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PubMed2002

Validation of a new scale for measuring problematic internet use: implications for pre-employment screening.

The current study introduced a theory-driven, multidimensional measure of problematic Internet use: the Online Cognition Scale (OCS). Undergraduate students (n = 211) in an industrial/organizational psychology course completed the OCS, along with measures of procrastination, rejection sensitivity, loneliness, depression, and impulsivity. A confirmatory factor analysis indicated that problematic Internet use consists of four dimensions: diminished impulse control, loneliness/depression, social comfort, and distraction. As hypothesized, the OCS predicted all of the study variables in the expected directions. Representing a departure from previous research in this area, the current article focused on procrastination, impulsivity, and social rejection as key elements of problematic Internet use. Furthermore, interactive applications (e.g., chat) were most related to problematic Internet use, and scores on the OCS predicted being reprimanded at school or work for inappropriate Internet use. As a result, the utility of the OCS for both clinical assessment of Internet addiction and as an organizational preemployment screening measure to identify potential employees who are likely to abuse the Internet in the workplace (also known as "cyberslacking") were discussed.

Adult↗
PubMed2003

A hierarchy of gambling disorders in the community.

AIMS: To help refine the definition and diagnosis of gambling disorders, we investigated the distribution among US gamblers of the 10 DSM-IV criteria for Pathological Gambling. DESIGN: We drew data from two stratified random surveys (n = 2417, n= 530) of gambling behavior and consequences among community-based samples of US adults. A fully structured questionnaire, administered by trained lay interviewers, screened for the life-time prevalence of problem and Pathological Gambling. Per DSM-IV definitions, anyone meeting five or more of 10 itemized criteria was considered a pathological gambler. We analyzed these criteria among all gamblers who met one or more criteria (n = 399). FINDINGS: Most gamblers who met only one or two criteria reported 'chasing their losses'. At subclinical levels (three to four criteria), gamblers also reported elevated rates of gambling-related fantasy: lying, gambling to escape and preoccupation. Pathological gamblers with five to seven criteria reported marked elevations of loss of control, withdrawal symptoms and tolerance (internalizing dimensions of dependence); risking their social relationships and needing to be bailed out financially (externalizing dimensions). Most of the highest-level pathological gamblers (eight to 10 criteria) reported committing illegal acts to support gambling. CONCLUSION: Dependence in a biobehavioral sense appears to be a hallmark of Pathological Gambling, but it marks only one threshold in a qualitative hierarchy of disorders beginning with a common subclinical behavior, 'chasing'. Epidemiological assessments and future DSM revisions might consider explicit recognition of a problem gambling disorder, identifying people presenting some cognitive symptoms of Pathological Gambling but not clear signs of dependence. Pathological gamblers in turn appear to have two distinct levels of severity.

Adolescent↗
PubMed2004

[Hypothesis: Parkinson's disease, reward deficiency syndrome and addictive effects of levodopa].

Since Parkinson's disease (PD) patients could suffer from a reward deficiency syndrome, they are particularly prone to develop addictive behaviours. Dopamine is involved in reward processing and in addiction. Pulsatile administration of antiparkinsonian drugs may lead to the development of dyskinesias and addictive behaviours. However, this phenomenon occurs in very few cases. Indeed, both processes share molecular mechanisms although with some differences such as the topography of the changes (it predominates in motor regions in PD with dyskinesias and in limbic regions in addictions). Nevertheless, investigations conducted to know the physiopathology of levodopa-induced dyskinesias may lead to important cues for understanding the underlying mechanisms responsible for addiction. Thus, this may have important implications for the discovery of new therapeutic strategies.

Adult↗
PubMed2006

Is severe obesity a form of addiction? Rationale, clinical approach, and controlled clinical trial.

