Dimensionality of Cognitions in Behavioral Addiction

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Abstract

Cognitive constructs provide conceptual frameworks for transpathological characterization and improved phenotyping of apparently disparate psychiatric groups. This dimensional approach can be applied to the examination of individuals with behavioral addictions, for example, towards gambling, video-games, the internet, food, and sex, allowing operationalization of core deficits. We use this approach to review constructs such as impulsivity, compulsivity, and attention regulation, which may be most relevant, applicable, and successful for the understanding and subsequent treatment of the addictions.

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Most cited references 136

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The neural basis of addiction: a pathology of motivation and choice.

Peter Kalivas, Nora D. Volkow (2005)

A primary behavioral pathology in drug addiction is the overpowering motivational strength and decreased ability to control the desire to obtain drugs. In this review the authors explore how advances in neurobiology are approaching an understanding of the cellular and circuitry underpinnings of addiction, and they describe the novel pharmacotherapeutic targets emerging from this understanding. Findings from neuroimaging of addicts are integrated with cellular studies in animal models of drug seeking. While dopamine is critical for acute reward and initiation of addiction, end-stage addiction results primarily from cellular adaptations in anterior cingulate and orbitofrontal glutamatergic projections to the nucleus accumbens. Pathophysiological plasticity in excitatory transmission reduces the capacity of the prefrontal cortex to initiate behaviors in response to biological rewards and to provide executive control over drug seeking. Simultaneously, the prefrontal cortex is hyperresponsive to stimuli predicting drug availability, resulting in supraphysiological glutamatergic drive in the nucleus accumbens, where excitatory synapses have a reduced capacity to regulate neurotransmission. Cellular adaptations in prefrontal glutamatergic innervation of the accumbens promote the compulsive character of drug seeking in addicts by decreasing the value of natural rewards, diminishing cognitive control (choice), and enhancing glutamatergic drive in response to drug-associated stimuli.

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Attentional bias in addictive behaviors: a review of its development, causes, and consequences.

M. Field, W. Cox (2008)

A wealth of research from the past two decades shows that addictive behaviors are characterized by attentional biases for substance-related stimuli. We review the relevant evidence and present an integration of existing theoretical models to explain the development, causes, and consequences of addiction-related attentional biases. We suggest that through classical conditioning, substance-related stimuli elicit the expectancy of substance availability, and this expectancy causes both attentional bias for substance-related stimuli and subjective craving. Furthermore, attentional bias and craving have a mutual excitatory relationship such that increases in one lead to increases in the other, a process that is likely to result in substance self-administration. Cognitive avoidance strategies, impulsivity, and impaired inhibitory control appear to influence the strength of attentional biases and subjective craving. However, some measures of attentional bias, particularly the addiction Stroop, might reflect multiple underlying processes, so results need to be interpreted cautiously. We make several predictions that require testing in future research, and we discuss implications for the treatment of addictive behaviors.

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Impulsivity as a vulnerability marker for substance-use disorders: review of findings from high-risk research, problem gamblers and genetic association studies.

Antonio Verdejo-Garcia, Andrew Lawrence, Luke Clark (2008)

There is a longstanding association between substance-use disorders (SUDs) and the psychological construct of impulsivity. In the first section of this review, personality and neurocognitive data pertaining to impulsivity will be summarised in regular users of four classes of substance: stimulants, opiates, alcohol and 3,4-methylenedioxymethamphetamine (MDMA). Impulsivity in these groups may arise via two alternative mechanisms, which are not mutually exclusive. By one account, impulsivity may occur as a consequence of chronic exposure to substances causing harmful effects on the brain. By the alternative account, impulsivity pre-dates SUDs and is associated with the vulnerability to addiction. We will review the evidence that impulsivity is associated with addiction vulnerability by considering three lines of evidence: (i) studies of groups at high-risk for development of SUDs; (ii) studies of pathological gamblers, where the harmful consequences of the addiction on brain structure are minimised, and (iii) genetic association studies linking impulsivity to genetic risk factors for addiction. Within each of these three lines of enquiry, there is accumulating evidence that impulsivity is a pre-existing vulnerability marker for SUDs.

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Author and article information

Contributors

V. Voon: voonval@gmail.com

Journal

Journal ID (nlm-ta): Curr Behav Neurosci Rep

Journal ID (iso-abbrev): Curr Behav Neurosci Rep

Title: Current Behavioral Neuroscience Reports

Publisher: Springer International Publishing (Cham )

ISSN (Electronic): 2196-2979

Publication date (Electronic): 20 February 2016

Publication date PMC-release: 20 February 2016

Publication date (Print): 2016

Volume: 3

Pages: 49-57

Affiliations

[ ]Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK

[ ]Department of Psychology, University of Cambridge, Cambridge, UK

[ ]Department of Psychiatry, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK

Article

Publisher ID: 68

DOI: 10.1007/s40473-016-0068-3

PMC ID: 4769313

PubMed ID: 27034915

SO-VID: bde10543-dd66-410b-9ecb-296484e6d266

License:

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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Keywords: behavioral addiction,gambling,binge-eating,gaming,compulsivity,impulsivity

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Keywords: behavioral addiction, gambling, binge-eating, gaming, compulsivity, impulsivity

Dimensionality of Cognitions in Behavioral Addiction

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Journal of Behavioral Addictions

Most cited references 136

The neural basis of addiction: a pathology of motivation and choice.

Attentional bias in addictive behaviors: a review of its development, causes, and consequences.

Impulsivity as a vulnerability marker for substance-use disorders: review of findings from high-risk research, problem gamblers and genetic association studies.

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