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Casile A, Marraudino M, Bonaldo B, Micioni Di Bonaventura MV, Nasini S, Cifani C, Gotti S. Novel rat model of gaming disorder: assessment of social reward and sex differences in behavior and c-Fos brain activity. Psychopharmacology (Berl) 2024:10.1007/s00213-024-06576-y. [PMID: 38575792 DOI: 10.1007/s00213-024-06576-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 03/14/2024] [Indexed: 04/06/2024]
Abstract
RATIONALE In 2018, the International Classification of Diseases (ICD-11) classified Gaming Disorder (GD) as a mental disorder. GD mainly occurs among adolescents, who, after developing addiction, show psychopathological traits, such as social anxiety, depression, social isolation, and attention deficit. However, the different studies conducted in humans so far show several limitations, such as the lack of demographic heterogeneity and equal representation of age, differences in the type of game and in the follow-up period. Furthermore, at present, no animal models specific to GD are available. OBJECTIVES To address the lack of an experimental model for GD, in the present work, we proposed a new GD rat model to investigate some peculiar tracts of the disorder. METHODS Two-month-old Wistar Kyoto rats, both males and females, were subject to a five-week training with a new innovative touch-screen platform. After five weeks of training, rats were assessed for: (a) their attachment to the play under several conditions, (b) their hyperactivity during gaming, and (c) the maintenance of these conditions after a period of game pause and reward interruption. After sacrifice, using immunohistochemistry techniques, the immunoreactivity of c-Fos (a marker of neuronal activity) was analyzed to study different neural areas. RESULTS After the training, the rats subjected to GD protocol developed GD-related traits (e.g., hyperactivity, loss control), and the behavioral phenotype was maintained consistently over time. These aspects were completely absent in the control groups. Lastly, the analysis of c-Fos immunoreactivity in prelimbic cortex (PrL), orbitofrontal cortex (OFC), nucleus Accumbens, amygdala and bed nucleus of stria terminalis (BNST) highlighted significant alterations in the GD groups compared to controls, suggesting modifications in neural activity related to the development of the GD phenotype. CONCLUSIONS The proposal of a new GD rat model could represent an innovative tool to investigate, in both sexes, the behavioral and neurobiological features of this disorder, the possible role of external factors in the predisposition and susceptibility and the development of new pharmacological therapies.
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Affiliation(s)
- Antonino Casile
- School of Pharmacy, Pharmacology Unit, Pharmacology Unit, University of Camerino, Via Madonna delle Carceri, 9, Camerino, 62032, Italy.
- Neuroscience Institute Cavalieri Ottolenghi (NICO), University of Turin, Regione Gonzole, 10, Orbassano, Turin, TO, 10043, Italy.
| | - Marilena Marraudino
- Neuroscience Institute Cavalieri Ottolenghi (NICO), University of Turin, Regione Gonzole, 10, Orbassano, Turin, TO, 10043, Italy
- Department of Neuroscience "Rita Levi-Montalcini", Via Cherasco 15, Turin, TO, 10126, Italy
| | - Brigitta Bonaldo
- Neuroscience Institute Cavalieri Ottolenghi (NICO), University of Turin, Regione Gonzole, 10, Orbassano, Turin, TO, 10043, Italy
- Department of Neuroscience "Rita Levi-Montalcini", Via Cherasco 15, Turin, TO, 10126, Italy
- Department of Health Sciences and Research Center on Autoimmune and Allergic Diseases (CAAD), University of Piemonte Orientale (UPO), Novara, Italy
| | | | - Sofia Nasini
- Laboratory of Molecular and Cellular Pharmacology, Department of Pharmacology, University of Padua, Largo Egidio Meneghetti, 2, Padua, 35131, Italy
| | - Carlo Cifani
- School of Pharmacy, Pharmacology Unit, Pharmacology Unit, University of Camerino, Via Madonna delle Carceri, 9, Camerino, 62032, Italy.
| | - Stefano Gotti
- Neuroscience Institute Cavalieri Ottolenghi (NICO), University of Turin, Regione Gonzole, 10, Orbassano, Turin, TO, 10043, Italy
- Department of Neuroscience "Rita Levi-Montalcini", Via Cherasco 15, Turin, TO, 10126, Italy
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Mestre-Bach G, Potenza MN. Neural mechanisms linked to treatment outcomes and recovery in substance-related and addictive disorders. DIALOGUES IN CLINICAL NEUROSCIENCE 2023; 25:75-91. [PMID: 37594217 PMCID: PMC10444012 DOI: 10.1080/19585969.2023.2242359] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 07/24/2023] [Accepted: 07/24/2023] [Indexed: 08/19/2023]
Abstract
The present review focuses on potential neural mechanisms underlying recovery from psychiatric conditions characterised by impaired impulse control, specifically substance use disorders, gambling disorder, and internet gaming disorder. Existing treatments (both pharmacological and psychological) for these addictions may impact brain processes, and these have been evaluated in neuroimaging studies. Medication challenge and short-term intervention administration will be considered with respect to treatment utility. Main models of addiction (e.g., dual process, reward deficiency syndrome) will be considered in the context of extant data. Additionally, advanced analytic approaches (e.g., machine-learning approaches) will be considered with respect to guiding treatment development efforts. Thus, this narrative review aims to provide directions for treatment development for addictive disorders.
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Affiliation(s)
- Gemma Mestre-Bach
- Centro de Investigación, Transferencia e Innovación (CITEI), Universidad Internacional de La Rioja, La Rioja, Spain
| | - Marc N. Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT, USA
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Wang ZL, Potenza MN, Song KR, Dong GH, Fang XY, Zhang JT. Subgroups of internet gaming disorder based on addiction-related resting-state functional connectivity. Addiction 2023; 118:327-339. [PMID: 36089824 DOI: 10.1111/add.16047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 08/31/2022] [Indexed: 01/05/2023]
Abstract
AIMS To identify subgroups of people with internet gaming disorder (IGD) based on addiction-related resting-state functional connectivity and how these subgroups show different clinical correlates and responses to treatment. DESIGN Secondary analysis of two functional magnetic resonance imaging (fMRI) data sets. SETTING Zhejiang province and Beijing, China. PARTICIPANTS One hundred and sixty-nine IGD and 147 control subjects. MEASUREMENTS k-Means algorithmic and support-vector machine-learning approaches were used to identify subgroups of IGD subjects. These groups were examined with respect to assessments of craving, behavioral activation and inhibition, emotional regulation, cue-reactivity and guessing-related measures. FINDINGS Two groups of subjects with IGD were identified and defined by distinct patterns of connectivity in brain networks previously implicated in addictions: subgroup 1 ('craving-related subgroup') and subgroup 2 ('mixed psychological subgroup'). Clustering IGD on this basis enabled the development of diagnostic classifiers with high sensitivity and specificity for IGD subgroups in 10-fold validation (n = 218) and out-of-sample replication (n = 98) data sets. Subgroup 1 is characterized by high craving scores, cue-reactivity during fMRI and responsiveness to a craving behavioral intervention therapy. Subgroup 2 is characterized by high craving, behavioral inhibition and activations scores, non-adaptive emotion-regulation strategies and guessing-task fMRI measures. Subgroups 1 and 2 showed largely opposite functional-connectivity patterns in overlapping networks. CONCLUSIONS There appear to be two subgroups of people with internet gaming disorder, each associated with differing patterns of brain functional connectivity and distinct clinical symptom profiles and gender compositions.
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Affiliation(s)
- Zi-Liang Wang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China.,IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China.,Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Marc N Potenza
- Department of Psychiatry and Child Study Center, Yale University School of Medicine, New Haven, CT, USA.,Connecticut Council on Problem Gambling, Wethersfield, CT, USA.,Connecticut Mental Health Center, New Haven, CT, USA.,Department of Neuroscience and Wu Tsai Institute, Yale University, New Haven, CT, USA
| | - Kun-Ru Song
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China.,IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Guang-Heng Dong
- Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, Zhejiang Province, China
| | - Xiao-Yi Fang
- Institute of Developmental Psychology, Beijing Normal University, Beijing, China
| | - Jin-Tao Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China.,IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
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Liu JL, Sun JT, Hu HL, Wang HY, Kang YX, Chen TQ, Chen ZH, Shang YX, Li YT, Hu B, Liu R. Structural and Functional Neural Alterations in Internet Addiction: A Study Protocol for Systematic Review and Meta-Analysis. Psychiatry Investig 2023; 20:69-74. [PMID: 36721888 PMCID: PMC9890045 DOI: 10.30773/pi.2021.0383] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 07/04/2022] [Indexed: 01/26/2023] Open
Abstract
A growing number of neuroimaging studies have revealed abnormal brain structural and functional alterations in subjects with internet addiction (IA), however, with conflicting conclusions. We plan to conduct a systematic review and meta-analysis on the studies of voxelbased morphometry (VBM) and resting-state functional connectivity (rsFC), to reach a consolidated conclusion and point out the future direction in this field. A comprehensive search of rsFC and VBM studies of IA will be conducted in the PubMed, Cochrane Library, and Web of Science databases to retrieve studies published from the inception dates to August 2021. If the extracted data are feasible, activation likelihood estimation and seed-based d mapping methods will be used to meta-analyze the brain structural and functional changes in IA patients. This study will hopefully reach a consolidated conclusion on the impact of IA on human brain or point out the future direction in this field.
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Affiliation(s)
- Jun-Li Liu
- Xi'an Technological University, Xi'an, China
| | - Jing-Ting Sun
- Shaanxi University of Chinese Medicine, Xianyang, China.,Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Hui-Lin Hu
- Arizona State University, Tempe, AZ, USA
| | | | - Yun-Xi Kang
- Xi'an Technological University, Xi'an, China
| | - Tian-Qi Chen
- Institution of Basic Medicine, Fourth Military Medical University, Xi'an, China
| | - Zhu-Hong Chen
- Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Yu-Xuan Shang
- Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Yu-Ting Li
- Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Bo Hu
- Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Rui Liu
- Department of Rehabilitation, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
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Turner D, Briken P, Grubbs J, Malandain L, Mestre-Bach G, Potenza MN, Thibaut F. The World Federation of Societies of Biological Psychiatry guidelines on the assessment and pharmacological treatment of compulsive sexual behaviour disorder. DIALOGUES IN CLINICAL NEUROSCIENCE 2022; 24:10-69. [PMID: 37522807 PMCID: PMC10408697 DOI: 10.1080/19585969.2022.2134739] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 09/18/2022] [Accepted: 10/03/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVES The current guidelines aim to evaluate the role of pharmacological agents in the treatment of patients with compulsive sexual behaviour disorder (CSBD). They are intended for use in clinical practice by clinicians who treat patients with CSBD. METHODS An extensive literature search was conducted using the English-language-literature indexed on PubMed and Google Scholar without time limit, supplemented by other sources, including published reviews. RESULTS Each treatment recommendation was evaluated with respect to the strength of evidence for its efficacy, safety, tolerability, and feasibility. Psychoeducation and psychotherapy are first-choice treatments and should always be conducted. The type of medication recommended depended mainly on the intensity of CSBD and comorbid sexual and psychiatric disorders. There are few randomised controlled trials. Although no medications carry formal indications for CSBD, selective-serotonin-reuptake-inhibitors and naltrexone currently constitute the most relevant pharmacological treatments for the treatment of CSBD. In cases of CSBD with comorbid paraphilic disorders, hormonal agents may be indicated, and one should refer to previously published guidelines on the treatment of adults with paraphilic disorders. Specific recommendations are also proposed in case of chemsex behaviour associated with CSBD. CONCLUSIONS An algorithm is proposed with different levels of treatment for different categories of patients with CSBD.
