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Li Q, Whelan JP. Behavioral Addiction from the Asian Americans Perspective: Exploration of Public and Help-Seeking Stigma. J Gambl Stud 2024; 40:367-385. [PMID: 37115421 PMCID: PMC10140728 DOI: 10.1007/s10899-023-10210-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2023] [Indexed: 04/29/2023]
Abstract
Asian Americans have been unlikely to seek mental health services despite their needs for treatment, particularly when experiencing significant gambling or Internet gaming problems. Stigma is often considered to be a barrier to seeking help. To understand how stigma impacts Asian Americans' willingness to seek mental health services, the present study used an online survey to investigate the public stigma associated with addictive behaviors and help-seeking stigma among Asian Americans. Participants (N = 431) who self-identified as Asian American, reside in the US. Using a between-groups vignette study design, it was found that the individual with a behavioral addiction received more stigma compared to the individual who experienced a financial crisis. In addition, participants were more likely to seek help if they experienced addictive behavioral problems rather than financial problems. Lastly, this study did not reveal a significant relation between public stigma attached to addictive behaviors and Asian Americans' willingness to seek help, but it found that participants' willingness to seek help was positively associated with public stigma of help seeking (β = 0.23) and negatively associated with self-stigma attached to help-seeking (β = - 0.09). Based on these findings, recommendations are provided to inform community outreach to reduce stigma and promote mental health service utilization among Asian Americans.
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Affiliation(s)
- Qian Li
- Northport VA Medical Center, 79 Middleville Rd, Northport, NY, 11768, USA.
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2
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Roza TH, Noronha LT, Shintani AO, Massuda R, Lobato MIR, Kessler FHP, Passos IC. Treatment Approaches for Problematic Pornography Use: A Systematic Review. Arch Sex Behav 2024; 53:645-672. [PMID: 37880509 DOI: 10.1007/s10508-023-02699-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 05/30/2023] [Accepted: 09/06/2023] [Indexed: 10/27/2023]
Abstract
Problematic pornography use (PPU) is an emerging condition associated with several negative psychological and sexual outcomes. This study aimed to systematically review treatment approaches for PPU. Potentially eligible studies were searched for in PubMed/MEDLINE, Embase, PsycINFO, and Web of Science up to April 1, 2023. The quality of the evidence was assessed with the use of the Joanna Briggs Institute's checklists, the Cochrane risk-of-bias tools, and the GRADE approach. A total of 8936 references were retrieved, and 28 studies were included in the systematic review (n = 500 participants). Included studies were case reports (k = 16), case series (k = 1), quasi-experimental investigations (k = 7), and randomized clinical trials (k = 4). The majority of included studies presented overall low quality and significant risk of bias, with all interventions receiving a low or very low rating according to the GRADE approach. Most studies investigated psychological interventions, with the predominance of second and third wave cognitive behavioral therapy interventions. Pharmacological treatments included opioid antagonists (naltrexone in most cases) and antidepressants, while one study investigated a protocol that included rTMS. Several investigations described the combination of psychological and pharmacological approaches. Most studies did not report on side effects, with online and self-help interventions presenting significant issues in terms of treatment adherence. Even though there are promising options that may have efficacy for the treatment of patients with PPU, the literature in the topic still presents significant limitations that compromise the reaching of more definitive conclusions.
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Affiliation(s)
- Thiago Henrique Roza
- Department of Psychiatry, Universidade Federal do Paraná, Rua Padre Camargo, 280, Curitiba, PR, CEP: 80060-240, Brazil.
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental and Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Lucas Tavares Noronha
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental and Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Augusto Ossamu Shintani
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental and Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Raffael Massuda
- Department of Psychiatry, Universidade Federal do Paraná, Rua Padre Camargo, 280, Curitiba, PR, CEP: 80060-240, Brazil
| | - Maria Inês Rodrigues Lobato
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Felix Henrique Paim Kessler
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Ives Cavalcante Passos
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental and Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Hamamura T, Kurokawa M, Mishima K, Konishi T, Nagata M, Honjo M. Standalone effects of focus mode and social comparison functions on problematic smartphone use among adolescents. Addict Behav 2023; 147:107834. [PMID: 37634339 DOI: 10.1016/j.addbeh.2023.107834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 07/19/2023] [Accepted: 08/12/2023] [Indexed: 08/29/2023]
Abstract
Problematic smartphone use (PSU) has been reported, particularly among adolescents. Digital interventions may be offered for preventing and reducing PSU. This study evaluated the effects of two smartphone-based interventions among adolescents. Grounded in nudge theory, the focus function allowed users to hide smartphone applications (apps) for a selected length of time, while the feedback function provided a social comparison of the smartphone use of the user and other users. In total, 305 adolescents with Android smartphones were randomly allocated to the focus-function group, feedback-function group or control group. Participants used their smartphones as usual during the two-week baseline period, followed by the one-week period of intervention app instillation and four-week period of intervention use. The primary outcome was self-reported PSU after the intervention period. The secondary outcomes were self-reported smartphone use time during weekdays and app-recorded smartphone use time and frequency. The Group × Time interaction effects showed reduced self-reported PSU in the focus-function and feedback-function groups, Cohen's d = -0.32, 95% CI [-0.63, -0.008], Cohen's d = -0.36, 95% CI [-0.66, -0.06], respectively. The app-recorded smartphone use frequency was also reduced in the focus-function and feedback-function groups, Cohen's d = -0.16, 95% CI [-0.07, -0.25], Cohen's d = -0.32, 95% CI [-0.23, -0.41], respectively. The findings suggest that both utilizing time-outs from nonessential apps and engaging in social comparison lower PSU and smartphone use frequency with small effect sizes. These functions may be noncoercive interventions for preventing and reducing PSU.
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Affiliation(s)
- Toshitaka Hamamura
- KDDI Research, Inc, Japan; National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Japan; College of Education, Psychology and Social Work, Flinders University, Australia.
| | - Masayuki Kurokawa
- Department of School Education, Aichi University of Education, Japan
| | - Koji Mishima
- Department of Contemporary Education, Chubu University, Japan
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Sinclair DL, Sussman S, Savahl S, Florence M, Vanderplasschen W. Narcotics Anonymous attendees' perceptions and experiences of substitute behaviors in the Western Cape, South Africa. Subst Abuse Treat Prev Policy 2023; 18:40. [PMID: 37408038 DOI: 10.1186/s13011-023-00552-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 06/26/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Much remains unknown about the dynamics of substitute behaviors during addiction recovery among persons attending recovery support groups. Insight into the nature, motives for, and course of substitute behaviors could help to shape recovery support and harm reduction services. METHODS Twenty-three semi-structured in-depth interviews (n = 14 males and n = 9 females) were conducted with a convenience sample of Narcotics Anonymous attendees from a number of groups in the Western Cape, South Africa. Participants ranged in age from 22-55 years (M = 39.3, SD = 9.35). RESULTS Thematic analysis yielded four themes: (i) substance-to-substance substitution; (ii) substance-to-behavior substitution; (iii) substitute behaviors and harm (reduction) and (iv) support needs to manage and resolve substitute behaviors. According to the study, participants' substitute behaviors developed across recovery stages; were temporary or long-term replacements for substance use disorders and were engaged for distraction, isolation from others, calming, assuaging boredom, keeping occupied, filling a perceived experiential void, modifying mood and to self-medicate. While substitutes were utilized for harm reduction or relapse prevention, the potential for ostensibly healthy behaviors to threaten recovery and lead to relapse was also recognized. CONCLUSIONS Self-monitoring, ongoing vigilance, and awareness of when substitutes become genuine addictions are critical for timely, suitable interventions.
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Affiliation(s)
- Deborah Louise Sinclair
- Department of Psychology, University of the Western Cape, Cape Town, 7535, South Africa.
- Department of Special Needs Education, Ghent University, 9000, Ghent, Belgium.
| | - Steve Sussman
- Departments of Population and Public Health Sciences, and Psychology, and School of Social Work, University of Southern California, Los Angeles, CA, 90032-3628, USA
| | - Shazly Savahl
- Centre for Interdisciplinary Studies of Children, Families and Society, University of the Western Cape, South Africa, Cape Town, 7535, South Africa
| | - Maria Florence
- Department of Psychology, University of the Western Cape, Cape Town, 7535, South Africa
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Ghinassi S, Casale S. The Role of Attachment in Gambling Behaviors and Gambling Disorder: A Systematic Review. J Gambl Stud 2023; 39:713-749. [PMID: 36322300 PMCID: PMC10175436 DOI: 10.1007/s10899-022-10163-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2022] [Indexed: 05/13/2023]
Abstract
In recent years, a growing number of attachment-based studies have contributed to the understanding of both substance and behavioral addictions. Although gambling is a form of addictive behavior widespread all over the world, both among young people and adults, the evidence on the association between attachment-related phenomena and gambling has not yet been systematized in literature. The aim of the present study, therefore, is to provide a systematic literature review aimed at summarizing the empirical evidence on this topic. Following the updated 2020 PRISMA guidelines, a systematic search in four electronic scientific databases (Scopus, PubMed, PsycInfo and Web of Science) was conducted. After removing duplicates, 146 records were double-screened, with 12 articles meeting the inclusion criteria. Additionally, by means of a backward search a further article was selected. Altogether, 13 articles were selected for the present systematic review. With few exceptions, the results underline the significant role played by attachment-related phenomena in gambling behaviors, highlighting that specific attachment contexts have a different influence on gambling, also depending on whether gamblers are youths or adults. In particular, while secure attachment has proven to be a protective factor for the onset of gambling behavior, insecure attachment has emerged to be a vulnerability factor in two ways. On the one hand, it directly favors gambling behaviors; on the other, it affects coping strategies and the individual's ability to identify and regulate emotions, which in turn predict gambling. Limitations, strengths, and implications of the present systematic review are discussed.
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Affiliation(s)
- Simon Ghinassi
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla, 3, 50134, Florence, Italy
| | - Silvia Casale
- Department of Health Sciences, Psychology Unit, University of Florence, Via di San Salvi, 12, 50135, Florence, Italy.
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Péter L, Paksi B, Magi A, Eisinger A, Kótyuk E, Czakó A, Griffiths MD, Demetrovics Z, Andó B. Severity of behavioral addiction symptoms among young adults using non-prescribed sedatives/hypnotics. Addict Behav Rep 2023; 17:100485. [PMID: 36941849 PMCID: PMC10024082 DOI: 10.1016/j.abrep.2023.100485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 02/23/2023] [Accepted: 02/27/2023] [Indexed: 03/09/2023] Open
Abstract
Introduction Young adulthood is considered a critical period in terms of non-medical use of sedatives/hypnotics (NMUSH) as well as different types of behavioral addictions (BAs). However, the relationship between these behaviors has received scarce attention among young adult samples. Therefore, the aim of the present study was to investigate the association between NMUSH and symptoms of distinct BAs among young adults. Materials and methods Analyses were conducted based on the data of two large sample studies (including a representative sample) carried out with young adult samples. The following BAs were assessed: problematic internet use, problematic video gaming, problematic social media use, problem gambling, exercise addiction, eating disorders, compulsive buying behavior, problematic mobile phone use, work addiction, and hair pulling. Symptoms of distinct BAs were analyzed in three groups formed based on the NMUSH: non-users, lifetime users, and current users. Results The symptoms of problematic internet use, problematic social media use, problem gambling, exercise addiction, eating disorders, compulsive buying behavior and work addiction were significantly more severe among lifetime and/or current non-medical sedative and hypnotic users, compared to the non-user participants. The symptoms of problematic mobile phone use were the most severe in the non-user group. Conclusions The results suggest co-occurrence between NMUSH and distinct BAs among young adults. These findings draw attention to the need for preventive interventions for this high-risk population.
