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PubMed1996

Common addictions.

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Behavior, Addictive↗
PubMed2005

Behavioral perspectives on the neuroscience of drug addiction.

Neuroscientific approaches to drug addiction traditionally have been based on the premise that addiction is a process that results from brain changes that in turn result from chronic administration of drugs of abuse. An alternative approach views drug addiction as a behavioral disorder in which drugs function as preeminent reinforcers. Although there is a fundamental discrepancy between these two approaches, the emerging neuroscience of reinforcement and choice behavior eventually may shed light on the brain mechanisms involved in excessive drug use. Behavioral scientists could assist in this understanding by devoting more attention to the assessment of differences in the reinforcing strength of drugs and by attempting to develop and validate behavioral models of addiction.

Animals↗
PubMed2000

Place, social exchange and health: proposed sociological framework.

A sociological framework is proposed to better understand how spatial characteristics translate into people's physical and psychosocial conditions that are relevant to their health. In particular, high susceptibility to poor health among specific adult population groups is analyzed in terms of exclusion from or inadequate participation in a society's structure of opportunities. Acquisition of, and agency through, core social roles, such as the work role, the family and marital role, and civic roles, are essential prerequisites for successful personal self-regulation in adult life, strengthening a sense of self-esteem, self-efficacy, and belonging (self-integration). It is argued that exclusion from, or loss of core social roles, threats to their continuity and confinement to non-reciprocal exchange impair personal self-regulation and trigger a state of 'social reward deficiency'. This state, in turn, elicits prolonged stressful experience, and it may reinforce a person's craving for stress-relieving, potentially addictive health-damaging behavior. This framework is applied to the explanation of the life expectancy gap between Western and Central/Eastern European countries. Although most of the epidemiological evidence reviewed in support of this approach originates from investigations that were conducted in western countries several results reported in the collection of articles published in this Special Issue of Social Science and Medicine are in line with the proposed framework.

Adult↗
PubMed1992

Safe sex behavior in drug-addicted males as a function of object relations.

An inventory of sexual behavior was administered in a hospital detoxification program to 127 drug-addicted males, who also completed a modified form of the Defense Mechanisms Inventory (DMI) which yields a measure of object relations. Condom use was shown to be related to an object relations mode that typifies the individual who can structure reality and needs without requiring an integral aspect of "the other" in his approach. Standardization and factor analytic data are also presented for the DMI and the object relations measure for this population. The resulting pattern and the small effect size are discussed within the reality constraints of the addicted patient, as well as within the psychometric parameters inherent in psychoanalytic research.

Adult↗
PubMed2004

The behavioral economics of violence.

From the viewpoint of teleological behaviorism the first question to ask in attempting to understand any behavior, including violent behavior, is: What are its contingencies of reward and punishment? Or, to put the question in economic terms: What are the short-term and long-term costs and benefits that such behavior entails? Let us therefore consider the costs and benefits of youth violence. Among the short-term costs of violent behavior are the physical effort of the act, the possibility of immediate physical retaliation, immediate social disapproval, and the opportunity cost of other social acts that the violent behavior takes the place of (you can't be affectionate and violent at the same time, for instance). Among the immediate benefits of violent behavior are the intrinsic satisfaction of the violent act itself and any extrinsic benefit; if A violently appropriates B's new sneakers then obtaining the sneakers reinforces A's violence. These immediate benefits may well outweigh the costs in many contexts. Among the long-term costs of violent behavior are delayed retaliation, possible social disapproval and loss of social support, rejection from a social group, job loss, and health risks associated with a violent lifestyle. Among the long-term benefits are long-term intimidation of others (your neighbor is less likely to build a fence on your property if you have a reputation for violence), and a possibly exciting lifestyle. These long-term benefits may well be outweighed by the long-term costs. Opposition of long-term net costs to short-term net benefits, where it exists, creates a personal self-control trap: Overall satisfaction may decrease monotonically with rate of the target behavior but, regardless of its rate, the immediate satisfaction of doing it is always higher than that of not doing it. In the case of violent behavior, this trap is exacerbated by the fact that as a person's violence increases, net immediate reinforcement also increases (due to membership in violence-reinforcing subgroups). This contingency fits the "primrose path" addiction model of Prelec and Herrnstein. Violence is thus a paradigm case of behavioral addiction. I consider three ways of controlling such addictive behavior: by punishment, by extinction, and by substitution. The problem with punishment in the case of violence is that physical punishment tends to increase violent behavior while incarceration drives the punished person into the very social subgroup (the prison culture) where violence is maximally reinforced. The problem with extinction is that the immediate benefits of violent behavior are largely intrinsic and some costs (immediate retaliation by unidentified others) are difficult to control. The best way to control violent behavior, as well as other addictive behaviors, is by decreasing the price of economic substitutes. There is much evidence that addictions, such as to cocaine, heroin, alcohol, and tobacco, may be reduced by decreasing the price of social support. The same is predicted for violent behavior--either by providing social support directly or by training in social skills. In addition, in considering control of violent behavior, we need to examine the immediate benefits and long-term costs to society of having violent individuals and violence-reinforcing subcultures among us. And we need to act to reduce our own dependence on those benefits.