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Affiliation(s)
- Daniel Turner
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Peer Briken
- Institute for Sex Research, Sexual Medicine, and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Joshua Grubbs
- Department of Psychology, Bowling Green State University, Bowling Green, OH, USA
| | - Leo Malandain
- Department of Psychiatry and Addictive Disorders, University Hospital Cochin (site Tarnier) AP-HP, Paris, France
| | - Gemma Mestre-Bach
- Facultad de Ciencias de la Salud, Universidad Internacional de La Rioja, La Rioja, Spain
| | - Marc N. Potenza
- Departments of Psychiatry and Neuroscience and Child Study Center, Yale School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
| | - Florence Thibaut
- Department of Psychiatry and Addictive Disorders, University Hospital Cochin (site Tarnier) AP-HP, Paris, France
- INSERM U1266, Institute of Psychiatry and Neurosciences, University of Paris Cité, Paris, France
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Eye problems and musculoskeletal pain in Pokémon Go players. Sci Rep 2022; 12:19315. [PMID: 36369515 PMCID: PMC9652395 DOI: 10.1038/s41598-022-22428-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 10/14/2022] [Indexed: 11/13/2022] Open
Abstract
Individuals benefit from Pokémon Go (PG) gaming because this mobile augmented reality geolocation video game provides an attractive opportunity to increase physical activity outdoors and socialize. However, based on gaming and electronic media studies, intense involvement with PG is likely related to adverse phenomena, such as arm pain or eye-related problems. We aimed to test how PG use (problematic vs. non-problematic gaming and gaming time) is related to physical symptoms (pain in three body regions and computer vision syndrome). To dissect game-specific effects, we controlled for general problematic smartphone use, phubbing, and electronic media usage. PG players (N = 455) completed an online survey. We found that PG players with problematic game use reported more pain and vision problems. Problematic PG use was a better predictor of physical symptoms than PG gaming time and variables related to electronic media use. Problematic PG use and problematic smartphone use were correlated but independent predictors of physical symptoms. We conclude that the type of participation rather than the time spent playing predicts poorer physical health among PG players.
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Guo Z, He Y, Yang T, Ren L, Qiu R, Zhu X, Wu S. The roles of behavioral inhibition/activation systems and impulsivity in problematic smartphone use: A network analysis. Front Public Health 2022; 10:1014548. [PMID: 36339154 PMCID: PMC9627346 DOI: 10.3389/fpubh.2022.1014548] [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] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 09/27/2022] [Indexed: 01/27/2023] Open
Abstract
Background Behavioral inhibition/activation systems (BIS/BAS) and impulsivity are associated with problematic smartphone use (PSU). However, no studies to date have explored how the subdomains of BIS/BAS and the dimensions of impulsivity relate to the components of PSU in a joint framework. This study aimed to examine the relationships between the three constructs at a fine-grained level and identify the central nodes and bridge nodes of their relationships using network analysis. Methods A regularized partial correlation network of PSU, BIS/BAS, and impulsivity communities was estimated to investigate the connections between variables and determine the expected influence and bridge expected influence for each variable based on data from 325 Chinese adults. PSU, BIS/BAS, and impulsivity were assessed using the Smartphone Application-Based Addiction Scale (SABAS), BIS/BAS scales, and Barratt Impulsiveness Scale-Version 11 (BIS-11), respectively. Results In addition to connections within each community, network analysis revealed that there were connections between different communities, especially connections to PSU. I2 "motor impulsivity" was strongly associated with PSU2 "conflict" and PSU6 "relapse"; BASR "BAS-reward responsiveness" was strongly associated with PSU5 "withdrawal." Nodes BASR "BAS-reward responsiveness" and PSU6 "relapse" were the most central variables, while nodes BASR "BAS-reward responsiveness" and I2 "motor impulsivity" were the strongest bridge variables. Conclusion The connections between the subdomains of BIS/BAS and the components of PSU and between the dimensions of impulsivity and the components of PSU may be particularly important in the development and maintenance of PSU. The central variables identified here, along with the bridge variables, could be promising and effective targets for the prevention and intervention of PSU.
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Sexual Differences in Internet Gaming Disorder (IGD): From Psychological Features to Neuroanatomical Networks. J Clin Med 2022; 11:jcm11041018. [PMID: 35207293 PMCID: PMC8877403 DOI: 10.3390/jcm11041018] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/26/2022] [Accepted: 02/13/2022] [Indexed: 01/27/2023] Open
Abstract
Internet gaming disorder (IGD) has been included in the 2013 Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a condition in need of further study, and gaming disorder was recognized by the World Health Organization as a mental disorder in the International Classification of Disease (ICD-11) of 2018. IGD has different characteristics in the two sexes and is more prevalent in males than females. However, even if the female gamer population is constantly growing, the majority of available studies analyzed only males, or the data were not analyzed by sex. To better elucidate sex differences in IGD, we selectively reviewed research publications that evaluated IGD separately for males and females collected in approximately one hundred publications over the past 20 years. The available data in this narrative review indicate that IGD is strongly dimorphic by sex for both its psychological features and the involvement of different brain areas. Impulsivity, low self-control, anxiety, emotion dysregulation, and depression are some of the psychological features associated with IGD that show a sex dimorphism. At the same time, IGD and its psychological alterations are strongly correlated to dimorphic functional characteristics in relevant brain areas, as evidenced by fMRI. More research is needed to better understand sex differences in IGD. Animal models could help to elucidate the neurological basis of this disorder.
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Kim SJ, Eom H, Hoon Jung Y, Kim MK, Kim E, Kim JJ. Brain functional connectivity during and after imagery of gaming and alternative leisure activities in patients with internet gaming disorder. Neurosci Lett 2022; 772:136451. [PMID: 35041909 DOI: 10.1016/j.neulet.2022.136451] [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: 10/26/2021] [Revised: 01/10/2022] [Accepted: 01/10/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND The effect of gaming cue exposure on brain activity in patients with internet gaming disorder (IGD) has been investigated a lot, but the effect on brain connectivity has not. This study aimed to investigate the effects of imageries of gaming and alternative leisure activities on functional connectivity during the during-task and post-task states in patients with IGD. METHODS Twenty-nine patients and 20 healthy controls were scanned in the 6-min states before, during, and after the imagery tasks for gaming and alternative leisure behaviors using fMRI. Seed-based functional connectivity during and after the tasks were analyzed. The seeds were the nucleus accumbens (NAcc), ventral tegmental area (VTA), caudate, putamen, anterior cingulate cortex (ACC), and posterior cingulate cortex. RESULTS The group-by-state interaction effects for the during-tasks were found in caudate-, putamen-, and ACC-based connectivity, whereas those for the post-tasks were shown only in NAcc-based connectivity. In particular, patients showed that caudate-right parahippocampal gyrus connectivity and putamen-right orbitofrontal cortex connectivity increased during gaming and decreased during alternative, whereas NAcc-right precuneus connectivity decreased at baseline, increased in post-gaming, and were not different in post-alternative. CONCLUSION Differences in during-task connectivity of the habit/motor and salience networks and post-task resting-state connectivity of the reward and limbic networks between the two imagery tasks may differ between the groups. In the treatment of IGD, when these network connections are reactive to alternative leisure activity, just as to gaming activity, they seem to be freed from gaming addiction.
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Affiliation(s)
- Soo-Jeong Kim
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyojung Eom
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young Hoon Jung
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Min-Kyeong Kim
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eunjoo Kim
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae-Jin Kim
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
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Zhou W, Wang Y, Wang M, Wang Z, Zheng H, Wang M, Potenza MN, Dong G. Connectome-based prediction of craving for gaming in internet gaming disorder. Addict Biol 2022; 27:e13076. [PMID: 34176197 DOI: 10.1111/adb.13076] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 06/15/2021] [Accepted: 06/18/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Craving-related brain responses have been associated with the emergence and maintenance of addictions. However, little is known about brain network organizations underlying cravings in internet gaming disorder (IGD). METHODS Sixty-six IGD subjects and 61 matched individuals with recreational game use (RGU) were scanned while performing a cue-craving task. A recently developed whole-brain analysis approach, connectome-based predictive modelling (CPM) with leave-one-out cross-validation was conducted to identify networks that predicted craving responses in IGD. Then, the craving network was tested in different brain states (cue-craving under deprivation) to investigate replicability. RESULTS CPM identified an IGD craving network, as indicated by a significant correspondence between predicted and actual craving values (r = 0.49, p < 0.001), characterized by within-network default mode (DMN) connectivity and connectivity between canonical networks implicated in executive/cognitive control (frontoparietal, medial frontal, DMN) and reward responsiveness (subcortical, motor/sensory). Network strength in the cue-craving task during gaming deprivation also predicted IGD craving scores (r = 0.43, p = 0.017), indicating network replication across brain states. CONCLUSIONS The CPM results demonstrate that individual differences in cognitive, attention, and control network function can predict craving intensities in IGD subjects. These networks may be targets for potential interventions using brain modulation.