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Key Words
- BA, behavioral addiction
- BLS, Budapest Longitudinal Study
- BWAS, Bergen Work Addiction Scale
- Behavioral addictions
- CUs, current users
- DSM‐IV‐MR‐J, Diagnostic Statistical Manual‐IV‐Adapted for Juveniles
- EAI, Exercise Addiction Inventory
- Hypnotics
- IGD, internet gaming disorder
- IGDT-10, Ten-Item Internet Gaming Disorder Test
- LUs, lifetime users
- MGH-HPS, Massachusetts General Hospital Hairpulling Scale
- NMUSH, non-medical use of sedatives/hypnotics
- NUs, non-users
- Non-medical prescription drug use
- PGA, Psychological and Genetic Factors of Addictive Behaviors Study
- PGSI, Problem Gambling Severity Index
- PIUQ, Problematic Internet Use Questionnaire
- PMPUQ-SV, Problematic Mobile Phone Use Questionnaire
- POGQ, Problematic Online Gaming Questionnaire
- RCBS, Richmond Compulsive Buying Scale
- Sedatives
- Young adults
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Affiliation(s)
- Lea Péter
- Department of Psychiatry, University of Szeged, 8-10 Korányi fasor, Szeged H-6720, Hungary
| | - Borbála Paksi
- Institute of Education, ELTE Eötvös Loránd University, 23-27 Kazinczy Street, Budapest H-1075, Hungary
| | - Anna Magi
- Doctoral School of Psychology, ELTE Eötvös Loránd University, 46 Izabella Street, Budapest H-1064, Hungary
- Institute of Psychology, ELTE Eötvös Loránd University, 46 Izabella Street, Budapest H-1064, Hungary
| | - Andrea Eisinger
- Doctoral School of Psychology, ELTE Eötvös Loránd University, 46 Izabella Street, Budapest H-1064, Hungary
- Institute of Psychology, ELTE Eötvös Loránd University, 46 Izabella Street, Budapest H-1064, Hungary
| | - Eszter Kótyuk
- Institute of Psychology, ELTE Eötvös Loránd University, 46 Izabella Street, Budapest H-1064, Hungary
| | - Andrea Czakó
- Institute of Psychology, ELTE Eötvös Loránd University, 46 Izabella Street, Budapest H-1064, Hungary
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Europa Point Campus, Gibraltar GX11 1AA, Gibraltar
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, 50 Shakespeare Street, NG1 4FQ Nottingham, United Kingdom
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, 46 Izabella Street, Budapest H-1064, Hungary
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Europa Point Campus, Gibraltar GX11 1AA, Gibraltar
| | - Bálint Andó
- Department of Psychiatry, University of Szeged, 8-10 Korányi fasor, Szeged H-6720, Hungary
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Fusaroli M, Pellegrini L, Fusaroli R, Raschi E, Menchetti M, Poluzzi E. Behavioral excess and disruptive conduct: A historical and taxonomic approach to the origin of the 'impulse control disorders' diagnostic construct. Addiction 2023; 118:763-770. [PMID: 36370093 DOI: 10.1111/add.16086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 10/21/2022] [Indexed: 11/15/2022]
Abstract
AIMS Impulse control disorders (ICDs) are iatrogenic and idiopathic conditions with psychosocial and economic consequences for the affected individuals and their families (e.g. bankruptcy and divorce). However, the definition of ICDs has changed over time, and ICDs are not consistently included within existing taxonomies. We discuss the origins of the ICD diagnostic construct and its unsolved tensions. METHODS To contextualize the ICD diagnostic construct, we provided an overview of its origins in past centuries and followed its development across multiple editions of the Diagnostic and Statistical Manual and the International Classification of Diseases, as well as its definition within emerging ontologies. RESULTS Two independent roots of the ICD construct emerged: (a) the interest in behavioral excess as expressed in encyclopedic compilations (18th century) and (b) the juridical debate on disruptive conduct and responsibility (19th-20th centuries). These roots underlie the repeated taxonomic remodeling observed throughout the 20th and 21st centuries and three critical issues persisting in both clinical practice and research. First, the number of ICDs keeps increasing across the spectrum of human behaviors, disregarding common pathogenetic and phenomenological grounds. Secondly, ICDs substantially overlap with other mental conditions. Impulsivity is often neglected as a minor inconvenience or side effect when co-occurring with major diagnoses (e.g. depression) and therefore inadequately managed. Finally, ICDs' definitions display an unsolved tension between being conceived as hobby, moral fault or pathological drive, which may be responsible for stigma and delayed intervention. CONCLUSION The reasons that made impulse control disorders (ICDs) difficult to define from their first conceptualization are the same reasons that now complicate taxonomic efforts and diagnosis. Tracing back ICDs' roots and criticalities can help to define a common and less ambiguous theoretical framework, which may also result in the demise of the ICD construct and a move towards more clearly defined and more useful ontologies.
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Affiliation(s)
- Michele Fusaroli
- Pharmacology Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Luca Pellegrini
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.,Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, UK.,Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Riccardo Fusaroli
- The Interacting Minds Center, School of Culture and Society, Aarhus University, Aarhus, Denmark.,Department of Linguistics, Cognitive Science and Semiotics, Aarhus University, Aarhus, Denmark
| | - Emanuel Raschi
- Pharmacology Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Marco Menchetti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Elisabetta Poluzzi
- Pharmacology Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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Monley CM, Liese BS, Oberleitner LM. Gamers' and non-gamers' perspectives on the development of problematic video game play. Curr Psychol 2023; 43:1-10. [PMID: 36776145 PMCID: PMC9900197 DOI: 10.1007/s12144-023-04278-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2023] [Indexed: 02/09/2023]
Abstract
Gaming Disorder was recently included in the 11th Edition of the International Classification of Diseases and Internet Gaming Disorder may be introduced in the sixth edition of The Diagnostic and Statistical Manual. Much is not understood about how problems with video games develop. This qualitative study aimed to better understand the development of problematic gaming through focus groups. Eleven young adult "frequent gamers," twelve young adult "non-frequent or non-gamers," and five older adult "non-gamers" discussed vulnerabilities and risk factors of problematic gaming. Participants across all groups believed that problematic gaming developed when people used video games as a primary means of meeting basic psychological needs that were unsatisfied, thwarted, or blocked outside of video games. Frequent and non-frequent gamers, compared to older adult non-gamers, were more likely to view video games as a healthy way to meet basic psychological needs and less likely to stereotype gamers. Video games are equipped to meet basic psychological needs for autonomy, competence, and relatedness. That is, gamers often experience a sense of agency, skill, and connection to others when playing video games. However, problematic gaming may develop when people with unmet psychological needs rely exclusively on video games to meet them. Treatment and prevention approaches to problematic gaming can benefit from greater attention to helping at risk individuals meet needs for autonomy, competence, and relatedness outside of video games.
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Affiliation(s)
- Corey M. Monley
- Department of Educational and Counseling Psychology, University at Albany-State University of New York, 1400 Washington Ave, Catskill 228, Albany, NY 12222 USA
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS USA
| | - Bruce S. Liese
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS USA
- Department of Family Medicine and Community Health, University of Kansas Medical Center, Kansas City, KS USA
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Kräplin A, Joshanloo M, Wolff M, Krönke KM, Goschke T, Bühringer G, Smolka MN. The relationship between executive functioning and addictive behavior: new insights from a longitudinal community study. Psychopharmacology (Berl) 2022; 239:3507-3524. [PMID: 36190537 PMCID: PMC9584881 DOI: 10.1007/s00213-022-06224-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 08/24/2022] [Indexed: 11/09/2022]
Abstract
RATIONALE Although there is evidence that impaired executive functioning plays a role in addictive behavior, the longitudinal relationship between the two remains relatively unknown. OBJECTIVES In a prospective-longitudinal community study, we tested the hypothesis that lower executive functioning is associated with more addictive behavior at one point in time and over time. METHODS Three hundred and thirty-eight individuals (19-27 years, 59% female) from a random community sample were recruited into three groups: addictive disorders related to substances (n = 100) or to behaviors (n = 118), or healthy controls (n = 120). At baseline, participants completed nine executive function tasks from which a latent variable of general executive functioning (GEF) was derived. Addictive behavior (i.e., quantity and frequency of use, and number of DSM-5 criteria met) were assessed using standardized clinical interviews at baseline and three annual follow-ups. The trajectories of addictive behaviors were examined using latent growth curve modeling. RESULTS At baseline, we found weak to no evidence of an associations between GEF and addictive behavior. We found evidence for an association between a lower GEF at baseline and a higher increase in the quantity of use and a smaller decrease in frequency of use over time, but no evidence for an association with an increase in the number of DSM-5 criteria met. CONCLUSIONS Lower EFs appear to lead to a continuing loss of control over use, whereas addictive disorders may develop secondarily after a long period of risky use. Previous etiological models assuming lower EF as a direct vulnerability factor for addictive disorders need to be refined.
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Affiliation(s)
- Anja Kräplin
- Work Group Addictive Behaviors, Risk Analysis and Risk Management, Faculty of Psychology, Technische Universität Dresden, Chemnitzer Straße 46, D-01187, Dresden, Germany.
| | - Mohsen Joshanloo
- Department of Psychology, Keimyung University, Daegu, South Korea
| | - Max Wolff
- Work Group Addictive Behaviors, Risk Analysis and Risk Management, Faculty of Psychology, Technische Universität Dresden, Chemnitzer Straße 46, D-01187, Dresden, Germany
- Department of Psychiatry, Technische Universität Dresden, Dresden, Germany
- MIND Foundation, Berlin, Germany
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Berlin, Germany
| | - Klaus-Martin Krönke
- Work Group Addictive Behaviors, Risk Analysis and Risk Management, Faculty of Psychology, Technische Universität Dresden, Chemnitzer Straße 46, D-01187, Dresden, Germany
| | - Thomas Goschke
- Work Group Addictive Behaviors, Risk Analysis and Risk Management, Faculty of Psychology, Technische Universität Dresden, Chemnitzer Straße 46, D-01187, Dresden, Germany
| | - Gerhard Bühringer
- Work Group Addictive Behaviors, Risk Analysis and Risk Management, Faculty of Psychology, Technische Universität Dresden, Chemnitzer Straße 46, D-01187, Dresden, Germany
- IFT Institut für Therapieforschung, Munich, Germany
- Department of Clinical Research, Faculty of Health, University of Southern Denmark, Odense, Denmark
| | - Michael N Smolka
- Department of Psychiatry, Technische Universität Dresden, Dresden, Germany
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10
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Wegmann E, Antons S, Brand M. The experience of gratification and compensation in addictive behaviors: How can these experiences be measured systematically within and across disorders due to addictive behaviors? Compr Psychiatry 2022; 117:152336. [PMID: 35843138 DOI: 10.1016/j.comppsych.2022.152336] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 06/29/2022] [Accepted: 07/05/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Beyond gaming disorder and gambling disorder, pornography-use disorder, buying-shopping disorder, and social-networksuse disorders are discussed as further disorders due to addictive behaviors. For addictive behaviors, it is assumed that the experience of gratification and the experience of compensation due to the specific behavior represent reinforcing processes involved in the development and maintenance of the problematic behaviors. We aimed to develop two questionnaires that capture the experienced gratification and experienced compensation while using online activities. We additionally assume significant relationships with further addiction-related constructs such as symptom severity, use expectancies, and craving experiences. METHODS We conducted three studies for the development of the "Experience of Gratification Scale" (EGS) and the "Experience of Compensation Scale" (ECS). In each study, participants answered the questionnaires modified for their preferred online activity (gaming, gambling, buying-shopping, social-networks use, pornography use). Additional questionnaires were used, assessing further addiction-related constructs. RESULTS The results of the gradual approach by using exploratory and confirmatory factor analyses indicated for both scales a two-factor solution resulting in "gratification of needs" and "experience of pleasure" for the EGS, and "compensation of needs" and "experience of relief from negative feelings" for the ECS. The factors were significantly correlated with each other as well as with craving experiences, use expectancies, and symptom severity. Moreover, we found significant differences in the experienced gratification and experienced compensation for specific online behaviors. CONCLUSION The theoretically plausible specific factors for experienced gratification and experienced compensation could be identified and were related to constructs considered important in addictive online behaviors. Further studies should investigate the relevance of these constructs for different types of addictive behaviors, but also within the addiction process addressing specific needs and motives as well as further positive and negative reinforcement mechanisms.
