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Queuing theory under competitive social foraging may explain a mathematical equivalence of delay and probability in impulsive decision-making.

Intertemporal and probabilistic decision-making has been studied in psychiatry, ecology, and neuroeconomics. Because drug addicts and psycopaths often make risky decisions (e.g., drug misuse and aggression), investigation into types of impulsivity in intertemporal and probabilistic choices (delay and probability discounting) are important for psychiatric treatments. Studies in behavioral ecology proposed that delay and probability discounting are mediated by the same psychological process, because a decrease in probability of winning corresponds to an increase in delay until winning. According to this view, odds-against winning (=1/p-1) in probabilistic choice corresponds to delay in intertemporal choice. This hypothesis predicts that preference of gambling (low degree of probability discounting) may be associated with patience, rather than impulsivity or impatience, in intertemporal choice (low degree of delay discounting). However, recent empirical evidence in psychiatric research employing pathological gamblers indicates that pathological gamblers are impulsive in intertemporal choice (high degrees of delay discounting). However, a hyperbolic discounting function (usually adopted to explain intertemporal choice) with odds-against (instead of delay) explain experimental data in probabilistic choice dramatically well. Therefore, an alternative explanation is required for the hypothetical equivalence of odds-against to delay. We propose that queuing theory (often adopted for analyzing computer network traffic) under a competitive social foraging condition may explain the equivalence. Our hypothesis may help understand impulsivity of psychiatrics in social behavior (e.g., aggression and antisocial behavior) in addition to non-social impulsivity in reward-seeking (e.g., substance misuse).

Behavior, Addictive↗

Replicating the Addicted-Self Model of recovery.

The purpose of this investigation is to replicate previous studies supporting a developing model of recovery from alcohol and drug addiction, the Addicted-Self Model [Fiorentine & Hillhouse, 2000c; Journal of Drug Issues 31 (2002a) 395; American Journal on Addictions (2002b) in press]. Data was utilized from the first phase of the Los Angeles Target Cities Treatment Enhancement Evaluation, a 2-year prospective study of 260 alcohol and drug treatment outpatients. The Addicted-Self Model is briefly outlined and four hypotheses are tested. Consistent with the assumptions of the model, low controlled use self-efficacy and a decline in controlled use self-efficacy over time predicts: (1) higher levels of the perceived certainty of negative consequences resulting from continued alcohol and drug use, (2) higher levels of abstinence acceptance, and (3) higher rates of abstinence from alcohol and drug use. Also consistent with the Addicted-Self Model, high controlled use self-efficacy does not predict lower levels of alcohol and drug use for those who relapse or continue to use these substances. These findings replicate previous findings supporting the developing Addicted-Self Model of recovery. Study limitations and directions for future research are discussed.

Adolescent↗

Overlapping addictions and self-esteem among college men and women.

To examine whether there is a tendency for individuals to be multiply addicted, overlapping addictions to common substances (alcohol, caffeine, chocolate, cigarettes) and activities (exercise, gambling, Internet use, television, video games) were studied in 129 college men and women. Contrary to previous research, moderate to large correlations were found, both within and between substances and activities. Self-esteem was positively related to exercise but unrelated to the remaining addictions. Several gender differences in addictive tendencies were also revealed: Men scored higher than women on addiction to alcohol, cigarettes, gambling, television, and Internet use, but women scored higher on caffeine and chocolate. The results have implications for theories of addiction and suggest new directions for the study of addiction among normally functioning young adults.

Activities of Daily Living↗

[The neurobiology of psychostimulant addiction].

INTRODUCTION AND DEVELOPMENT: Psychostimulant drugs encompass amphetamines, natural alkaloids like cocaine, and methyl-xanthynes. These drugs induce a strong dependence, manifested as sensitization and tolerance at a neurobiological level. Sensitization is currently being studied experimentally, and it is made up of two stages: initial induction and consolidated expression. During induction, the mesocorticolimbic circuit along with dopamine and glutamate changes in the ventral tegmentum play a critical role. During expression, addictive habits are consolidated through changes in the cortico-striato-amygdaloid loop. CONCLUSION: All together leads to a consolidated addiction, considered as an anomalous learning process, along with a loss of control over drug taking.

Amphetamines↗

PET imaging studies in drug abuse.