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Affiliation(s)
- Wei‐ran Zhou
- Center for Cognition and Brain Disorders The Affiliated Hospital of Hangzhou Normal University Hangzhou Zhejiang Province China
- Institutes of Psychological Sciences Hangzhou Normal University Hangzhou Zhejiang Province China
- Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments Hangzhou Zhejiang Province China
- College of Education Hangzhou Normal University Hangzhou Zhejiang Province China
| | - Yi‐ming Wang
- College of Education Hangzhou Normal University Hangzhou Zhejiang Province China
| | - Min Wang
- Center for Cognition and Brain Disorders The Affiliated Hospital of Hangzhou Normal University Hangzhou Zhejiang Province China
- Institutes of Psychological Sciences Hangzhou Normal University Hangzhou Zhejiang Province China
| | - Zi‐liang Wang
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research Beijing Normal University Beijing China
| | - Hui Zheng
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center Shanghai Jiaotong University School of Medicine Shanghai China
| | - Meng‐jing Wang
- Southeast University ‐ Monash University Joint Graduate School Southeast University Nanjing China
| | - Marc N. Potenza
- Department of Psychiatry and the Child Study Center Yale University School of Medicine New Haven Connecticut USA
- Department of Neuroscience Yale University New Haven Connecticut USA
- Connecticut Council on Problem Gambling Wethersfield Connecticut USA
- Connecticut Mental Health Center New Haven Connecticut USA
| | - Guang‐Heng Dong
- Center for Cognition and Brain Disorders The Affiliated Hospital of Hangzhou Normal University Hangzhou Zhejiang Province China
- Institutes of Psychological Sciences Hangzhou Normal University Hangzhou Zhejiang Province China
- Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments Hangzhou Zhejiang Province China
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Seo EH, Yang HJ, Kim SG, Park SC, Lee SK, Yoon HJ. A Literature Review on the Efficacy and Related Neural Effects of Pharmacological and Psychosocial Treatments in Individuals With Internet Gaming Disorder. Psychiatry Investig 2021; 18:1149-1163. [PMID: 34872237 PMCID: PMC8721297 DOI: 10.30773/pi.2021.0207] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 10/27/2021] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE Internet gaming disorder (IGD) has attracted considerable attention as a serious mental and public health issue worldwide. Currently, there are no established treatment guidelines for IGD. Herein, we review the latest findings on the efficacy and related neural effects of pharmacological and psychosocial treatments for individuals with IGD. METHODS A database search of relevant studies published between 2007 and 2020 was conducted using PubMed and Google Scholar. Twenty-seven studies were reviewed for current evidence related to the efficacy and neural effects of pharmacological and psychosocial IGD treatments. RESULTS Pharmacological studies suggest that bupropion may play a significant role in IGD. Additionally, nuclear imaging studies on IGD have demonstrated functional impairment of the dopamine system, providing a neurobiological basis for the efficacy of dopamineenhancing drugs. Among the various psychosocial interventions, current evidence suggests that cognitive behavioral therapy may be an effective intervention for IGD. Cognitive behavioral therapy and bupropion were found to influence resting-state functional connectivity within the cortico-subcortical circuit and default mode network, suggesting a possible neural mechanism. Innovative approaches, including virtual reality treatment, residential camps, voluntary abstinence, and transcranial direct current stimulation, have shown promising results. However, methodological limitations, such as the absence of proper controls, small sample sizes, short duration, inconsistency of inclusion criteria across studies, and self-report measures of outcome, hamper conclusions regarding the efficacy of treatments. CONCLUSION Ongoing basic research and clinical trials overcoming these limitations could add to the existing knowledge on IGD and contribute to the development of evidence-based treatments.
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Affiliation(s)
- Eun Hyun Seo
- Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Hae-Jung Yang
- Department of Psychiatry, Chosun University Hospital, Gwangju, Republic of Korea
| | - Seung-Gon Kim
- Department of Psychiatry, Chosun University Hospital, Gwangju, Republic of Korea.,Department of Psychiatry, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Seon-Cheol Park
- Department of Psychiatry, Hanyang University Guri Hospital, Guri, Republic of Korea
| | - Sang-Kyu Lee
- Department of Psychiatry, College of Medicine, Hallym University, Chuncheon, Republic of Korea
| | - Hyung-Jun Yoon
- Department of Psychiatry, Chosun University Hospital, Gwangju, Republic of Korea.,Department of Psychiatry, College of Medicine, Chosun University, Gwangju, Republic of Korea
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Xu LX, Wu LL, Geng XM, Wang ZL, Guo XY, Song KR, Liu GQ, Deng LY, Zhang JT, Potenza MN. A review of psychological interventions for internet addiction. Psychiatry Res 2021; 302:114016. [PMID: 34087672 DOI: 10.1016/j.psychres.2021.114016] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 05/16/2021] [Indexed: 12/20/2022]
Abstract
Internet addiction (IA) may constitute a widespread and serious mental problem. Previous reviews have not fully considered potential factors that may contribute to therapeutic outcomes or predict behavioral changes. Such information is relevant to understand the active ingredients of interventions and to develop more efficacious treatments that target features of IA. This systematic review was designed to relate theories of IA to treatments, describe studies of psychotherapies for IA, and propose a model of addiction and interventions based on extant studies. A computer database search of PubMed, PsychINFO, ScienceDirect, China National Knowledge Infrastructure, and Google Scholar was conducted to identify all available research evidence on psychological treatments for IA (N = 31 studies). Among these psychological interventions, the targeted reduction of addiction-related impulsivity and craving, improvement of cognitive maladjustment, and alleviation of family problems have been investigated in IA interventions. The targeted domains and intervention methods are not mutually exclusive, and further research is needed to demonstrate the effective components and mechanisms of action for treatments of IA. Such research will help generate more efficacious evidence-based interventions.
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Affiliation(s)
- Lin-Xuan Xu
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Lu-Lu Wu
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Xiao-Min Geng
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Zi-Liang Wang
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | | | - Kun-Ru Song
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Guan-Qun Liu
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Lin-Yuan Deng
- Faculty of Education, Beijing Normal University, Beijing 100875, China
| | - Jin-Tao Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China.
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Child Study Center, Yale University School of Medicine, New Haven, CT, USA; Department of Neuroscience, Yale University School of Medicine, Connecticut Mental Health Center, New Haven, Connecticut Council on Problem Gambling, Wethersfield, CT, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA; Connecticut Mental Health Center, New Haven, CT, USA
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13
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Han DH, Bae S, Hong J, Kim SM, Son YD, Renshaw P. Resting-State fMRI Study of ADHD and Internet Gaming Disorder. J Atten Disord 2021; 25:1080-1095. [PMID: 31640464 DOI: 10.1177/1087054719883022] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Objective: We aimed to understand whether Attention Deficit Hyperactivity Disorder (ADHD) and Internet gaming disorder (IGD) share similar brain functional connectivity (FC) between the frontal and subcortices. Method: We compared changes in clinical symptoms and brain activity using functional magnetic resonance imaging (fMRI) in 26 patients with ADHD but without IGD, 29 patients with ADHD and IGD, and 20 patients with IGD but without ADHD. Results: The functional connectivity (FC) from the cortex to subcortex in both groups was decreased relative to that in age-matched healthy participants. One-year treatment for ADHD and IGD symptoms increased the FC between the cortex and subcortex in all ADHD participants and all IGD participants with good prognoses compared with those in all ADHD participants and all IGD participants with poor prognoses. Conclusion: Patients with ADHD and IGD shared similar brain FC at baseline and FC changes in response to treatment.
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Affiliation(s)
| | - Sujin Bae
- Chung-Ang University, Seoul, South Korea
| | - Jisun Hong
- Chung-Ang University, Seoul, South Korea
| | - Sun Mi Kim
- Chung-Ang University Hospital, Seoul, South Korea
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14
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Ahn J, Lee D, Namkoong K, Jung YC. Altered Functional Connectivity of the Salience Network in Problematic Smartphone Users. Front Psychiatry 2021; 12:636730. [PMID: 34349676 PMCID: PMC8326368 DOI: 10.3389/fpsyt.2021.636730] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 06/16/2021] [Indexed: 11/18/2022] Open
Abstract
Smartphones provide convenience in everyday life. Smartphones, however, can elicit adverse effects when used excessively. The purpose of this study was to examine the underlying neurobiological alterations that arise from problematic smartphone use. We performed resting state seed-based functional connectivity (FC) analysis of 44 problematic smartphone users and 54 healthy controls. This analysis assessed the salience, central executive, default mode, and affective networks. Compared to controls, problematic smartphone users showed enhanced FC within the salience network and between the salience and default mode network. Moreover, we observed decreased FC between the salience and central executive network in problematic smartphone users, compared to controls. These results imply that problematic smartphone use is associated with aberrant FC in key brain networks. Our results suggest that changes in FC of key networks centered around the salience network might be associated with problematic smartphone use.
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Affiliation(s)
- Jaeun Ahn
- Psychiatry, National Health Insurance Service Ilsan Hospital, Goyang, South Korea.,Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Deokjong Lee
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea.,Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea
| | - Kee Namkoong
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea.,Psychiatry, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Young-Chul Jung
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea.,Psychiatry, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
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15
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Gullo MJ, Saunders JB. The essential role of theory in minimizing harm from emerging technologies. Lost in committee? •. J Behav Addict 2020; 9:879-885. [PMID: 33325839 PMCID: PMC8969739 DOI: 10.1556/2006.2020.00087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 10/13/2020] [Accepted: 10/25/2020] [Indexed: 12/03/2022] Open
Abstract
A coherent framework for addressing risk arising from new technologies is needed. In proposing a framework of broad application and future focus, where empirical evidence is scarce, reliance on strong theory becomes all the more important. Some technologies are more prone to excessive engagement than others (i.e. more addictive). Some users are also more susceptible to excessive engagement than others. Impulsivity theory emphasises the importance of reinforcement magnitude in determining the risk associated with a new technology, and that an individual's sensitivity to reinforcement (reward drive) and capacity to inhibit previously reinforced behaviour (rash impulsiveness) determines their susceptibility to problematic engagement. Online gaming provides a good example of how such theory can be applied to facilitate intervention efforts and develop policy.
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Affiliation(s)
| | - John B. Saunders
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, QLD 4072, Australia
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16
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Abstract
Abstract
Purpose of Review
Gaming disorder (GD), meanwhile classified as a mental disorder in both DSM-5 and ICD-11, is a current public health issue. Theoretical models assume core psychological processes, such as cue reactivity, craving, reward processing, decision-making, cognitive biases, inhibitory control, and stress relief, to be crucially involved in the development and maintenance of GD. This review summarizes neuroscientific findings on these processes in the context of GD as well as treatments and intervention programs addressing these processes.
Recent Findings
We identified overlaps regarding the involvement of neural structures and networks related to psychological processes which may be targeted by public health programs. Complex interactions between executive control, salience, reward, and habit networks are crucially linked to processes involved in GD and public health programs respectively.