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Affiliation(s)
- Elisa Wegmann
- Department of General Psychology, Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany.
| | - Stephanie Antons
- Department of General Psychology, Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany.
| | - Matthias Brand
- Department of General Psychology, Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany.
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Zhou M, Zhu W, Sun X, Huang L. Internet addiction and child physical and mental health: Evidence from panel dataset in China. J Affect Disord 2022; 309:52-62. [PMID: 35469911 DOI: 10.1016/j.jad.2022.04.115] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 03/10/2022] [Accepted: 04/16/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND The number of internet users has increased substantially in the last decade and these increasing rates of internet use also apply to children. Children usually have poorer self-control and poorer cognition than college-age populations or adults, the impact of Internet addiction on the health of this group has important implications not only for their individual economic and social outcomes but also the future human capital development in China. METHODS We use data from the 2016 and 2018 China Family Panel Survey, a survey that collected data from a large and nationally representative sample of the Chinese population, to construct a sample of children from 25 provinces, and then use DID and PSM-DID methods to investigate whether Internet addiction (increased screen time in this article) impacts the physical and mental health of children (ages 10-15) in China. RESULTS Internet addiction has a significant negative impact on child physical and mental health. The mediating effect model shows that Internet addiction impairs child physical and mental health by reducing their sleep and exercise time. The heterogeneity analysis shows that, Internet addiction has a stronger negative effect on urban children than rural children. Additionally, Internet addiction has a significant correlation with the mental health of left-behind children (LBC), but not children living with both parents (CLP). LIMITATIONS Our research has several weaknesses. First, this article uses time spent online to measure Internet addiction and this measurement method is not perfect. Also, given that the sample is made up of only Chinese children, conclusions about generalizability remain tentative. Future studies should be conducted in other countries. CONCLUSION This study systematically studied the effects of Internet addiction on the physical and mental health of Chinese children. This study can help government leaders make targeted programs to prevent children from Internet addiction in the future, especially to reduce internet dependence among students.
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12
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Wizła M, Kraus SW, Lewczuk K. Perspective: Can psychedelic-assisted therapy be a promising aid in compulsive sexual behavior disorder treatment? Compr Psychiatry 2022; 115:152303. [PMID: 35334305 DOI: 10.1016/j.comppsych.2022.152303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/24/2021] [Accepted: 03/01/2022] [Indexed: 11/03/2022] Open
Abstract
Recently, there has been an increase in studies yielding evidence for psychedelics' anxiolytic and anti-depressive qualities. Preliminary evidence for treatment in substance addiction is also available. In our manuscript, we present a perspective on the possible effectiveness and mechanisms of action of psychedelics' introduction in the treatment of Compulsive Sexual Behavior Disorder (CSBD) and other p roblematic sexual behaviors, which are considered representative of the so-called "behavioral addiction" category. Evidence for the efficacy of Mindfulness Based Interventions in CSBD treatment is promising. Psychedelics- and mindfulness-induced states share common characteristics on both a subjective and objective level. One of the proposed mechanisms regards reduction of experiential avoidance through the promotion of exposure and acceptance. On the neurophysiological level, a shift from higher- to lower-level association regions and an impact on 5- HT2A receptors is observed. Elaborated mechanisms explain the possible enhancement of therapeutic processes by psychedelics. Psychedelics' relative safety and low addictive potential support their introduction into traditional forms of therapy for CSBD and other out of control behaviors.
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Affiliation(s)
- Magdalena Wizła
- Institute of Psychology, Cardinal Stefan Wyszynski University, Warsaw, Poland.
| | - Shane W Kraus
- Department of Psychology, University of Nevada, Las Vegas, NV, USA.
| | - Karol Lewczuk
- Institute of Psychology, Cardinal Stefan Wyszynski University, Warsaw, Poland.
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Snodgrass JG, Lacy MG, Cole SW. Internet gaming, embodied distress, and psychosocial well-being: A syndemic-syndaimonic continuum. Soc Sci Med 2022; 295:112728. [PMID: 31879045 PMCID: PMC7289667 DOI: 10.1016/j.socscimed.2019.112728] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 11/28/2019] [Accepted: 12/09/2019] [Indexed: 02/03/2023]
Abstract
We examine internet gaming-related suffering as a novel syndemic most prevalent among contemporary emerging adults. Synthetic analysis of our prior research on internet gaming and health affirms how social factors and mental and physical wellness mutually condition each other in this online play context. Employing biocultural anthropological mixed methods, we focus on statistical interactions between intensive gaming and social well-being in relation to genomic markers of immune function. We show that among gamers with low social well-being, intensive game play is associated with compromised immunity markers, but among those with robust social connection, that same play correlates with decreased activation of stress-related immunity activation. The apparently beneficial interaction of higher social well-being and intensive game play resonates with an emerging body of research showing how positive practices-in this case, engaged and pleasurable videogame play-can increase resilience to the negative linked psychological and genomic responses to precarity. Based on these findings, we argue, in relation to gaming behaviors, a syndemics analysis could usefully be expanded by attending to both sides of the synergistic interaction between two social conditions: not just exacerbation of dysfunction in relation to their combined effect, but also non-additive enhancement of health that may stem from such combinations. We draw on literature emphasizing the relevance to health of "eudaimonic" well-being-psychosocial processes that transcend immediate self-gratification and involve the pursuit of meaningful and pro-social goals. On that basis, we propose the term "syndaimonics" to capture synergies between social context and mental flourishing, which, in this context and presumably others, can illuminate sources of health resilience and overall improved psychosocial wellbeing.
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Affiliation(s)
- Jeffrey G. Snodgrass
- Department of Anthropology, Colorado State University, Fort Collins, CO, 80523-1787, USA,Corresponding author. (J.G. Snodgrass)
| | - Michael G. Lacy
- Department of Sociology, Colorado State University, Fort Collins, CO, 80523-1784, USA
| | - Steven W. Cole
- Division of Hematology-Oncology, Department of Medicine, University of California, Los Angeles School of Medicine, Los Angeles, CA, 90095, USA,Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles School of Medicine, Los Angeles, CA, 90095, USA
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14
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Ayala-Rojas RE, Granero R, Mora-Maltas B, Rivas S, Fernández-Aranda F, Gómez-Peña M, Moragas L, Baenas I, Solé-Morata N, Menchón JM, Jiménez-Murcia S. Factors related to the dual condition of gambling and gaming disorders: A path analysis model. J Psychiatr Res 2021; 145:148-158. [PMID: 34923355 DOI: 10.1016/j.jpsychires.2021.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 11/13/2021] [Accepted: 12/10/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIMS Gaming disorder has experienced rapid growth in the last decade among youth and adult populations, in parallel to the expansion of the videogame industry. The objective of this study was to explore the underlying process to explain the dual diagnosis of gaming with gambling disorder. METHODS The sample included n = 117 patients who met clinical criteria for gaming disorder, recruited from a tertiary care unit specialized in the treatment of behavioral addictions. Path analysis (implemented through structural equation modeling) assessed the direct and mediational mechanisms between the dual condition of gaming + gambling disorder and sociodemographic variables and personality traits. RESULTS The comorbid gaming + gambling disorder was met for 14.5% of the participants (additionally, 6.0% of the sample also met criteria for problematic gambling). The dual diagnosis was directly related to an older age at onset of the addiction problems, a higher level of the novelty seeking trait and being in active work. Employment status also mediated the relationship between persistence levels and chronological age. Greater psychopathological distress was related to females, higher levels of harm avoidance and persistence and lower levels of self-directedness. CONCLUSIONS The results of this study provide empirical evidence for the specific factors that increase the likelihood of the dual gaming + gambling disorder. Clinical settings should consider these features to improve gaming diagnosis and treatment. Preventive programs should also be focused on the most vulnerable groups to prevent onset and progression of this comorbid condition.
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Affiliation(s)
- Rocío Elena Ayala-Rojas
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain.
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Barcelona, Spain; Department of Psychobiology and Methodology, Autonomous University of Barcelona, Barcelona, Spain.
| | - Bernat Mora-Maltas
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain.
| | - Sandra Rivas
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain.
| | - Fernando Fernández-Aranda
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Barcelona, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, Universitat de Barcelona - UB, L'Hospitalet de Llobregat, Spain.
| | - Mónica Gómez-Peña
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain.
| | - Laura Moragas
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain.
| | - Isabel Baenas
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Barcelona, Spain.
| | - Neus Solé-Morata
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain.
| | - José M Menchón
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, Universitat de Barcelona - UB, L'Hospitalet de Llobregat, Spain; Ciber Salut Mental (CIBERSam), Instituto de Salud Carlos III, Barcelona, Spain.
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Barcelona, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, Universitat de Barcelona - UB, L'Hospitalet de Llobregat, Spain.
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15
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Cavicchioli M, Kraslavski A, Movalli M, Maffei C, Ogliari A. The investigation of mechanisms underlying addictive behaviors: a case-control study. J Addict Dis 2021; 40:306-325. [PMID: 34751104 DOI: 10.1080/10550887.2021.1989250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Background: The contradictory nature of behavioral addictions has sustained a nondefinitive debate regarding their construct validity. Objective(s): The current study aims at exploring mechanisms underlying two distinct classes of behaviors-behavioral addictions characterized by core alterations in reward processing systems (ARPS) and behaviors with a main function of maladaptive coping. Methods: This case-control study included 99 treatment-seeking individuals with a primary diagnosis of alcohol use disorder (male: N = 68; female: N = 31) and 74 healthy control (HC) subjects (male: N = 38; female: N = 36). The severity of maladaptive behaviors was measured through the Shorter PROMIS Questionnaire (SPQ). Latent mechanisms were assessed by the Disinhibition Domain of the Personality Inventory for DSM-5 (PID-5-DI) and the Acceptance and Action Questionnaire-II (AAQ-II). Results: The clinical group showed higher severity of behavioral addictions than HC. This difference was not replicated for the other class of maladaptive behaviors, except for compulsive buying. Ordinal regression analysis showed that the clinical group significantly predicted SPQ scores reflecting ARPS, SPQ shopping and starving subscales. This was not replicated for the overall SPQ score capturing maladaptive coping and binge eating behaviors. Controlling for PID-5-DI and AAQ-II scores, which were significantly associated to SPQ subscales, effects of the aforementioned clinical group were not significant. Conclusions: The study highlighted distinct and common mechanisms underlying different classes of maladaptive behaviors. Results supported future neuroscience research for clarifying the role of ARPS in compulsive sex and buying in order to consider them as addictive disorders.