For many, obesity is just a problem of energy input and expenditure: more energy input than expenditure. However, the clinical practice and epidemiological data clearly show that weight control is more complex than expected by this simple equation. This is particularly true in morbid obesity, a form of severe obesity in which a person's Body Mass Index (BMI, kg/m(2)) is over 40. If we compare the definitions and diagnostic criteria for "dependence" and "addiction" with the situation of many severe obese subjects, it is apparent that they match very well. Further, different neurological studies confirm this similarity: both addiction and obesity patients have a deficiency of dopamine receptors. Nevertheless, when we compare many of the actual obesity treatments with the ones used in the area of addictions it is possible to find relevant differences: obesity treatments neither consider different levels of type and intensity of care, nor a multidimensional approach. To overcome these limitations, in this paper we propose a bio-psychosocial approach in which the genetic influence (lack of dopamine receptors) is matched by psychosocial issues (pressure for thinness and diet as main body image dissatisfaction treatment). Further, the paper outlines how this approach may influence the treatment options, by focusing both on the lessons coming from actual addiction treatment and the opportunities offered by virtual reality. Finally, the paper presents and discusses the outcome of a controlled trial, based on the proposed approach, including a 6-month follow-up (211 morbid obese females with a BMI of >40 and a documented history of failures.

Adaptation, Psychological↗
PubMed2000

The long-term risks in the short-term benefits: perceptions of potentially addictive activities.

It is generally assumed that individuals who take risks with their health either underestimate the magnitude of those risks or seek some benefit. This study assessed whether risk taking might also result from underestimating the benefits. In Study 1, lower estimates of the pleasure of drug use and risk of addiction were significantly related to increased self-reported experimentation and problems with drug use. This relationship remained significant even after controlling for preexisting psychosocial factors. In Study 2, perceptions of these "risks-in-the-benefits" were shown (a) to be distinct from perceptions of immediate benefits and (b) to serve as a protective factor against future alcohol use. Results are discussed in terms of creating improved interventions.

Adult↗
PubMed1994

Narcissism: shame, rage and addiction.

This paper employs perspectives from Self psychology to illuminate our understanding of narcissism. Striving for complete independence and autonomy, a goal of classical psychoanalysis, encourages the disavowal of narcissism. Instead, narcissism is viewed as necessary for the survival of a sense of self and not on the same continuum with object love. The concepts of self-object and self-object functions are defined. Shame and rage are explained as byproducts of self-object failure. It is postulated that shame emerges out of self-depletion and that narcissistic rage emerges out of self-fragmentation. Countertransference and treatment implications are discussed. Following Lichtenberg, addictions are viewed as deriving from the quest for self-object experience, regardless of the long-term detriment.

Adolescent↗
PubMed2006

Defining and defending 'unhealthy' practices: a discourse analysis of chocolate 'addicts" accounts.

Contemporary ideals of health and nutrition conspire to render the consumption of chocolate and similar snacks problematic. Individuals who self-define as 'chocoholics' therefore present an ideal opportunity to investigate how ostensibly unhealthy acts are defined, defended and maintained within a health-conscious climate. This article reports on an interview-based study with five self-professed chocoholics. A Foucauldian form of discourse analysis was applied to the interview transcripts and four main discourses identified: chocolate as dirty and dangerous; chocolate as pleasure; self-surveillance; and addiction. The function of such discourses in terms of upholding the moral status of these individuals is discussed.

Anecdotes as Topic↗
PubMed2002

Why and how the tobacco industry sells cigarettes to young adults: evidence from industry documents.

OBJECTIVES: To improve tobacco control campaigns, we analyzed tobacco industry strategies that encourage young adults (aged 18 to 24) to smoke. METHODS: Initial searches of tobacco industry documents with keywords (e.g., "young adult") were extended by using names, locations, and dates. RESULTS: Approximately 200 relevant documents were found. Transitions from experimentation to addiction, with adult levels of cigarette consumption, may take years. Tobacco marketing solidifies addiction among young adults. Cigarette advertisements encourage regular smoking and increased consumption by integrating smoking into activities and places where young adults' lives change (e.g., leaving home, college, jobs, the military, bars). CONCLUSIONS: Tobacco control efforts should include both adults and youths. Life changes are also opportunities to stop occasional smokers' progress to addiction. Clean air policies in workplaces, the military, bars, colleges, and homes can combat tobacco marketing.

Adolescent↗
PubMed2006

Factors affecting hospital staff judgments about sickle cell disease pain.