Summary
We point at the difficulties of making one to one assignments of neural networks to psychological processes or interventions. Furthermore, new treatment and prevention programs of GD are discussed pointing at possible future directions for neuroscientific research and treatment programs for GD.
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Dong GH, Wang M, Zhang J, Du X, Potenza MN. Functional neural changes and altered cortical-subcortical connectivity associated with recovery from Internet gaming disorder. J Behav Addict 2019; 8:692-702. [PMID: 31891311 PMCID: PMC7044574 DOI: 10.1556/2006.8.2019.75] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND AND AIMS Although studies have suggested that individuals with Internet gaming disorder (IGD) may have impairments in cognitive functioning, the nature of the relationship is unclear given that the information is typically derived from cross-sectional studies. METHODS Individuals with active IGD (n = 154) and those individuals no longer meeting criteria (n = 29) after 1 year were examined longitudinally using functional magnetic resonance imaging during performance of cue-craving tasks. Subjective responses and neural correlates were contrasted at study onset and at 1 year. RESULTS Subjects' craving responses to gaming cues decreased significantly at 1 year relative to study onset. Decreased brain responses in the anterior cingulate cortex (ACC) and lentiform nucleus were observed at 1 year relative to onset. Significant positive correlations were observed between changes in brain activities in the lentiform nucleus and changes in self-reported cravings. Dynamic causal modeling analysis showed increased ACC-lentiform connectivity at 1 year relative to study onset. CONCLUSIONS After recovery from IGD, individuals appear less sensitive to gaming cues. This recovery may involve increased ACC-related control over lentiform-related motivations in the control over cravings. The extent to which cortical control over subcortical motivations may be targeted in treatments for IGD should be examined further.
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Affiliation(s)
- Guang-Heng Dong
- Center for Cognition and Brain Disorder, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China,Zhejiang Key Laboratory for Assessment of Cognitive Impairments, Hangzhou, China,Corresponding authors: Guang-Heng Dong, PhD; Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, 2318 Yuhangtang Road, Hangzhou, Zhejiang Province 311121, China; Phone: +86 158 6794 9909; Fax: +86 571 2886 7717; E-mail: ; Marc N. Potenza, PhD, MD; Department of Psychiatry, Yale University School of Medicine, 1 Church Street, New Haven 06511, CT, USA; Phone: +1 203 737 3553; Fax: +1 203 737 3591; E-mail:
| | - Min Wang
- Center for Cognition and Brain Disorder, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
| | - Jialin Zhang
- Department of Psychology, Zhejiang Normal University, Jinhua, China
| | - Xiaoxia Du
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, China
| | - Marc N. Potenza
- Department of Psychiatry, Department of Neurobiology, and Child Study Center, Yale University School of Medicine, New Haven, CT, USA,The Connecticut Council on Problem Gambling, Wethersfield, CT, USA,The Connecticut Mental Health Center, New Haven, CT, USA,Corresponding authors: Guang-Heng Dong, PhD; Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, 2318 Yuhangtang Road, Hangzhou, Zhejiang Province 311121, China; Phone: +86 158 6794 9909; Fax: +86 571 2886 7717; E-mail: ; Marc N. Potenza, PhD, MD; Department of Psychiatry, Yale University School of Medicine, 1 Church Street, New Haven 06511, CT, USA; Phone: +1 203 737 3553; Fax: +1 203 737 3591; E-mail:
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18
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McClintock CH, Worhunsky PD, Xu J, Balodis IM, Sinha R, Miller L, Potenza MN. Spiritual experiences are related to engagement of a ventral frontotemporal functional brain network: Implications for prevention and treatment of behavioral and substance addictions. J Behav Addict 2019; 8:678-691. [PMID: 31891313 PMCID: PMC7044576 DOI: 10.1556/2006.8.2019.71] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND AND AIMS Spirituality is an important component of 12-step programs for behavioral and substance addictions and has been linked to recovery processes. Understanding the neural correlates of spiritual experiences may help to promote efforts to enhance recovery processes in behavioral addictions. We recently used general linear model (GLM) analyses of functional magnetic resonance imaging data to examine neural correlates of spiritual experiences, with findings implicating cortical and subcortical brain regions. Although informative, the GLM-based approach does not provide insight into brain circuits that may underlie spiritual experiences. METHODS Spatial independent component analysis (sICA) was used to identify functional brain networks specifically linked to spiritual (vs. stressful or neutral-relaxing) conditions using a previously validated guided imagery task in 27 young adults. RESULTS Using sICA, engagement of a ventral frontotemporal network was identified that was engaged at the onset and conclusion of the spiritual condition in a manner distinct from engagement during the stress or neutral-relaxing conditions. Degree of engagement correlated with subjective reports of spirituality in the scanner (r = .71, p < .001) and an out-of-the-magnet measure of spirituality (r = .48, p < .018). DISCUSSION AND CONCLUSION The current findings suggest a distributed functional neural network associated with spiritual experiences and provide a foundation for investigating brain mechanisms underlying the role of spirituality in recovery from behavioral addictions.
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Affiliation(s)
- Clayton H. McClintock
- Spirituality Mind Body Institute, Teachers College, Columbia University, New York, NY, USA
| | - Patrick D. Worhunsky
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Jiansong Xu
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Iris M. Balodis
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA,Peter Boris Centre for Addictions Research, Department of Psychiatry and Behavioral Neurosciences, DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Rajita Sinha
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA,Child Study Center, Yale University School of Medicine, New Haven, CT, USA,Department of Neuroscience, Yale University School of Medicine, New Haven, CT, USA
| | - Lisa Miller
- Spirituality Mind Body Institute, Teachers College, Columbia University, New York, NY, USA
| | - Marc N. Potenza
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA,Department of Neuroscience, Yale University School of Medicine, New Haven, CT, USA,Connecticut Mental Health Center, New Haven, CT, USA,Connecticut Council on Problem Gambling, Wethersfield, CT, USA,Corresponding author: Marc N. Potenza, MD, PhD; Department of Neuroscience, Yale University School of Medicine, 1 Church Street, 7th floor New Haven, CT 06510, USA; Phone: +1 203 737 3553; Fax: +1 203 737 3591; E-mail:
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19
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Rahmani F, Sanjari Moghaddam H, Aarabi MH. Microstructural changes and internet addiction behaviour: A preliminary diffusion MRI study. Addict Behav 2019; 98:106039. [PMID: 31302309 DOI: 10.1016/j.addbeh.2019.106039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Revised: 06/05/2019] [Accepted: 06/26/2019] [Indexed: 11/18/2022]
Abstract
Internet addiction (IA) is a major health problem and is associated with comorbidities like insomnia and depression. These consequences frequently confound neuroanatomical correlates of IA in those suffering from it. We enrolled a number of 123 healthy native German-speaking adults (53 male, mean age: 36.8 ± 18.86) from the Leipzig Study for Mind-Body-Emotion Interactions (LEMON) database, for whom diffusion MRI data, internet addiction test, brief self-control scale (SCS), coping orientations to problems experienced (COPE), and depression scores were available. DMRI connectometry was used to investigate white matter microstructural correlates of the severity of internet addiction identified through IAT, in a group of healty young individuals. A multiple regression model was adopted with age, gender, SCS total score, COPE total score, and BDI-sum as covariates to track white matter fibers in which connectivity was associated with IAT. The connectometry analysis identified a direct correlation between connectivity in the splenium of corpus callosum (CC), parts of bilateral corticospinal tracts (CST), and bilateral arcuate fasciculi (AF) (FDR = 0.0023001), and an inverse correlation of the connectivity in the genu of CC and right fornix (FDR = 0.047138), with the IAT score in healthy adults. We suggest connectivity in the CC and CST as well as fornix and AF to be considered as microstructural biomarkers of predisposition to IA in healthy population.
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Affiliation(s)
- Farzaneh Rahmani
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran; Neuroimaging Network (NIN), Universal Scientific Education and Research Network, Tehran, Iran
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20
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Zajac K, Ginley MK, Chang R. Treatments of internet gaming disorder: a systematic review of the evidence. Expert Rev Neurother 2019; 20:85-93. [PMID: 31544539 DOI: 10.1080/14737175.2020.1671824] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Introduction: The American Psychiatric Association included Internet gaming disorder (IGD) in the 5th Edition of the Diagnostic and Statistical Manual of Mental Disorders, and the World Health Organization included gaming disorder in the 11th revision of the International Classification of Diseases. These recent updates suggest significant concern related to the harms of excessive gaming.Areas covered: This systematic review provides an updated summary of the scientific literature on treatments for IGD. Inclusion criteria were that studies: 1) evaluate the effectiveness of an intervention for IGD or excessive gaming; 2) use an experimental design (i.e. multi-armed [randomized or nonrandomized] or pretest-posttest); 3) include at least 10 participants per group; and 4) include an outcome measure of IGD symptoms or gaming duration. The review identified 22 studies evaluating treatments for IGD: 8 evaluating medication, 7 evaluating cognitive behavioral psychotherapy, and 7 evaluating other interventions and psychosocial treatments.Expert opinion: Even with the recent uptick in publication of such clinical trials, methodological flaws prevent strong conclusions about the efficacy of any treatment for IGD. Additional well-designed clinical trials using common metrics for assessing IGD symptoms are needed to advance the field.
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Affiliation(s)
- Kristyn Zajac
- Calhoun Cardiology Center, Department of Medicine, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Meredith K Ginley
- Department of Psychology, East Tennessee State University, Johnson City, TN, USA
| | - Rocio Chang
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
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21
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Vaccaro AG, Potenza MN. Diagnostic and Classification Considerations Regarding Gaming Disorder: Neurocognitive and Neurobiological Features. Front Psychiatry 2019; 10:405. [PMID: 31258494 PMCID: PMC6586738 DOI: 10.3389/fpsyt.2019.00405] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 05/21/2019] [Indexed: 12/26/2022] Open
Abstract
Video gaming and Internet use have become a part of the everyday lives of many individuals, especially during adolescence. Given the health concerns related to problematic gaming behaviors, gaming disorder (GD) has been included in the version of the 11th edition of The International Classification of Diseases (ICD-11) ratified by the secretariat of the World Health Organization. Given these considerations and others (including debate regarding the most appropriate classification of GD and how best to prevent and treat the condition), there is a need for further research into GD. Specifically, we suggest that researching intermediate phenotypes focusing on cognitive and neurobiological function may help clarify GD's relationships to other addictive disorders and more accurately define their relationships with core and associated features of GD. Overlaps in neural activity, cognitive functioning, and other features suggest that GD shares similarities with gambling and substance-use disorders and may best be classified as an addictive disorder. Individuals with GD differ from those with regular game use (RGU) on neurocognitive levels. However, concerns have been raised with respect to the differences between GD and substance-use disorders in certain dimensional features, such as tolerance. Additionally, it has been argued that differences between GD and RGU may not be fully captured by nomenclature systems like the ICD-11. Nonetheless, individuals seek treatment for help with GD, despite the limited data available for effective treatments. As more data are gathered from investigations of GD, they should be translated into refining criteria for GD and optimizing interventions.