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Affiliation(s)
- Marco Cavicchioli
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Alexandra Kraslavski
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Mariagrazia Movalli
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Cesare Maffei
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Anna Ogliari
- Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy.,Child in Mind Lab, University "Vita-Salute San Raffaele", Milan, Italy
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16
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Charzyńska E, Sussman S, Atroszko PA. Profiles of potential behavioral addictions' severity and their associations with gender, personality, and well-being: A person-centered approach. Addict Behav 2021; 119:106941. [PMID: 33915392 DOI: 10.1016/j.addbeh.2021.106941] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Addictions share common etiological factors associated with personality vulnerabilities such as narcissism or emotional instability. Also, there are gender differences in the type of and risk for addiction (e.g., men may be more prone to addictions, overall). These are considerably less understood in relation to behavioral addictions (BAs) than in substance use disorders. This study aimed to investigate associations between profiles of six potential BAs (study, shopping, gaming, Facebook, pornography, and food) and gender, personality, and well-being among Polish emerging adults, as a partial replication and extension of previous work. PARTICIPANTS AND PROCEDURE In a paper-and-pencil cross-sectional study, 1182 Polish undergraduate students (mean age = 20.33 years; SD = 1.68) completed questionnaires measuring six potential BAs alongside questions on demographic variables, personality traits (Big Five, narcissism), and well-being indicators (general quality of life, health quality, sleep quality, perceived stress, anxiety, and hopelessness). RESULTS Using latent profile analysis, four profiles were identified: (1) elevated levels of study, Facebook, shopping, and food addictions; (2) elevated levels of gaming and pornography addictions; (3) low or average levels of all potential BAs, and (4) highest levels of all potential BAs. The second and fourth profiles included men predominantly, and the first profile included almost exclusively women. The fourth profile, in comparison to all other profiles, demonstrated significantly higher scores on all potential BAs, narcissism, lowest conscientiousness and emotional stability, and lowest well-being. CONCLUSIONS The results suggest that there is a general proclivity to potential BAs. Furthermore, there are gender-specific profiles of potential BAs, which at present are poorly understood.
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Abstract
This special issue addresses the affective and cognitive processes and their interactions potentially reflecting mechanisms underlying the development, maintenance of, or recovery from behavioral addictions. Various specific types of behavioral addictions will be considered, including those already in ICD-11 (gambling disorder, gaming disorder), but also new phenomena that are not yet classified (e.g., buying-shopping disorder, social-network-disorder) and phenomena potentially belonging to behavioral addictions although they are currently classified elsewhere (e.g., compulsive sexual behavior disorder). The articles included in this special issue directly investigate affective processes (e.g., cue-reactivity, craving, mood, stress, social interactions) and/or cognitive processes (e.g., executive functions, attention, memory). The studies involve experimental paradigms, neuropsychological tasks, psychophysiological measures, and neuroimaging techniques. Specific articles also deal with the relationship between affective and cognitive processes. The special issue is complemented by articles covering current debates and reviewing current empirical findings in the field.
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Grassi G, Albani G, Terenzi F, Razzolini L, Ramat S. New pharmacological and neuromodulation approaches for impulsive-compulsive behaviors in Parkinson's disease. Neurol Sci 2021; 42:2673-2682. [PMID: 33852081 DOI: 10.1007/s10072-021-05237-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 04/07/2021] [Indexed: 12/15/2022]
Abstract
INTRODUCTION A significant proportion of patients with Parkinson's disease (PD) display a set of impulsive-compulsive behaviors at some point during the course of illness. These behaviors range from the so-called behavioral addictions to dopamine dysregulation syndrome, punding and hoarding disorders. These behaviors have been consistently linked to the use of dopaminergic medications used to treat PD motor symptoms (dopamine agonists, levodopa, and other agents) and less consistently to neuromodulation techniques such as deep brain stimulation (DBS). Since there are still no approved treatments for these conditions, their pharmacological management is still a big challenge for clinicians. METHODS We conducted an extensive review of current pharmacological and neuromodulation literature for the management of impulsive-compulsive disorders in PD patients. RESULTS Pharmacological treatment approaches for impulsive-compulsive behaviors and DDS in PD patients include reduction of levodopa (LD), reduction/cessation of dopamine agonist (DA), and initiation of infusion therapies (apomorphine infusion and duodopa). Also, atomoxetine, a noradrenergic agent approved for the treatment of attention deficit hyperactivity disorder, showed some interesting preliminary results but there is still a lack of controlled longitudinal studies. Finally, while DBS effects on impulsive-compulsive disorders are still controversial, non-invasive techniques (such as transcranial magnetic stimulation and transcranial direct current stimulation) could have a potential positive effect but, again, there is still a lack of controlled trials. CONCLUSION Managing impulsivity and compulsivity in PD patients is still a non-evidence-based challenge for clinicians. Controlled trials on promising approaches such as atomoxetine and non-invasive neuromodulation techniques are needed.
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Affiliation(s)
- Giacomo Grassi
- Brain Center Firenze, Viale Belfiore 36, 5014, Florence, Italy.
| | | | | | - Lorenzo Razzolini
- Brain Center Firenze, Viale Belfiore 36, 5014, Florence, Italy.,University of Florence, Florence, Italy
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Affiliation(s)
- Yatan Pal Singh Balhara
- Additional Professor of Psychiatry, Behavioral Addictions Clinic (BAC), Department of Psychiatry, National Drug Dependence Treatment Center, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
| | - Ketaki Chandiok
- Scientist B, National Drug Dependence Treatment Center, All India Institute of Medical Sciences (AIIMS), New Delhi, India
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20
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Cavicchioli M, Ramella P, Vassena G, Simone G, Prudenziati F, Sirtori F, Movalli M, Maffei C. Mindful self-regulation of attention is a key protective factor for emotional dysregulation and addictive behaviors among individuals with alcohol use disorder. Addict Behav 2020; 105:106317. [PMID: 32007831 DOI: 10.1016/j.addbeh.2020.106317] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 01/12/2020] [Accepted: 01/13/2020] [Indexed: 11/17/2022]
Abstract
Individuals with alcohol use disorder (AUD) and other substance use disorders (SUDs) frequently show co-occurrent behavioral addictions (BAs) (i.e., gambling and compulsive sex) and other inflexible behaviors (IBs) (i.e., compulsive buying and dysfunctional eating behaviors). The covariation of these conditions might be explained by a role of emotion dysregulation (ED) and executive dysfunctions. This study aims at investigating whether ED and self-regulation of attention (SRA) could be common processes that underpin BAs and other IBs among individuals with AUD. The study hypothesized that SRA should represent a key protective factor for the relationships between ED and BAs/IBs. The research included 319 treatment-seeking individuals with a primary diagnosis of AUD. Five independent multiple parallel mediational models were tested. Self-report instruments were administered in order to assess ED, BAs and other IBs, which represented independent and dependent variables respectively. SRA was self-report assessed and, it was considered the key mediator variable. The analyses highlighted significant total effects of ED on the severity of BAs and IBs. SRA fully mediated the relationships between ED and BAs/IBs, with exception of gambling. ED and SRA should be considered common dimensions that explain the covariation of BAs and IBs among individuals with AUD. SRA represents an adaptive form of emotion regulation that sustains the engagement in goal-oriented behaviors. Future neuroimaging and longitudinal studies are recommended in order to demonstrate the role of ED and SRA on development, maintenance and treatment of BAs and IBs among individuals with SUDs.
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Affiliation(s)
- Marco Cavicchioli
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy; Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy.
| | - Pietro Ramella
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy; Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy.
| | - Giulia Vassena
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy; Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Giulia Simone
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy; Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy.
| | - Francesca Prudenziati
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy; Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Federica Sirtori
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy; Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy.
| | - Mariagrazia Movalli
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy; Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy.
| | - Cesare Maffei
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy; Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy.
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Pal Singh Balhara Y, Singh S. Online course on basics of management of behavioral addictions involving use of internet: Observations from the first batch of participants. Asian J Psychiatr 2019; 44:1-3. [PMID: 31299581 DOI: 10.1016/j.ajp.2019.07.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/17/2019] [Accepted: 07/05/2019] [Indexed: 12/27/2022]
Abstract
Problematic internet use has been reported to be high among school students. An online course was developed with an aim to strengthen the capacity of school teachers and counsellors on early identification, detection and intervention for behavioral addictions involving use of internet. The current report presents the observation from the first batch of participants of this course. Of the 28 teachers and counselors who expressed interest by enrollment in the course, a total of 15 participants provided both the pre and post course evaluation forms. The preliminary findings suggest that the online course is feasible, acceptable and effective in strengthening the capacity of school teachers and counsellors on behavioral addictions involving use of internet.
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Affiliation(s)
- Yatan Pal Singh Balhara
- Behavioral Addictions Clinic (BAC), Department of Psychiatry, National Drug Dependence Treatment Center, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
| | - Shalini Singh
- Institute of Liver and Biliary Sciences (ILBS), New Delhi, India
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Brand M, Wegmann E, Stark R, Müller A, Wölfling K, Robbins TW, Potenza MN. The Interaction of Person-Affect-Cognition-Execution (I-PACE) model for addictive behaviors: Update, generalization to addictive behaviors beyond internet-use disorders, and specification of the process character of addictive behaviors. Neurosci Biobehav Rev 2019; 104:1-10. [PMID: 31247240 DOI: 10.1016/j.neubiorev.2019.06.032] [Citation(s) in RCA: 592] [Impact Index Per Article: 118.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 06/17/2019] [Accepted: 06/23/2019] [Indexed: 12/24/2022]
Abstract
We propose an updated version of the Interaction of Person-Affect-Cognition-Execution (I-PACE) model, which we argue to be valid for several types of addictive behaviors, such as gambling, gaming, buying-shopping, and compulsive sexual behavior disorders. Based on recent empirical findings and theoretical considerations, we argue that addictive behaviors develop as a consequence of the interactions between predisposing variables, affective and cognitive responses to specific stimuli, and executive functions, such as inhibitory control and decision-making. In the process of addictive behaviors, the associations between cue-reactivity/craving and diminished inhibitory control contribute to the development of habitual behaviors. An imbalance between structures of fronto-striatal circuits, particularly between ventral striatum, amygdala, and dorsolateral prefrontal areas, may be particularly relevant to early stages and the dorsal striatum to later stages of addictive processes. The I-PACE model may provide a theoretical foundation for future studies on addictive behaviors and clinical practice. Future studies should investigate common and unique mechanisms involved in addictive, obsessive-compulsive-related, impulse-control, and substance-use disorders.
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Affiliation(s)
- Matthias Brand
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany.
| | - Elisa Wegmann
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Germany
| | - Rudolf Stark
- Department of Psychotherapy and Systems Neuroscience, Justus-Liebig-University of Giessen, Germany; Bender Institute of Neuroimaging, Justus-Liebig-University of Giessen, Germany
| | - Astrid Müller
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Klaus Wölfling
- Outpatient Clinic for Behavioral Addiction, Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University Mainz, Germany
| | - Trevor W Robbins
- Department of Psychology, Behavioural and Clinical Neuroscience Institute, University of Cambridge, UK
| | - Marc N Potenza
- Departments of Psychiatry, Neuroscience and Child Study, Yale University School of Medicine, New Haven, USA; Connecticut Council on Problem Gambling, Wethersfield, USA; Connecticut Mental Health Center, New Haven, USA
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Snodgrass JG, Zhao W, Lacy MG, Zhang S, Tate R. The cross-cultural expression of internet gaming distress in North America, Europe, and China. Addict Behav Rep 2019; 9:100146. [PMID: 31193753 DOI: 10.1016/j.abrep.2018.100146] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 10/22/2018] [Accepted: 11/17/2018] [Indexed: 11/23/2022] Open
Abstract
We compare the forms online gaming-related distress takes cross-culturally, and examine how much such distress resembles the World Health Organization's (WHO) “Gaming disorder,” understood to be an “addiction.” Our preliminary exploratory factor analysis (EFA) in North America (n = 2025), Europe (n = 1198), and China (n = 841) revealed a constant four-factor structure across the three regions, with classic “addiction” symptoms always clustering together on the first and most important factor, though with some variability in regional factors' exact item composition. In the present study, we use second-order confirmatory factor analysis (CFA) to further examine this factor structure and the cultural similarities and differences. Specifically, we focus on confirming the regional structure and composition of an ethnographically developed 21-item gaming distress scale, which contains a wider symptoms pool than typical gaming disorder scales, and thus allows us to better separate generalized gaming distress's “addictive” from other culturally-influenced “problem” experiences and behaviors in each regional case. We use propensity score matching to separate the impact on gaming-related distress of regional culture from demographic variables (North America/Europe: n = 1043 pairs; North America/China: n = 535 pairs). Although our results support current WHO formulations of gaming-related distress as an addictive disorder, we show how cultural forces can shape how “addictive” and “problem” gaming are experienced and thus psychiatrically presented in different parts of the world. In particular, generalized gaming distress's addictive and problematic dimensions seem to be shaped by culture-specific expressions of achievement motivations, social connection and disconnection, and unique psychosomatic experiences. Second-order CFA shows similarities and differences between online gaming distress in North America, Europe, and China. Our 21-item distress scale allows us to separate “addictive” from “problem” experiences and behaviors in each regional case. Propensity score matching helps us separate the impact on gaming distress of regional culture from demographic variables. Generalized gaming distress consists of four dimensions, with three closely related to addiction experiences and behaviors. Our results support current WHO and APA formulations of gaming-related distress as an addictive disorder. Culture also shapes how “addictive” and “problem” gaming are experienced in different parts of the world.
