Key elements of addiction

2018 ◽  
Author(s):  
David J. Nutt ◽  
Liam J. Nestor
Keyword(s):  
Substance Use ◽  
Emotional State ◽  
Psychological Treatment ◽  
Brain Networks ◽  
Loss Of Control ◽  
Treatment Interventions ◽  
Enhanced Sensitivity ◽  
Negative Emotional State ◽  
Natural Rewards

Addiction is characterized by the compulsion to seek and take a substance, the loss of control in limiting substance intake, and the emergence of a negative emotional state (e.g. dysphoria, anxiety) when substance intake is prevented. Importantly, there are elements of addiction that emerge during the addiction trajectory (e.g. liking, wanting, habit, craving) that are a reflection of key changes in the homeostasis of brain networks that control different behaviours. These homeostatic changes ultimately lead to 1) a decreased sensitivity for natural rewards, 2) an enhanced sensitivity for conditioned substance cues and the expectation of substance use rewards, 3) a weakened control over substance use urges and substance-taking behaviour, and 4) substance tolerance and withdrawal. Significantly, these changes are targets for pharmacological and psychological treatment interventions in addiction.

What is addiction?

2018 ◽  
Author(s):  
David J. Nutt ◽  
Liam J. Nestor
Keyword(s):  
Substance Use ◽  
Withdrawal Syndrome ◽  
Emotional State ◽  
Brain Networks ◽  
Loss Of Control ◽  
Psychological Processes ◽  
Substance Addiction ◽  
Human Survival ◽  
Negative Emotional State

Substance addiction is defined as a chronic relapsing disorder characterized by (1) compulsion to seek and take a substance, (2) loss of control in limiting substance intake, and (3) the emergence of a negative emotional state (e.g. dysphoria, anxiety, irritability) reflecting a motivational withdrawal syndrome when access to the substance is prevented. Importantly, the occasional but limited use of addictive substances is clinically distinct from escalated substance use, loss of control over substance intake, and the emergence of chronic compulsive substance-seeking that characterizes addiction. Importantly, substance addiction (including alcohol) is a manifestation of the long-term pharmacological actions substances have on receptor mechanisms in brain networks that govern cognitive and psychological processes that have evolved for human survival.

A Controlled Comparison of Cognitive—Behaviour Therapy, Diazepam and Placebo in the Management of Generalized Anxiety

1989 ◽  
Vol 17 (1) ◽  
pp. 1-14 ◽  
Author(s):  
K. G. Power ◽  
D. W. A. Jerrom ◽  
R. J. Simpson ◽  
M. J. Mitchell ◽  
V. Swanson
Keyword(s):  
Cognitive Behaviour Therapy ◽  
Psychological Treatment ◽  
Subsequent Treatment ◽  
Self Report ◽  
Response To Treatment ◽  
Generalized Anxiety ◽  
Behaviour Therapy ◽  
Treatment Interventions ◽  
Group Response ◽  
Cognitive Behaviour

Generalized anxiety patients were randomly allocated to Cognitive-Behaviour Therapy, Diazepam or Placebo and managed in a primary care setting. Treatments were balanced for degree of psychologist/patient contact. A range of outcome measures, including patient self report, psychologist assessor and general practitioner ratings were used. Large variations within group response to treatment emerged. At the end of active treatment the superiority of Cognitive-Behaviour Therapy was suggested. Post-study psychotropic prescription and psychological treatment was assessed at a 12-month follow-up. The Cognitive-Behaviour group revealed the lowest incidence of subsequent treatment interventions.

Drug Withdrawal

2020 ◽  
pp. 97-116
Author(s):  
George F. Koob
Keyword(s):  
Substance Use ◽  
Stress Response ◽  
Substance Use Disorders ◽  
Negative Reinforcement ◽  
Drug Withdrawal ◽  
Primary Factor ◽  
Motivational Factor ◽  
Drug Seeking ◽  
Molecular Changes ◽  
Negative Emotional State