UNLABELLED: In spite of the massive public health problem associated with drug abuse, effective treatments remain elusive. This is due in part to a relatively poor understanding of the neurochemical changes which drugs of abuse produce in the human brain and the relationship of these changes to the behavioral and addictive properties of drugs. With the development of modern imaging methods and a variety of labeled drugs and radiotracers, it has now become possible to track many aspects of drug pharmacokinetics and pharmacodynamics directly in the human brain and to relate these parameters to the behavioral and toxic properties of drugs. REVIEW: In this article, we will highlight some examples of the use of Positron Emission Tomography to measure drug pharmacokinetics and pharmacodynamics and their relationship to addiction and to toxicity.

Brain↗

Update on pathological gambling.

Pathological gambling (PG) is a significant public health concern associated with high rates of psychiatric comorbidity and mortality. Although research into the biology of PG is still in an early stage, recent advances in our understanding of motivation, reward, and addiction have provided substantial insight into the possible pathophysiology of this disorder. In addition, over the past 5 years, extraordinary progress has been made in the area of clinical research examining treatments for PG. Although PG is a disabling disorder that continues to represent a clinical challenge for the healthcare professional, our current knowledge of pharmacotherapy and psychosocial interventions offers potentially effective treatment options.

Behavior, Addictive↗

A comparative study of nonparaphilic sexual addictions and paraphilias in men.

BACKGROUND: A definition of nonparaphilic sexual addiction (NPSA) is offered and the literature suggesting comorbidity between NPSA and paraphilias (PAs) is reviewed. We describe a study to clarify the relationship between NPSA and PA. METHOD: Thirty consecutive male respondents to an advertisement (PA: N = 15; NPSA: N = 15) were evaluated. The frequency of sexual behaviors, total sexual outlet, intensity of sexual desire, time spent in unconventional sexual behaviors, and a total sexual interest ratio were measured. Group differences were statistically examined using the Fisher's exact probability test (one-tailed). Concomitant psychological, social, work, financial, legal, and medical sequelae were ascertained. RESULTS: The most prevalent lifetime sexual behaviors in both groups were NPSAs, especially compulsive masturbation, ego-dystonic promiscuity, and dependence on pornography. Mean total sexual outlet in both groups was approximately three times that of a comparable "normal" male sample. Components of total sexual outlet were reported in a nonnormative distribution pattern, and NPSA/PA sexual behaviors eclipsed conventional sexual activities in all measures. Group differences in measures of sexual behavior frequency, intensity, and time consumed by these behaviors were not statistically significant. CONCLUSION: The cormorbid presence of multiple NPSAs in 93% of the paraphilic men accompanied by comparable sexual and psychosocial sequelae suggests that NPSAs may represent a culturally adapted form of psychopathology that can also be manifested as PAs. A definition of hypersexual desire is offered, and a relationship between hypersexual desire and unconventional sexual outlet is suggested.

Behavior, Addictive↗

Individual differences in drug abuse vulnerability: d-amphetamine and sensation-seeking status.

RATIONALE: While the personality dimensions of novelty seeking and sensation seeking are associated with drug abuse vulnerability, the mechanisms associated with this vulnerability remain obscure. OBJECTIVE: This study examined the behavioral effects of d-amphetamine in healthy volunteers scoring in the upper and lower quartiles based on age- and gender-adjusted population norms on the impulsive Sensation-Seeking Scale (SSS) of the Zuckerman-Kuhlman personality questionnaire (ZKPQ). METHOD: Participants completed 7-day outpatient studies examining the subjective, performance, and cardiovascular effects of d-amphetamine (0, 7.5, and 15 mg/70 kg, p.o.) under double-blind conditions according to a randomized block design. Performance tasks included behavioral measures of impulsivity, including attention, inhibition, and risk-taking behavior. RESULTS: No differences in baseline performance or d-amphetamine effects on measures of attention, inhibition, and risk-taking behavior were observed. High impulsive sensation seekers reported greater increases on several subjective report measures associated with drug abuse potential, including visual analog scales feel drug, like drug, and high. CONCLUSIONS: Healthy adults scoring in the top quartile on the population of the impulsive SSS of the ZKPQ may be vulnerable to the abuse potential of d-amphetamine.

Adult↗

"Not lighting up": a case study of a woman who quit smoking.

