Addiction Flashcards
behavioral addictions
non-substance addiction
controversial
often considered to be impulse control problems rather than addiction
definition of addiction
“bound to”/ “enslaved by” loss of control
examples of addiction
compulsive buying internet addiction sexual addiction skin picking excessive tanning food, work, exercise pathological gamlbing
definition of gambling:
placing something of value at risk for the chance of obtaining something of greater value
what is pathological gambling?
impulse control disorder must have 5/10 symptoms
symptoms of pathological gambling 1. preoccupation with gambling
relieving gambling experiences, planning the next venture
symptoms of pathological gambling 2. increasing amounts of money are needed to maintain gambling excitement
similar to tolerance in substance dependence
symptoms of pathological gambling 3. repeated and unsuccessful attempt to….
quit or cut back on gambling
symptoms of pathological gambling 4. restlessness or irritability when reducing or quitting gambling
similar to withdrawal in substance dependence
symptoms of pathological gambling 5. using gambling as a way to escape from
problems or negative mood
symptoms of pathological gambling 6. chasing losses
returning another day to win back money lost
symptoms of pathological gambling 7. lying to family, friends or others about
gambling to hide the extent of it
symptoms of pathological gambling 8. engaging in illegal acts to finance gambling
forger, embezzlement (this is removed in DSMV)
symptoms of pathological gambling 9. placing a relationship, job, educational career opportunity in
jeopardy as a result of gambling
symptoms of pathological gambling 10. seeking help from others to relieve a desperate
financial situation caused by gambling
the four C’s of addiction
control - loss of control over behavior
conseuquences - continued engagement despite negative consequences
compulsion - constatn preoccupation
craving - physical drive/urge
mood disorders common in gamblers
depression
gambling is about risk and reward
involves placing something at risk in order to obtain something of greater value
response inhibition
ability to respond to a stop signal after being present with a go signal
working memory
ability to maintain attention to detail essential in planning
cognitive flexibility and preservation
ability to shift one’s thought or action to fit the demands of the situation
planing
ability to identify and organize elements needed to carry out a planned act or achieve a goal
clinical reasons for the importance of impulsivity and executive function
impulsivity and EF deficits impair a person’s ability to learn from their experiences and make plans based on long-term consequences of their behaviors
treatment is geared toward longer-term consequence
pathological gamblers may have greater difficulty benefitting from treatment
striatum: includes caudate and putamen
coordinates motivation with body movement
associated with reward, decision making and executive function
increase in ventral striatum while
winning relative to losing in pathological gambler
a decrease in ventral striatal and ventromedial prefrontal activation is associated with
gambling severity
nucleus accumbesn
pleasure center
DA levels when drug on board
prefrontal cortex
executive functions, regulates overall motivational salience and determine intensity of response
hippocampus
formation of novel memories about experienced events
amygdala
memory and emotional reactions
insular cortex
consciousness, self-awareness, autonomic fix, emotional states related to awareness, drug craving
dopamine
a decrease in D2/D3 receptor availability in a problem gambling group - they also had Parkinson’s
treatments
no FDA approved medications for gambling disorder
opioid antagonists
addictive behaviors associted with dysregulation of the mesolimbic DA system
endogenous opioids may serve to modulate DA release form nAC
naloxone inhibits DA in the VTA and reduces DA function in the in the nAC
modulation of the DA system may reduce the excitement and urges associated with gambling
glutamate agonists
very limited evidence so far just that glutamate has been linked to the reward process and imbalance may affect changes in corticostriatal neuroplasticity impairing communication between brain reward regions
other medications
antipsychotics and mood stabilizers
behavioral treatments
mutual fellowship - gambler anonymous
evidence-based psychotherapy - motivational interviewing/motivational enhancement therapy cognitive therapy/cognitive behavior therapy
what is the hallmark feature of gambling?
IMPULSIVITY
what underlying brain processes are associated with gambling disorder?
deficits in reward processing and executive function