Drug withdrawal has long been considered a key symptom in the diagnosis of alcohol and substance use disorders. In this chapter, it is also conceptualized as a major motivational factor that drives compulsive drug taking. Drawing from the negative emotional components of withdrawal, termed hyperkatifeia (i.e., the negative emotional and motivational signs of withdrawal), the hypothesis here is that withdrawal sets up another major source of reinforcement—namely, negative reinforcement—for drug seeking in substance use disorders. From the perspective of the hyperkatifeia phenotype, withdrawal then returns to being a key part of moderate to severe alcohol and substance use disorders to become the primary factor that motivates sustained drug seeking. Such hyperkatifeia is mediated by a multidetermined neurocircuitry that compromises within-system neurochemical systems that are involved in the rewarding effects of drugs and promotes the activation of pro-stress neuromodulators that combine with a weakening or inadequate anti-stress response. Altogether, these neurocircuitry, neurochemical, and molecular changes lead to a negative emotional state (hyperkatifeia) that sets up an allostatic hedonic load that drives negative reinforcement. Under this framework, strong multidetermined buffers, if activated and sufficient to allow the reward and pro-stress systems to recover, may help return the organism to homeostasis.

scholarly journals Neurocircuitry of Reward and Addiction: Potential Impact of Dopamine–Glutamate Co-release as Future Target in Substance Use Disorder

2019 ◽  
Vol 8 (11) ◽  
pp. 1887
Author(s):  
Zisis Bimpisidis ◽  
Åsa Wallén-Mackenzie
Keyword(s):  
Substance Use ◽  
Unique Property ◽  
Conditional Knockout ◽  
Dopamine Neurons ◽  
Behavioral Regulation ◽  
The Past ◽  
Midbrain Neurons ◽  
Natural Rewards ◽  
Potential Impact ◽  
The Impact

Dopamine–glutamate co-release is a unique property of midbrain neurons primarily located in the ventral tegmental area (VTA). Dopamine neurons of the VTA are important for behavioral regulation in response to rewarding substances, including natural rewards and addictive drugs. The impact of glutamate co-release on behaviors regulated by VTA dopamine neurons has been challenging to probe due to lack of selective methodology. However, several studies implementing conditional knockout and optogenetics technologies in transgenic mice have during the past decade pointed towards a role for glutamate co-release in multiple physiological and behavioral processes of importance to substance use and abuse. In this review, we discuss these studies to highlight findings that may be critical when considering mechanisms of importance for prevention and treatment of substance abuse.

Communicating the Diagnosis

2017 ◽  
Author(s):  
Markus Reuber
Keyword(s):  
Healthcare Professional ◽  
Health Professionals ◽  
Psychological Treatment ◽  
Physical Problem ◽  
Reflex Response ◽  
Treatment Interventions ◽  
Psychogenic Nonepileptic Seizures ◽  
Nonepileptic Seizures ◽  
Clear Communication ◽  
Diagnostic Label

Psychogenic nonepileptic seizures (PNES) can stop after the communication of the diagnosis by a healthcare professional, or PNES disorders can become more entrenched and patients are less able to control their seizures. This chapter addresses strategies for the explanation of the diagnosis of PNES, compares their effectiveness, and offers recommendations for delivering the diagnosis. A “positive” diagnostic label (such as “dissociative attacks”) may have advantages over a “negative” label (stating what the problem is not). Explaining PNES as a reflex response to potentially threatening triggers may be acceptable to PNES patients, who tend to experience PNES as a “physical” problem, while providing a rationale for psychological treatment interventions. However, PNES are a heterogeneous disorder and explanations have to be adapted to fit particular patients’ circumstances. How the diagnosis is communicated may be more important than what words are used for the disorder. Additional resources such as leaflets or websites may help patients understand their problem better. The explanation to patients should be followed by clear communication of the diagnosis to other health professionals involved in the patient’s care.

scholarly journals Emotional intelligence and recovering from induced negative emotional state

2015 ◽  
Vol 6 ◽  
Author(s):  
Joaquín T. Limonero ◽  
Jordi Fernández-Castro ◽  
Jordi Soler-Oritja ◽  
María Álvarez-Moleiro
Keyword(s):  
Emotional Intelligence ◽  
Emotional State ◽  
Negative Emotional State