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Affiliation(s)
- Anthony G. Vaccaro
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
- Brain and Creativity Institute, Dornsife College of Arts and Sciences, University of Southern California, Los Angeles, CA, United States
| | - Marc N. Potenza
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT, United States
- Connecticut Council on Problem Gambling, Wethersfield, CT, United States
- Connecticut Mental Health Center, New Haven, CT, United States
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22
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Costa S, Kuss DJ. Current diagnostic procedures and interventions for Gaming Disorders: A Systematic Review. Front Psychol 2019; 10:578. [PMID: 30971971 PMCID: PMC6445881 DOI: 10.3389/fpsyg.2019.00578] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 03/01/2019] [Indexed: 12/24/2022] Open
Abstract
Background: Despite the growth in the number of studies on Gaming Disorders (GD), assessing the characteristics of clinical subjects is still limited. Driven by the need to overcome this limitation, a broad systematic review is essential to cover the studies that have already assessed the clinical characteristics of individuals diagnosed with GD. Objectives: The aim of this systematic review is to provide a broad cross-cultural picture of the current diagnostic procedures and interventions used for GDs in clinical practice. Methods: A total of 28 studies met the inclusion criteria, and data were synthesized in these categories: (1) the cultural background of the country where the research took place; (2) the instruments used to measure GD; (3) the diagnostic criteria for GD; (4) the diagnostic procedures used; and (5) the treatment protocol applied. Results: Results of this systematic review suggest that in GD clinical practice, there is a great deal of heterogeneity in the choice of instruments, the diagnostic and intervention processes for GD. Conclusions: This systematic review indicates that a validation process of standard procedures in clinical populations with GD is necessary to create clear shared guidelines for practitioners.
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Affiliation(s)
- Sebastiano Costa
- Dipartimento di Psicologia, Università degli Studi della Campania Luigi Vanvitelli, Caserta, Italy
| | - Daria J Kuss
- Department of Psychology, Nottingham Trent University, Nottingham, United Kingdom
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23
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Torres-Rodríguez A, Griffiths MD, Carbonell X, Oberst U. Treatment efficacy of a specialized psychotherapy program for Internet Gaming Disorder. J Behav Addict 2018; 7:939-952. [PMID: 30427213 PMCID: PMC6376389 DOI: 10.1556/2006.7.2018.111] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND AND AIMS Internet Gaming Disorder (IGD) has become health concern around the world, and specialized health services for the treatment of IGD are emerging. Despite the increase in such services, few studies have examined the efficacy of psychological treatments for IGD. The primary aim of this study was to assess the efficacy of a specialized psychotherapy program for adolescents with IGD [i.e., the "Programa Individualizado Psicoterapéutico para la Adicción a las Tecnologías de la Información y la Comunicación" (PIPATIC) program]. METHODS The sample comprised 31 adolescents (aged 12-18 years) from two public mental health centers who were assigned to either the (a) PIPATIC intervention experimental group or (b) standard cognitive-behavioral therapy (CBT) control group. The interventions were assessed at pre-, middle-, and post-treatment phases, as well as a 3-month assessment was carried out after completing the interventions. RESULTS No significant differences between either group in the pre-treatment phase were found. Relating to the different interventions examined, significant differences were found at pre-test and post-test on the following variables: comorbid disorders, intrapersonal and interpersonal abilities, family relationships, and therapists' measures. Both groups experienced a significant reduction of IGD symptoms, although the PIPATIC group experienced higher significant improvements in the remainder of the variables examined. DISCUSSION AND CONCLUSIONS The findings suggest that PIPATIC program is effective in the treatment of IGD and its comorbid disorders/symptoms, alongside the improvement of intra- and interpersonal abilities and family relationships. However, it should also be noted that standard CBT was also effective in the treatment of IGD. Changing the focus of treatment and applying an integrative focus (including the addiction, the comorbid symptoms, intra- and interpersonal abilities, and family psychotherapy) appear to be more effective in facilitating adolescent behavior change than CBT focusing only on the IGD itself.
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Affiliation(s)
- Alexandra Torres-Rodríguez
- Psychology Department, FPCEE Blanquerna, Universitat Ramon Llull, Barcelona, Spain,Corresponding author: Alexandra Torres-Rodríguez; Psychology Department, FPCEE Blanquerna, Universitat Ramon Llull, 34 Císter Street, Barcelona 08022, Spain; Phone: +34 93 253 30 00; Fax: +34 93 253 30 32; E-mail:
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Xavier Carbonell
- Psychology Department, FPCEE Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Ursula Oberst
- Psychology Department, FPCEE Blanquerna, Universitat Ramon Llull, Barcelona, Spain
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24
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Potenza MN. Clinical neuropsychiatric considerations regarding nonsubstance or behavioral addictions. DIALOGUES IN CLINICAL NEUROSCIENCE 2018. [PMID: 29302225 PMCID: PMC5741111 DOI: 10.31887/dcns.2017.19.3/mpotenza] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Over the past several decades, non-substance-use behaviors like gambling, gaming, and sex have received greater consideration as possible foci of addictions. In this article, I will review the recent history and current status of non-substance or behavioral addictions. A main focus will involve gambling and gambling disorder, given that the latter is currently the sole non-substance addictive disorder described in the main text of the current (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Internet gaming disorder, currently in the DSM-5 section addressing conditions that may need additional research, will also be considered, as will the concept of Internet addiction. Compulsive sexual behaviors (including problematic pornography use) will be considered, particularly with respect to how behavioral addictions may be considered in the forthcoming 11th edition of the International Classification of Diseases (ICD-11).
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Affiliation(s)
- Marc N Potenza
- Department of Psychiatry, Child Study Center, the National Center on Addiction and Substance Abuse, Yale University School of Medicine and the Connecticut Mental Health Center, Connecticut, USA
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25
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Yip SW, Gross JJ, Chawla M, Ma SS, Shi XH, Liu L, Yao YW, Zhu L, Worhunsky PD, Zhang J. Is Neural Processing of Negative Stimuli Altered in Addiction Independent of Drug Effects? Findings From Drug-Naïve Youth with Internet Gaming Disorder. Neuropsychopharmacology 2018; 43:1364-1372. [PMID: 29154365 PMCID: PMC5916358 DOI: 10.1038/npp.2017.283] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 11/05/2017] [Accepted: 11/08/2017] [Indexed: 12/31/2022]
Abstract
Difficulties in emotion regulation are commonly reported among individuals with alcohol and drug addictions and contribute to the acquisition and maintenance of addictive behaviors. Alterations in neural processing of negative affective stimuli have further been demonstrated among individuals with addictions. However, it is unclear whether these alterations are a general feature of addictions or are a result of prolonged exposure to drugs of abuse. To test the hypothesis of altered negative affect processing independent of drug effects, this study assessed neural function among drug-naïve youth with a behavioral addiction-Internet gaming disorder (IGD). Fifty-six young adults (28 with IGD, 28 matched controls) participated in fMRI scanning during performance of a well-validated emotion regulation task. Between-group differences in neural activity during task performance were assessed using a whole-brain, mixed-effects ANOVA with correction for multiple comparisons at currently recommended thresholds (voxel-level p<0.001, pFWE<0.05). Compared to controls, youth with IGD exhibited significantly blunted neural responses within distributed subcortical and cortical regions including the striatum, insula, lateral prefrontal cortex and anterior cingulate in response to negative affective cues, as well as during emotion regulation. Independent component analysis (ICA) further identified between-group differences in engagement of a fronto-cingulo-parietal network, involving decreased engagement in IGD youth relative to controls. Study findings are largely consistent with those from prior neuroimaging studies in substance-use disorders, thus raising the possibility that neural processing of negative affect may be blunted across drug and behavioral addictions independent of acute or chronic drug effects.
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Affiliation(s)
- Sarah W Yip
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - James J Gross
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Megha Chawla
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Shan-Shan Ma
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Xing-Hui Shi
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Lu Liu
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Yuan-Wei Yao
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Lei Zhu
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | | | - Jintao Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China,Institute of Developmental Psychology, Beijing Normal University, Beijing, China,State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, No. 19 XieJieKouWai Street, Haidian Strict, Beijing 100875, China, Tel: +861058800728, Fax: +8615010233046, E-mail:
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26
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Shin YB, Kim JJ, Kim MK, Kyeong S, Jung YH, Eom H, Kim E. Development of an effective virtual environment in eliciting craving in adolescents and young adults with internet gaming disorder. PLoS One 2018; 13:e0195677. [PMID: 29672530 PMCID: PMC5908156 DOI: 10.1371/journal.pone.0195677] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Accepted: 03/27/2018] [Indexed: 12/13/2022] Open
Abstract
Internet gaming disorder (IGD) is a new disorder that warrants further investigation, as recently noted in the research criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Offering controlled environments that increase cue-induced craving, virtual reality cue-exposure therapy has been shown to be effective for some addiction disorders. To assess the feasibility of virtual reality for patients with IGD, this study aimed to develop virtual environments that represent risk situations for inducing craving, and assess the effect of virtual reality in cue reactivity. A total of 64 male adolescents and young adults (34 with IGD and 30 without) were recruited for participation. We developed a virtual internet café environment and the participants were exposed to four different tasks. As the primary feasibility outcome, cravings were measured with a visual analogue scale measuring current urge to play a game after exposure to each task. The virtual internet café induced significantly greater cravings in patients with IGD compared to controls. Additionally, patients exhibited a significantly higher acceptance rate of an avatar's invitation to play a game together than that of controls. In IGD, craving response to the tasks was positively associated with the symptom severity score as measured by Young's Internet Addiction Test. These findings reveal that virtual reality laden with complex game-related cues could evoke game craving in patients with IGD and could be used in the treatment of IGD as a cue-exposure therapy tool for eliciting craving.