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Baroni S, Marazziti D, Mucci F, Diadema E, Dell’Osso L. Problematic Internet use in drug addicts under treatment in public rehab centers. World J Psychiatry 2019; 9:55-64. [PMID: 31211113 PMCID: PMC6560498 DOI: 10.5498/wjp.v9.i3.55] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 05/07/2019] [Accepted: 05/14/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Problematic Internet use (PIU) or Internet addiction has been recognized to be a behavioral addiction characterized by excessive or poorly controlled preoccupations, urges, or behaviors regarding computer use and Internet access that leads to impairment or distress resembling substance abuse.
AIM To investigate the prevalence and characteristics of Internet use and abuse in a group of drug addicts from Southern Italy, by means of a specific questionnaire [“Questionario sull’Utilizzo delle Nuove Tecnologie” (QUNT)].
METHODS All subjects (183) were heavy smokers, almost 50% of them used heroin and/or opioid compounds, 30% alcohol, 10% cannabis, 8% cocaine, and 5% were polydrug users. Almost 10% of the individuals were also suffering from gambling disorder.
RESULTS The time spent online was more than 4 hours a day in the total sample, with a slight prevalence in male subjects. Cocaine and cannabis users spent more than 6 hours online, significantly more than opioid and alcohol abusers. Distribution of the QUNT factors was not different in both sexes. Cocaine users showed higher scores at the “loss of control”, “pornography addiction”, and “addiction to social networks” factors, for the stimulant effect of this substance. Moreover, 15 out of the total 17 cocaine users were pathological gamblers. Positive and statistically significant relationships were observed between some QUNT factors and body mass index.
CONCLUSION These findings indicate that PIU is less severe in subjects taking sedative substances, such as heroin/opioids and alcohol, than in subjects taking stimulants. Alternatively, it may be used as a “stimulant” trigger in cocaine and cannabis users. Flattening effect of abuse drugs was noted on possible sex-related differences in QUNT items. We observed a sort of “protective” effect of a love relationship and/or living together with a partner, as those engaged subjects showed lower scores on different items than single subjects or those living alone. The relationship between time spent online (and related sedentary lifestyle) and body mass index would suggest that Internet use might be a contributing factor to increasing weight gain and obesity amongst adolescents and young adults worldwide. Our findings also highlighted the specific vulnerability of drug addicts who use stimulants, rather than sedative compounds, to other kinds of behavioral addictions, such as gambling disorder.
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Affiliation(s)
- Stefano Baroni
- Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, University of Pisa, Pisa 56100, Italy
| | - Donatella Marazziti
- Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, University of Pisa, Pisa 56100, Italy
| | - Federico Mucci
- Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, University of Pisa, Pisa 56100, Italy
| | - Elisa Diadema
- Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, University of Pisa, Pisa 56100, Italy
| | - Liliana Dell’Osso
- Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, University of Pisa, Pisa 56100, Italy
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Snodgrass JG, Zhao W, Lacy MG, Zhang S, Tate R. Distinguishing Core from Peripheral Psychiatric Symptoms: Addictive and Problematic Internet Gaming in North America, Europe, and China. Cult Med Psychiatry 2019; 43:181-210. [PMID: 30426360 DOI: 10.1007/s11013-018-9608-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We explore the problem of distinguishing the relatively constant versus culturally variable dimensions of mental suffering and disorder in the context of a cross-cultural study of Internet gaming-related distress. We extend the conceptual contrast of "core" and "peripheral" symptoms drawn from game studies and use a framework that synthesizes cultural and neurobiological understandings of emotional distress. In our framework, "core" symptoms are relatively constant across cultures and therefore presumed to be more closely tied to a neurobiological base. By contrast, we treat as "peripheral" symptoms those that are more culturally variable, and thus less directly tied to the neurobiology of addiction. We develop and illustrate this approach with a factor analysis of cross-cultural survey data, resting on previous ethnographic work, through which we compare online gaming distress experienced in North America (n = 2025), Europe (n = 1198), and China (n = 841). We identify the same four-factor structure across the three regions, with Addiction always the first and most important factor, though with variability in regional factors' exact item composition. The study aims to advance an integrative biocultural approach to distinguishing universal as opposed to culturally contingent dimensions of human suffering, and to help resolve debates about whether problem gaming represents a form of addiction.
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Béreau M, Krack P, Brüggemann N, Münte TF. Neurobiology and clinical features of impulse control failure in Parkinson's disease. Neurol Res Pract 2019; 1:9. [PMID: 33324875 PMCID: PMC7650064 DOI: 10.1186/s42466-019-0013-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 02/12/2019] [Indexed: 12/02/2022] Open
Abstract
Impulse control disorders (ICDs) and other impulsive-compulsive related behaviours are frequent and still under recognized non-motor complications of Parkinson's disease (PD). They result from sensitization of the mesocorticolimbic pathway that arose in predisposed PD patients concomitantly with spreading of PD pathology, non-physiological dopaminergic and pulsatile administration of dopamine replacement therapy (DRT). Neuropsychiatric fluctuations (NPF) reflect the psychotropic effects of dopaminergic drugs and play a crucial role in the emergence of ICDs and behavioral addictions. Dopamine agonists (DA) which selectively target D2 and D3 receptors mostly expressed within the mesocorticolimbic pathway, are the main risk factor to develop ICDs. Neuroimaging studies suggest that dopamine agonists lead to a blunted response of the brain's reward system both during reward delivery and anticipation. Genetic predispositions are crucial for the responsiveness of the mesolimbic system and the development of ICDs with several genes having been identified. Early screening for neuropsychiatric fluctuations, reduction of DA, fractionating levodopa dosage, education of patients and their relatives, are the key strategies for diagnosis and management of ICDs and related disorders.
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Affiliation(s)
- Matthieu Béreau
- Department of Neurology, University Hospital of Besançon, 25030 Besançon, Cedex France
| | - Paul Krack
- Department of Neurology, Inselspital, University of Bern, CH-3010 Bern, Switzerland
| | | | - Thomas F. Münte
- Department of Neurology, University of Lübeck, 23562 Lübeck, Germany
- Institute of Psychology II, University of Lübeck, 23562 Lübeck, Germany
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Varo C, Murru A, Salagre E, Jiménez E, Solé B, Montejo L, Carvalho AF, Stubbs B, Grande I, Martínez-Arán A, Vieta E, Reinares M. Behavioral addictions in bipolar disorders: A systematic review. Eur Neuropsychopharmacol 2019; 29:76-97. [PMID: 30420190 DOI: 10.1016/j.euroneuro.2018.10.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 09/18/2018] [Accepted: 10/23/2018] [Indexed: 12/16/2022]
Abstract
Clinical and epidemiological research suggests that behavioral addictions (BA) are associated with a wide range of psychiatric disorders. However, the relationship between BA and bipolar disorders (BD) has not been thoroughly explored. The aim of this systematic review was to critically summarize and evaluate the current available evidence regarding a possible association between BA and BD. A systematic review of major electronic databases according to PRISMA guidelines was conducted from inception to 31st December 2017. We sought quantitative studies data concerning prevalence of comorbidity, features and treatment related to BA-BD comorbidity. Data were narratively synthesized. Of the 1250 studies returned from the search, a total of 28 articles were included in this review. BA may be overrepresented in BD samples, and the other way around. Pathological gambling and kleptomania were the most prevalent conditions followed by compulsive buying, compulsive sexual behavior and internet addiction. BA was also associated with other mood disorders, anxiety disorders and substance use disorder. BD-BA comorbidity was related with more severe course of illness. Studies on treatment strategies for BD-BA comorbidity are rather limited; only one randomized controlled trial that fulfilled inclusion criteria was identified. Methodological heterogeneity in terms of design and results among studies was found. BD-BA commonly co-occurs although there is a need for rigorous studies. Routine screening and adequate assessment may be helpful in BD patients to identify individuals at risk for BA and to effectively manage the complex consequences associated with BA-BD comorbidity.
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Affiliation(s)
- C Varo
- Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - A Murru
- Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
| | - E Salagre
- Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - E Jiménez
- Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - B Solé
- Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - L Montejo
- Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - A F Carvalho
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - B Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, Box SE5 8AF, United Kingdom
| | - I Grande
- Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - A Martínez-Arán
- Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - E Vieta
- Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
| | - M Reinares
- Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
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28
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Filgueiras AR, Pires de Almeida VB, Koch Nogueira PC, Alvares Domene SM, Eduardo da Silva C, Sesso R, Sawaya AL. Exploring the consumption of ultra-processed foods and its association with food addiction in overweight children. Appetite 2018; 135:137-145. [PMID: 30439381 DOI: 10.1016/j.appet.2018.11.005] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 11/08/2018] [Accepted: 11/10/2018] [Indexed: 01/18/2023]
Abstract
The present study explored the consumption of ultra-processed foods and its association with food addiction in overweight children. The prevalence of food addiction was investigated using the Yale Food Addiction Scale for Children in overweight 9-11 year-old children (BMI/age ≥1 Z score) of both sexes from two schools (n = 139). Food intake was estimated by a food frequency questionnaire and the food items were classified into 4 categories: minimally processed, culinary ingredients, processed foods and ultra-processed foods (UPF), based on their degree of processing. Among the children, 95% showed at least one of the seven symptoms of food addiction and 24% presented with a diagnosis of food addiction. In analysis of covariance adjusted for age and sex, a tendency of higher consumption of added sugar (refined sugar, honey, corn syrup) and UPF was found among those diagnosed with food addiction. Multiple logistic regression adjusted for sugar, sodium and fat ingestion showed that consumption of cookies/biscuits (OR = 4.19, p = 0.015) and sausages (OR = 11.77, p = 0.029) were independently associated with food addiction. The identification of foods that may be associated with addictive behavior is very important for correctly treating and preventing childhood obesity, which continues to be one of the greatest health problems in the world.
