospital, Howlands, Welwyn Garden City, Hertfordshire, UK
| | - Philip A.P.M. Gorwood
- INSERM UMR894 (Centre of Psychiatry and Neuroscience), 2ter rue d’Alesia, Paris, FRANCE
- Sainte-Anne hospital, CMME (University Paris Descartes), 100 rue de la Santé, Paris, FRANCE
| | - Valerie Voon
- Behavioural and Clinical Neuroscience Institute (BCNI), University of Cambridge, Cambridge, UK
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Sharon Morein-Zamir
- Behavioural and Clinical Neuroscience Institute (BCNI), University of Cambridge, Cambridge, UK
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Damiaan Denys
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- The Netherlands Institute for Neuroscience, an institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Barbara J. Sahakian
- Cambridge University, School of Clinical Medicine, Addenbrooke’s Hospital, Cambridge, UK
- Behavioural and Clinical Neuroscience Institute (BCNI), University of Cambridge, Cambridge, UK
| | - F. Gerard Moeller
- Departments of Psychiatry and Pharmacology and Toxicology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Trevor W. Robbins
- Behavioural and Clinical Neuroscience Institute (BCNI), University of Cambridge, Cambridge, UK
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Marc N. Potenza
- Departments of Psychiatry, Child Study and Neurobiology, Yale School of Medicine, New Haven, Connecticut, USA
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Potenza MN. Neurobiology of gambling behaviors. Curr Opin Neurobiol 2013; 23:660-7. [PMID: 23541597 PMCID: PMC3803105 DOI: 10.1016/j.conb.2013.03.004] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Revised: 03/06/2013] [Accepted: 03/07/2013] [Indexed: 01/09/2023]
Abstract
For many, gambling is a recreational activity that is performed periodically without ill effects, but for some, gambling may interfere with life functioning. A diagnostic entity, pathological gambling (PG), is currently used to define a condition marked by excessive and problematic gambling. In this review, the current status of understanding of the neurobiologies of gambling and PG is described. Multiple neurotransmitter systems (norepinephrine, serotonin, dopamine, opioid and glutamate) and brain regions (ventral striatum, ventromedial prefrontal cortex, insula, among others) have been implicated in gambling and PG. Considerations for future directions in gambling research, with a view towards translating neurobiological advances into more effective prevention and treatment strategies, are discussed.
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Affiliation(s)
- Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
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Abstract
PURPOSE OF REVIEW The aim of this review was to examine current trends in cannabis use and cannabis use disorder (CUD) among youth, and to investigate recent findings concerning the relationship between cannabis use and mental health concerns, with a focus on how use during adolescence may interact with related mental health disorders. RECENT FINDINGS Current data indicate that cannabis use among adolescents has shown both marginal increases and decreases, depending on global location; however, the profile of cannabinoids in cannabis may now be biased toward those that promote psychotogenic and memory-impairing effects. CUD has been found most prevalent among youth. After controlling for multiple confounders, longitudinal research suggests that cannabis use predicts the development of anxiety disorders, depression, suicidal ideation, certain personality disorders, and interpersonal violence. Further, associations have been found stronger in adolescents relative to adults, and younger age of initiation increases the risk of developing mental health disorders. SUMMARY Cannabis use among youth remains prevalent, and recent studies are consolidating previous findings that adolescents are especially vulnerable to mental health disorders associated with cannabis. This suggests that cannabis involvement requires increased prominence in research, prevention initiatives, routine screening, and interventions to improve adolescent mental health.
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Patel V. Reducing the burden of depression in youth: what are the implications of neuroscience and genetics on policies and programs? J Adolesc Health 2013; 52:S36-8. [PMID: 23332569 DOI: 10.1016/j.jadohealth.2012.04.016] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2011] [Revised: 04/08/2012] [Accepted: 04/09/2012] [Indexed: 11/29/2022]
Abstract
Mood disorders are a leading cause of the burden of disease in youth. Three critical lessons emerge from the reviews in this issue that are relevant to our understanding of these common mental disorders: first, that the brain is in a highly dynamic stage of its development during youth; second, that environmental factors interact with genetic factors to influence the probability of risk behaviors and dysphoric states; and third, that shared developmental and genetic factors may account for the bulk of emotional and behavioral outcomes in youth, and that environmental influences may affect the specific expression of the phenotypes associated with these pathways. Although this evidence does not immediately indicate the potential for new interventions, it is consistent with current policy and practice recommendations. Interventions should focus on both improving the early detection and management of depressive disorders as well as preventive strategies that aim to train children and youth to improve cognitive control and manage stress more effectively. Limiting access to harmful risk-taking situations and providing opportunities to engage are less harmful, but equally exciting, alternatives in a pragmatic universal prevention policy option. Key research priorities and paradigms emerge from this evidence, particularly in the context of the grand challenges in global mental health.
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Affiliation(s)
- Vikram Patel
- London School of Hygiene and Tropical Medicine, London, UK.
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Strengthening global programs and policies for youth based on the emerging science. J Adolesc Health 2013; 52:S1-3. [PMID: 23332565 DOI: 10.1016/j.jadohealth.2012.11.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Accepted: 11/26/2012] [Indexed: 11/21/2022]
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Lee A, Gibbs SE. Neurobiology of food addiction and adolescent obesity prevention in low- and middle-income countries. J Adolesc Health 2013; 52:S39-42. [PMID: 23332570 DOI: 10.1016/j.jadohealth.2012.06.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2010] [Revised: 06/10/2012] [Accepted: 06/12/2012] [Indexed: 11/26/2022]
Abstract
Adolescent obesity has become an increasingly urgent issue in low- and middle-income countries. Recent relevant advances include the application of the neurobiology of addiction to food addiction and obesity. The biochemistry of the etiology of obesity indicates the need for multilevel interventions that go beyond simple behavioral approaches. Additional research on the neurobiology of food addiction and adolescent obesity in low- and middle-income countries, as well as program evaluations that examine the biochemical effects of complex interventions, is urgently needed.
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Affiliation(s)
- Albert Lee
- Centre for Health Education and Health Promotion, JC School of Public Health and Primary Care the Chinese University of Hong Kong, Hong Kong; Department of Applied Health Science, School of Health, Physical Education and Recreation Management, Indiana University, Indiana.
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Evidence-based interventions in low- and middle-income countries: the tigress awakens. J Adolesc Health 2013; 52:S5-6. [PMID: 23332573 DOI: 10.1016/j.jadohealth.2012.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Accepted: 11/26/2012] [Indexed: 11/22/2022]
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Medina-Mora ME, Gibbs SE. Implications of science for illicit drug use policies for adolescents in low- and middle-income countries. J Adolesc Health 2013; 52:S33-5. [PMID: 23332568 DOI: 10.1016/j.jadohealth.2012.09.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2012] [Revised: 09/24/2012] [Accepted: 09/26/2012] [Indexed: 10/27/2022]
Abstract
Advances in neuroscience have improved our knowledge of the impact of illicit drug use on the adolescent brain. Translating this new knowledge into improved policies and programs requires the participation of public health and social sciences. This article discusses the implications of the recent advances of neurobiology for policies especially as they pertain to adolescents in low- and middle-income countries. It includes an overview of adolescent use of illicit drugs in low- and middle-income countries and calls for a move toward a transdisciplinary approach. It presents some of the challenges for research aimed at increasing our understanding of the issue and for policy.
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