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PubMed2001

Is smoking automatic? Demands of smoking behavior on attentional resources.

The role of attention in the production of smoking behavior was investigated. Experienced and novice smokers were asked to perform a reaction time (RT) task under 4 conditions: while smoking (smoking), while mimicking all aspects of smoking except inhaling (pseudosmoking), while simply holding a cigarette (holding), and while not smoking (baseline). Experienced smokers' RTs increased during the pseudosmoking and holding conditions compared with baseline but did not differ between the smoking and baseline conditions, suggesting that attentional resources were not required for typical smoking behavior but were required to alter or inhibit smoking behavior. Novice smokers' RTs were slower during both the smoking and pseudosmoking conditions but not the holding condition, suggesting that novice smokers require the use of resources to smoke. Experiment 2 demonstrated that the differences in RT across conditions could not be explained by differences in urges.

Adult↗
PubMed2005

[The evolution in the concept of smoking].

The concept of smoking has evolved considerably in recent decades. From a habit in the 1960s, tobacco consumption came to be viewed as a chemical dependency in the 1970s and an addiction in the 1980s, until smokers' clinics were implemented in the 1990s. To understand the mechanism of the smoking habit, it is important to recall that smoking represents much more than physical dependence on nicotine. Over time, smokers receive social, behavioral, and cultural stimuli that reinforce their habit and probably serve as the causal elements for establishing their psychological dependence. Both the psychological and physical components of tobacco dependence play a fundamental role in maintaining the habit.

Behavior, Addictive↗
PubMed2001

[Psychotherapy of alcohol addiction--principles and new findings of therapy research].

The psychotherapy of alcohol dependence has for long been neglected by psychiatric research. Meanwhile a number of clinical and experimental studies have been performed to examine the efficacy of different kinds of psychotherapeutic approaches in alcoholism. Most clinical settings follow an integrative concept based on behavioural and coping skills therapy, psychodynamic or psychoanalytic and family therapy. Further therapy elements are self-help groups or muscular relaxation, among others. Most therapies are conducted as group therapy but individual therapy is a well-examined alternative. Early intervention in alcohol dependence is of special relevance. Motivational enhancement is a key goal of alcohol therapy and can already be implemented in early interventions or in the detoxification phase. Results of clinical studies suggest that after inpatient treatment 30-40% of patients remain abstinent. Outpatient treatment of alcoholism has for long been neglected, with only few prospective studies conducted so far. The most ambitious study has been the US Project Match. A difficult question remains the allocation of patients to different treatments. Current concepts of treatment for alcoholics are described and results of different treatment studies are given.

Alcoholism↗
PubMed2007

[An anthropological view of addiction].

In psychiatric discourse, addiction is normally understood according to the original paradigm of "dependency" which claims lifelong and unchangeable dependency on the addictive substance or "psychotropic technique". In the attempt to reduce damage or achieve abstinency, therapeutic interests and understanding of the human mind contradict this inflexibility. This contradiction in psychiatric understanding of addiction can be viewed as a dynamic part of the addiction process. A philosophical anthropology of addiction is presented in that light. Using the concept "the psychotropic technique achieves a superior position", both sides of the psychiatric understanding are combined and integrated. The addictive mind and its self-awareness can then be understood as a "fragile monoidentity". Implications of such an understanding are discussed.

Anthropology, Cultural↗
PubMed1991

Chocolate craving and liking.

Liking and craving for chocolate and related substances were surveyed in a sample of University of Pennsylvania undergraduates (n = 249) and their parents (n = 319). Chocolate was highly liked in all groups, with a stronger liking by females. Chocolate is the most craved food among females, and is craved by almost half of the female sample (in both age groups). Although this craving is related to a sweet craving, it cannot be accounted for as a craving for sweets. About half of the female cravers show a very well defined craving peak for chocolate in the perimenstrual period, beginning from a few days before the onset of menses and extending into the first few days of menses. There is not a significant relation in chocolate craving or liking between parents and their children. The current motivation for chocolate preference seems to be primarily, if not entirely, sensory. Liking for chocolate correlates significantly with liking for sweets and white chocolate. The liking for the sensory properties could originate in innate or acquired liking based on the sweetness, texture and aroma of chocolate, or it could be based in part on interactions between the postingestional effects of chocolate and a person's state (e.g., mood, hormone levels). Based on correlational data, we find little evidence for a relation between addiction to chocolate or the pharmacological (e.g., xanthine-based) effects of chocolate and the liking for chocolate.

Adolescent↗
PubMed2004

[The auto-addictive hypothesis of pathological eating disorders].