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Affiliation(s)
| | | | | | | | | | - Ricardo Sesso
- Department of Medicine, Federal University of São Paulo, UNIFESP, Brazil
| | - Ana Lydia Sawaya
- Department of Physiology, Federal University of São Paulo, UNIFESP, Brazil
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29
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Schivinski B, Brzozowska-Woś M, Buchanan EM, Griffiths MD, Pontes HM. Psychometric assessment of the Internet Gaming Disorder diagnostic criteria: An Item Response Theory study. Addict Behav Rep 2018; 8:176-184. [PMID: 30505924 PMCID: PMC6251978 DOI: 10.1016/j.abrep.2018.06.004] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 05/04/2018] [Accepted: 06/20/2018] [Indexed: 12/12/2022] Open
Abstract
Internet Gaming Disorder (IGD) has been recognized by the American Psychiatric Association (APA) as a tentative disorder in the latest fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). In order to advance research on IGD, the APA has suggested that further research on the nine IGD criteria to investigate its clinical and empirical feasibility is necessary. The aim of the present study was to develop the Polish the Internet Gaming Disorder Scale–Short-Form (IGDS9-SF) and scrutinize the nine IGD criteria empirically. To achieve this, the newly developed IGDS9-SF was examined using a wide range of psychometric methods, including a polytomous Item Response Theory (IRT) analysis to evaluate the measurement performance of the nine IGD criteria. A sample of 3377 gamers (82.7% male, mean age 20 years, SD = 4.3 years) was recruited online for the present study. Overall, the findings obtained confirmed that suitability of the Polish IGDS9-SF to assess IGD amongst Polish gamers given the adequate levels of validity and reliability found. The IRT analysis revealed that the IGDS9-SF is a suitable tool to measure IGD levels above the average; however, criteria “continuation” (item 6), “deception” (item 7), and “escape” (item 8) presented with poor fit. Taken together, these results suggest that some of the diagnostic criteria may present with a different clinical weighting towards final diagnosis of IGD. The implications of these findings are further discussed. The APA diagnostic criteria for IGD was investigated in a large sample of gamers. The construct of IGD was examined via validity analysis and Item Response Theory. The results revealed the suitability of the IGDS9-SF to assess IGD-related symptoms. Each IGD criterion present with distinct clinical diagnostic weighting. The nine IGD criteria need to take into account different clinical weighting.
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Affiliation(s)
- Bruno Schivinski
- Birkbeck, University of London, Department of Management, Malet Street, Bloomsbury, WC1E 7HX London, United Kingdom of Great Britain and Northern Ireland
| | - Magdalena Brzozowska-Woś
- Gdansk University of Technology, Department of Marketing, Ul. Narutowicza 11/12, Gdansk 80-233, Poland
| | - Erin M Buchanan
- Missouri State University, Department of Psychology, 901 S. National Ave, Springfield, MO 65897, USA
| | - Mark D Griffiths
- Nottingham Trent University, International Gaming Research Unit, Psychology Department, 50 Shakespeare Street, Nottingham NG1 4QF, United Kingdom of Great Britain and Northern Ireland
| | - Halley M Pontes
- Nottingham Trent University, International Gaming Research Unit, Psychology Department, 50 Shakespeare Street, Nottingham NG1 4QF, United Kingdom of Great Britain and Northern Ireland
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Lacroix E, Tavares H, von Ranson KM. Moving beyond the "eating addiction" versus "food addiction" debate: Comment on Schulte et al. (2017). Appetite 2018; 130:286-292. [PMID: 29936021 DOI: 10.1016/j.appet.2018.06.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 06/19/2018] [Accepted: 06/19/2018] [Indexed: 12/21/2022]
Abstract
In a recent commentary, Schulte et al. (2017) argued that addictive-like eating should be conceptualized as a substance use disorder rather than a behavioural addiction, and noted that many parallels that Hebebrand et al. (2014) drew between addictive-like eating and behavioural addictions apply likewise to substance use disorders. However, we argue that many of the arguments advanced by Schulte et al. (2017) in support of a substance-based food addiction model, including the important role played by ingested substances, are nonspecific. That is, these arguments apply equally well to behavioural addictions and other mental disorders, notably eating disorders, which raises the question of whether the phenomenon of addictive-like eating is encompassed by existing eating disorder diagnoses. Similarities between addictive-like eating and substance use, no matter how compelling, do not ensure the validity or clinical utility of a substance-based food addiction model and should not drive the conceptualization of addictive-like eating. The present commentary discusses problems with Schulte et al.'s (2017) arguments for substance-based food addiction, and draws attention to alternative conceptualizations of addictive-like eating which risk being overlooked when this conversation is framed as a dichotomous debate between the food and eating addiction models.
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Affiliation(s)
- Emilie Lacroix
- Department of Psychology, University of Calgary, 2500 University Dr. NW, Calgary, AB, T2N 1N4, Canada.
| | - Hermano Tavares
- Department of Psychiatry, University of São Paulo, Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, Sao Paulo, SP, CEP 05403-010, Brazil.
| | - Kristin M von Ranson
- Department of Psychology, University of Calgary, 2500 University Dr. NW, Calgary, AB, T2N 1N4, Canada.
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Balhara YPS, Harshwardhan M, Kumar R, Singh S. Extent and pattern of problematic internet use among school students from Delhi: Findings from the cyber awareness programme. Asian J Psychiatr 2018; 34:38-42. [PMID: 29631149 DOI: 10.1016/j.ajp.2018.04.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 03/20/2018] [Accepted: 04/01/2018] [Indexed: 12/23/2022]
Abstract
The student population is likely to be vulnerable to problems associated with increased online activity. We present the findings on extent and pattern of problematic internet use based on observations from a cyber awareness initiative undertaken in national capital city of New Delhi. A total of 25 schools were enrolled in the first phase of the initiative. The students in the middle, high, secondary and senior secondary grades were eligible for inclusion in the initiative. The Generalized Problematic Internet Use Scale 2 was used to assess problematic internet use. Correlation analysis was done using Pearson's correlation. A binary logistic regression was carried to see how various variables predicted the GPIUS scores. The level of statistical significance was kept at p < 0.05 for all the tests. A total of 6291 students participated in first phase. Around 19% of study participants reported problematic internet use and 37% used internet for mood regulation. Male gender, older age, studying in senior grades, and owning a personal device were associated with higher rates of problematic internet use. Use of internet for accessing social media, online gaming, and recreational surfing is associated with problematic internet use, while use of internet for educational activities was associated with lesser problems. There is a need to cover all students under cyber awareness program in order to facilitate safe and healthy use of internet.
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Affiliation(s)
- Yatan Pal Singh Balhara
- Behavioral Addictions Clinic (BAC), Department of Psychiatry, National Drug Dependence Treatment Center, All India Institute of Medical Sciences (AIIMS), New Delhi, India; Department of Psychiatry, National Drug Dependence Treatment Center, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
| | - M Harshwardhan
- South East District Delhi Police, India; Department of Psychiatry, National Drug Dependence Treatment Center, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Rajeev Kumar
- South East District Delhi Police, India; Department of Psychiatry, National Drug Dependence Treatment Center, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Shalini Singh
- Behavioral Addictions Clinic (BAC), Department of Psychiatry, National Drug Dependence Treatment Center, All India Institute of Medical Sciences (AIIMS), New Delhi, India; South East District Delhi Police, India; Department of Psychiatry, National Drug Dependence Treatment Center, All India Institute of Medical Sciences (AIIMS), New Delhi, India
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Barrault S, Durousseau F, Ballon N, Réveillère C, Brunault P. [Smartphone addiction: French validation of the Internet Addiction Test-Smartphone version (IAT-smartphone) and associated psychopathological features]. Encephale 2018; 45:53-59. [PMID: 29397925 DOI: 10.1016/j.encep.2017.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 12/03/2017] [Accepted: 12/04/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Since their first appearance in 1992 smartphones have improved constantly, and their use, combined with the rapid spread of the Internet, has increased dramatically. The recent emergence of this technology raises new issues, at both individual and societal levels. Several studies have investigated the physical and psychological harm that may be caused by smartphones. The issue of excessive smartphone use as an addictive disorder is frequently raised and debated, although it is not acknowledged in international classifications. In France, there is no validated assessment tool for smartphone addiction. Therefore, the aims of this research were: to validate a French translation of the Internet Addiction Test-smartphone version (IAT-smartphone); to study the links between smartphone addiction, Internet addiction, depression, anxiety and impulsivity. METHOD Two hundred and sixteen participants from the general population were included in the study (January to February 2016), which was available online using Sphinx software. We assessed smartphone addiction (French version of the Internet Addiction Scale - smartphone version, IAT-smartphone), specificity of smartphone use (time spent, types of activity), Internet addiction (Internet Addiction Test, IAT), impulsivity (UPPS Impulsiveness Behavior Scale), and anxiety and depression (Hospital Anxiety and Depression scale, HAD). We tested the construct validity of the IAT-smartphone (exploratory factor analysis, internal consistency, non-parametric correlation tests for convergent validity). We also carried out multiple linear regressions to determine the factors associated with IAT-smartphone. RESULTS Mean age was 32.4±12.2 years; 75.5% of the participants were women. The IAT-smartphone had a one-factor structure (explaining 42 % of the variance), excellent internal consistency (α=0.93) and satisfactory convergent validity. Smartphone addiction was associated with Internet addiction (ρ=0.85), depression (ρ=0.31), anxiety (ρ=0.14), and some impulsivity subscales, including "negative urgency" (ρ=0.20; P<0.01), "positive urgency" (ρ=0.20; P<0.01), and "lack of perseverance" (ρ=0.16; P<0.05). Age was negatively associated with the IAT-S total score (ρ=-0.25; P<0.001), and there was a non-significant difference between the IAT-S total scores of men and women (29.3±10.2 vs. 32.7±12.4; P=0.06). Multiple linear regression showed that age, anxiety, depression, average time spent on the smartphone, impulsivity and Internet addiction explained 71.4 % of the variance of IAT-smartphone scores. However, this score dropped to 13.2 % when Internet addiction was removed from the model. This variable alone explained 70.8 % of the IAT-smartphone scores. CONCLUSION The French version of the IAT-smartphone is a reliable and valid questionnaire to assess smartphone addiction. This addiction appears to be strongly linked to anxiety, depression and impulsivity. The strong association between smartphone addiction and Internet addiction suggests that smartphone addiction is one of the many forms of Internet addiction. In fact, smartphones may not be the object of the addiction but rather a medium facilitating Internet access as it makes it possible to connect anywhere anytime. This raises the issue of the potential role of smartphones in speeding up and facilitating the development of Internet addiction.
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Affiliation(s)
- S Barrault
- Département de psychologie, université François-Rabelais-de-Tours, EA 2114 « Psychologie des Âges de la Vie », 37000 Tours, France; CHRU de Tours, CSAPA-37, centre Port-Bretagne, 37000 Tours, France.
| | - F Durousseau
- Département de psychologie, université François-Rabelais-de-Tours, EA 2114 « Psychologie des Âges de la Vie », 37000 Tours, France
| | - N Ballon
- Équipe de liaison et de soins en addictologie, CHRU de Tours, 37000 Tours, France; UMR Inserm U930 ERL, 37000 Tours, France; Université François-Rabelais-de-Tours, 37000 Tours, France
| | - C Réveillère
- Département de psychologie, université François-Rabelais-de-Tours, EA 2114 « Psychologie des Âges de la Vie », 37000 Tours, France
| | - P Brunault
- Département de psychologie, université François-Rabelais-de-Tours, EA 2114 « Psychologie des Âges de la Vie », 37000 Tours, France; Équipe de liaison et de soins en addictologie, CHRU de Tours, 37000 Tours, France; UMR Inserm U930 ERL, 37000 Tours, France; Université François-Rabelais-de-Tours, 37000 Tours, France
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Yong RKF, Inoue A, Kawakami N. The validity and psychometric properties of the Japanese version of the Compulsive Internet Use Scale (CIUS). BMC Psychiatry 2017; 17:201. [PMID: 28558728 PMCID: PMC5450409 DOI: 10.1186/s12888-017-1364-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 05/19/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Prolonged Internet use is often associated with reduced social involvement and comorbid psychopathologies, including depression, anxiety, attention-deficit/hyperactivity disorder, and obsessive-compulsive disorder. Asian countries where Internet access is widely available have high reported levels of Internet addiction. As Internet use has changed drastically since concerns about Internet addiction were first raised, the results of recent studies may be inaccurate because the scales they employed to measure Internet addiction were formulated for different Internet usage from the present. It is thus necessary to develop more-up-to-date scales to assess problematic private use of the Internet. METHODS The Compulsive Internet Use Scale (CIUS) was translated into Japanese. An online sample whose ages and sexes reflected that of the national population of Internet users was recruited to test the scale's reliability and validity. Correlations between the scale and Internet-related parameters (such as time spent online, motivation for going online, and applications used) and psychosocial factors (such as psychological distress symptoms and loneliness) were examined. Psychometric properties were examined by the split-half method using both exploratory and confirmatory factor analysis. Model fits were compared across gender. RESULTS CIUS was found to have a high reliability and good concurrent, correlation and construct validity. Both exploratory and confirmatory factors revealed that the one-factor solution yielded a satisfactory result across gender. However, the three-factor structural model in which compulsiveness was gauged by "excessive absorption", "difficulty in setting priorities", and "mood regulation" gave the best fit of the model for the general population as well as across gender. CONCLUSIONS Compulsive Internet behavior in Japan can be assessed in terms of absorption, priorities, and mood. CIUS is a valid scale for screening compulsive Internet behavior in the general Japanese population regardless of age and gender.