Behavior, Addictive↗
PubMed2000

Self-efficacy, expectancies, and abstinence acceptance: further evidence for the addicted-self model of cessation of alcohol- and drug- dependent behavior.

The Addicted-Self Model of the cessation of alcohol- and drug-dependent behaviors is outlined briefly, and five hypotheses consistent with the predictions of the model are examined. All five hypotheses are confirmed, broadening the support for the Addicted-Self Model of recovery. These findings also suggest modifications of the assumptions underlying alcohol and drug expectancy research. These modifications are discussed, and directions for further research are suggested.

Adult↗
PubMed2005

Addiction in Parkinson's disease: impact of subthalamic nucleus deep brain stimulation.

In Parkinson's disease, dopamine dysregulation syndrome (DDS) is characterized by severe dopamine addiction and behavioral disorders such as manic psychosis, hypersexuality, pathological gambling, and mood swings. Here, we describe the case of 2 young parkinsonian patients suffering from disabling motor fluctuations and dyskinesia associated with severe DDS. In addition to alleviating the motor disability in both patients, subthalamic nucleus (STN) deep brain stimulation greatly reduced the behavioral disorders as well as completely abolished the addiction to dopaminergic treatment. Dopaminergic addiction in patients with Parkinson's disease, therefore, does not constitute an obstacle to high-frequency STN stimulation, and this treatment may even cure the addiction.

Adult↗
PubMed1992

Fluoxetine treatment of nonparaphilic sexual addictions and paraphilias in men.

BACKGROUND: Paraphilias (PAs) and non-paraphilic sexual addictions (NPSAs) may be behaviors that share a common perturbation of central serotonin neuroregulation as a component of their pathophysiology. Fluoxetine was selected as an agent that might mitigate these behaviors, based on the observations that PAs and NPSAs are associated with depression, compulsion, impulsivity, and disinhibited aggression. METHOD: Twenty men (PA, N = 10; NPSA, N = 10) recruited through newspaper advertisement were evaluated for depression and sexual behaviors at baseline and 4-week intervals while receiving fluoxetine pharmacotherapy in an open trial. Sixteen men completed the drug trial. Outcome was determined at 12 weeks using a single-factor, repeated-measures design and an analysis of variance. The general linear models procedure was used to test each of nine dependent measures. RESULTS: Nineteen (95%) of 20 men met non-exclusionary DSM-III-R criteria for dysthymia and 11 men (55%) met criteria for current major depression. At baseline, the paraphilic and the nonparaphilic subgroups were comparable in most intergroup measures of sexual function except total sexual outlet. PAs shared extensive comorbidity with NPSAs (100%). At outcome, statistically significant effects (p < .05) of fluoxetine were found in both groups over time for all variables pertaining to depression and PA/NPSA sexual behaviors. Statistically significant reduction in PA/NPSA response was evident by Week 4, while conventional sexual behavior was not adversely affected by pharmacotherapy. CONCLUSION: Men seeking treatment for PAs/NPSAs reported current depressive symptoms accompanied by a positive history of mood disorders, especially dysthymia and major depression. Fluoxetine selectively reduced both PA and NPSA behaviors in men reporting the presence of mild-severe depressive symptoms. Treatment response of PAs/NPSAs at outcome was independent of baseline depression score. Enhancement of central serotonin neurotransmission by fluoxetine may ameliorate symptoms of mood disorder, heightened sexual desire, and compulsivity/impulsivity associated with these conditions.

Adult↗
PubMed2004

Individual differences in sensitivity to factors provoking reinstatement of cocaine-seeking behavior.