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Affiliation(s)
- Yu-Bin Shin
- Brain Korea 21 PLUS Project for Medical Science, Yonsei University, Seoul, Republic of Korea
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae-Jin Kim
- Brain Korea 21 PLUS Project for Medical Science, Yonsei University, Seoul, Republic of Korea
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Psychiatry, Yonsei University Gangnam Severance Hospital, Seoul, Republic of Korea
| | - Min-Kyeong Kim
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Psychiatry, Yonsei University Gangnam Severance Hospital, Seoul, Republic of Korea
| | - Sunghyon Kyeong
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young Hoon Jung
- Brain Korea 21 PLUS Project for Medical Science, Yonsei University, Seoul, Republic of Korea
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyojung Eom
- Brain Korea 21 PLUS Project for Medical Science, Yonsei University, Seoul, Republic of Korea
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eunjoo Kim
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Psychiatry, Yonsei University Gangnam Severance Hospital, Seoul, Republic of Korea
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27
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Tian M, Tao R, Zheng Y, Zhang H, Yang G, Li Q, Liu X. Internet gaming disorder in adolescents is linked to delay discounting but not probability discounting. COMPUTERS IN HUMAN BEHAVIOR 2018. [DOI: 10.1016/j.chb.2017.10.018] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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28
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Zhang JT, Ma SS, Li CSR, Liu L, Xia CC, Lan J, Wang LJ, Liu B, Yao YW, Fang XY. Craving behavioral intervention for internet gaming disorder: remediation of functional connectivity of the ventral striatum. Addict Biol 2018; 23:337-346. [PMID: 27894158 DOI: 10.1111/adb.12474] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 10/11/2016] [Accepted: 10/13/2016] [Indexed: 12/14/2022]
Abstract
Psychobehavioral intervention is an effective treatment of Internet addiction, including Internet gaming disorder (IGD). However, the neural mechanisms underlying its efficacy remain unclear. Cortical-ventral striatum (VS) circuitry is a common target of psychobehavioral interventions in drug addiction, and cortical-VS dysfunction has been reported in IGD; hence, the primary aim of the study was to investigate how the VS circuitry responds to psychobehavioral interventions in IGD. In a cross-sectional study, we examined resting-state functional connectivity of the VS in 74 IGD subjects (IGDs) and 41 healthy controls (HCs). In a follow-up craving behavioral intervention (CBI) study, of the 74 IGD subjects, 20 IGD subjects received CBI (CBI+) and 16 IGD subjects did not (CBI-). All participants were scanned twice with similar time interval to assess the effects of CBI. IGD subjects showed greater resting-state functional connectivity of the VS to left inferior parietal lobule (lIPL), right inferior frontal gyrus and left middle frontal gyrus, in positive association with the severity of IGD. Moreover, compared with CBI-, CBI+ showed significantly greater decrease in VS-lIPL connectivity, along with amelioration in addiction severity following the intervention. These findings demonstrated that functional connectivity between VS and lIPL, each presumably mediating gaming craving and attentional bias, may be a potential biomarker of the efficacy of psychobehavioral intervention. These results also suggested that non-invasive techniques such as transcranial magnetic or direct current stimulation targeting the VS-IPL circuitry may be used in the treatment of Internet gaming disorders.
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Affiliation(s)
- Jin-Tao Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research; Beijing Normal University; Beijing China
- Center for Collaboration and Innovation in Brain and Learning Sciences; Beijing Normal University; Beijing China
| | - Shan-Shan Ma
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research; Beijing Normal University; Beijing China
| | - Chiang-Shan R. Li
- Department of Psychiatry and Neuroscience; Yale University School of Medicine; New Haven CT USA
| | - Lu Liu
- Institute of Developmental Psychology; Beijing Normal University; Beijing China
| | - Cui-Cui Xia
- Students Counselling Center; Beijing Normal University; Beijing China
| | - Jing Lan
- Institute of Developmental Psychology; Beijing Normal University; Beijing China
| | - Ling-Jiao Wang
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research; Beijing Normal University; Beijing China
| | - Ben Liu
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research; Beijing Normal University; Beijing China
| | - Yuan-Wei Yao
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research; Beijing Normal University; Beijing China
| | - Xiao-Yi Fang
- Institute of Developmental Psychology; Beijing Normal University; Beijing China
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29
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Han X, Wang Y, Jiang W, Bao X, Sun Y, Ding W, Cao M, Wu X, Du Y, Zhou Y. Resting-State Activity of Prefrontal-Striatal Circuits in Internet Gaming Disorder: Changes With Cognitive Behavior Therapy and Predictors of Treatment Response. Front Psychiatry 2018; 9:341. [PMID: 30123144 PMCID: PMC6085723 DOI: 10.3389/fpsyt.2018.00341] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 07/09/2018] [Indexed: 11/13/2022] Open
Abstract
Cognitive behavior therapy (CBT) is effective for the treatment of Internet gaming disorder (IGD). However, the mechanisms by which CBT improves IGD-related clinical symptoms remain unknown. This study aimed to discover the therapeutic mechanism of CBT in IGD subjects using resting-state functional magnetic resonance imaging (rsfMRI). Twenty-six IGD subjects and 30 matched healthy controls (HCs) received rsfMRI scan and clinical assessments; 20 IGD subjects completed CBT and then were scanned again. The amplitude of low-frequency (ALFF) values and the functional connectivity (FC) between the IGD group and the HC group were compared at baseline, as well as the ALFF values and FC before and after the CBT in the IGD group. Prior to treatment, the IGD group exhibited significantly increased ALFF values in the bilateral putamen, the right medial orbitofrontal cortex (OFC), the bilateral supplementary motor area (SMA), the left postcentral gyrus, and the left anterior cingulate (ACC) compared with the HC group. The HC group showed significantly increased FC values between the left medial OFC and the putamen compared with the IGD group, the FC values of IGD group were negatively associated with the BIS-11 scores before treatment. After the CBT, the weekly gaming time was significantly shorter, and the CIAS and BIS-II scores were significantly lower. The ALFF values in the IGD subjects significantly decreased in the left superior OFC and the left putamen, and the FC between them significantly increased after the CBT. The degree of the FC changes (ΔFC/Pre-FC) was positively correlated with the scale of the CIAS scores changes (ΔCIAS/Pre-CIAS) in the IGD subjects. CBT could regulate the abnormal low-frequency fluctuations in prefrontal-striatal regions in IGD subjects and could improve IGD-related symptoms. Resting-state alternations in prefrontal-striatal regions may reveal the therapeutic mechanism of CBT in IGD subjects.
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Affiliation(s)
- Xu Han
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yao Wang
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wenqing Jiang
- Department of Child and Adolescent Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaochen Bao
- Department of Child and Adolescent Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University, Shanghai, China
| | - Yawen Sun
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Weina Ding
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Mengqiu Cao
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaowei Wu
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yasong Du
- Department of Child and Adolescent Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University, Shanghai, China
| | - Yan Zhou
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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30
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Liu L, Yao YW, Li CSR, Zhang JT, Xia CC, Lan J, Ma SS, Zhou N, Fang XY. The Comorbidity Between Internet Gaming Disorder and Depression: Interrelationship and Neural Mechanisms. Front Psychiatry 2018; 9:154. [PMID: 29740358 PMCID: PMC5924965 DOI: 10.3389/fpsyt.2018.00154] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 04/04/2018] [Indexed: 12/14/2022] Open
Abstract
Internet gaming disorder (IGD) is characterized by cognitive and emotional deficits. Previous studies have reported the co-occurrence of IGD and depression. However, extant brain imaging research has largely focused on cognitive deficits in IGD. Few studies have addressed the comorbidity between IGD and depression symptoms and underlying neural mechanisms. Here, we systematically investigated this issue by combining a longitudinal survey study, a cross-sectional resting-state functional connectivity (rsFC) study and an intervention study. Autoregressive cross-lagged modeling on a longitudinal dataset of college students showed that IGD severity and depression are reciprocally predictive. At the neural level, individuals with IGD exhibited enhanced rsFC between the left amygdala and right dorsolateral prefrontal cortex (DLPFC), inferior frontal and precentral gyrus, compared with control participants, and the amygdala-frontoparietal connectivity at the baseline negatively predicted reduction in depression symptoms following a psychotherapy intervention. Further, following the intervention, individuals with IGD showed decreased connectivity between the left amygdala and left middle frontal and precentral gyrus, as compared with the non-intervention group. These findings together suggest that IGD may be closely associated with depression; aberrant rsFC between emotion and executive control networks may underlie depression and represent a therapeutic target in individuals with IGD. Registry name: The behavioral and brain mechanism of IGD; URL: https://www.clinicaltrials.gov/ct2/show/NCT02550405; Registration number: NCT02550405.
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Affiliation(s)
- Lu Liu
- Faculty of Psychology, Institute of Developmental Psychology, Beijing Normal University, Beijing, China.,State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Yuan-Wei Yao
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Chiang-Shan R Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States.,Beijing Huilongguan Hospital, Beijing, China
| | - Jin-Tao Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Cui-Cui Xia
- Students Counseling Center, Beijing Normal University, Beijing, China
| | - Jing Lan
- Faculty of Psychology, Institute of Developmental Psychology, Beijing Normal University, Beijing, China
| | - Shan-Shan Ma
- Faculty of Psychology, Institute of Developmental Psychology, Beijing Normal University, Beijing, China
| | - Nan Zhou
- Faculty of Psychology, Institute of Developmental Psychology, Beijing Normal University, Beijing, China
| | - Xiao-Yi Fang
- Faculty of Psychology, Institute of Developmental Psychology, Beijing Normal University, Beijing, China
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31
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Park S, Ryu H, Lee JY, Choi A, Kim DJ, Kim SN, Choi JS. Longitudinal Changes in Neural Connectivity in Patients With Internet Gaming Disorder: A Resting-State EEG Coherence Study. Front Psychiatry 2018; 9:252. [PMID: 29930524 PMCID: PMC5999751 DOI: 10.3389/fpsyt.2018.00252] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 05/23/2018] [Indexed: 01/25/2023] Open
Abstract
Aims: The present study investigated neural connectivity associated with treatment responses in patients with Internet gaming disorder (IGD) using resting-state electroencephalography (EEG) coherence analyses. Methods: We included 30 patients with IGD and 32 healthy control subjects (HCs). Of the IGD patients, 18 completed an outpatient treatment that included pharmacotherapy with selective serotonin reuptake inhibitors for 6 months. Resting-state EEG coherence and self-report questionnaires were used to evaluate clinical and psychological features pre- and post-treatment, and data were analyzed using generalized estimating equations. Results: Compared with HCs, patients with IGD showed increased beta and gamma intrahemispheric coherence and increased delta intrahemispheric coherence of the right hemisphere at baseline. After 6 months of outpatient management, patients with IGD exhibited improvements in IGD symptoms compared with baseline, but they continued to show increased beta and gamma intrahemispheric coherence compared with that of HCs. No significant EEG coherence changes between the pre- and post-treatment assessments were detected in any band in the IGD group. Conclusion: These findings suggest that significantly greater intrahemispheric fast-frequency coherence may be an important neurophysiological trait marker of patients with IGD.