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Affiliation(s)
- Roseline Kim Fong Yong
- Department of Public Health, Graduate School of Medicine, Akita University, Akita, Japan. .,Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Akiomi Inoue
- 0000 0000 9206 2938grid.410786.cDepartment of Public Health, Kitasato University School of Medicine, Sagamihara, Japan ,0000 0001 2151 536Xgrid.26999.3dDepartment of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Norito Kawakami
- 0000 0001 2151 536Xgrid.26999.3dDepartment of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Abstract
Research examining the development of online addictions has grown greatly over the last decade with many studies suggesting both risk factors and protective factors. In an attempt to integrate the theories of attachment and identity formation, the present study investigated the extent to which identity styles and attachment orientations account for three types of online addiction (i.e., internet addiction, online gaming addiction, and social media addiction). The sample comprised 712 Italian students (381 males and 331 females) recruited from schools and universities who completed an offline self-report questionnaire. The findings showed that addictions to the internet, online gaming, and social media were interrelated and were predicted by common underlying risk and protective factors. Among identity styles, 'informational' and 'diffuse-avoidant' styles were risk factors, whereas 'normative' style was a protective factor. Among attachment dimensions, the 'secure' attachment orientation negatively predicted the three online addictions, and a different pattern of causal relationships were observed between the styles underlying 'anxious' and 'avoidant' attachment orientations. Hierarchical multiple regressions demonstrated that identity styles explained between 21.2 and 30% of the variance in online addictions, whereas attachment styles incrementally explained between 9.2 and 14% of the variance in the scores on the three addiction scales. These findings highlight the important role played by identity formation in the development of online addictions.
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Affiliation(s)
| | | | - Mark D Griffiths
- International Gaming Research Unit, Division of Psychology, Nottingham Trent University, Nottingham, NG1 4BU UK
| | - Maria Sinatra
- Department of Educational Sciences, Psychology, Communication, University of Bari Aldo Moro, Bari, Italy
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Kim HS, Christianini AR, Bertoni D, de Oliveira MDCM, Hodgins DC, Tavares H. Kleptomania and Co-morbid addictive disorders. Psychiatry Res 2017; 250:35-37. [PMID: 28142063 DOI: 10.1016/j.psychres.2017.01.048] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 12/09/2016] [Accepted: 01/18/2017] [Indexed: 12/01/2022]
Abstract
We examined the association between kleptomania and addictive disorders, including behavioral addictions. Fifty-three individuals with a diagnosis of kleptomania completed measures of kleptomania severity, semi-structured clinical interviews to assess co-morbid diagnosis of addictive disorders, and the Shorter PROMIS Questionnaire (SPQ) assessing an array of addictive behaviors. 20.75% of the sample met criteria for an addictive disorder; four for a substance use disorder and four for a behavioral addiction. Kleptomania severity was significantly associated with compulsive work and shopping measured by the SPQ. The results suggest the need to assess a wide array of addictive behaviors in individuals with kleptomania.
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Affiliation(s)
- Hyoun S Kim
- Addictive Behaviours Laboratory, Department of Psychology, University of Calgary, Calgary, Alberta, Canada.
| | - Aparecida Rangon Christianini
- Impulse Control Disorders Outpatient Unit, Institute and Department of Psychiatry, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Daniela Bertoni
- Impulse Control Disorders Outpatient Unit, Institute and Department of Psychiatry, University of Sao Paulo, Sao Paulo, SP, Brazil
| | | | - David C Hodgins
- Addictive Behaviours Laboratory, Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Hermano Tavares
- Impulse Control Disorders Outpatient Unit, Institute and Department of Psychiatry, University of Sao Paulo, Sao Paulo, SP, Brazil
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Müller KW, Dreier M, Beutel ME, Wölfling K. Is Sensation Seeking a correlate of excessive behaviors and behavioral addictions? A detailed examination of patients with Gambling Disorder and Internet Addiction. Psychiatry Res 2016; 242:319-325. [PMID: 27322843 DOI: 10.1016/j.psychres.2016.06.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 06/02/2016] [Accepted: 06/05/2016] [Indexed: 01/14/2023]
Abstract
Sensation Seeking has repeatedly been related to substance use. Also, its role as a correlate of Gambling Disorder has been discussed although research has led to heterogeneous results. Likewise, first studies on Internet Addiction have indicated increased Sensation Seeking, to some extent contradicting clinical impression of patients suffering from internet addiction. We assessed Sensation Seeking in a clinical sample of n=251 patients with Gambling Disorder, n=243 patients with internet addiction, n=103 clients with excessive but not addictive internet use, and n=142 healthy controls. The clinical groups were further sub-divided according to the preferred type of addictive behavior (slot-machine gambling vs. high arousal gambling activities and internet gaming disorder vs. other internet-related addictive behaviors). Decreased scores in some subscales of Sensation Seeking were found among male patients compared to healthy controls with no differences between patients with Gambling Disorder and Internet Addiction. The type of preferred gambling or online activity was not related to differences in Sensation Seeking. Previous findings indicating only small associations between Sensation Seeking and Gambling Disorder were confirmed. Regarding Internet Addiction our results contradict findings from non-clinical samples. Sensation Seeking might be relevant in initiating contact to the health care system.
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Affiliation(s)
- K W Müller
- Department of Psychosomatic Medicine and Psychotherapy, Outpatient Clinic for Behavioural Addictions, University Medical Centre, Johannes Gutenberg University Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany.
| | - M Dreier
- Department of Psychosomatic Medicine and Psychotherapy, Outpatient Clinic for Behavioural Addictions, University Medical Centre, Johannes Gutenberg University Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany.
| | - M E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, Outpatient Clinic for Behavioural Addictions, University Medical Centre, Johannes Gutenberg University Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany.
| | - K Wölfling
- Department of Psychosomatic Medicine and Psychotherapy, Outpatient Clinic for Behavioural Addictions, University Medical Centre, Johannes Gutenberg University Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany.
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Abstract
INTRODUCTION Naltrexone (NTX), a mu-opioid receptor antagonist, has been approved for the treatment of alcoholism and opioid dependence. More recently, however, NTX and a related drug, nalmefene (NMF), have also shown positive results for the treatment of gambling disorders. AREAS COVERED In this study, we reviewed the trials testing the effect of opioid antagonists (OA) in gambling disorders and in other broadly defined behavioral addictions, including selected DSM-5 disruptive, impulse-control, and conduct disorders, obsessive-compulsive and related disorders, eating disorders, and other conditions not currently recognized by official classification schemes. We found six randomized controlled trials (RCTs) of OA in gambling disorder, two RCTs of OA in trichotillomania (hair pulling disorder), two RCTs of OA in binge eating disorder, and one RCT of OA for kleptomania. We also reviewed case reports on hypersexual disorder, compulsive buying and skin picking disorders. EXPERT OPINION The reviewed data supported the use of OA, namely NTX and NMF, in gambling disorder (both) and kleptomania (NTX). We did not find enough evidence to support the use of NTX or NMF in trichotillomania (hair pulling disorder), excoriation (skin-picking) disorder, compulsive buying disorder, hypersexual disorder, or binge eating disorder.
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Affiliation(s)
- Marcelo Piquet-Pessôa
- a Obsessive, Compulsive, and Anxiety Spectrum Disorders Research Program, Institute of Psychiatry , Federal University of Rio de Janeiro (UFRJ) , Rio de Janeiro , Brasil
| | - Leonardo F Fontenelle
- a Obsessive, Compulsive, and Anxiety Spectrum Disorders Research Program, Institute of Psychiatry , Federal University of Rio de Janeiro (UFRJ) , Rio de Janeiro , Brasil.,b D'Or Institute for Research and Education (IDOR) , Rio de Janeiro , Brasil.,c Monash Institute of Cognitive and Clinical Neurosciences (MICCN), School of Psychological Sciences & Monash Biomedical Imaging (MBI) Facility , Monash University , Victoria , Australia
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Abstract
Elevated levels of both pathological gambling (PG) and problem shopping (PS) have been reported among adolescents, and each is associated with a range of other negative health/functioning measures. However, relationships between PS and PG, particularly during adolescence, are not well understood. In this study, we explored the relationship between different levels of problem-gambling severity and health/functioning characteristics, gambling-related social experiences, gambling behaviors and motivations among adolescents with and without at-risk/problematic shopping (ARPS). Survey data from Connecticut high school students (n = 2,100) were analyzed using bivariate analyses and logistic regression modeling. Although at-risk/problematic gambling (ARPG) was not increased among adolescents with ARPS, adolescents with ARPG (vs non-gamblers) were more likely to report having experienced a growing tension or anxiety that could only be relieved by shopping and missing other obligations due to shopping. In comparison to the non-ARPS group, a smaller proportion of respondents in the ARPS group reported paid part-time employment, whereas a greater proportion of respondents reported excessive gambling by peers and feeling concerned over the gambling of a close family member. In general, similar associations between problem-gambling severity and measures of health/functioning and gambling-related behaviors and motivations were observed across ARPS and non-ARPS adolescents. However, associations were weaker among ARPS adolescents for several variables: engagement in extracurricular activities, alcohol and caffeine use and gambling for financial reasons. These findings suggest a complex relationship between problem-gambling severity and ARPS. They highlight the importance of considering co-occurring risk behaviors such as ARPS when treating adolescents with at-risk/problem gambling.
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Affiliation(s)
- Sarah W Yip
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Songli Mei
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- School of Public Health, Jilin University, Changchun, China
| | - Corey E Pilver
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | | | | | | | - Rani A Hoff
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- VA CT Healthcare System, West Haven, CT, USA
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Neurobiology, Yale University School of Medicine, New Haven, CT, USA
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
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Raposo-Lima C, Castro L, Sousa N, Morgado P. SCRATCH THAT!—Two case reports of scratch-card gambling disorder. Addict Behav 2015; 45:30-3. [PMID: 25637885 DOI: 10.1016/j.addbeh.2015.01.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 11/16/2014] [Accepted: 01/12/2015] [Indexed: 12/20/2022]
Abstract
Gambling disorder is a common, clinically relevant condition that impacts significantly one's life. Given that approved pharmacological interventions are lacking, it is crucial to readily identify these cases to provide available interventions in psychiatric care services. Here, we present two uncommon cases of unique scratch-card gambling disorder, a specific type of pathological gambling that could be increasing as availability of these games are growing.