The pathogenic role of self-addiction. Addiction to an endogenous chemical is a new paradigm termed 'self-addiction'. It may contribute to the development of certain habits, the pathological nature of which may set-in on the basis of this "self-addictive"dimension. Pathological eating habits could be inscribed in this perspective. Two extreme situations. In well-fed populations, the ingestion of food does not represent a limiting phase in the global feeding process. Its pathological management may, however, lead to two extreme situations: the absence of ingestion (anorexia) and excessive ingestion (bulimia). In favour of the self-addictive hypothesis. Eating disorders are associated with abnormal levels of endorphins and share clinical similarities with psychoactive drug abuse. The key role of endorphins has recently been demonstrated in animals with regard to certain aspects of normal, pathological and experimental eating habits (food restriction combined with stress, locomotor hyperactivity). The factors leading to pathological eating habits. Neurobiological bases for eating disorders and their durability have recently come to light in the recent implication of abnormalities in the recompense system in the onset of addiction. The endorphin self-addictive model in fact appears the most pertinent with regard to the clinical profile of eating habits and integrates the role of stress.

Behavior, Addictive↗
PubMed2003

Attentional bias and addictive behaviour: automaticity in a gambling-specific modified Stroop task.

AIMS: This study examined the relationship between attention and gambling behaviour by measuring the level of Stroop interference towards gambling-related words in a group of regular poker machine players. DESIGN: A 3 x 2 repeated measures experimental design was employed. The type of word presented (neutral, drug or gambling) was the within-subjects factor and the level of impaired control (high or low) over gambling behaviour was the between-subjects factor. PARTICIPANTS: A sample of poker machine players (n = 60), varying in their frequency of play, were split into two groups based on their level of subjective impaired control over their gambling behaviour (high or low). MEASUREMENTS: A computerized gambling-specific modified version of the Stroop task was used to assess response latencies. The test comprised three word categories: gambling, drug and neutral. The Scale of Gambling Choices (SGC) was used to assess participants' level of impaired control over gambling behaviour. FINDINGS: It was found that the participants who had difficulty in controlling their gambling behaviour (the low control group) took significantly longer to name the colour of the words relating to poker machine gambling, whereas those who had good control over their gambling behaviour (the high control group) did not show any significant differences across the three word categories. CONCLUSIONS: Results support the previous finding that people with a problem behaviour or emotion take longer to colour-name words relating to the area of their concern. The current study extends previous work that has investigated the role of cognitive distortions and biases in the area of addictive behaviour. The current study confirms McCusker & Gettings's findings, but by avoiding the mental disorder conceptualization facilitates theoretical understanding of addictive behaviour. Implications for past models and theories of the Stroop as well as future research directions are discussed.

Analysis of Variance↗
PubMed2003

Internet addiction of adolescents in Taiwan: an interview study.

This study presented a follow-up investigation of a series of studies about Taiwanese adolescents' Internet addiction. Through analyzing a series of questionnaires, 10 Taiwanese adolescents with Internet addiction were selected for in-depth interviews. Adolescents' interview data revealed the following: First, almost all of the interviewed adolescents exhibited most of the symptoms of Internet addiction as identified by previous studies, including compulsive use and withdrawal, tolerance, and related problems of school, health, family, finance, and time management. Moreover, almost all of the interviewed adolescents stated that messages on the Internet became the primary source of their information and knowledge. Many of them were addicted to the messages and activity on the Internet, but not by the Internet as a medium per se. Also, the world of the Internet seemed to become a place to relieve adolescents' depression. Most of the interviewed adolescents self-declared that they were Internet addicts, but none of them could clearly state what to do with such an addiction. Psychologists and educators should pay more attention to this and then propose possible solutions for adolescents.

Adolescent↗
PubMed2005

[Patients treated for addictive diseases in the Psychiatric Centre Bohnice in years 1994 to 2003].

During 1994 to 2003 the number of patients treated in the Psychiatric Centre Bohnice who had within the first three dismissory diagnosis alcohol related disorders increased by 77% and disorders caused by other psychoactive drugs increased more than four times. An increase was observed also in pathological gambling (37%). In alcohol related problems the highest increase was seen in drug cessation (about four times). In other drug related problems the highest increase was marked in addiction treatment (almost five times). Such trend probably reflects the situation in the society together with other effects described in the study.

Alcoholism↗
PubMed1991

[Changes in the German psychiatric drug dependence definition].

Experience recorded in the psychiatric/psychotherapeutic sector with young persons dependent on drugs, with compulsive gamblers and, especially, with alcoholics, some of them in relatively early stages of the disease, has led to shifts in attitudes to the problem of addiction among German-speaking psychiatrists and thus to a shift in their understanding of the term addiction (in the sense of addictive illness). The concept of addiction was extended when the existence of nicotine dependence was recognized. Prevention of addiction is an urgent priority, and therapy must be instituted as soon as possible; these aims mean that addiction (dependence) must be clearly and objectively defined without reference to value-systems, but also comprehensively. The sign of addiction that is most important in pracice, as it is fairly specific and occurs at an early stage, is the phenomenon of loss of control.