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Affiliation(s)
- Sunyoung Park
- Department of Psychiatry SMG-SMU Boramae Medical Center, Seoul, South Korea
| | - Hyera Ryu
- Department of Psychiatry SMG-SMU Boramae Medical Center, Seoul, South Korea
| | - Ji-Yoon Lee
- Department of Psychiatry SMG-SMU Boramae Medical Center, Seoul, South Korea
| | - Aruem Choi
- Department of Psychiatry SMG-SMU Boramae Medical Center, Seoul, South Korea
| | - Dai-Jin Kim
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine Catholic University of Korea, Seoul, South Korea
| | - Sung Nyun Kim
- Department of Psychiatry Seoul Medical Center, Seoul, South Korea
| | - Jung-Seok Choi
- Department of Psychiatry SMG-SMU Boramae Medical Center, Seoul, South Korea.,Department of Psychiatry and Behavioral Science Seoul National University College of Medicine, Seoul, South Korea
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32
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Zajac K, Ginley MK, Chang R, Petry NM. Treatments for Internet gaming disorder and Internet addiction: A systematic review. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2017; 31:979-994. [PMID: 28921996 PMCID: PMC5714660 DOI: 10.1037/adb0000315] [Citation(s) in RCA: 115] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Problems related to excessive use of the Internet and video games have recently captured the interests of both researchers and clinicians. The goals of this review are to summarize the literature on treatment effectiveness for these problems and to determine whether any treatments meet the minimum requirement of an evidence-based treatment as defined by Chambless et al. (1998). Studies of treatments for Internet gaming disorder (IGD) and Internet addiction were examined separately, as past studies have linked IGD to more severe outcomes. The systematic review identified 26 studies meeting predefined criteria; 13 focused on treatments for IGD and 13 on Internet addiction. The results highlighted a paucity of well-designed treatment outcome studies and limited evidence for the effectiveness of any treatment modality. Studies were limited by methodological flaws, including small sample sizes, lack of control groups, and little information on treatment adherence, among other problems. In addition, the field is beset by a lack of consistent definitions of and established instruments to measure IGD and Internet addiction. The results of this review highlight the need for additional work in the area of treatment development and evaluation for IGD and Internet addiction. Attention to methodological concerns identified within this review should improve subsequent research related to treating these conditions, and ultimately outcomes of patients suffering from them. (PsycINFO Database Record
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Affiliation(s)
- Kristyn Zajac
- Calhoun Cardiology Center, Department of Medicine, University of Connecticut School of Medicine
| | - Meredith K. Ginley
- Calhoun Cardiology Center, Department of Medicine, University of Connecticut School of Medicine
| | - Rocio Chang
- Department of Psychiatry, University of Connecticut School of Medicine
| | - Nancy M. Petry
- Calhoun Cardiology Center, Department of Medicine, University of Connecticut School of Medicine
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33
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Saunders JB, Hao W, Long J, King DL, Mann K, Fauth-Bühler M, Rumpf HJ, Bowden-Jones H, Rahimi-Movaghar A, Chung T, Chan E, Bahar N, Achab S, Lee HK, Potenza M, Petry N, Spritzer D, Ambekar A, Derevensky J, Griffiths MD, Pontes HM, Kuss D, Higuchi S, Mihara S, Assangangkornchai S, Sharma M, Kashef AE, Ip P, Farrell M, Scafato E, Carragher N, Poznyak V. Gaming disorder: Its delineation as an important condition for diagnosis, management, and prevention. J Behav Addict 2017; 6:271-279. [PMID: 28816494 PMCID: PMC5700714 DOI: 10.1556/2006.6.2017.039] [Citation(s) in RCA: 224] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Online gaming has greatly increased in popularity in recent years, and with this has come a multiplicity of problems due to excessive involvement in gaming. Gaming disorder, both online and offline, has been defined for the first time in the draft of 11th revision of the International Classification of Diseases (ICD-11). National surveys have shown prevalence rates of gaming disorder/addiction of 10%-15% among young people in several Asian countries and of 1%-10% in their counterparts in some Western countries. Several diseases related to excessive gaming are now recognized, and clinics are being established to respond to individual, family, and community concerns, but many cases remain hidden. Gaming disorder shares many features with addictions due to psychoactive substances and with gambling disorder, and functional neuroimaging shows that similar areas of the brain are activated. Governments and health agencies worldwide are seeking for the effects of online gaming to be addressed, and for preventive approaches to be developed. Central to this effort is a need to delineate the nature of the problem, which is the purpose of the definitions in the draft of ICD-11.
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Affiliation(s)
- John B. Saunders
- Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, QLD, Australia,Corresponding author: John B. Saunders; Centre for Youth Substance Abuse Research, The University of Queensland, 1 Macquarie Street, Sydney, NSW 2000, Australia; Phone: +61 2 9252 0959; E-mail:
| | - Wei Hao
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jiang Long
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Daniel L. King
- School of Psychology, The University of Adelaide, Adelaide, SA, Australia
| | - Karl Mann
- Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Mira Fauth-Bühler
- Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Hans-Jürgen Rumpf
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Henrietta Bowden-Jones
- Central North West London NHS Trust and Division of Brain Science, Imperial College London, London, UK
| | - Afarin Rahimi-Movaghar
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | | | - Elda Chan
- Integrated Centre on Addiction Prevention and Treatment, Tung Wah Group of Hospitals, Hong Kong SAR, China
| | - Norharlina Bahar
- Department of Psychiatry and Mental Health, Hospital Selayang, Selangor, Malaysia
| | - Sophia Achab
- Mental Health and Psychiatry Department, University Hospitals of Geneva, Geneva, Switzerland
| | - Hae Kook Lee
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Marc Potenza
- Departments of Psychiatry and Neuroscience, Child Study Center, and The National Center on Addiction and Substance Abuse, Yale University School of Medicine, and Connecticut Mental Health Center, New Haven, CT, USA
| | - Nancy Petry
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Daniel Spritzer
- Study Group on Technological Addictions, Porto Alegre, Brazil
| | - Atul Ambekar
- Department of Psychiatry, National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Jeffrey Derevensky
- Applied Child Psychology and Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Halley M. Pontes
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Daria Kuss
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Susumu Higuchi
- National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Kanagawa, Japan
| | - Satoko Mihara
- National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Kanagawa, Japan
| | - Sawitri Assangangkornchai
- Epidemiology Unit and Centre for Alcohol Studies, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Manoj Sharma
- National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Ahmad El Kashef
- National Rehabilitation Center, Abu Dhabi, United Arab Emirates
| | - Patrick Ip
- Department of Paediatrics & Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Michael Farrell
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, NSW, Australia
| | - Emanuele Scafato
- National Observatory on Alcohol, National Institute of Health, Rome, Italy
| | - Natacha Carragher
- Department of Mental Health and Substance Abuse, WHO Headquarters, Geneva, Switzerland
| | - Vladimir Poznyak
- Department of Mental Health and Substance Abuse, WHO Headquarters, Geneva, Switzerland
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34
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Potenza MN. Clinical neuropsychiatric considerations regarding nonsubstance or behavioral addictions. DIALOGUES IN CLINICAL NEUROSCIENCE 2017; 19:281-291. [PMID: 29302225 PMCID: PMC5741111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
Over the past several decades, non-substance-use behaviors like gambling, gaming, and sex have received greater consideration as possible foci of addictions. In this article, I will review the recent history and current status of non-substance or behavioral addictions. A main focus will involve gambling and gambling disorder, given that the latter is currently the sole non-substance addictive disorder described in the main text of the current (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Internet gaming disorder, currently in the DSM-5 section addressing conditions that may need additional research, will also be considered, as will the concept of Internet addiction. Compulsive sexual behaviors (including problematic pornography use) will be considered, particularly with respect to how behavioral addictions may be considered in the forthcoming 11th edition of the International Classification of Diseases (ICD-11).
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Affiliation(s)
- Marc N. Potenza
- Department of Psychiatry, Child Study Center, the National Center on Addiction and Substance Abuse, Yale University School of Medicine and the Connecticut Mental Health Center, Connecticut, USA
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35
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Park SM, Lee JY, Kim YJ, Lee JY, Jung HY, Sohn BK, Kim DJ, Choi JS. Neural connectivity in Internet gaming disorder and alcohol use disorder: A resting-state EEG coherence study. Sci Rep 2017; 7:1333. [PMID: 28465521 PMCID: PMC5430990 DOI: 10.1038/s41598-017-01419-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 03/28/2017] [Indexed: 12/24/2022] Open
Abstract
The present study compared neural connectivity and the level of phasic synchronization between neural populations in patients with Internet gaming disorder (IGD), patients with alcohol use disorder (AUD), and healthy controls (HCs) using resting-state electroencephalography (EEG) coherence analyses. For this study, 92 adult males were categorized into three groups: IGD (n = 30), AUD (n = 30), and HC (n = 32). The IGD group exhibited increased intrahemispheric gamma (30-40 Hz) coherence compared to the AUD and HC groups regardless of psychological features (e.g., depression, anxiety, and impulsivity) and right fronto-central gamma coherence positively predicted the scores of the Internet addiction test in all groups. In contrast, the AUD group showed marginal tendency of increased intrahemispheric theta (4-8 Hz) coherence relative to the HC group and this was dependent on the psychological features. The present findings indicate that patients with IGD and AUD exhibit different neurophysiological patterns of brain connectivity and that an increase in the fast phasic synchrony of gamma coherence might be a core neurophysiological feature of IGD.
