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[Behavior pattern of young opiate addicts in comparison with classical morphinists].
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Narratives of recovery from addictive behaviours.
AIMS: The purpose of this study was to look for the ways in which people who have recovered from various addictions understand and present their change process. MATERIALS: The research material consisted of 51 autobiographical stories of people who had been able to quit their addiction to alcohol, multiple drugs, binge eating, smoking, sex and gambling. METHODS: The basic logic of each narrative was first defined. The narratives were then categorized according to what they presented as the key to recovery. Composite stories were then constructed and analysed with regard to their emotional, causal, moral and ethical meanings. FINDINGS: The analysis revealed five different story types among these self-narratives: the AA story, the growth story, the co-dependence story, the love story and the mastery story. All of them helped to make the addiction and recovery understandable, they released the protagonist from guilt and had a happy ending by which the values of the story were realized. Each story type was told predominantly by representatives of a particular gender and addiction. CONCLUSIONS: As there are several ways out of addictive behaviours there are also several ways to construe the change. People who try to quit addictive behaviours could be encouraged to make full use of the cultural stock of stories in creating an account that fits their own experience of defeating their particular addiction.
A clinical approach to help psychiatric patients with smoking cessation.
In this paper we briefly review the dynamics of smoking and nicotine dependence, discuss the evaluation of the addicted smoker, and describe interventions to facilitate the attempt to quit smoking. We also discuss the interface of psychiatric illness and smoking, particularly among those chronically hospitalized in psychiatric institutions, and suggest a rational approach to help patients with psychiatric illness stop smoking.
[Sex addiction diagnosis. When libido becomes a burden. Interview by Dr. Beate Schumacher].
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[Self-help on the internet. Chances and risks of communication in electronic networks].
The worldwide web is used for self-help purposes by an increasing number of patients with a variety of mental disorders. The benefits and dangers of applying the internet in psychiatry are discussed based on a case report concerning a female with post traumatic stress and multiple personality disorders who visited a chat-room in the internet with two of her 48 supernumerary identities. During one stage of her history, she displayed an excessive use of the internet which must be considered a symptom of mental disorder rather than a distinct disease entity, viz. "internet addiction".
Drug addiction: the neurobiology of behaviour gone awry.
Drug addiction manifests as a compulsive drive to take a drug despite serious adverse consequences. This aberrant behaviour has traditionally been viewed as bad "choices" that are made voluntarily by the addict. However, recent studies have shown that repeated drug use leads to long-lasting changes in the brain that undermine voluntary control. This, combined with new knowledge of how environmental, genetic and developmental factors contribute to addiction, should bring about changes in our approach to the prevention and treatment of addiction.
The moral relevance of addiction.
I attempt to understand and assess the widespread belief that addiction is relevant to morality. I examine several accounts of how addiction might be significant from a moral point of view. Although I briefly discuss theories of virtue, I focus on three possible ways addiction might be relevant to moral blame. First, blame might be imposed for the act of using addictive drugs. Second, blame might be imposed for the condition of being addicted. Third, blame might be imposed for further risks persons are likely to undertake once they have become addicts. I conclude that each of these accounts has some plausibility, but none is entirely unproblematic. Addiction probably is relevant to morality, although its degree of importance is not as great as some commentators appear to believe. The moral relevance of addiction does not appear to rise to whatever level would justify a punitive response to addictive drug users.
The role of flow experience in cyber-game addiction.
Consumer habit, an important key to repetitive consumption, is an interesting yet puzzling phenomenon. Sometimes this consumption becomes obsessive--consumers will continue to act a certain way even when they feel it is not in their best interests. However, not all consumers develop such addictions. This study uses cyber-game addiction syndrome as an analogue to trace the possible causes of consumer addiction. Results from structure equation modeling show that repetition of favorite activities has a moderate effect upon addiction, which is in line with the assertion of rational addiction theory. However, flow experience--the emotional state embracing perceptional distortion and enjoyment--shows a much stronger impact on addiction. This suggests that consumers who have experienced flow are more likely to be addicted.
Psychology of computer use: XLIII. Some comments on 'addictive use of the Internet' by Young.
This paper adds further comments to a case description by Young on addictive use of the Internet. Brief comments relating to the Internet as a behavioural addiction and the problem of to what users are actually addicted, are discussed.
The neurobiology of addiction: an overview.
Addiction can be defined in part as a compulsion to use alcohol or other drugs and the occurrence of withdrawal symptoms when long-term consumption ceases. In addition to physical symptoms related to nervous system hyperexcitability, withdrawal includes changes in mental state that may motivate renewed AOD consumption. The manifestations of addiction are associated with changes in nerve cell function by which the brain attempts to adapt to a drug's presence. These functional changes modulate a person's initial response to a drug, the establishment of long-term craving for the drug (i.e., addiction), and the persistent sense of discomfort that leads to relapse after abstinence has been achieved. Research is beginning to reveal how specific brain regions may be integrated to form neural circuits that modulate aspects of addiction.
Experiences and perspectives in using telematic prevention on sensitive health issues.
The new information and communication technologies, telematics - such as the Internet, telephone services and videoconferencing - are simultaneously both an instrument and a symbol - a sign of progress - but also a potential addiction problem. Sensitive topics - like substances or mental health - bring out all these characteristics of telematics. Therefore the computer world, substances and addictions are closely connected.
On the psychodynamics of collecting.