Among cocaine addicts, there is a strong variation in response to relapse provoking factors like conditioned cues and renewed contact with the drug. Here we show that such large individual differences also exist in rats. Reinstatement of extinguished cocaine-seeking behavior was triggered by contingent presentation of a cocaine-conditioned cue or an amphetamine priming injection. We found no positive correlation between cue- and drug-controlled reinstatement of cocaine seeking. Rather, a slight, but significant negative correlation was observed, which was particularly evident in two subgroups of rats that responded highest following either amphetamine priming or cue presentation. A large middle group responded equally for both relapse provoking factors. Further, cocaine-seeking behavior during the first extinction session correlated positively with cue-induced reinstatement. In conclusion, the present findings indicate that the therapeutic efficacy of relapse prevention strategies may depend on individual sensitivity to distinct relapse provoking stimuli.

Amphetamine↗
PubMed2004

Effects of the kappa opioid agonist U50,488 and the kappa opioid antagonist nor-binaltorphimine on choice between cocaine and food in rhesus monkeys.

RATIONALE: Selective kappa opioid receptor agonists usually decrease cocaine self-administration in procedures that use rate-based measures of reinforcement; however, the rate-altering effects of kappa agonists complicate interpretation of these findings. OBJECTIVES: To evaluate the effects of the selective kappa agonist U50,488 and the selective kappa antagonist nor-binaltorphimine (nor-BNI) on concurrent choice between cocaine and food in rhesus monkeys. The concurrent-choice procedure provides a rate-independent measure of the relative reinforcing effects of cocaine in comparison with food. METHODS: Four rhesus monkeys were trained to respond under a concurrent-choice schedule for food (1-g pellets) or cocaine (0-0.1 mg/kg per injection). Saline and increasing doses of U50,488 (0.0032-0.1 mg/kg per h) were administered by pseudo-continuous i.v. infusion (one infusion every 20 min) during sequential 3-day blocks. In a separate experiment, monkeys were treated with nor-BNI (3.2 mg/kg, i.v.), and cocaine choice was re-determined during pseudo-continuous infusion with saline or U50,488 (0.1 mg/kg per h). RESULTS: During saline treatment, cocaine maintained a dose-dependent and monotonic increase in cocaine choice. Monkeys responded primarily for food when low cocaine doses were available (0-0.01 mg/kg per injection) and primarily for cocaine when higher cocaine doses were available (0.032-0.1 mg/kg per injection). U50,488 produced a dose-dependent increase in cocaine choice, manifested as leftward shifts in the cocaine-choice, dose-effect curve. U50,488 also dose-dependently decreased overall response rates. Nor-BNI did not alter cocaine choice, but it attenuated the effects of U50,488. CONCLUSIONS: These results suggest that continuous treatment with U50,488 produces a kappa receptor-mediated increase in the relative reinforcing effects of cocaine in comparison with food.

3,4-Dichloro-N-methyl-N-(2-(1-pyrrolidinyl)-cycloh↗
PubMed2005

Interactions between the reinforcing effects of cocaine and heroin in a drug-vs-food choice procedure in rhesus monkeys: a dose-addition analysis.

RATIONALE: Concurrent abuse of cocaine and heroin is a common form of polydrug abuse, but the interactions between the reinforcing effects of cocaine and heroin are poorly understood. Dose-addition analysis is a tool for the quantitative assessment of drug interactions, but this analysis has not been applied to evaluation of the reinforcing effects of cocaine and heroin. OBJECTIVES: To evaluate interactions between the reinforcing effects of cocaine and heroin using dose-addition analysis. METHODS: Rhesus monkeys were trained under a concurrent-choice schedule of food delivery (1 gm pellets) and drug injections (cocaine or heroin, 0-0.1 mg kg(-1) injection(-1)). Full dose-effect curves were determined for cocaine alone and heroin alone. Subsequently, full dose-effect curves were determined for three fixed-proportion mixtures of cocaine and heroin (fixed proportions of 1:3.2, 1:1 and 3.2:1 cocaine/heroin). Dose-addition analysis was used to assess whether cocaine/heroin interactions were super-additive, additive, or sub-additive. RESULTS: Cocaine, heroin, and all cocaine/heroin mixtures maintained dose-dependent and monotonic increases in drug choice and dose-dependent decreases in response rates. Choice dose-effect curves for cocaine/heroin mixtures were shifted to the left of dose-effect curves for cocaine or heroin alone, and dose-addition analysis indicated that cocaine/heroin interactions on drug choice were sub-additive or additive. Cocaine/heroin interactions on response-rate measures were also sub-additive or additive. CONCLUSIONS: These results confirm that mixtures of cocaine and heroin produce reinforcing effects in rhesus monkeys; however, cocaine/heroin interactions were only or sub-additive or additive. Thus, these results do not support the hypothesis that simultaneously delivered cocaine and heroin produces super-additive reinforcing effects.

Animals↗