PURPOSE/OBJECTIVES: To review the prevalence, incidence, and risks of smoking by American women; to outline services, treatments, and educational options for smoking prevention and cessation; and to present the conceptual link between the epidemiologic and research literature and experiences of one individual in the target population--an adult female former smoker with a 30-year habit who began smoking during her teenage years. DATA SOURCES: Published literature, expert opinion, and an interview with a former smoker--a female healthcare professional who had a 30-year habit. DATA SYNTHESIS: Literature was reviewed and the content was evaluated for relevance, accuracy, and timeliness. The relevant content was augmented with the author's practical experience and applied to the case study to make recommendations. CONCLUSIONS: Oncology nurses may use a number of strategies to assist people to never start or to stop using tobacco products. The most effective strategy begins with collaboration between healthcare professionals and patients and a combination of instruction, counseling, and emotional support. Oncology nurses can participate in grassroots efforts to educate the public about addiction related to tobacco use, provide counseling for patients who smoke, and become actively involved in legislative solutions to the problem of tobacco use. IMPLICATIONS FOR NURSING: Oncology nurses may intervene to affect positive behavioral change and participate in grassroots efforts to educate the public. Substantial resources are available to professionals and patients who wish to quit smoking or prevent tobacco use by friends and relatives. Nurses should take every opportunity to support smoking cessation and tobacco use prevention.

Adolescent↗

Patient characteristics, HIV serostatus, and risk behaviors among gay and bisexual males seeking treatment for methamphetamine abuse and dependence in Los Angeles.

Methamphetamine, a drug used at alarming rates among gay/bisexual males in the West, is often combined with sexual activities, thereby increasing HIV-related risks in an already high-risk group. Findings from 68 gay/bisexual men seeking treatment for methamphetamine dependence in Hollywood, California were analyzed to predict HIV serostatus based on demographic, drug use, or sexual behavior variables. Results showed that more HIV-infected participants than non-infected men reported medical problems (97.6% versus 46.2%; X2 = 24.7, df = 1, p < .0001), histories of genital gonorrhea (59.5% versus 26.9%; X2 = 6.9, df = 1, p < .01), use of injection methods (45.2% versus 19.2%; X2 = 4.8, df = 1, p < .03), and more sexual partners with unprotected receptive anal intercourse in the 30 days prior to intake (5.9 versus 0.7; separate t = 3.5, df = 43.7, p < .001). More non-infected participants (19.2%) reported suicidal thoughts than HIV-infected men (0%; X2 = 4.8, df = 1, p < .03). Discriminant function analysis correctly classified 74.6% of cases into serostatus groupings based on presence of suicidal thoughts, history of gonorrhea, number of sexual partners with unprotected receptive anal intercourse and prior methamphetamine treatment. Findings provide information that may prove helpful in tailoring culturally relevant treatment and prevention messages.

AIDS Serodiagnosis↗

Exploring children's conceptions of smoking addiction.

Tobacco addiction is a major health problem for both adults and young people--between 20 and 60% of adolescents are dependent on nicotine and more than two-thirds who attempt to quit experience withdrawal symptoms. Yet, anti-smoking efforts targeted at children emphasize primary prevention and ignore addiction education, which is generally considered relevant only to adult smoking and cessation efforts. This study reports children's concepts of smoking and addiction from interviews with 32 Western Australian boys and girls, aged 9-10 years, all non-smokers. Results suggest children's concepts of smoking addiction may influence attitudes toward smoking trials. Children who thought addiction happened immediately were committed to never smoke at all. Others who thought addiction happened after several cigarettes expressed intentions to experiment. These children believed they could avoid addiction by smoking less than the number of cigarettes that caused addiction. Children who defined addiction as 'liking' or 'enjoying the taste of cigarettes' believed they could avoid being 'hooked' as long as they managed to avoid enjoying the experience. Recent findings that children can get 'hooked' within a few days of smoking highlight the importance of addiction strategies targeted at children, particularly in relation to influencing intentions to experiment with smoking.

Australia↗

Activation in mesolimbic and visuospatial neural circuits elicited by smoking cues: evidence from functional magnetic resonance imaging.