Judgments about people with pain are influenced by contextual factors that can lead to stigmatization of patients who present in certain ways. Misplaced staff perceptions of addiction may contribute to this, because certain pain behaviors superficially resemble symptoms of analgesic addiction. We used a vignette study to examine hospital staff judgments about patients with genuine symptoms of analgesic addiction and those with pain behaviors that merely resemble those symptoms. Nurses and doctors at hospitals in London, UK, judged the level of pain, the likelihood of addiction, and the analgesic needs of fictitious sickle cell disease patients. The patient descriptions included systematic variations to test the effects of genuine addiction, pain behaviors resembling addiction, and disputes with staff, which all significantly increased estimates of addiction likelihood and significantly decreased estimates of analgesic needs. Participants differentiated genuine addiction from pain behaviors resembling addiction when making judgments about addiction likelihood but not when making judgments about analgesic needs. The treatment by staff of certain pain behaviors as symptoms of analgesic addiction is therefore a likely contributory cause of inadequate or problematic hospital pain management. The findings also show what a complex task it is for hospital staff to make sensitive judgments that incorporate multiple aspects of patients and their pain. There are implications for staff training, patient education, and further research.

Adolescent↗
PubMed2003

From morphine clinics to buprenorphine: regulating opioid agonist treatment of addiction in the United States.

The practice of prescribing opioid drugs for opioid dependent patients in the U.S. has been subjected to special government scrutiny for almost 100 years. From 1920 until 1964, doctors who used opioids to treat addicts risked federal and/or state criminal prosecution. Although that period ended when oral methadone maintenance was established as legitimate medical practice, public concern about methadone diversion and accidental overdose fatalities, combined with political pressure from both hostile bureaucracies and groups committed to drug-free treatments, led to the development of unprecedented and detailed Food and Drug Administration (FDA) regulations that specified the manner in which methadone (and later, levo-alpha-acetyl methadol, or levomethadyl acetate, (LAAM)) could be provided. In 1974, Congress gave the Drug Enforcement Administration (DEA) additional oversight of methadone treatment programs. Efforts to liberalize the FDA regulations over the past 30 years have been resisted by both the DEA and existing treatment providers. Additional flexibility for clinicians may evolve from the most recent effort to create an accreditation system to replace some of the FDA regulations. The development of buprenorphine, a partial opioid agonist, as an effective treatment for opioid addiction reopened the possibility for having a less burdensome oversight process, especially because of its reduced toxicity if ingested by non-tolerant individuals. New legislation, the Drug Addiction Treatment Act (DATA) of 2000, created an opportunity for clinicians with special training to be exempted from both federal methadone regulations and the requirement to obtain a special DEA license when using buprenorphine to treat addicts. Some details of how the DATA was developed, moved through Congress, and signed into law are described.

Analgesics, Opioid↗
PubMed2005

Internet addiction: a review of current assessment techniques and potential assessment questions.

The concept of Internet addiction has been proposed as an explanation for uncontrollable and damaging use of the Internet. Symptoms of excessive Internet use have been compared to the criteria used to diagnose other addictions such as pathological gambling. Although criteria to diagnose this problem have been proposed, methods of assessing excessive Internet use are limited. A structured interview based on the criteria proposed by Beard and Wolf is proposed to aid in the assessment of "Internet addiction." This, in turn, could aid in the diagnosis and intervention of a client who enters treatment reporting difficulties with excessive Internet use.

Behavior, Addictive↗
PubMed2006

Why are adolescents addicted to online gaming? An interview study in Taiwan.

The purpose of this study was twofold: to investigate the conscious and unconscious psychological motivations of online game addicts, and to further discuss the relationship between surface and source motivations. Ten Taiwanese adolescents with online game addiction were selected for in-depth interviews. Through sentence completion test and semi-structured interviews, data were collected and analyzed from the following four realms: (1) surface motivations, (2) source motivations, (3) self-conception, and (4) interpersonal relationships in real life. After content analysis, five categories with distinct themes were formed: (1) addicts' psychological needs and motivations; (2) online games as the everyday focus of the addicts; (3) the interplay of real self and virtual self; (4) online games as the compensatory or extensive satisfaction for addicts' needs; and (5) addicts' self-reflections. The implications of the present study are discussed.

Adaptation, Psychological↗
PubMed2001

Limbic responsiveness to procaine in cocaine-addicted subjects.