THE EFFECT OF EMOTIONAL STATE ON WAITING IN DECISION MAKING

2008 ◽  
Vol 36 (5) ◽  
pp. 591-602 ◽  
Author(s):  
Ya-Chung Sun ◽  
Shih-Chia Wu
Keyword(s):  
Decision Making ◽  
Experimental Study ◽  
Emotional State ◽  
Emotional States ◽  
Extra Time ◽  
New Information ◽  
Negative Emotional State ◽  
Current Mood ◽  
The Relationship ◽  
Do So

Previous research has indicated that many people often take extra time to consider existing information. They do so possibly in order to acquire more information, or even to “wait” in the hope that new information may be forthcoming before they make a decision. However, recent studies have provided scant information about how waiting affects a person's choice given different emotional states. In this paper, an experimental study was carried out to demonstrate and explain the relationship between waiting and a person's choice. Results show that when conditions are certain, more people choose to wait – when they are in a positive emotional state – in order to maintain their current mood. However, under either certain or uncertain conditions, when people are in a negative emotional state they prefer to take immediate action rather than wait. The causes and implications of this phenomenon are discussed in relation to the existing literature on emotions and choice.

scholarly journals Exploring Personality and Readiness to Change in Patients With Substance Use Disorders With and Without ADHD

2016 ◽  
Vol 24 (9) ◽  
pp. 1255-1265 ◽  
Author(s):  
L. Flores-García ◽  
E. Ytterstad ◽  
M. B. Lensing ◽  
M. Eisemann
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Stages Of Change ◽  
Readiness To Change ◽  
Change Readiness ◽  
Temperament And Character Inventory ◽  
Treatment Interventions ◽  
Character Inventory

Objective: To explore personality and readiness to change among substance use disorders (SUD) patients with and without ADHD. Method: SUD + ADHD versus SUD − ADHD patients consecutively entering treatment between 2010 and 2012 were compared concerning personality (Temperament and Character Inventory) and readiness to change (Stages of Change Readiness and Treatment Eagerness Scale). Results: Among 103 SUD patients (76 men, age M = 43.3, SD = 11.1), 16 (15.5%) were diagnosed with ADHD. SUD + ADHD patients reported significantly elevated eagerness to effort ( p = .008) compared with SUD − ADHD patients, who reported significantly elevated fear of uncertainty ( p < .000). SUD + ADHD patients reported higher ambition ( p = .025), self-forgetfulness ( p = .029), and lower recognition ( p = .022). They were younger ( p = .019) and showed more often amphetamine addiction ( p = .022) compared with SUD − ADHD patients. Conclusion: The distinct characteristics found in SUD + ADHD and SUD − ADHD patients underline the need for differentiated treatment interventions.

Dimensions of Adolescent Self-Concept Associated with Substance Use

1993 ◽  
Vol 23 (3) ◽  
pp. 525-533 ◽  
Author(s):  
Donna B. Towberman ◽  
R. Michael McDonald
Keyword(s):  
Substance Use ◽  
Drug Use ◽  
Strong Association ◽  
Cumulative Effect ◽  
Self Concept ◽  
Treatment Interventions ◽  
Negative Image ◽  
Alcohol And Drug Use ◽  
Self Confidence ◽  
Ongoing Support

Self-concept has been often examined in relation to adolescent substance use and research results have shown consistently strong association between the two. Yet, the authors maintain that the global construct is amorphous and lacking in defined boundaries that allow for planning and implementation of educational and treatment interventions that effectively impact self-concept. The purpose of the study was to examine the underlying dimensions of self-concept that relate to adolescent alcohol and drug use. Four constitutive dimensions of self-concept were identified through factor analysis. These four factors are negative image, self- confidence, bonding and effectiveness. All four self-concept measures were found to significantly correlate with both drug experimentation and frequency of drug use. Three of the self- concept factors (negative image, self-confidence, and effectiveness) are considered to be internally referenced. These dimensions of self-concept may be the cumulative effect of genetic, psychological and environmental forces. The intractable nature of internal self-concept dimensions may require intensive services and ongoing support services for effective treatment of deficits. However, the fourth self-concept factor, bonding, is primarily viewed as an externally-referenced factor. Remediation of bonding deficits calls for inclusion of significant others in the overall strategy of self-concept enhancement.

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