OBJECTIVE: The authors sought to increase understanding of the brain mechanisms involved in cigarette addiction by identifying neural substrates modulated by visual smoking cues in nicotine-deprived smokers. METHOD: Event-related functional magnetic resonance imaging (fMRI) was used to detect brain activation after exposure to smoking-related images in a group of nicotine-deprived smokers and a nonsmoking comparison group. Subjects viewed a pseudo-random sequence of smoking images, neutral nonsmoking images, and rare targets (photographs of animals). Subjects pressed a button whenever a rare target appeared. RESULTS: In smokers, the fMRI signal was greater after exposure to smoking-related images than after exposure to neutral images in mesolimbic dopamine reward circuits known to be activated by addictive drugs (right posterior amygdala, posterior hippocampus, ventral tegmental area, and medial thalamus) as well as in areas related to visuospatial attention (bilateral prefrontal and parietal cortex and right fusiform gyrus). In nonsmokers, no significant differences in fMRI signal following exposure to smoking-related and neutral images were detected. In most regions studied, both subject groups showed greater activation following presentation of rare target images than after exposure to neutral images. CONCLUSIONS: In nicotine-deprived smokers, both reward and attention circuits were activated by exposure to smoking-related images. Smoking cues are processed like rare targets in that they activate attentional regions. These cues are also processed like addictive drugs in that they activate mesolimbic reward regions.

Adult↗

Through the haze of cigarettes: teenage girls' stories about cigarette addiction.

Narrative inquiry was used to explore the meaning of nicotine addiction among teenage girls, age 14 to 17 years, who had recent experience with smoking. The following three narratives emerged: invincibility, giving in, and unanticipated addiction. Those who told a story of invincibility depicted how they were in control of their smoking and not addicted. Participants who gave accounts of giving in to smoking described yielding to external forces. In the narrative of unanticipated addiction, participants recounted their surprise at realizing that they were addicted. Two subnarratives, needing to quit and repeating history, were also uncovered. The study findings reveal the importance of semantics and identity issues as teenage girls talked about nicotine addiction. Listening to their stories is paramount in continued efforts in the reduction of tobacco consumption.

Adolescent↗

Psychiatric comorbidity assessed in Korean children and adolescents who screen positive for Internet addiction.

OBJECTIVES: This study aimed to evaluate clinical comorbidity in children and adolescents with Internet addiction by using structured interview. METHOD: The study was performed in 2 stages. We screened for the presence of Internet addiction among 455 children (mean +/- SD age = 11.0 +/- 0.9 years) and 836 adolescents (mean +/- SD age = 15.8 +/- 0.8 years) using Young's Internet Addiction Scale. These subjects also completed a measure of psychopathology for comparison between addicted and nonaddicted subjects. Sixty-three children (13.8%) and 170 adolescents (20.3%) screened positive for Internet addiction. Of these, 12 children (male, N = 9; female, N = 3) and 12 adolescents (male, N = 11; female, N = 1) were randomly selected for evaluation of current psychiatric diagnoses. Structured interviews used were K-SADS-PL-K for children and SCID-IV for adolescents. Data were collected and interviews were conducted from August 2003 through October 2004. RESULTS: In the child group, 7 were diagnosed with attention-deficit/hyperactivity disorder (ADHD) not otherwise specified including those with subthreshold levels. Mean DuPaul's ADHD Rating Scale scores were more than 20% higher than the mean in Korean children for 6 subjects. In the adolescent group, 3 subjects had major depressive disorder, 1 had schizophrenia, and 1 had obsessive-compulsive disorder. CONCLUSION: By structured interview, we found that Internet-addicted subjects had various comorbid psychiatric disorders. The most closely related comorbidities differ with age. Though we can not conclude that Internet addiction is a cause or consequence of these disorders, clinicians must consider the possibility of age-specific comorbid psychiatric disorders in cases of Internet addiction.

Adolescent↗

The quality world change as a cause of addiction development in conditions of the north.

OBJECTIVE: The aim was to study the quality world (QW), according to Glasser, in newcomers to the North. METHOD: The study included clinical examination of newcomers to the North according to DSM-IV criteria. The QW was studies defined as important figures of significant others (parents, family members, persons loved, friends, acquaintances etc.) with various functions, such as control, revision, support and others. RESULTS: It was found in the newcomers of North that they were unable to structure time in the way typical of their previous life, and that the absence of outside control from the significant others was expressed. The clinical evaluation revealed a strong sense of discomfort, anxiety, and depression. It was typical of the newcomers that they often tried to escape these feelings by alcohol intake, The newcomers used alcohol as a remedy to stimulate the imagination and to overcome the barriers in interpersonal relationships in the new environmental conditions. Alcohol also helped to re-establish the former patterns of self-object relationships and to re-experience the feelings of the comfortable QW pattern. The obtained data revealed that social isolation and hypostimulation led to a faster development of psychological alcohol dependence.

Adult↗