The urge to collect is a ubiquitous phenomenon which has anthropological, sociobiological and individual psychodynamic roots, but occurs far more frequently among men than women. The author examines the reasons for this gender difference and defines systematic collecting to distinguish it from addictive, obsessive and messy collecting, and from related phenomena such as perversion. The mode of collecting and choice of object are important indicators as to the unconscious psychodynamics of a collector and offer opportunity to describe his structural level. Collecting ranges across a broad spectrum, from an ego-syntonic integrated mode, i.e. sublimation, to a neurotic defence against pre-oedipal or oedipal traumas and conflicts. Alongside this drive-theoretical approach, object and Kleinian theory are also applied to the understanding of collecting. Collecting represents a specific form of object relating and way of handling primary loss trauma, which is different from addiction, compulsion, or perversion. Under certain circumstances collecting can also result in a successful Gestalt or way of life. The paper concludes with a case study showing how collecting develops from a pre-oedipal to a more integrated oedipal mode during the course of the analysis, which is reflected in changes in the transference.
Autonomy, addiction and the drive to pleasure: designing drugs and our biology: a reply to Neil Levy.
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Economic modeling of the rational consumption of addictive substances.
This article gives an overview of the way economists model the decision to consume addictive commodities and reviews some of the relevant literature testing aspects of the model. It aims to answer the question of how it is that economists can speak of the consumption of addictive harmful commodities as a rational decision. Health economics treats the consumption of commodities that have beneficial (or harmful) effects on health, and therefore on utility or well-being, as intertemporal decisions with regard to investment decisions. In investment in health, the payoff to an action comes appreciably later than the action itself. The decision to consume harmful, and even addictive, commodities fits into the investment in health framework, with the benefit comes now, in the form of the pleasure derived from consuming them, and the costs, in terms of damage to the individual's health, comes later. The value that a person places on the future vs. the present is called time preference or subjective rate of time discounting, which represents the weight he places on the future relative to the present when he makes decisions that have future consequences. The more they discount the future, the more myopic they are and the more likely to undertake risky behaviors, including smoking or using drugs such as amphetamines or heroin, as well as dropping out of school or taking on high risk jobs.
Exercise dependence in relation to competitive orientation of runners.
An increasing number of runners seem to be vulnerable to the exercise dependence (ED) syndrome, a clinical disorder in which the athlete is unwilling to alter or discontinue training regimens despite medical contraindications to continued training compliance. As habituation to a stimulus has been regarded to be a diagnostic criterion of an addicted state, we hypothesized that performance in running events of increasing distances would be accompanied by an increased tendency towards ED. To examine this relationship, an exercise addiction scale was completed by recreational (non-competitive) runners (N = 33), five kilometer (5K) runners (N = 24), marathoners (N = 32), and ultramarathon (50 miles) runners (N = 61). ANOVA procedures indicated that both marathoners and ultramarathoners showed significantly higher ED scores [3.78 +/- 1.6 (SD) and 4.59 +/- 1.8, respectively] as compared to 5K (2.9 +/- 1.0) and recreational runners (2.16 +/- 1.3) (p < 0.05). In addition, ultramarathoners presented significantly higher ED scores than those of marathoners (p < 0.05). The data indicate that a tendency towards ED may motivate participation in competition of increasing distance and support a habituation effect consistent with acquired dependence behavior.
Stimulation of protein kinase a activity in the rat amygdala enhances reward-related learning.
BACKGROUND: Drug addiction in humans is associated with abnormal metabolic activity within the amygdala and heightened control of behavior by drugs and drug-related (conditioned) stimuli. Drug-induced neuroadaptations, including activation of cAMP (cyclic adenosine monophosphate)-dependent protein kinase A (PKA), within the amygdala may contribute to the synaptic plasticity and reward-related learning that underlies pathologic behavior in addicted individuals. METHODS: In this study, we tested the hypothesis that stimulation of PKA activity within the rat amygdala would facilitate the acquisition of Pavlovian approach behavior, a measure of reward-related learning. RESULTS: Intraamygdala infusions of Sp-cAMPS (which activates PKA) produced concentration-dependent enhancements of the acquisition of approach to a conditioned stimulus that predicted water availability; intraamygdala infusions of cholera toxin (which elevates cAMP levels) produced a similar effect. Conversely, intraamygdala infusions of Rp-cAMPS, an inhibitor of PKA, impaired acquisition of approach behavior. CONCLUSIONS: Together, these data demonstrate that stimulation of PKA activity in the amygdala can facilitate reward-related learning and suggest that neuroadaptative changes in the PKA pathway within this brain region may be a mechanism by which chronic drug abuse alters the control of behavior by drug-associated stimuli.
A preliminary report on crime and addiction within a community-wide population of narcotic addicts.
This paper discusses the criminal behavior of narcotic addicts and is based on a sample of males identified as narcotic abusers by a large urban Police Department in the United States over a twenty-year period (1952-1971). The records of 252 subjects (representing a 92% interview response rate) were analyzed to determine whether there were differences between blacks and whites with regard to criminality before first use and after first regular use of narcotics. The findings generally support previous ones in regard to the increase of criminal activity after the onset of narcotic addiction. In addition, this community-wide population of narcotic addicts revealed that black addicts tend to commit more crimes, and more serious crimes, than white addicts before first use of narcotics and after the onset of addiction. Further, weighted crime index scores of both the "before" and "after" segments appear higher for blacks who became addicted in the most recent years, while this appears to be true for the whites only after the onset of their addiction.