OBJECTIVE: The limbic system plays a critical role in motivation, emotional expression, and memory. The authors investigated whether a state of permanent limbic neuronal hyperexcitability, or sensitization, is present in cocaine addicts as a consequence of repeated cocaine use. METHOD: Single photon emission computed tomography (SPECT) of regional cerebral blood flow (rCBF) was used to compare the central nervous system response to the limbic stimulus procaine in 10 cocaine-dependent male patients and 10 healthy comparison male subjects. RESULTS: The cocaine-addicted subjects demonstrated bilateral activation of the orbitofrontal cortex after the procaine challenge, whereas the comparison subjects showed activation of the anterior cingulate, bilateral insular, and right amygdalar regions. After receiving placebo, the cocaine-addicted subjects showed markedly lower rCBF in the bilateral orbitofrontal cortex than the comparison subjects. CONCLUSIONS: The pattern of hypoperfusion in the placebo state followed by heightened activation with procaine in the cocaine-addicted subjects is similar to the pattern of interictal hypoperfusion and ictal hyperperfusion that has been observed in subjects with epilepsy. The findings for the cocaine-addicted subjects may thus represent evidence of localized (orbitofrontal) sensitization.

Adult↗
PubMed2003

Selective processing of smoking-related cues in current smokers, ex-smokers and never-smokers on the modified Stroop task.

The aim of this study was to investigate selective processing biases towards smoking-related stimuli in relation to acute abstinence and smoking history. Differences in the processing of smoking-related and control cues in current smokers, ex-smokers and never-smokers on the modified Stroop task were investigated, with smokers randomized to either abstain or smoke normally for a period of 24 h. The results indicated no significant effect of deprivation (abstinent versus non-abstinent smokers), or of smoking history (ex- versus never-smokers) on colour-naming times for smoking-related versus control words. However, there was a significant effect of smoking status (current versus non-smokers) on colour-naming times for smoking words compared to control words (i.e. slower colour-naming of smoking-related words in smokers). This effect approached significance when stimuli were presented in a masked exposure condition. Among smokers, colour-naming interference was associated with the personality trait of Sensitivity to Reward. These results indicate a processing bias for smoking-related cues in current smokers. However, this bias does not appear to be a permanent feature of nicotine addiction, given the lack of difference between ex-smokers and never-smokers.

Adult↗
PubMed2004

Modulators of G protein-activated inwardly rectifying K+ channels: potentially therapeutic agents for addictive drug users.

G protein-activated inwardly rectifying K+ (GIRK, Kir3) channels play an important role in the inhibitory regulation of neuronal excitability in most brain regions and heart rate through activation of various G protein-coupled receptors, such as opioid, cannabinoid, and D2 dopamine receptors. Therefore, modulators of GIRK channels may affect many brain functions. We have shown using Xenopus oocyte expression assays that ethanol directly activates GIRK channels, whereas various antipsychotics (thioridazine, clozapine, pimozide, and haloperidol) inhibit the channels. Here we investigated not only the effects of various selective serotonin reuptake inhibitor (SSRI) antidepressants (fluoxetine, citalopram, fluvoxamine, and zimelidine) and risperidone, an atypical antipsychotic, on GIRK channels, but also those of the various drugs tested on other Kir channels using the Xenopus oocyte system. Fluoxetine inhibited GIRK channels, whereas the other SSRIs and risperidone had a small or no effect on the channels. In contrast, Kir1.1 and Kir2.1 channels were insensitive to ethanol and various SSRIs and antipsychotics, although thioridazine weakly inhibited Kir1.1 channels. It has been shown that the function of GIRK channels is involved in seizure susceptibility, antinociception by opioids, cannabinoids, or ethanol, and cocaine reinforcement in studies using GIRK knockout mice and weaver mutant mice that have mutant GIRK2 channels insensitive to G proteins and ethanol. Activation of GIRK channels by opioids, cannabinoids, or ethanol may be one of these key effects. Therefore, GIRK channel modulators might be potential agents for the treatment of users of addictive drugs, such as cocaine, opioids, cannabinoids, and ethanol, as well as for the treatment of epilepsy and pain.

Animals↗
PubMed2004

Accessories to addiction: G protein regulators play a key role in cocaine seeking and neuroplasticity.

The prefrontal cortex mediates many aspects of addiction. In this issue of Neuron, Bowers et al. demonstrate that an activator of G protein signaling (AGS3) is persistently upregulated in the prefrontal cortex after cessation of chronic cocaine treatment. Furthermore, they find that AGS3 is responsible for altered behavior, such as enhanced drug seeking, and altered neurotransmission in cocaine-treated rats, representing a novel therapeutic target.

Animals↗