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Konkolÿ Thege B, Colman I, el-Guebaly N, Hodgins DC, Patten SB, Schopflocher D, Wolfe J, Wild TC. Social judgments of behavioral versus substance-related addictions: a population-based study. Addict Behav 2015; 42:24-31. [PMID: 25462650 DOI: 10.1016/j.addbeh.2014.10.025] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 08/05/2014] [Accepted: 10/24/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Recently, the concept of addiction has expanded to include many types of problematic repetitive behaviors beyond those related to substance misuse. This trend may have implications for the way that lay people think about addictions and about people struggling with addictive disorders. The aim of this study was to provide a better understanding of how the public understands a variety of substance-related and behavioral addictions. METHODS A representative sample of 4000 individuals from Alberta, Canada completed an online survey. Participants were randomly assigned to answer questions about perceived addiction liability, etiology, and prevalence of problems with four substances (alcohol, tobacco, marijuana, and cocaine) and six behaviors (problematic gambling, eating, shopping, sexual behavior, video gaming, and work). RESULTS Bivariate analyses revealed that respondents considered substances to have greater addiction liability than behaviors and that most risk factors (moral, biological, or psychosocial) were considered as more important in the etiology of behavioral versus substance addictions. A discriminant function analysis demonstrated that perceived addiction liability and character flaws were the two most important features differentiating judgments of substance-related versus behavioral addictions. Perceived addiction liability was judged to be greater for substances. Conversely, character flaws were viewed as more associated with behavioral addictions. CONCLUSIONS The general public appreciates the complex bio-psycho-social etiology underlying addictions, but perceives substance-related and behavioral addictions differently. These attitudes, in turn, may shape a variety of important outcomes, including the extent to which people believed to manifest behavioral addictions feel stigmatized, seek treatment, or initiate behavior changes on their own.
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Affiliation(s)
- Barna Konkolÿ Thege
- Department of Psychology, University of Calgary, 2500 University Drive, Calgary T2N 1N4, Canada.
| | - Ian Colman
- Department of Epidemiology and Community Medicine, University of Ottawa, Room 3105, 451 Smyth Road, Ottawa, Ontario K1H 8M5, Canada.
| | - Nady el-Guebaly
- Department of Psychiatry, University of Calgary, 1403-29 Street, Calgary T2N 2T9, Canada.
| | - David C Hodgins
- Department of Psychology, University of Calgary, 2500 University Drive, Calgary T2N 1N4, Canada.
| | - Scott B Patten
- Department of Psychiatry, University of Calgary, 1403-29 Street, Calgary T2N 2T9, Canada; Department of Community Health Sciences, University of Calgary, 3rd Floor, TRW Building, 3280 Hospital Drive, Calgary T2N 4Z6, Canada.
| | - Don Schopflocher
- School of Public Health, University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405-97 Avenue, Edmonton T6G 1C9, Canada.
| | - Jody Wolfe
- School of Public Health, University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405-97 Avenue, Edmonton T6G 1C9, Canada.
| | - T Cameron Wild
- School of Public Health, University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405-97 Avenue, Edmonton T6G 1C9, Canada.
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Di Nicola M, Tedeschi D, De Risio L, Pettorruso M, Martinotti G, Ruggeri F, Swierkosz-Lenart K, Guglielmo R, Callea A, Ruggeri G, Pozzi G, Di Giannantonio M, Janiri L. Co-occurrence of alcohol use disorder and behavioral addictions: relevance of impulsivity and craving. Drug Alcohol Depend 2015; 148:118-25. [PMID: 25630963 DOI: 10.1016/j.drugalcdep.2014.12.028] [Citation(s) in RCA: 108] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2014] [Revised: 12/20/2014] [Accepted: 12/22/2014] [Indexed: 12/24/2022]
Abstract
PURPOSE The aims of the study were to evaluate the occurrence of behavioral addictions (BAs) in alcohol use disorder (AUD) subjects and to investigate the role of impulsivity, personality dimensions and craving. METHODS 95 AUD outpatients (DSM-5) and 140 homogeneous controls were assessed with diagnostic criteria and specific tests for gambling disorder, compulsive buying, sexual, internet and physical exercise addictions, as well as with the Barratt Impulsiveness Scale (BIS-11) and Temperamental and Character Inventory-Revised (TCI-R). The Obsessive Compulsive Drinking Scale (OCDS) and Visual Analogue Scale for craving (VASc) were also administered to the AUD sample. RESULTS 28.4% (n=27) of AUD subjects had at least one BA, as compared to 15% (n=21) of controls (χ(2)=6.27; p=.014). In AUD subjects, direct correlations between BIS-11 and Compulsive Buying Scale (CBS), Internet Addiction Disorder test (IAD), Exercise Addiction Inventory-Short Form (EAI-SF) scores (p<.01), between OCDS obsessive and CBS and VASc and CBS, IAD scores (p<.003), were found. BIS-11 (t=-2.36; p=.020), OCDS obsessive (Z=-4.13; p<.001), OCDS compulsive (Z=-2.12; p=.034) and VASc (Z=-4.94; p<.001) scores were higher in AUD subjects with co-occurring BAs. The occurrence of BAs was associated with higher impulsivity traits (BIS-11 scores; OR=1.08; p=.012) and higher craving levels (VASc scores; OR=2.48; p<.001). CONCLUSIONS Our findings emphasize a significant rate of co-occurrence of BAs in AUD. High levels of impulsivity and craving for alcohol seem to be associated with other addictive behaviors.
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Affiliation(s)
- Marco Di Nicola
- Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy; University Consortium Humanitas, Via della Conciliazione 22, 00193 Rome, Italy.
| | - Daniela Tedeschi
- Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy
| | - Luisa De Risio
- Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy
| | - Mauro Pettorruso
- Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy
| | - Giovanni Martinotti
- Department of Neuroscience and Imaging, Institute of Psychiatry, "G. d'Annunzio" University of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy
| | - Filippo Ruggeri
- Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy
| | - Kevin Swierkosz-Lenart
- Centre Neuchâtelois de Psychiatrie, République et Canton de Neuchâtel, Site de Préfargier, 2074 Marin-Epagnier, Switzerland
| | - Riccardo Guglielmo
- Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy
| | - Antonino Callea
- Science of Education, LUMSA University, Borgo Sant'Angelo, 13, 00193 Rome, Italy
| | - Giuseppe Ruggeri
- Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy
| | - Gino Pozzi
- Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy
| | - Massimo Di Giannantonio
- Department of Neuroscience and Imaging, Institute of Psychiatry, "G. d'Annunzio" University of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy
| | - Luigi Janiri
- Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy; University Consortium Humanitas, Via della Conciliazione 22, 00193 Rome, Italy
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Jiménez-Murcia S, Fernández-Aranda F, Granero R, Menchón JM. Gambling in Spain: update on experience, research and policy. Addiction 2014; 109:1595-601. [PMID: 23718704 DOI: 10.1111/add.12232] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Revised: 12/28/2012] [Accepted: 04/23/2013] [Indexed: 11/27/2022]
Abstract
AIMS To describe the current situation of gambling in Spain, sketching its history and discussing the regulations and legislation currently in force within the framework of the European Union (EU), and to review the epidemiology of gambling in Spain, the self-help groups and professional treatments available, and their potential effectiveness. METHODS A systematic computerized search was performed in three databases (EMBASE, PubMed and PsychINFO, including articles and chapters) and the reference lists from previous reviews to obtain some of the most relevant studies published up to now on the topic of pathologic gambling in Spain. RESULTS Similar to other EU countries, Spain has a high prevalence of pathologic gambling, focused on specific culturally bounded types of gambling. Expenditure in online gaming has risen significantly in the last few years, prompting the Spanish government to draft new legislation to regulate gaming. CONCLUSIONS The gaming industry is expected to be one of the fastest growing sectors in Spain in the coming years owing to the rise of new technologies and the development of online gaming.
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Affiliation(s)
- Susana Jiménez-Murcia
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain; Clinical Science Department, School of Medicine, University of Barcelona, Barcelona, Spain; CIBER Fisiopatologia Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Barcelona, Spain
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Sapir R, Zohar AH, Bersudsky Y, Belmaker R, Osher Y. Behavioral addictions in euthymic patients with bipolar I disorder: a comparison to controls. Int J Bipolar Disord 2013; 1:27. [PMID: 25505690 PMCID: PMC4215809 DOI: 10.1186/2194-7511-1-27] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Accepted: 12/04/2013] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Bipolar disorder may be associated with a hypersensitive behavioral approach system and therefore to increased reward sensitivity. The objective of this study is to explore the interrelationships between bipolar disorder, behavioral addictions, and personality/temperament traits in a group of euthymic outpatients with bipolar I disorder and in a group of comparison subjects. METHODS Fifty clinically stable patients and 50 comparison subjects matched for age, sex, and educational level were administered the Temperament and Character Inventory-140 and the Behavioral Addiction Scale. RESULTS The patient group scored significantly higher than comparison subjects for two benign behavioral addictions (music, shopping) as well as for smoking. Comparison subjects scored higher on two harmful behavioral addictions (drugs, alcohol). Novelty Seeking was positively correlated with harmful addictions, and Cooperativeness was negatively correlated with harmful addictions, in both groups. DISCUSSION The hypersensitive behavioral approach system model of bipolar disorder would predict higher levels of various addictions in bipolar patients as compared to controls. In this study, this was true for three behavioral addictions, whereas controls showed higher levels of behavioral addiction to drugs and alcohol. This may be because the patients in this study are stable, have received considerable psychoeducation, and are relatively adherent to their medication recommendations. Temperament and character traits may play roles both as risk and protective factors regarding behavioral addictions.
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Affiliation(s)
- Ran Sapir
- Department of Psychology, Ruppin Academic Center, Emek Hefer, Israel
| | - Ada H Zohar
- Department of Psychology, Ruppin Academic Center, Emek Hefer, Israel
| | - Yuly Bersudsky
- Department of Psychiatry, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Rh Belmaker
- Department of Psychiatry, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Yamima Osher
- Department of Psychiatry, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
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Spanagel R. Convergent functional genomics in addiction research - a translational approach to study candidate genes and gene networks. In Silico Pharmacol 2013; 1:18. [PMID: 25505662 PMCID: PMC4230431 DOI: 10.1186/2193-9616-1-18] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 11/12/2013] [Indexed: 01/16/2023] Open
Abstract
Convergent functional genomics (CFG) is a translational methodology that integrates in a Bayesian fashion multiple lines of evidence from studies in human and animal models to get a better understanding of the genetics of a disease or pathological behavior. Here the integration of data sets that derive from forward genetics in animals and genetic association studies including genome wide association studies (GWAS) in humans is described for addictive behavior. The aim of forward genetics in animals and association studies in humans is to identify mutations (e.g. SNPs) that produce a certain phenotype; i.e. "from phenotype to genotype". Most powerful in terms of forward genetics is combined quantitative trait loci (QTL) analysis and gene expression profiling in recombinant inbreed rodent lines or genetically selected animals for a specific phenotype, e.g. high vs. low drug consumption. By Bayesian scoring genomic information from forward genetics in animals is then combined with human GWAS data on a similar addiction-relevant phenotype. This integrative approach generates a robust candidate gene list that has to be functionally validated by means of reverse genetics in animals; i.e. "from genotype to phenotype". It is proposed that studying addiction relevant phenotypes and endophenotypes by this CFG approach will allow a better determination of the genetics of addictive behavior.
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Affiliation(s)
- Rainer Spanagel
- Institute of Psychopharmacology, Central Institute of Mental Health, Faculty of Medicine Mannheim, University of Heidelberg, J5, 68159 Mannheim, Germany
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