Behavior, Addictive↗
PubMed1998

Sexual addiction: many conceptions, minimal data.

Sexual addiction has received increasing attention in the past decade. We review existing literature on (a) competing conceptualizations of this syndrome as constituting an addictive, obsessive-compulsive, or impulse control disorder; (b) symptomatology and progression; (c) etiological models; and (d) treatment approaches. Based on this review, we conclude by identifying questions requiring resolution via empirical investigation.

Behavior, Addictive↗
PubMed1987

The mislabeling of sexual impulsivity.

Several authors have discussed a pattern of behavior that has been called Compulsive Sexual Behavior, Sexual Addiction, or Hypersexuality. The literature concerning this disorder is reviewed. It is suggested that the various labels applied to this disorder are inaccurate descriptions that are not reflective of the true nature of the condition. It is further suggested that this behavioral pattern is best viewed as a manifestation of an Atypical Impulse Control Disorder.

Diagnosis, Differential↗
PubMed2006

Effects of lofexidine on stress-induced and cue-induced opioid craving and opioid abstinence rates: preliminary findings.

OBJECTIVE: A preliminary study examined whether lofexidine decreases stress-induced and cue-induced opioid craving and improves opioid abstinence in naltrexone-treated opioid-dependent individuals. MATERIALS AND METHODS: Eighteen opioid-dependent patients were stabilized for 4 weeks with naltrexone (50 mg daily) and lofexidine (2.4 mg bid) before entering a 4-week randomized, double-blind placebo-controlled discontinuation study where one group continued on lofexidine for an additional 4 weeks, while the second was tapered to placebo (Lofexidine-naltrexone vs Placebo-naltrexone). Ten patients also participated in guided imagery exposure to stress, drug cue, and neutral scenarios in a single laboratory session. RESULTS: Lofexidine-naltrexone patients had higher opioid abstinence rates and improved relapse outcomes as compared to the Placebo-naltrexone group. Furthermore, Lofexidine-naltrexone patients had significantly lower heart rates and an attenuated stress and drug cue-induced opioid craving response in the laboratory as compared to the Placebo-naltrexone group. CONCLUSIONS: Although preliminary, these findings are the first to document lofexidine's potential in addressing stress-related opioid craving and relapse outcomes in humans. The results also suggest that combination therapies that target both drug-related reinforcement (naltrexone) and stress- and cue-related aspects of drug seeking could be beneficial in addiction relapse prevention. Further development of lofexidine to address stress-related opioid craving and relapse is warranted.

Adult↗
PubMed2005

Compulsive behavior in tobacco users.

Addictions have been associated with compulsive behaviors, which serve to reduce emotional distress. Tobacco use has been associated with increased adverse moods such as anxiety. Nicotine has established anxiolytic effects through modulation of central neurotransmitters, including monoamines. Both obsessive-compulsive behaviors and tobacco use have both been associated with dysfunction in orbitofrontal-subcortical circuits. This study demonstrated greater intensity of compulsive behaviors (as measured by the Yale-Brown Obsessive Compulsive Scale [Y-BOCS]) in tobacco users compared to nonusers, which was not due to demographic influences or use of other psychoactive drugs. Both the frequency of tobacco use and level of overall emotional distress correlated positively with the severity of compulsive symptoms. The results are consistent with tobacco use as a form of self-medicating compulsive symptoms, likely through monoamine modulation of orbitofrontal-subcortical circuits.

Adolescent↗
PubMed2005

What do we know about relapse in pathological gambling?

The study of pathological gambling and its treatment is in a nascent stage. To date, no consistent definition of relapse to gambling exists, and only a few empirical studies have evaluated the phenomenon of relapse directly in this patient population. Perspectives on relapse to drug and alcohol use appear relevant to the study of pathological gambling, and relapse to gambling is reviewed within the larger context of addictive disorders. The application of psychological, biological, environmental, and treatment factors are described as they may relate to relapse among pathological gamblers.

Behavior, Addictive↗
PubMed2003

Attentional bias in drug dependence: vigilance for cigarette-related cues in smokers.

Two experiments investigated attentional biases for smoking-related cues in smokers and nonsmokers, using the visual probe task. In Experiment 1, when pictures were displayed for 500 ms, smokers who had made repeated quit attempts showed an attentional bias for smoking-related scenes. Experiment 2 replicated this finding and revealed that when pictures were presented for 2,000 ms, the smoker group as a whole showed vigilance for smoking-related cues, but nonsmokers did not. The findings from the 500-ms exposure condition suggest that initial orienting of attention to smoking cues was associated with repeated unsuccessful attempts at abstinence in smokers. Results are discussed with reference to incentive-sensitization theories of addiction and to component processes of selective attention, such as initial orienting versus maintenance.

Adult↗