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Affiliation(s)
- Su Mi Park
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea.,Department of Clinical Medical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ji Yoon Lee
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea.,Interdisciplinary Program in Neuroscience, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Yeon Jin Kim
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea
| | - Jun-Young Lee
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea.,Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hee Yeon Jung
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea.,Department of Clinical Medical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Bo Kyung Sohn
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea.,Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Dai Jin Kim
- Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
| | - Jung-Seok Choi
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea. .,Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Choi J, Cho H, Kim JY, Jung DJ, Ahn KJ, Kang HB, Choi JS, Chun JW, Kim DJ. Structural alterations in the prefrontal cortex mediate the relationship between Internet gaming disorder and depressed mood. Sci Rep 2017; 7:1245. [PMID: 28455501 PMCID: PMC5430685 DOI: 10.1038/s41598-017-01275-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 03/28/2017] [Indexed: 12/21/2022] Open
Abstract
Adaptive gaming use has positive effects, whereas depression has been reported to be prevalent in Internet gaming disorder (IGD). However, the neural correlates underlying the association between depression and Internet gaming remain unclear. Moreover, the neuroanatomical profile of the striatum in IGD is relatively less clear despite its important role in addiction. We found lower gray matter (GM) density in the left dorsolateral prefrontal cortex (DLPFC) in the IGD group than in the Internet gaming control (IGC) group and non-gaming control (NGC) group, and the GM density was associated with lifetime usage of Internet gaming, depressed mood, craving, and impulsivity in the gaming users. Striatal volumetric analysis detected a significant reduction in the right nucleus accumbens (NAcc) in the IGD group and its association with lifetime usage of gaming and depression. These findings suggest that alterations in the brain structures involved in the reward system are associated with IGD-related behavioral characteristics. Furthermore, the DLPFC, involved in cognitive control, was observed to serve as a mediator in the association between prolonged gaming and depressed mood. This finding may provide insight into an intervention strategy for treating IGD with comorbid depression.
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Affiliation(s)
- Jihye Choi
- Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Hyun Cho
- Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Jin-Young Kim
- Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Dong Jin Jung
- Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Kook Jin Ahn
- Department of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Hang-Bong Kang
- Department of Digital Media, The Catholic University of Korea, Bucheon, Korea
| | - Jung-Seok Choi
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Ji-Won Chun
- Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
| | - Dai-Jin Kim
- Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
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Wang Y, Wu L, Zhou H, Lin X, Zhang Y, Du X, Dong G. Impaired executive control and reward circuit in Internet gaming addicts under a delay discounting task: independent component analysis. Eur Arch Psychiatry Clin Neurosci 2017; 267:245-255. [PMID: 27506757 DOI: 10.1007/s00406-016-0721-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 08/01/2016] [Indexed: 12/28/2022]
Abstract
This study utilized independent component analysis to explore the abnormal functional connectivity (FC) in male participants with Internet gaming disorder (IGD). Functional magnetic resonance imaging and behavioral data were collected from 21 healthy controls (HC) and 18 IGD patients when they were performing a delay discounting task. Behavioral results revealed that the IGD patients showed higher delay discounting rates than HC. Two networks were found to be associated with IGD: (1) the executive control network containing the anterior cingulate cortex and the medial and superior frontal gyrus, and (2) the basal ganglia network containing the lentiform nucleus. Comparing to HC, IGD exhibited stronger FC when selecting small and now options. In addition, the delay discounting rates were positively correlated with the modulation of the two networks and the reaction time. The results suggested that the IGD patients have enhanced sensitivity to reward and decreased ability to control their impulsivity effectively, which leads to myopic decision making.
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Affiliation(s)
- Yifan Wang
- Department of Psychology, Zhejiang Normal University, 688 Yingbin Road, Jinhua, 321004, Zhejiang Province, People's Republic of China
| | - Lingdan Wu
- Department of Psychology, University of Konstanz, Constance, Germany
| | - Hongli Zhou
- Department of Psychology, Zhejiang Normal University, 688 Yingbin Road, Jinhua, 321004, Zhejiang Province, People's Republic of China
| | - Xiao Lin
- Peking-Tsinghua Center for Life Science, Peking University, Beijing, People's Republic of China
| | - Yifen Zhang
- Department of Psychology, Zhejiang Normal University, 688 Yingbin Road, Jinhua, 321004, Zhejiang Province, People's Republic of China
| | - Xiaoxia Du
- Department of Physics, Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, People's Republic of China
| | - Guangheng Dong
- Department of Psychology, Zhejiang Normal University, 688 Yingbin Road, Jinhua, 321004, Zhejiang Province, People's Republic of China.
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Liu L, Xue G, Potenza MN, Zhang JT, Yao YW, Xia CC, Lan J, Ma SS, Fang XY. Dissociable neural processes during risky decision-making in individuals with Internet-gaming disorder. Neuroimage Clin 2017; 14:741-749. [PMID: 28413776 PMCID: PMC5385591 DOI: 10.1016/j.nicl.2017.03.010] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 03/05/2017] [Accepted: 03/24/2017] [Indexed: 12/21/2022]
Abstract
Risk-taking is purported to be central to addictive behaviors. However, for Internet gaming disorder (IGD), a condition conceptualized as a behavioral addiction, the neural processes underlying impaired decision-making (risk evaluation and outcome processing) related to gains and losses have not been systematically investigated. Forty-one males with IGD and 27 healthy comparison (HC) male participants were recruited, and the cups task was used to identify neural processes associated with gain- and loss-related risk- and outcome-processing in IGD. During risk evaluation, the IGD group, compared to the HC participants, showed weaker modulation for experienced risk within the bilateral dorsolateral prefrontal cortex (DLPFC) (t = - 4.07; t = - 3.94; PFWE < 0.05) and inferior parietal lobule (IPL) (t = - 4.08; t = - 4.08; PFWE < 0.05) for potential losses. The modulation of the left DLPFC and bilateral IPL activation were negatively related to addiction severity within the IGD group (r = - 0.55; r = - 0.61; r = - 0.51; PFWE < 0.05). During outcome processing, the IGD group presented greater responses for the experienced reward within the ventral striatum, ventromedial prefrontal cortex, and orbitofrontal cortex (OFC) (t = 5.04, PFWE < 0.05) for potential gains, as compared to HC participants. Within the IGD group, the increased reward-related activity in the right OFC was positively associated with severity of IGD (r = 0.51, PFWE < 0.05). These results provide a neurobiological foundation for decision-making deficits in individuals with IGD and suggest an imbalance between hypersensitivity for reward and weaker risk experience and self-control for loss. The findings suggest a biological mechanism for why individuals with IGD may persist in game-seeking behavior despite negative consequences, and treatment development strategies may focus on targeting these neural pathways in this population.
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Affiliation(s)
- Lu Liu
- Institute of Developmental Psychology, Beijing Normal University, Beijing 100875, China
| | - Gui Xue
- State Key Laboratory of Cognitive Neuroscience, Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
- Center for Collaboration and Innovation in Brain and Learning Sciences, Beijing Normal University, Beijing 100875, China
| | - Marc N. Potenza
- Departments of Psychiatry and Neuroscience, the Child Study Center, the National Center on Addiction and Substance Abuse, Yale University School of Medicine, New Haven, CT 06519, USA
- Connecticut Mental Health Center, New Haven, CT 06519, USA
| | - Jin-Tao Zhang
- State Key Laboratory of Cognitive Neuroscience, Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
| | - Yuan-Wei Yao
- State Key Laboratory of Cognitive Neuroscience, Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
| | - Cui-Cui Xia
- Institute of Developmental Psychology, Beijing Normal University, Beijing 100875, China
- Students Counseling Center, Beijing Normal University, Beijing 100875, China
| | - Jing Lan
- Institute of Developmental Psychology, Beijing Normal University, Beijing 100875, China
| | - Shan-Shan Ma
- State Key Laboratory of Cognitive Neuroscience, Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
| | - Xiao-Yi Fang
- Institute of Developmental Psychology, Beijing Normal University, Beijing 100875, China
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Yao YW, Chen PR, Li CSR, Hare TA, Li S, Zhang JT, Liu L, Ma SS, Fang XY. Combined reality therapy and mindfulness meditation decrease intertemporal decisional impulsivity in young adults with Internet gaming disorder. COMPUTERS IN HUMAN BEHAVIOR 2017. [DOI: 10.1016/j.chb.2016.11.038] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Zhang JT, Yao YW, Potenza MN, Xia CC, Lan J, Liu L, Wang LJ, Liu B, Ma SS, Fang XY. Effects of craving behavioral intervention on neural substrates of cue-induced craving in Internet gaming disorder. NEUROIMAGE-CLINICAL 2016; 12:591-599. [PMID: 27699148 PMCID: PMC5035334 DOI: 10.1016/j.nicl.2016.09.004] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 08/09/2016] [Accepted: 09/05/2016] [Indexed: 01/15/2023]
Abstract
Internet gaming disorder (IGD) is characterized by high levels of craving for online gaming and related cues. Since addiction-related cues can evoke increased activation in brain areas involved in motivational and reward processing and may engender gaming behaviors or trigger relapse, ameliorating cue-induced craving may be a promising target for interventions for IGD. This study compared neural activation between 40 IGD and 19 healthy control (HC) subjects during an Internet-gaming cue-reactivity task and found that IGD subjects showed stronger activation in multiple brain areas, including the dorsal striatum, brainstem, substantia nigra, and anterior cingulate cortex, but lower activation in the posterior insula. Furthermore, twenty-three IGD subjects (CBI + group) participated in a craving behavioral intervention (CBI) group therapy, whereas the remaining 17 IGD subjects (CBI − group) did not receive any intervention, and all IGD subjects were scanned during similar time intervals. The CBI + group showed decreased IGD severity and cue-induced craving, enhanced activation in the anterior insula and decreased insular connectivity with the lingual gyrus and precuneus after receiving CBI. These findings suggest that CBI is effective in reducing craving and severity in IGD, and it may exert its effects by altering insula activation and its connectivity with regions involved in visual processing and attention bias. IGD subjects showed altered cue-induced neural activation in reward-related areas. IGD subjects alleviated IGD symptoms after CBI. IGD subjects showed higher insular activation after CBI. IGD subjects showed lower insula-lingual gyrus/precuneus connectivity after CBI.
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Affiliation(s)
- Jin-Tao Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
- Center for Collaboration and Innovation in Brain and Learning Sciences, Beijing Normal University, Beijing 100875, China
| | - Yuan-Wei Yao
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
| | - Marc N. Potenza
- Departments of Psychiatry and Neuroscience, Child Study Center, and CASAColumbia, Yale University School of Medicine, New Haven, CT 06519, USA
- Connecticut Mental Health Center, New Haven, CT 06519, USA
| | - Cui-Cui Xia
- Students Counseling Center, Beijing Normal University, Beijing 100875, China
| | - Jing Lan
- Institute of Developmental Psychology, Beijing Normal University, Beijing 100875, China
| | - Lu Liu
- Institute of Developmental Psychology, Beijing Normal University, Beijing 100875, China
| | - Ling-Jiao Wang
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
| | - Ben Liu
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
| | - Shan-Shan Ma
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
| | - Xiao-Yi Fang
- Institute of Developmental Psychology, Beijing Normal University, Beijing 100875, China
- Corresponding author.
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