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The neurobiology of substance and behavioral addictions.

Behavioral addictions, such as pathological gambling, kleptomania, pyromania, compulsive buying, and compulsive sexual behavior, represent significant public health concerns and are associated with high rates of psychiatric comorbidity and mortality. Although research into the biology of these behaviors is still in the early stages, recent advances in the understanding of motivation, reward, and addiction have provided insight into the possible pathophysiology of these disorders. Biochemical, functional neuroimaging, genetic studies, and treatment research have suggested a strong neurobiological link between behavioral addictions and substance use disorders. Given the substantial co-occurrence of these groups of disorders, improved understanding of their relationship has important implications not only for further understanding the neurobiology of both categories of disorders but also for improving prevention and treatment strategies.

Arousal↗

Drinking, binge drinking, and other drug use among southwestern undergraduates: three-year trends.

This study examined substance use patterns and consequences in college students over a three year period. Students were surveyed at a large, southwestern university, allowing for a diverse sample that included a large percentage of minority respondents. Students (total N = 2710) in 1994, 1995, and 1996 responded anonymously to the Core Survey of Alcohol and Drugs. Over 80% of students at each time point were current drinkers, and over one-third at each time period reported binge drinking. Binge drinking was associated with greater weekly drinking and with a range of negative consequences. Underage drinking was prevalent at all time points, and underage drinkers reported drinking in a range of on- and off-campus situations. Hispanic students reported higher rates of binge drinking than other ethnic groups. Nonwhite, non-Hispanic students reported greater rates of abstinence than other students. Although other drug use was much less prevalent, drug use in combination with drinking was associated with more problematic patterns of drinking and more negative consequences. Results are discussed in terms of implications for interventions with college students.

Adult↗

Compulsive drug-seeking behavior and relapse. Neuroadaptation, stress, and conditioning factors.

The development of addiction and vulnerability to relapse following withdrawal is proposed to be the result of neuroadaptive processes within the central nervous system that oppose the acute reinforcing actions of drugs of abuse. These changes lead to impairment in the mechanisms that mediate positive reinforcement and the emergence of affective changes such as anxiety, dysphoria, and depression during withdrawal. Considerable evidence exists implicating perturbations in DA and 5-HT transmission in the nucleus accumbens--neurochemical systems that are activated by cocaine and ethanol self-administration and deficient during withdrawal--as potential substrates for these affective changes. In addition, growing evidence suggests that enhanced CRF release in the central nucleus of the amygdala represents a mechanism underlying the anxiogenic and stress-like consequences of withdrawal that are common to all drugs of abuse. A growing body of evidence also implicates dysregulation of the non-neuroendocrine CRF stress system within the central nucleus of the amygdala as a common factor in the anxiogenic and aversive consequences of withdrawal from drugs of abuse. Moreover, a possible link may exist between long-lasting abnormalities in CRF function in the CeA and vulnerability to relapse during protracted abstinence. Another presumably critical element contributing to the chronic relapsing nature of drug addiction is the learned responses to drug-related stimuli. The long-lasting efficacy of drug- and alcohol-associated contextual stimuli in eliciting drug-seeking behavior in animal models of relapse resembles the endurance of conditioned cue reactivity and cue-induced cocaine craving in humans and confirms a significant role of learning factors in the long-lasting addictive potential of cocaine. With cocaine, D1-dependent neural mechanisms within the medial prefrontal cortex and basolateral amygdala may be important substrates for the motivating effects of drug-related environmental stimuli. With ethanol, available data suggest a role for opioid receptors in the mediation of conditioned drug-seeking behavior. Finally, conditioning factors (i.e., exposure to drug-associated stimuli) and stress can interact to augment vulnerability to relapse. This finding emphasizes that it will be important to consider the simultaneous effects of multiple environmental triggers for relapse in the development of treatment and medication strategies.

Adaptation, Physiological↗

Towards a classification of compulsions in obsessive compulsive neurosis.

The aim of this study is to derive a system of classification of compulsive phenomena occurring in obsessive compulsive disorder (OCD). 461 compulsions were found in 65.53% of 412 patients seen during the decade 1975 to 1984. An attempt has been made to break down the compulsions observed into different categories of form and content. The rationale for such a classification has been presented, and earlier attempts at classification of compulsions reviewed.

Compulsive Behavior↗

Exercise-dependence in bodybuilders: antecedents and reliability of measurement.

AIM: The purposes of this study were: a) to examine social and psychological antecedents of bodybuilding dependence (life satisfaction, socio-economic status, marital status and parental status) and b) to examine the test-retest reliability of the Bodybuilding Dependence Scale (BDS). METHODS: One hundred and eighty-one male bodybuilders agreed to participate in the study. Nineteen of these failed to complete the questionnaire on the second occasion, resulting in a sample size of 162. Each participant completed the BDS on two occasions 3 weeks apart, together with the Satisfaction with Life Scale (SWLS) and items relating to occupation, marital status and parental status. RESULTS: Pearson correlations revealed high test-retest reliability for all three subscales (r=0.94, 0.96 and 0.94 for social-dependence, training-dependence and mastery-dependence, respectively). Pearson correlations also revealed significant negative correlations between all three BDS subscales and SWLS scores (r=-0.66 in all cases). A MANOVA revealed that working class participants scored significantly higher on all three BDS subscales than intermediate class participants who, in turn, scored significantly higher than professional class participants. Participants who were not currently involved in a romantic relationship scored significantly higher on all BDS subscales than those who were romantically involved. Parents scored significantly higher than non-parents on social and mastery-dependence, but not on training-dependence. CONCLUSION: These results show acceptable test-retest reliability for all three BDS subscales. They also demonstrate that life satisfaction, socio-economic status, marital status and parental status can successfully predict BDS scores.

Adult↗